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The Role of Collaboration and Networking in Dentistry

Summary:

Equity models offer dentists opportunities for profit sharing and long-term financial stability within group practices.

In this episode, Mark Greenstein, the EVP and Chief Growth Officer at Heartland Dental Group, delves into the future of dentistry and the role of group practices like Heartland in revolutionizing the dental field. Heartland, Mark explains, focuses on supporting dentists and their teams, adding practices annually, and leading in dental supply procurement. He emphasizes the company’s mission to empower doctors and provide top-notch non-clinical support, education, and community. Mark discusses equity models, acquisition strategies, and the company’s vision for the future, stressing that Heartland aims to be a leader in dentistry, leveraging technology and collaboration to enhance patient care and community engagement. He also believes that dentists should prioritize networking and collaboration to stay abreast of industry trends and opportunities. Finally, Mark underscores the importance of acquisition strategies, which play a significant role in the growth and success of dental group practices like Heartland.

 

Tune in and learn about the future of dentistry, the benefits of group practices, and how Heartland Dental Group is shaping the landscape of dental care in America and beyond!

Secure Dental_Mark Greenstein.mp3: Audio automatically transcribed by Sonix

Secure Dental_Mark Greenstein.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Noel Liu:
Welcome to the Secure Dental Podcast. Through conversations with the brightest minds in the dental and business communities, we'll share practical tips you can use to scale your practice and create financial freedom for yourself and your family. My name is Dr. Noel Liu, CEO and Dentist at Secure Dental, and also co-founder of DentVia. I'm your host for the Secure Dental podcast, and I'm so glad you're joining in.

Noel Liu:
Hey, everybody, welcome to another episode of our Secure Dental pod. And today we have a very special guest. This guy is from the Heartland Dental Group, and he has some severe experience. I would call it severe because he is one hell of a guy. And I'm going to introduce him real quick. But before we dive in, I just wanted to give a shout out to our sponsor. DentVia is a local company where they have virtual dental administration staff that helps the front desk and the office managers. So definitely visit them at DentVia.com; www.DentVia.com. And without further ado, let's pass the mic. And I have Mark Greenstein. So Mark joined Dental Heartland in October 2015. And he serves as a company executive Vice President and Chief Growth officer. He leads the Heartland's affiliation and de novo footprint, growth and management, corporate development, payor relationships, strategic sourcing, and Mark brings over 25 years of experience in business growth through strategy, operations, procurement, mergers, integration, leadership. Now, Mark, I would like you to continue with your intro and tell us a little bit what exactly do you do at Heartland in layman's terms?

Mark Greenstein:
Sure. First, Dr. Liu, thanks for inviting me on your podcast. It's a real pleasure to be here and talk a little bit about Heartland and hopefully answer some, some questions that are out there. My experience before Heartland had very little to do with health care or dentistry. I was a strategist in a variety of corporate settings, from financial services to wealth management to manufacturing and distribution. I just had a wide variety, and I was introduced to Heartland in the summer of 2015, and I fell in love. I went down to Effingham, Illinois. And for your listeners who do not know where Effingham, Illinois is, we often say, take the effing highway, but it's in the southern part of Illinois. It's about 240 miles south of the Chicago area where I live. And I keep an apartment down there. I spend about half of my time down there. The company was founded by Doctor Rick Workman. He had a dental practice there almost 40 years ago. He is essentially is the pioneer of the large group dentistry space. Back when he started with one practice became two, became three, and then so on and so forth to where it is today. He's still our executive chairman and 100% involved in the business. So he is the grand, we think of him as the granddaddy of the DSO space. Companies, also led by rest of my colleagues on the senior team are long, long-time folks at Hartwood. Our CEO Pat's been with us 27 years, our CEO DeAnn 28 years, our CFO Travis 21 years, our chief dental officer, Doctor Singh, clinical officer has been with, leads also Heartland Dental University has been with us 23 years. So a very strong group of leaders who this is their passion is supporting doctors and their teams and trying to create a better life for dentists and a better way of doing dentistry in America. So that's a little bit about my background management consulting. And I've just been blessed to be trained up and taught by these great folks who have really helped me lean into the business. To answer your question about what I exactly do, Heartland adds about 150-170 practices per year to its footprint. That consists of our de novo program, which are scratch start builds, starting from a piece of dirt, usually in front of a nice supermarket. If you're in Florida, it could be a Publix. In Texas, it could be an H-e-b, but a nice supermarket, maybe in Illinois and Mariano's. And it's that beautiful outparcel right in front that people get a lot of visibility when they drive by. So we do about 100 of those per year, and then we add somewhere between 50 and 70 solo practices, which are typically doctors who are looking we call that affiliation; they're looking to affiliate with Heartland. And we try to find top 20% of doctors across the country, those who are certainly seasoned and have built their practices and their communities, but also looking for something more, more community, more leadership, more growth, more patient care. So folks who are looking for the kinds of support that we provide to them. I also lead our relationships with payers, being the largest DSO or typically also the largest check that most or a set of checks that any of the major players in the United States write each year. So we have a dedicated team focused there. And then, Heartland as a community, is the largest procurer of dental supplies and equipment in the United States so outside of the government. So we are very active in the dental supply and equipment markets, obviously for labs as well. And so I have the privilege of leading that team also, and then as an umbrella of corporate strategy. So those are the hats that I wear. And it's been a great ride. I've been here just about nine years. And it's just a wonderful way to be involved at this point in my career in such a wonderful endeavor, with such a great group of people and a company that has just a strong set of values.

Noel Liu:
That's remarkable. It's so impressive. Like, all these guys have been over, like two decades. And it seems like, yeah, exactly, over two, three getting there. So that kind of speaks a lot about the leadership and the culture in this organization. So do you want to share a little bit about what's it like on a day-to-day with executives and the doctors and the team?

Mark Greenstein:
Yeah. First, we all wake up. Every one of us at Heartland, our job is to support doctors so that, and their teams, so that they can take care of their patients. And that's an important distinction between how Heartland looks at dentistry versus maybe some others. A lot of other organizations that at least I've had the experience with, they tend to, they don't think of the patients; they think of, that they they're responsible for the patients or that the patients are part of the DSO. That's not the case in the Heartland model. Our job is to just enable and support doctors as best as we possibly can. They're in their communities. They can take care of their patients. We want to provide a full range of non-clinical services, and we want to provide the very best education, on clinical leadership and operational skills. And we do that for not only doctors and hygienists, but the dental assistants, the business assistants in the office, as well as the entire field infrastructure. In fact, Heartland Dental University, which Doctor Singh leads for us, is the largest educator of dentists and their teams in the United States. So we provide over 250,000 CE hours per year. We have our own facilities. We have our own faculty and relationships both internally and externally. We run the largest aesthetic continuum in the United States. We teach oral surgery. We teach endodontics, we teach orthodontics with Invisalign, and we also teach leadership skills. And the Heartland model, the doctor is the leader of their practice and, or the doctors. And so we spend a lot of time with our doctors is how do you lead a large practice? What are the skill sets that you need to inspire and empower your team to achieve whatever your goals are? And so we're focused very much on taking care of the doctors and supporting them. And that's always been Doctor Workman's vision. That's something we all carry with us as we wake up every day. So we start every day thinking about what do our doctors need, where are their pain points? And where can we add value? Where can we take the external environment and bring it inside? A good example is we just deployed the largest installation of clinical AI in dentistry anywhere in the world. We have now, have a clinical AI in over 1500 dental practices in 40 states. So we're super excited by that. And that's really taking hold. ... which is a preventative treatment; we started rolling that out in January, and that's just doing great things for our doctors and the care of their patients. So our job is to bring to them opportunities that help them advance dentistry and give them community, which we do quite a bit to help grow themselves and grow their practice.

Noel Liu:
That's awesome. You guys are hitting it all fronts of dentistry. So I can see like a group size, like Heartland having so much firepower. Right? So let's switch gears a little bit like a solo practitioner who's actually running bread and butter dentistry day-to-day. I know, like they are trying to run the practice and Heartland is on the other side of the spectrum. How do you see yourself or see Heartland, or maybe like other DSOs? How do you see, what's the future going to hold? Is there going to be a merge? Is there going to be a collaboration? Is there going to be a competition? What's the landscape like?

Mark Greenstein:
Well, even at Heartland's vast size, I think we're roughly maybe 2, 2.5% of dentistry, general dentistry in the United States. So there's still 97% that we're not. There's a lot.

Noel Liu:
That's a lot.

Mark Greenstein:
There's a lot, I think there's always going to be room for the sole practitioner. Just like in medicine, there's still plenty of room for solo practitioners. But I would say just like in medicine, there's a set of natural forces that are creating opportunities to perhaps consider a group practice. And there are benefits that a group practice can provide. Certainly, community and knowledge exchange is one of the key ones. If I, when I talk to doctors who affiliate with us and they say, Oh geez, I wish I did this ten years earlier, I'd say to them why? They said, Because I know so much more now than I did then, and I would never have had a path to learn it if it wasn't for Heartland. So I think, first and foremost, what we end up doing is bringing education to doctors and their teams on all parts of just clinical and operational and leadership dimensions, and I think they value that the most. And that's of course, we're taking care of, helping them take care of HR topics and accounting topics and IT topics and legal topics, should they have them. We have an entire set of armies that are there to support doctors in their practices. But if you ask doctors what is it that they makes them wish they did it for ten years earlier? I think it's the peace of mind of having all of those non-clinical functions performed at a world-class level, and then a series of educational capabilities and community for knowledge exchange. All the programs we run on weekends where they can learn how to do full-arch implants if they want, or go shadow someone who they see is doing really nice Invisalign cases; how do you do it? You go, Well, you don't have to talk to me; just come to my office and watch. And I think that community and knowledge sharing, both from a formal setting with Heartland Dental University and then informally in the doctors working side by side with each other, I don't even get involved in that. But we do bring them together for dinners every quarter, and that forms those relationships. I think that speaks a lot to where they get value from their relationship with Heartland.

Noel Liu:
So one thing I just wanted to clarify was, so the doctor in your group with Heartland, basically they are in control, right, I mean of clinical. So they can do let's say full-arch implant, they want to do Invisalign, they can do any of that stuff. Because that was one of the misconceptions that was passed on, like it's Heartland telling them what to do and what they cannot do. I'm glad that you brought that up and you clarified this.

Mark Greenstein:
I would, I'd also say, Dr. Liu, I think we have 18 or 19 doctors and hygienists on state dental boards. If we, for a minute, for a minute, were to actually do that, we wouldn't have been here for ... almost 30 years.

Noel Liu:
Wow, wow. I was telling you before this, before we started this recording, this is, Heartland is one of those companies that I really, I'm really proud seeing you guys as so, like, vigilant and so compliant, let's put it this way, with the state laws and everything else that goes along hand-in-hand with dentistry.

Mark Greenstein:
Yes, I would agree with that. We, Doctor Singh leads our clinical audit functions. We're very much in touch with our doctors who are on state dental boards, and we have some hygienists on state dental boards. And this is not a financial enterprise. Of course, it's a business, don't make no mistake, but this is simply the outgrowth of Dr. Workman's vision that there's a better way for dentists to be happier, to be more productive, to take better care of their patients, provide more for their patients. And so we just have created a set of services to enable them to do just that.

Noel Liu:
And it shows, right, it shows that you guys are growing exponentially. And one of those things where I always say that if there are doctors who's out there who cannot stand Heartland, they are always going to be that those group of people, I mean, regardless.

Mark Greenstein:
We don't always get it right either, Dr. Liu. We're far from perfect. We're human. We have a saying, though, Do the right thing for the right reason. So if we make a mistake, we try to own up to it, and we try to fix it. And that you can hold us, we're pretty good. We try to fix it almost 100% of the time. If we know that we're making a mistake, we'll try to fix it. So do the right thing for the right reason is a core value of ours, and we empower our people to do just that. So they won't always get it right, it's complicated. Every practice is different. Every doctor is different. Their needs are different. We're trying to serve the needs of doctors and their teams in 40 different states. So regulations are different. So we're not going to be perfect, but we are going to try to be and we're going to try to definitely, we're absolutely going to.

Noel Liu:
Absolutely, absolutely. So we spoke about one aspect where there is a lot of solo practitioners. And now the other aspect is sooner or later, we all know dentistry is going to be like pharmacy or medicine, right? There are going to be roll ups. Where do you see like we are currently and where do you see like us in ten years or maybe even 20 years in the future? And how has Heartland positioned itself?

Mark Greenstein:
Yeah, we're in what I call the messy middle. So I think there's a couple of DSOs that are very strong, of which Heartland is one of them. They tend to be the larger ones with the most duration in the marketplace. You learn something. If you do something long enough, you learn all the things not to do, and you develop all the things you should do. And I think those models, Pacific Dental is another one that comes to mind, high-quality businesses that are focused on their doctors. And I think they have a long, prosperous road ahead of them. Just like in medicine, I think they will continue to grow because they create real value. I think that's a, it's a concept that I think cuts through a lot of the noise that you have out there is: Does the group create value? Does one and one equals three? Are you bringing people together and doing support, or enabling them to do things that they otherwise would not do for the benefit of their patients and their communities? If you can do that and do that repeatedly and demonstrably, you're creating value. I think there are some DSOs that are very good at that. There's also a group of DSOs that, and it's a large group that are still trying to figure out how to do that. And they're often caught between a rock and a hard place because they have financial constraints, often a sponsor or time window that sometimes gets in the way of the longer-term decisions that you have to make or investments that you have to make in order to build that true value creation engine. And so you have a lot of enterprises out there that are I would call aggregations and that are selling more around what we won't tell you at all what to do. In fact, we won't even support, give you much support. We're just going to let you be. But in 12 months we're going to do an IPO and you can sell your part of the, you can keep a part of your practice and you can sell. It's more, if you actually strip it down, it's more of a financial play than a play around the creation of value for the doctor and their team in order to enable them to improve care to their community, which at any, any way you slice it, if you're not delivering that set of value, it's not a sustainable model for the long term. And we do have organizations that are in that middle, and there are some that are trying to figure out how they're going to play, because so many have grown up in the last decade or so, and I think there will be a shakeout of those. I think we've seen it. Great Expressions is a good example of one several years ago. Elite dentistry is another example. Many of these groups are going to, they'll find their way, or they will struggle and be either absorbed or just fail. And I think that's an unfortunate reality. But it's also not unlike what's happened in medicine over the decades. And medicine is still, is now probably 80% consolidated. So it's hit a pretty consolidated. Look at Optum. Optum is the largest employer of doctors in the United States. They have 90,000 MDs. A full 10% of the doctors in the US work for Optum. So does dentistry eventually get there? I would argue, since there is a path and companies are doing it that actually create value, then you'd suggest, why wouldn't it? Why wouldn't if there is a different, better way, why wouldn't that take place? And if I'm a solo doctor, you can absolutely be wildly successful now and in the future. But you might want to look at what these DSOs offer and see if it's a value to you in helping you grow and create what you want to achieve and serve your patients.

Noel Liu:
One of the things that I see Mark these days is it's all about control. And I think that's where most of the solo practitioners, they're wary because they're like, Hey, if I join a DSO, I'm going to get ripped off and I will have no control. So that's one of those, I guess we call it misconception or whatever you want to call it. And one of the biggest things that I always see is equity, right? So let's say practices that are affiliated with Heartland, you don't have to give Heartland example, but let's say any other DSO. What are some of the equity models out there for some of these solo practitioners where they can feel a little bit, let's say safe?

Mark Greenstein:
So two dots, one on the notion of control. I get that a lot. They're going to tell me what to do. Now, the question I would ask folks just to consider. There's 2800 and change doctors at Heartland Dental, many of whom have got 20 and 30 years of experience, many of whom hundreds had wildly successful solo practices. And yet they're still at Hartland. Now, do you think they'd be at Hartland if they actually thought they didn't have any control? I mean, at the end of the day, the notion that some corporation is going to tell somebody what, a professional doctor what to do, and would, in a highly competitive marketplace where there's so much more demand for dentistry than there are doctors to do it, we wouldn't have the high retention rates, we wouldn't have these doctors staying with us five, ten, fifteen years. It wouldn't happen. So that alone, I think, is the biggest kind of data point that I share with doctors. And then I give them a list of 100 doctors and say, You randomly call these 100, find 100 of your own. I don't really care. And what you'll find, and ask them their why. Find out, are they being told what to do? Most of them will say, Νo. In fact, I get to do more of what I want to do because I don't have to worry about hiring and all the labor challenges. People get sick. Somebody else takes care of replacements. There's a water leak in the office. I don't have to worry about that. I'm actually doing more of what I want to do. I have more control, especially over my patient care and my life than I ever did before. And you'll hear that by the hundreds. I don't think a business could be successful at our size, or be successful for as long as we've been doing this. If in fact, that notion of control was actually true. This doesn't pan out. In terms of equity models, there are a couple of different models out there. There are models like Heartland where you get which I think is the, let me start with some of the other ones. Some models allow you to retain a portion of your practice, and that really feeds into the notion of, I still have 20% equity in my practice and I'm in control. But what are you in control of? You're in control, I guess, of your practice. But what, how are you benefiting from the collective growth of the entire enterprise? You're part of something much bigger. That's typically the reason why you want to join a group organization to be part of the group. So if you're incentive and you're, everything is revolving around your four walls, did you, did much really change or are you growing or benefiting as much as you possibly can? That's a question. So that's one model. Another question is where do you, how do you get rid of that 20%? Who buys it from you, and at what price? How do you know it's actually going to transact when you need it to transact? And by the way, if you still have that 20%, that means you only got 80% of the value for your practice. So what was the best? If you would have gotten 100%, you could have taken 20%, could have invested it in Treasury bills and watched it grow, and perhaps had more liquidity in Treasury bills than you're going to get under 20% that you might have to hold for 15 years. And at what value, again? So there's a lot of questions about that 20%. People latch on to it because they think they are going to get control. But that 20% is, and I would submit and I would encourage folks to talk to Heartland doctors or others with our model, that you can have control a lot of different ways. One is just work for a company that just gives you control. That's its ethos. Doctors are the leaders of our practice. They have control. They have autonomy. It's been that way since the day we started. The other model is they, you also can get what's called topco equity. So topco equity is you can get equity at the overall enterprise. And that's a very interesting model because now you're participating in the growth of the whole. And that feels very right to me because you're joining a group, you're partnering with the rest of the doctors in the group to grow the entire enterprise. That gives you incentive to help the next generation of doctors get ramped up. It gives you incentive to advise the company on ways to solve problems. It's got a lot of real community and teamwork embedded in it, and a model that has both of those is pretty good, except when that model doesn't really have the ability for you to get liquidity. And that's where I think having that equity is fine. But can you get cash for it at some point because it costs you money to get that equity? You bought it with your practice or you bought it with cash after you had your practice. So those are the two different kinds of equity, local equity, I call it in your practice, and then global equity in the DSO. In the Heartland model, what we have is we give all of our doctors virtual profit sharing at the practice level. They don't have to put a penny in to get that. All Heartland doctors are paid the same way. And I'm talking about our general dentists, which are, and general dentistry is 97% of our business, so it's the vast majority. They're all paid the same way, and they get a virtual profit sharing in their practice. They don't have to put any cash up to do that. So unlike some other models where you actually have to, you have an opportunity cost with whatever that 20% might have been. At Heartland, you can you get an equity interest or it's a virtual profit sharing, so that's what you get with equity is profit sharing, without putting up any cash. And that ties you locally to the practice, the better the practice does, just as if you all did, the more you're going to make. And in a multi doctor practice you both can share. And that's proportional to how you contribute to the profits of the practice. Then we do allow Heartland-supported doctors to buy equity in Heartland and every five years, and we've done this I think 6 or 7 times now, so we've done it more than every five years, we've provided a liquidity event. And so we have a really strong track record of providing liquidity to doctors when they, every period of time, and they can buy in that equity and they can grow with, alongside the company. And if they retire or they get sick, their spouse gets sick, well, let's just call it life happens, then we have paths for them to also get liquidity if they need to for life. And we have a long track record of taking care of our doctors in that way. So it's a, I would say the equity models have some similarities, they have some differences, but it's really about what's the track record on executing the model? And that's what I encourage all of your listeners to pay attention to. You can, anybody can tell you, We're going to go public in a year, and you're going to make a lot of money on that piece. Every dental group I've ever seen go public has done quite poorly. One current big public one is Dental Corp of Canada. I think it's down 40% or 50% since it went public. Years ago, there were public dental companies they did not do. So I really be careful about promises that say, We're going to go public, and that's how you're going to get your liquidity. It's a, there's not a lot of track record around that.

Noel Liu:
Let's talk a little bit about that profit sharing. So you are like they can, they get up without buying in. They get a little piece of the profit sharing and that local office. Right? So are now, are these like the affiliates or are these like?

Mark Greenstein:
All doctors.

Noel Liu:
All doctors?

Mark Greenstein:
100% of our general practitioners, 97% of our doctors.

Noel Liu:
So how does an affiliate doctor work? So let's say you guys acquire a practice. So now are you doing like a capital event with a doctor, let's say if they have a single practice?

Mark Greenstein:
Affiliation, what we typically will do is we're buying 100% of it. We're not buying ... not paying 80. We're buying 100%. So you can, now you've got a full 100%. Now you can do with that 100. You've got more cash. So with that cash you can buy treasury bills, you can buy CDs, you can invest it in the stock market, but you don't have to sit on the sidelines and have to wait for a trickle of dividends from the practice; you're getting it day one. So you're getting a higher value for your practice in cash. And now that interest rates are between 5% and 6%, you can get a very nice return on that cash from day one. And that's, we're finding that's a real advantage for especially those doctors that invested in their practices. Maybe they have some debt, a post-pandemic, and now the interest rates are causing them to service that debt at a higher level. So we're giving them more cash at closing. And then if they want, they can at any time, the closing, or every year, we provide an event where doctors can take some of their cash they want and they can buy Heartland stock. It's 100% optional for them. If they do.

Noel Liu:
It's not like a require?

Mark Greenstein:
No. 100% optional, but you.

Noel Liu:
And any, and is there any like staggered, like they got to be like with Heartland for a while to get the other percent? No? Okay.

Mark Greenstein:
No. They got to buy it every year, every, typically in the summertime. We offer an event and they can buy. So they get, every doctor who joins by affiliation. Remember we're doing, we also have our de novo models and we also hire associates everywhere. So the affiliation selling doctors can buy stock at the time of affiliation, or they can wait for the next annual event. Every other doctor can just wait for the annual event. So it's no less than once per year that they can buy in and they can buy, that's topco. The local profit sharing is free from day one for everybody.

Noel Liu:
Wow. Okay. ...

Mark Greenstein:
Can we call it an aligned model? Because without, so let me give you a good example. Let's assume you're a doctor, and you're affiliated in a model that gives you 20% equity, they let you keep 20% or 25% equity in your practice. You have that. Now, let's assume it's a large practice. It grows. It works. The DSO adds value. You add a second or third doctor. You've got. It's beautiful. But the problem is, you're the only one who's profit sharing. So now you have a hierarchy or a caste system inside the practice, and those second and third doctors who don't have that equity, they're not waking up with the same energy level that you are. They don't have it. In fact, many cases, two-thirds of the capacity of the practice doesn't have the energy level that the owner doctor does. And so you typically see in those models higher turnover and less commitment. And that makes complete sense to me because two-thirds of the doctors don't have equity in the practice. In the Heartland model, everybody has virtual profit sharing, which is the purpose of the equity, is to give you profit sharing. We take the hierarchy out whether you're 72-years-old or you're 29-years-old; you have the same compensation model in the practice. So now, not only are you aligned with Heartland, but you're aligned with each other. One grows, you both grow. And now we have a team that's trying to be of most service to their communities. And that's the power of our particular model is it takes away hierarchy. Hierarchy, I believe in most organizations, kills. And once you give a doctor a special status in that practice, they, the next generation isn't as motivated. It's harder to find them. The very best doctors out there in the country who may be chose, and many of them are coming out of dental school, the last thing I want is to own my own practice. I don't want the headache. I grew up in organized medicine. I want somebody else to hire all the people. I want somebody else to manage. I just want to practice dentistry. Many of those doctors come chasing us down now, especially many of them are women; over 50% of the dental students are female today. So they're looking for a higher level of support. They're looking for higher level of flexibility. For them, they don't want to be owners, so they're immediately going into a practice and they're at a disadvantage to the owner doctor of the practice. It would much rather, much, they prefer our model where they're all equal, they're an equal partner, and they also have the support network that if they need to take time off for their family or raise a family, they can do that, they can drop the part time. Many of them shift offices if their spouse needs to move for work, and they get a whole set of services they otherwise wouldn't. That's, and by the way, if you are the owner doctor, one of the biggest opportunities we provide our more senior doctors is they get their grandchildren come along, they want to move to warmer climates, right? If you have 20%, you're stuck to your practice if you're the seller. Can't move. In our model, and we do this all the time, doctors move all the time. They move from one practice to another. We love it. We have doctors that moved from Illinois to Florida to South Carolina. Sometimes we build them their own practice because they've got so much energy at age 55, they want to start again. Other times they move into existing practices. This is a much, this model also supports mobility because it doesn't tie you to your physical box. And everybody now is also equal. It takes out hierarchy and it promotes mobility for those that want it.

Noel Liu:
And that is for your associate doctors as well, right, from day one?

Mark Greenstein:
Happens all the time. A lot of doctors, especially the younger ones, are married to doctors, and so, or MDS, and they go through residencies, they go through fellowships, and they need to move around. And Heartland provides a, especially with the size of our footprint and the number of states we're in, provides a very convenient opportunity for them to be mobile.

Noel Liu:
Oh, that's great. So the de novos, let's talk a little bit about that. So de novos, you guys like to know what's as well. Right? What are some of the pros and cons that you guys see like with existing and de novos? And let's talk a little bit about that because there's a whole, you can write a whole book on that.

Mark Greenstein:
Yeah. Well, we do have a book on it/. And say the pros are the biggest pro is the opportunity is just massive at de novo. But like any new business, it comes with a risk and it comes with a lot of hard work to start a business. And I think that's doesn't have, the door opens, doesn't have a patient base. Now our de novo is typically open with 150 to 200 patients on the schedule when we open it because of where we situate them. Start with the pros first. The pros are, it's a state of the art practice. Our de novos are 10 to 12 operatories with the very latest of all technology, from intraoral scanning to AI to the displays in the office, the way the office is designed, the lab in the office, it's all perfected, to be honest with you. And we know what works, right? We built 100 a year. So we know how to lay them out. We know how, what are the right chairs to buy? What are the right waiting room chairs to buy? What's the right things to put in the wall? What's the right color schemes to use? All of the decisions doctors typically fret over when they're designing their dental offic, we've invested and I've learned over the years what actually works; how wide to make the hallways, how many surgical suites to put in, how, what should be in the surgical suite versus regular laboratory, all of that stuff. But it's a true state of the art. They're absolutely stunning. They're built to be 30, 40-year assets in their community. When people drive by them, they go, Wow. And that's, and we've been doing that at scale. Probably have 8 or 900 of those at this point. Or for, that's the probably the biggest pro. And because of where they're situated, they're at the center of their community. So for patient volume, patient visibility, when you're going into the high schools or you're sponsoring the high school games, right? People will remember your practice because of where it's located. Yes, I'm right in front of the Publix or in front of Mariano's or the Wegmans or whatever.

Noel Liu:
So location.

Mark Greenstein:
Location matters. We've done so many.

Noel Liu:
So you mentioned something about opportunity. What did you mean by that?

Mark Greenstein:
The opportunity is to be so visible in your community. You're trying strengthen your community. And that opportunity and the size of the practice as well is you haven't put up the capital for that. So you can, so we have. We put up the capital. No capital investment required, not a dime. And now you are the leader, of a 10 or 12 operatory dental practice that.

Noel Liu:
Who goes in there? Which doctor goes in there?

Mark Greenstein:
What do you mean, which doctor?

Noel Liu:
So who would be your ideal, like, let's say avatar to go in there?

Mark Greenstein:
I wish I knew because we've seen every size and shape be wildly successful. When we started new de novo, they do best when we have a senior doctor, an experienced doctor, and a junior doctor. The senior doctor typically comes in. They're very productive, and they train up the junior doctor. And junior, I only mean junior in terms of tenure, not in terms of, they're still all, they're both paying the same. But that's the ideal model when we can do it. But I was just in Florida last week, and I had two practices where I had male-female doctor teams, both started within months of graduation from dental school. And they're both just, they've been together now seven years in each of their practices. They're just crushing it. We've seen it all work. I would say, though, the senior and junior doctor model work is the one that you try to get if you can, but there's, even two junior doctors, we have so much mentorship surrounding our practices that they have plenty of resources available to them both to go see and also come into their practice to help them grow that business. It does on the downside, it's a little scary. Are the patients going to come? Many doctors aren't used to going and talking to the physical therapy location next door and telling them about what you provide, and maybe giving some cleanings to their employees so that they can experience your care, building that relationship with the community. So we have to teach them that. It's scarier because the patients are just not coming in the door. In an affiliation, these are often practices that have been in their communities 20 to 30 years. Sometimes more. Sometimes they're second, third generation before they transition. It's, we like to say we have something for everyone, and we have enough practices everywhere that we have something for someone, everybody, something for everyone, in whatever flavor that they want. And that's what we try to provide. It's really a spectrum to meet the personality and the interests of the doctors. But those are the pros and cons of the de novos is, the biggest con is just you're starting a business and it may be a few months going slow.

Noel Liu:
Exactly, exactly. Now let's dive into the other bucket.

Mark Greenstein:
Which, by the way, just to mention, because of their size, they typically grow to be larger. And they typically grow longer because they're newer, so they'll keep growing seven, ten years after they opened. Whereas an affiliation and may only be six chairs is probably going to start to cap out. So it's both are great. Both, we have, we have junior and we have younger doctors who love the affiliations. They love that idea of continuing somebody's legacy. They just love it. And others, sometimes even in the communities they grew up in. So it's like, Oh my God, I always wanted to be a dentist in that practice. Sometimes they take over for the dentist that inspired them to be a dentist when they were a kid. We've seen all of this, and I think that's the key point, is that there's something for everybody.

Noel Liu:
So with de novo, why 12-14 chairs if it's only going to be two doctors, right? What's your game plan? Is it like, just continuous growth like down the road? Is it just future-proofing it?

Mark Greenstein:
No. They get to three doctors eventually. So they go to three doctors and they try to go to 50 to 60 hours a week. Because convenience is important as well. You just want to, it's a capacity, and it's a capacity for having enough to be able to have two doctors and 2 to 3 hygienists per doctor at the same time. And most of our de novos do just that. So they, because the demand is there, the community wants the, it's not a lack of demand for dentistry. There's a lack of dentists and hygienists to meet the demand.

Noel Liu:
All right. Let's dive straight into the acquisition bucket. And what's the pros and cons that you've encountered?

Mark Greenstein:
We've done acquisitions of, we've done, the largest acquisition in dentistry was done in June of '21. So it'll be three years ago and two months June 15th.

Noel Liu:
Wow. After Covid.

Mark Greenstein:
Yeah, we did that, we bought American Dental Partners, another wonderful practice that had been in their communities 30 years, Metro Dental up in Wisconsin. Excuse me, Minnesota. Sorry. Metro is up in Minnesota in western New York, Buffalo Market, the Western New York Dental Group, UDA, University Dental Associates in North Carolina. We had a bunch of regional brands, Forward Dental. And we, that was not easy, but boy was it the right thing to do. And we just introduced into Heartland a group of so such high quality clinicians and team members in just fantastic practices that have been deeply rooted in their communities. So it's been a real boon for us. So that's probably the biggest, that was 275 offices, and we've done smaller ones at ten offices. We've done 20 office groups. About 11 years ago we did nine-hour group, which has been also another great one. We bought MyDentist, which is in Oklahoma and the southwest many years ago. Every couple of years we try to find the very best dental groups out there. And if they're interested and they're willing to be open to our model around how we like to empower the dentist, that the doctor is the leader of the practice. If they're interested in that and the services that we offer, then it can be a great match. And so far we've had pretty good luck. They don't all work out what's a portfolio like anything else, but for the most part it's been something we've been very successful with and we're continuing to be quite active.

Noel Liu:
So for the most part, do you guys just replace the entire executive team or do you like keep some of them who's good?

Mark Greenstein:
So it really, it becomes, very rarely just the CEO ... be A CEO somewhere else. Not really us. It's what do they want to do, right, at the operational level? So it's, but we're, I mean, even if, there's what they call the magic word of synergies. Once you get, we have so many team members from American Dental Partners that are still with us because we're constantly growing. So we need great operations talent, we need great data scientists. We need great folks who can handle legal and accounting and finance and payroll and everything else that we do, HR. In fact, we have HR members during our HR team from American Dental Partners. So it's, I think when you net out those who actually want to stay, it works out pretty well. The Neibauer, our chief of staff, or our COO, Kim Urso, came from Neibauer; that was 11 years ago. We had many doctors still with us from MyDentist. Many of their ... Tom McKnight and our, one of our vice presidents of operations came from MyDentist, and that was over a decade ago. So I think we've got a really good track record of creating long careers for those who are interested in growing.

Noel Liu:
Hey, Mark, all I can say is if they're staying, there is definitely something going on, which is, which you guys are doing right. Otherwise, we know how they are, right? They will come and go.

Mark Greenstein:
Dr. Liu, that is the easiest way. People say, I often get asked, How do you evaluate? Because we evaluate 300 dental practices a year, probably a dozen groups. And they say, How do you do all that? How big is your team? It's like, you know, it's not that big. How do you do it so fast? It's really easy; you prioritize what you look at. What do you, what's the first thing you look at? How long are the doctors and team members there? All right. I can learn more about any asset from that. And so you're spot on, Dr. Liu, if the doctors have been there for a long time, if the turnover is low, hygienist turnover is low, team members are there, then that's the entry point to then say, Okay, now please send me the financials.

Noel Liu:
Precisely, precisely. And I think that's a huge point to take away, because that's where it drives the value of an organization. Like, how long has the team members been in that place? Last question for you is: What is Heartland's vision moving forward?

Mark Greenstein:
Our vision is to be a world-class company and the leader in dentistry. That is our stated vision. And I think our vision is to keep doing that. We think we are the leader in dentistry and that gives us responsibilities. So AI, for us, is as much about helping the sector move forward with AI. So a lot, if you look at the company, we're working with and how they're advancing their AI in a real, right now, at a record rate, it's going to benefit the entire industry because we're just pushing the limits of that technology. We partnered with Align Technology. Oh, geez, for well over a decade now, a truly world-class company, pure R&D that has created the entire digital ortho. And we've been partnered with them for a long time, and we helped them get better. And they help us obviously every day with their products and services. But we, so being the leader in dentistry requires us to give back. And we do that through helping other companies serve dentistry better. That's one of our key planks. And then of course, we do many mission trips and give back to communities in need and help dentists grow. We help dentists from other countries come to the United States if they want and get their license. We have a lot of programs designed to help, basically, Americans get the dental care that they need, want and, desire. I think that's essentially what we're all about. If you focus on the doctors and you focus on eating dentistry and helping them lead dentistry, the rest of it, the PNL, the metrics, everything else takes care of itself. It really does. Just stay focused on helping doctors take care of their patients, helping them get the skills that they need to do as much as they'd like to do, practice where they want to practice, do the procedures that they want to do, and help them engage with their communities. The rest just takes care of itself. Heartland Dental University is the largest education, as I said earlier in the country, and we're super proud of it. Our founder, Dr. Workman, invested in High Point University. The Workman School of Dental Medicine takes its first class in August. So that's the newest dental school in the United States. And it's, so this August, it starts its first class. We're working actively on creation of hygiene schools. We're, that's how we interpret our vision to be the leader in dentistry.

Noel Liu:
You mentioned international. What about growing international? Global?

Mark Greenstein:
Two years ago we made an investment in Canada and that is international. Coast international, but within a second largest group up in Canada, it's called 1-2-3 Dentist. And we're getting smarter. And it's very different. We often say when we look at our opportunity strategically, we still think there's far more opportunity in the United States. The runway here is far longer than it is in any other opportunity globally. So I think you'll, I think our investment in Canada is a very important one, and we're continuing to invest in it. And they're doing just fine. We support them. We provide our systems. When we say systems, I mean how we help doctors and teams with workflow and verbiage and whatever services they want. And, but, you know, Canada in total is only dental is only 10%. It's only 10% of the US population. It's only, dentistry is only 10% of the size of it is in the United States. And so there's still so much more opportunity. We just opened our first office in Salt Lake City, Utah. We could do a lot more there. That community is just booming. Nashville is booming. The Carolinas are booming. There's so much in the United States still to go that I still think that's our greatest opportunity.

Noel Liu:
I think that's a great strategy because you can do so much more here. That's so much more land to fill. So love it.

Mark Greenstein:
And I don't see a lot of synergies cross border. It's hard enough to navigate the regulatory environment in the United States and do it at our quality level, which is exceptionally high. It's very different elsewhere. So we love the United States. We'll continue to support our partners in Canada. They're doing great. They have all, they need to continue to grow and expand across that country. But I think our focus is primarily on growing here in the US.

Noel Liu:
Got it. That was great, Mark, thanks so much for coming on. Thank you for sharing so much knowledge. This is something which I think I took away a lot of keynotes. Well, I'm not sure if you know or not, I was taking a lot of notes.

Mark Greenstein:
Okay, Dr. Liu. Listen, I really appreciate the opportunity. If you or any of your listeners have any questions, they can reach out at Greenstein@Heartland.com, and I'm on LinkedIn, they can connect with me. We spend quite, part of our vision to be a world-class company, and the leader in dentistry means we help doctors and other groups all the time. It's not a competition. How could it be a competition when we're not 97%?

Noel Liu:
And that's one of those key takeaways I would like everybody to know. It's more about collaboration and networking, and that's what I feel it is. And that's where the future is.

Mark Greenstein:
I think that's exactly right. It is about collaboration. In fact, we call our quarterly meetings collaborate to connect, c2c's, and, or connect to collaborate, sorry, I had it backwards; connect to collaborate. I think the essence of Heartland is collaboration. The model, we talked about equity and how we should profit, share, and all that. Those are really just aligned to get people to work together.

Noel Liu:
Whatever it takes, right?

Mark Greenstein:
Whatever it takes. Because one and one definitely can equal three or more.

Noel Liu:
Mark, thanks again for your time, and we appreciate the opportunity. Mark Greenstein, you guys know where to reach him at. Once again, make sure to like and subscribe, and we will catch you on the next episode.

Mark Greenstein:
Have a great evening.

Noel Liu:
Thanks for tuning in to the Secure Dental Podcast. We hope you found today's podcast inspiring and useful to your practice and financial growth. For show notes, resources, and ways to stay engaged with us, visit us at NoelLiuDDs.com. That's N O E L L I U D D S.com.

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About Mark Greenstein:

Mark Greenstein brings a wealth of experience to Heartland Dental as their EVP & Chief Growth Officer, having had a distinguished career in consulting and asset management, including a role as an associate partner at McKinsey & Co. At Heartland, Mark spearheads our expansion efforts, manages payer relations, and devises intricate cross-functional strategies. He also ensures that our supported dentists access top-quality products at competitive prices. In his capacity as an opportunity creator, Mark fosters strategic partnerships to drive growth for Heartland Dental and its affiliated offices. Hailing from New York City, Mark infuses his work with his lively personality. Outside of the office, he cherishes moments with his wife, two children, two dogs, and a fluctuating number of goldfish. Mark draws inspiration from Bruce Springsteen, and his favorite quote from The Shawshank Redemption encapsulates his outlook on life: “Get busy living or get busy dying.”

Things You’ll Learn:

  • Group practices like Heartland aim to empower dentists through support, education, and community engagement.
  • Dentists can benefit from joining group practices for non-clinical support, education, and opportunities for growth.
  • Equity models offer dentists opportunities for profit sharing and long-term financial stability within group practices.
  • Dentists should prioritize networking and collaboration to stay abreast of industry trends and opportunities.
  • Acquisition strategies play a significant role in the growth and success of dental group practices like Heartland.

Resources:

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Podcast

Shark Tank Success: How a Toothbrush Took the Spotlight

Summary:

Providing personalized care and attention to patients’ needs can differentiate dental practices and contribute to patient satisfaction and retention.

In this episode, Dr. Bobbi Peterson, renowned orthodontist and inventor, shares how her commitment to providing quality dental care to underserved communities led her to develop the Big Mouth Toothbrush, a revolutionary electronic and sonic toothbrush designed for optimal oral health. With a passion for serving her patients, Dr. Peterson emphasizes the importance of leadership, accountability, and personalized care in dental practices. When it comes to scaling a business, Bobbi shares that expanding distribution channels, such as partnering with dental offices and leveraging online platforms like Amazon, is crucial for reaching a wider audience and driving product sales. Through her practices in Brooklyn and Philadelphia, she creates a familial environment where patients feel valued and heard. Dr. Peterson’s appearance on Shark Tank catapulted her product to success, leading to partnerships and expansion into dental offices and boutiques. She emphasizes the significance of delegation, respect, and teamwork in building a successful practice. 

Tune in and learn how Dr. Peterson’s dedication to innovation and community impact continues to inspire and uplift dental professionals worldwide!

Secure Dental_Bobbi Peterson.mp3: Audio automatically transcribed by Sonix

Secure Dental_Bobbi Peterson.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Noel Liu:
Welcome to the Secure Dental Podcast. Through conversations with the brightest minds in the dental and business communities, we'll share practical tips you can use to scale your practice and create financial freedom for yourself and your family. My name is Dr. Noel Liu, CEO and Dentist at Secure Dental, and also co-founder of DentVia. I'm your host for the Secure Dental Podcast and I'm so glad you're joining in.

Noel Liu:
Hey, welcome back to another episode of our Secure Dental podcast. Today we have yet another very special guest here. Before we get started, I'm just going to start with a little bit about the sponsorship of the pod. The pod has been sponsored by DentVia. It's a virtual dental assistant company, and basically they help your back team staff members with virtual administration. Visit them at www.DentVia.com. Again, that's www.DentVia.com. Now, since that's out of the way, let's dive right in. So I got here Dr. Bobbi here, and she is such an amazing person. She does great things. She has two practices in Brooklyn and Philadelphia. And what are they really inspired by her is the work she does in the community. So without further ado, I'm going to pass the mic on to you and let you do the intro and tell us exactly what's going on and how you got started.

Bobbi Peterson:
Yes. Thank you so much for that introduction. I'm really happy to be here on the Secure Dental Studio podcast. I admire your work and thank you for what you do as well. But my name is Dr. Bobbi Peterson. As you said, I have two practices, one in Brooklyn, one here in Philadelphia. I've been practicing since 2008. I may not look, I know I was born in '92, but I've been a dentist since I was four and I'm not kidding. But I've been practicing dentistry and orthodontics for a long time. I definitely pride myself in getting back to the community like you said. Both of my practices are located in major cities and we accept all insurances and we cater to those that may not necessarily be able to afford proper dental health care. We also donate dental supplies to different high schools and middle schools in both cities. I opened up a practice in Philadelphia because I had family here, and I also went to Drexel University, so I'm very familiar with this city. Most recently, I became an inventor, and I know you want to touch base on that a little bit.

Noel Liu:
I think you're all about it.

Bobbi Peterson:
Yes. I designed an electronic mouth sonic toothbrush.

Noel Liu:
Wait, you said electronic mouth sonic toothbrush?

Bobbi Peterson:
Yes. So what that means is, yeah, so I, so a few years ago, I got with a few engineers, and I wanted to design an electronic toothbrush with a wider head. Now, the reason I wanted to do that is because, within my practice of dentistry and orthodontics, because I have some dentists that work for me, we noticed that there was a higher prevalence of gingivitis and periodontal disease. So I'm like I personally did not like how the latest advances and all of the electronic toothbrushes from these big companies were getting smaller and smaller, the brush heads were getting smaller and smaller. I'm like, How is this helping the gingivitis and oral health care problems? So I said, I personally want a wider toothbrush hand. So I got with a couple of engineers. We did our design. Four prototypes later, came up with a big mouth toothbrush. I said this works well in every corner of the average sized mouth. And we put it on the market. Yes. After being on the market for about six months, I applied for Shark Tank.

Noel Liu:
So before when it was in a market for six months, what was the name? Big mouth toothbrush? That's it?

Bobbi Peterson:
The big-mouth toothbrush. That's always been the name. Yep. That's always been the name.

Noel Liu:
And where did you have them?

Bobbi Peterson:
So initially it was only direct to consumer. Then gradually we got on to Amazon and that was pretty much it. At that point, it was direct to consumer and Amazon. That was, and then I sold them at my practice too. At that point in time I only had the practice in Brooklyn. So we sold that at the office and then we sold them direct to consumer.

Noel Liu:
And what year was that?

Bobbi Peterson:
That was 2022.

Noel Liu:
2022?

Bobbi Peterson:
Yeah. Very recent.

Noel Liu:
Wow. Wow. Okay. Okay. So yeah, keep going.

Bobbi Peterson:
Yeah. So we launched in January of 2022. In June or July, I applied for Shark Tank because it really is one of my favorite shows. And I really feel like that platform gives opportunities to entrepreneurs at every level. Like, you can go on Shark Tank with an idea. You can go on there with a prototype that you just want to sell for licensing. You can go on there if you have a failed business. You can go on there if you have a successful business. They help entrepreneurs on every level. I personally wanted to have some numbers behind my brands to bring to them to show proof of the concept. So that's why I waited about six months before I applied. So I applied six months in. They responded to me, I believe, by August. And then in September I went to go pitch. Now the problem with that was, and what a lot of people don't know is that you can go through all the stages to get onto Shark Tank, right? But you don't, and you can pitch in front of the sharks. But it does not necessarily mean that your episode is going to air. Now, your episode airing is key to your brand going through the roof in terms of sales. If no one sees the episode, it's like, How do they even know you exist? So I pitched in September and some of the people that were there with me when I pitched, like some of the brands, their episode aired like the following month. So I'm seeing all these people that were there with me and their episodes are airing, and I'm like, Oh my gosh, is my episode not going to air? It didn't air until the following March. Okay? So my episode didn't air till March of 2023. It just aired last year.

Noel Liu:
Wow, wow.

Bobbi Peterson:
Yeah, I was on pins and needles. I'm like, Oh my gosh. Because the network, they can't confirm that to you. They will, because they don't really know because it's television. It's like reality TV. You don't, they can't really tell you until maybe a month or two before.

Noel Liu:
Amazing.

Bobbi Peterson:
You just have to be ready. I sold out in 24 hours.

Noel Liu:
How did you come about this idea that you want to go to Shark Tank?

Bobbi Peterson:
So it's always been one of my favorite shows. So Big Mouth is not my first business, okay? It's not my first product. So it's my first product. So I have, initially, so the reason why they call me the celebrity orthodontist is because when I first finished my residency and I started practicing, there were in a lot of celebrity circles, right? And I wanted to be able to offer them something different. So I came up with my own line of tooth jewelry called oral fixation, and I used to make, I got with a jeweler and I made custom tooth jewelry pieces for a bunch of celebrities. Namely, one was the production company for hip-hop artist; his name is FettyWAP. So back then he was really, really popular. So he was so popular. And so that's like where I got my platform from. That's where my platform ... And that's how my name started ringing bells in those circles. So that was the first thing. So I'm not naive when it comes to selling something. Funny ...

Noel Liu:
I love your background.

Bobbi Peterson:
But yeah. So that's, just to give you a little bit of background on me finding my passion and being so passionate about the things that I bring to the world, you know what I mean?

Noel Liu:
You got this, like, inner spirit just pops out.

Bobbi Peterson:
I can't help it.

Noel Liu:
So this whole process with the Shark Tank, how tedious or how cumbersome or how challenging was it for you?

Bobbi Peterson:
I would say, I don't think it was like a cumbersome type of experience, because once they accept you, once they tell you they want you to move forward, right? They don't really tell you exactly what's gonna happen step by step. They keep you in the dark when it comes to certain things. But I was super determined and I really believed in my product. And I think they feel that when they as they bring you through the different levels. So basically you're going through different levels and different stages of pitching. So they want to make sure that you have everything together, your numbers, before they bring you in front of the sharks. Because if you go in front of them and you don't have your numbers and you don't have everything that you could possibly sell about your brand in your brain, you're not going to be able to take those questions, you're not going to be able to respond under pressure. The producers kind of work with you to make sure that you're prepared to go to the next level. And if they don't feel that you're prepared, then you're not going the next level. Exactly. After going through the different levels, I guess they felt that I was ready made. I was super, super nervous. I don't know if I've ever been that nervous because once you're flown out there, you like, I guess you know that you're gonna pitch, but you don't know when, you could be there all day waiting. That's how television is. You know, you could be in there all day waiting like me. But then, when you go out there, you literally have maybe five minutes or so. And so it's a really intense make-or-break moment. And it's, I don't know.

Noel Liu:
Tell me what was the opening pitch.

Bobbi Peterson:
Oh my gosh, you have to watch it. It was basically, the way I had it set up. My one stage, I had like a picture of my daughter, a picture of my mother, a picture of a couple different family members with the toothbrush. The display had the toothbrush there with the packaging. Now, the toothbrush that I initially pitched on Shark Tank was the electronic version because we hadn't come up with the Sonic version yet, right? So that's what was up there. And I came out there in all black, right? And I didn't introduce myself as a doctor. I just said, my name is Bobbi Peterson and I'm from Brooklyn, New York, and I started talking about how important it is to maintain your overall; the relationship between your oral health and your overall health is connected. So you've got to keep your teeth clean. And then what I did was, I said, Why do you guys think I care so much about this? Like, why do you think I care so much? And they're like, Why? I said, ... And I put on my white coat and I said, Because I'm an orthodontist. My name is Dr. Bobbi Peterson and I'm an orthodontist. My product is the Big Mouth Toothbrush. So then it made more sense to them. Like, why is this person coming out here talking about oral health care? Why is he using all these crazy big dental words? And I made the comparison with a photo of Mr. Wonderful. So basically I'm like, if you don't take care of your teeth, you could look like this guy. So I had a picture of Mr. Wonderful with missing teeth and ... Love.

Noel Liu:
Love it. Love it.

Bobbi Peterson:
But it really came down to the wire, right? Because almost all of the sharks were out. They'd all gone out. They both, all of them loved the product. They were like, We really...

Noel Liu:
Which is pretty typical with these guys.

Bobbi Peterson:
Yeah, they pretty much all were ... except Mr. Wonderful and they were like, I think their main thing was that the oral health care is such a competitive market. They didn't want to, I guess they weren't up for the challenge. That's what it sounded like to me. But they were like, but good luck. You've been doing a great, you've been doing a great job so far. So Mr. Wonderful came at me with an offer. Kevin came at me with an offer, and I was like, man, because he loves royalty. So ... royalty is killing me. And then I countered his offer. And then Barbara came in and was like, I'll take that offer. And I said, Yes. So that's my partner. Yeah, that's my partner.

Noel Liu:
That's amazing. So fast forward, what's happening now?

Bobbi Peterson:
Okay. As I said before, the initial version of the toothbrush was electronic, so I went from electronic to sonic. So for those of your viewers and listeners that don't know the difference, I'll explain it. The difference is the amount of vibrations per minute. So an electronic toothbrush, the maximum amount of vibrations is 10,000 vibrations per minute. When you move into the sonic realm, the maximum is 50,000 per minute, so it's much more powerful. My toothbrush has five different speeds. It has five different levels of intensity. And I find that a lot more oral, health-conscious people, they like sonic toothbrushes, even though some, a lot of people, when I first put it on the market, they thought sonic was a brand, but it's not. It's an actual type of toothbrush like Philips had a sonic version and electronic version. Big Mouth had an electronic version. Now they have a sonic version.

Noel Liu:
See, I did not even know. I just learned something new from you.

Bobbi Peterson:
Yeah, so that's it. But it's doing amazing. The toothbrush is doing amazing. We're now in Amazon. We are in over 100 dental practices. There's a lot of dental practices that actually sell the toothbrush. Dental practices get commissions for selling the toothbrush in their office. So what we do is we ship them a free toothbrush, let them try it out. For anyone, any dentists that are listening to your podcast, we send you.

Noel Liu:
I'll be the first one after this.

Bobbi Peterson:
Yeah, absolutely. We'll send you a toothbrush for free to try, give us feedback on it. Yep. And then you get commissioned for your sales. Like it's been doing really well. We also are about to launch in boutiques in Soho. So there are these like tattoo and piercing places where they also do tooth jewelry. So I've been training them on how to place the tooth jewelry, and they add the toothbrush as part of their home care regimen.

Noel Liu:
Amazing, amazing.

Bobbi Peterson:
Amazing, right? It's crazy. So it's been doing really well.

Noel Liu:
No, that's so awesome. So how much have these guys supported you in terms of networking, connections, getting the product out?

Bobbi Peterson:
I think that. I have meetings with them. I meet with them like bi-weekly. Yeah. But they're, the most of the meetings are about what I've been doing. Like she's not extremely hands on. She chooses entrepreneurs that she believes in so she doesn't have to walk them through things. And I think with the type of relationship that we have is that I'm in a position where I've learned a lot from her and I want to impress her. So being a partner with her makes me want to work even harder if you can imagine.

Noel Liu:
That's such a great attribute, because once you do that, that accountability automatically kicks in.

Bobbi Peterson:
Absolutely, absolutely.

Noel Liu:
So let's switch gears a little bit. Let's talk about your dental practice, your patients. What's going on on that end? Like what are you doing to start getting into these disenfranchised communities? And what are you doing to help them?

Bobbi Peterson:
Yeah. So what I find is, so I've had my practice in Brooklyn since 2008, like I said, and I have a wide variety of patients. Yes, I do. Like I told you, I do accept all insurances, but the unique thing about my orthodontic practice is that 50% of my patient population are adults. A lot of orthodontists see the majority, like the majority of their practice, preteens and teenage. I do have a lot. I have a lot of those too. But a lot of the adults come to me because a, I make it affordable and I just have a ton of experience at this point. So a lot of, I see a lot of adults, but when you come into my office, it's a very bulk offices. It's a very familial environment. Right now, my mom, when she retired, I grabbed her as quickly as I could. She's my office manager. My daughter is my treatment coordinator. So also, so when you walk in the door, it's just a very familial environment. We always remember people's names. We actually talk to our patients. So for example, I know a patient has like a prom or a graduation coming up; we make a note in the chart so that we see them next time. Hey, how was your graduation? Oh, hey, how was your birthday? I built my staff up to do that, to make it just a little bit more comfortable. Because dentistry is not a comfortable place.

Noel Liu:
Nobody likes going to the dentist or the orthodontist. Right?

Bobbi Peterson:
So we try to make it good. We play all kinds of music when they come in. You could hear anything from country music to reggae when you walk in. Reggaeton, you get your Spanish music. We cater to everybody. Practices has been really successful. The Philadelphia practice was a little bit easier to open because Instagram and social media, sure, they make it a lot easier for people to find you. So some of my followers already known about me from having my practice in New York. Once I made the announcement that I was coming here, people started calling.

Noel Liu:
Look at you. I love it.

Bobbi Peterson:
Yeah, yeah, it's really cool. I'm really blessed.

Noel Liu:
So tell me, what's your vision right now for your practice as well as with your product?

Bobbi Peterson:
For me personally, I don't see myself opening up another practice where I'm going to be present. Okay? I can be with so many places at one time, and I know that once when people see my practice and they see me, if they want to see me. Like they don't want to be seen, they don't want to come to Aces Braces and see other dentists. Like they want to see me. I don't see that for me. I think Philly is it for me in terms of opening up practices. And my daughter ..., if they want to open up another office. It's okay, that's on them. ... In terms of a big mouth. I would like to continue to have the product being sold in other dental offices. I don't think that retail is for me and my partner agrees with that. I don't think. It's a very specific type of toothbrush. It's an upscale toothbrush. It's a very, it's posh. So it's going to be presented that way. It's being presented that way. So yeah, I don't think it's for retail, but I definitely love the, that the dentists have been reaching out and basically saying that they want to sell the product in their office. I want to keep it as a dental, being sold in dental offices. And then of course, directing is over. We're still on Amazon. We have an Amazon store. Amazon is almost like a must for a product like mine, because when you have platforms and you're selling through platforms like Shopify, just to let the listeners know, the shipping costs are very high for people outside of the US. So Amazon makes it a lot more cost effective for the owner of a brand to be able to sell in other countries.

Noel Liu:
Are they pretty hard to deal with or are they like pretty okay?

Bobbi Peterson:
Yes and no. I think the bigger you get, the bigger you get on Amazon, the more problems you encounter. But I think that, I would say that every problem that we have had has worked itself out in a timely manner.

Noel Liu:
Got it, got it.

Noel Liu:
Yeah. So you are more like a boutique kind of.

Noel Liu:
Yes. Oh, that's great.

Bobbi Peterson:
Very ... Yes. I want to keep it that way.

Noel Liu:
Now, has Barbara ever told you to expand your dental practice?

Bobbi Peterson:
No, she has not. She has not said that. Yeah. No, she's never said that. We don't really speak much about my dental practice. What if I expressed to her that I had hired some more dentist? That was the only thing that she commented on, like that I hired people to help me, probably so I could put more time into Big Mouth. But yeah.

Noel Liu:
No, I love it. I love it, yeah. Pretty much I think we've covered quite a bit.

Bobbi Peterson:
Yes, I think so too.

Noel Liu:
So any last comments? Just one last question for you. What do you think about for the audience with dental practices, how important is leadership and accountability?

Bobbi Peterson:
Oh, good question.

Noel Liu:
From your perspective.

Bobbi Peterson:
From my perspective, I feel as though leadership is extremely important. There really can only be one and the dental practice. That leader needs to delegate and respect the opinions and the opinions and the inputs of their employees at all times. I take suggestions, when we have our meetings, I always add any suggestions on how we can make this better, and I'm very accepting of that. Accountability is huge as well. You can't, a team cannot function without people taking accountability for the good things they do and the bad things they do. You know, that's super important. I think that delegation is important. Everyone knowing their jobs very well is very important. Not allowing others to do other people's jobs is very important, but everyone know what their tasks should be and be able to execute them very well.

Noel Liu:
Great. Love it. Yeah, we've covered all. So how can people find you?

Bobbi Peterson:
To fine me directly, my Instagram is iamdrbobbi. My office Instagram is allthingsdrbobbi. I am drbobbilicious on TikTok, and the Big Mouth toothbrush also has a page that's not curated by myself, but it's BigMouthToothBrush on Instagram. They can also purchase my toothbrush on Amazon. All you have to do is type in big mouth toothbrush or best sonic toothbrush, anything like that, and it'll come up. And you could also purchase them on our website at BigMouthToothbrush.com.

Noel Liu:
BigMouthToothbrush.com. Love it. We're going to have the link below. So definitely. And I think this brings us to our conclusion. And I really appreciate your time and coming and your commitment to the community. I love it.

Bobbi Peterson:
Thank you so much for having me.

Noel Liu:
No, absolutely. The pleasure's all mine. And yeah, with that being said, we're going to land a plane. This is going to be the end of our episode. So make sure everybody like and subscribe, and we will see you on the next pod.

Bobbi Peterson:
Thank you so much.

Noel Liu:
Thanks for tuning in to the Secure Dental podcast. We hope you found today's podcast inspiring and useful to your practice and financial growth. For show notes, resources, and ways to stay engaged with us, visit us at NoelLiuDDS.com. That's N O E L L I U D D S.com.

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About Dr. Bobbi Peterson

Dr. Barbara “Bobbi” Peterson is an orthodontist and entrepreneur, known for her appearance on ABC’s Shark Tank, where she successfully pitched her product, the BigMouth toothbrush. Growing up in a family of healthcare professionals, Dr. Peterson developed a passion for oral hygiene, leading her to pursue a career in dentistry. After completing her orthodontic residency in New York, she opened her practice in Brooklyn in 2008.

Concerned about her patients’ oral health, Dr. Peterson developed the BigMouth toothbrush, aiming to address issues of plaque buildup and gingivitis. Inspired by her childhood nickname, “Mighty Mouth,” the BigMouth toothbrush features a wider head for more effective cleaning.

Beyond her two dental practices in Brooklyn and Philadelphia, Dr. Peterson continues to innovate, expanding the BigMouth product line to include sonic toothbrushes and new color editions. With products available on Amazon and in over 100 dental offices nationwide, Dr. Peterson remains committed to promoting oral health and providing quality dental care.

Things You’ll Learn:

  • Providing personalized care and attention to patients’ needs can differentiate dental practices and contribute to patient satisfaction and retention.
  • Navigating the entrepreneurial journey requires resilience, strategic planning, and a willingness to seek mentorship and guidance.
  • Developing successful products requires thorough research, prototyping, and attention to customer feedback.
  • Pitching to investors requires preparation, confidence, and a compelling narrative to secure funding and support for business growth.
  • Expanding distribution channels, such as partnering with dental offices and leveraging online platforms like Amazon, is crucial for reaching a wider audience and driving product sales.

Resources:

  • Connect with and follow Bobbi on Instagram and TikTok.
  • Follow Big Mouth Toothbrush’s Instagram page here.
  • Buy Big Mouth Toothbrush on their website!
  • Discover more about Aces Braces on their Instagram.
Categories
Podcast

The Critical Intersection of Quality Care and Business in Dentistry

Summary:

Understanding the rapid consolidation in dentistry is crucial for positioning your practice successfully amidst powerful entities.

In this episode, Charles Moser, a seasoned dentist and executive business coach, dives deep into the intricacies of dentistry’s consolidation wave, the rising influence of private equity in practice management, and the critical role of leadership and ethics in providing quality patient care. Charles brings his 16 years of hands-on dental practice and 15 years of DSO expertise to the table, discussing the challenges and opportunities that come with managing group practices and the delicate balance between patient care and profitability. He also tackles the perception of ethics in dentistry, the importance of personal accountability, and the impact of corporate influence on the day-to-day life of practitioners. Charles offers invaluable advice for dental practitioners at all stages, from solo practitioners to associate dentists, emphasizing the importance of maintaining a patient-centric approach and the benefits of mentorship and coaching. He explores how the culture within a dental practice can affect team retention and the success of the practice, along with insights into making practices attractive for acquisitions and investments.

Whether you’re a freshly minted dentist or a veteran in the field, this episode will provide you with the tools to navigate the changing tides of dental practice ownership and management. Stay tuned because you won’t want to miss the wisdom Charles Moser has to share.

Secure Dental-Charles Moser: Audio automatically transcribed by Sonix

Secure Dental-Charles Moser: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Noel Liu:
Welcome to the Secure Dental Podcast. Through conversations with the brightest minds in the dental and business communities, we'll share practical tips you can use to scale your practice and create financial freedom for yourself and your family. My name is Dr. Noel Liu, CEO and Dentist at Secure Dental, and also co-founder of DentVia. I'm your host for the Secure Dental Podcast and I'm so glad you're joining in.

Noel Liu:
Welcome back to another episode of our Secure Dental podcast, where we bring in many bright individuals and talents from both inside and outside our dental profession. Today we have a very special guest, and this guy used to also be my mentor back in the day. Before we get started, this part is sponsored by DentVia, a dental virtual administration company that focuses on back-end dental office tasks like calls, claims, AR, etc., to assist our front desk and personnel with office tasks that we get done daily. Visit them at www.DentViacom. That's www. DentVia.com.

Noel Liu:
Now, let's dive right in. So today we have Doctor Charles Moser who is an Executive Business Coach for Dentists. His 16 years at the chair and over 15 years in the DSL space give him a perspective that has helped many dentists owners build and expand their businesses the right way. Whether you're looking to grow or maximize your current situation, Doctor Moser can help. He was a key member of the DEO team once upon a time. And is a certified speaker, trainer, and coach for the John Maxwell team. He always has an interesting perspective on the state of our dental industry, but we'll never waver in our belief that quality patient care and an excellent experience should be the primary focus of any practice, which is what I love about you. Without further adieu, I'm going to pass the mic on to you.

Charles Moser:
Oh man, no, great to be here. I couldn't have said that better myself. You know, that was really well done. I appreciate the kind words, and it's great to reconnect with you.

Noel Liu:
Absolutely. It's such an honor to have you here on my pod and share some insights for everyone listening.

Charles Moser:
What do you want to know about?

Noel Liu:
So, let's dive right in. Dentistry, in general, is solo practice versus group practice versus corporate. Give me a little bit about the insights and a little bit about the pros and cons of each.

Charles Moser:
Well, well.

Noel Liu:
It's a broad topic. Yeah, I was gonna say how.

Charles Moser:
Yeah, I was gonna say, how much time do you have? All I ever wanted to be was a chairside clinician ever since I was 13 years old. The reason I say that is because I'm not sure. I would love to think that. That's still why people are going into dentistry, and they still have that passion to go into dentistry at that type of young age. I mean, I knew exactly what I wanted to do. I wanted to hang out a shingle. I wanted to help people by fixing their teeth. I recognized that a healthy oral cavity was somewhat of a gateway to healthy systemic health, as well. So, it was all I ever wanted to do. When I ask people those questions and believe me, I understand that I have a bias because of the people that I talk to and the arena in which I play that maybe those people have a different opinion and a different reason for going into dentistry. But what I see right now is a bit of confusion out there as to what the mission is for people. Now, you said it perfectly when I said quality care is absolutely number one, no doubt about it. You've got to do as I used to tell my associates. You got to do the best quality that your hands can possibly do. That's all anybody can ask. And then second to that is making money. I'm a big believer in making money. I don't think there's a problem at all with making as much money as your two hands can possibly make, morally and ethically, are the two key words there. And again, that's kind of a broad topic, too. We all know that if you give one patient to ten dentists, you're going to get 11 treatment plans, right? You know, and I'm okay with that, really.

Charles Moser:
I have no problem with that. As long as you believe in your treatment planning and you can walk the walk, you can do the dentistry that will last the appropriate amount of time, bring the patient back to a state of health, and maintain it. If that's 28 crowns in your world, I guess, great. It might not be in somebody else's, but we know people who do that, and we know people who do it well, and we know that they believe in that. So whatever. But I just hope that people are going into dentistry with their eyes wide open, if you will, recognizing how hard it is. I've said this so many times on so many podcasts, and I'll say it again: there is nothing harder than dentistry. There's not a job out there that is as tedious, works on an awake patient, has the margins that we have, has to deal with external forces that we're not prepared for, and has to be an entrepreneur and a producer at the same time. There's nothing as hard as being a dentist. So, I just hope that people are going into it with the right frame of mind. And there's so much more dentistry to learn now than there was when I was a dentist, and yet we're still trying to do it in four years. I didn't have scanners, I didn't have milling machines, I didn't have CVTs, I didn't have any. I didn't have to learn any of that. And I don't think they've taken nearly as much out of the curriculum as they have put into the curriculum. So find yourself a good coach, find yourself a good mentor.

Noel Liu:
So basically, what you're saying is whether it's a solo practice, a group practice, or a DSO or corporate dentistry, I mean, the patient-centric, that is like the key focus, right? Because that's what I see. Many solo practitioners really hate the DSOS and they really hate the corporates because they feel like it's just a money-grabbing machine. But what you just said, I think it kind of nails it right in the head.

Charles Moser:
So look, I want to speak to people out there who are working as an associate anywhere right now. If you're an associate, right, and you're not on a pathway to partnership, I know that most of you out there are thinking, well, I'll do it right when I own my own practice. You know, when I own my own practice, I'll do it differently. I'll put the rubber dam on it when I own my own practice. I wouldn't seat that crown, but I'll seat it in somebody else's practice. Hey, man, I know it. You know what I mean? So, let's just be honest out there.

Noel Liu:
Let's just be honest.

Charles Moser:
Let's just be honest: if you're working, especially if you're working for a DSO, I know it, I just know it. And so I would say to you, I know it, I understand it. And stop it, okay. Just stop it. Just tell yourself right now, no, tomorrow I'm going to walk into the office and treat these patients as if they were patients in a practice that had my name on top of the building.

Noel Liu:
I love what you just said, you know. I just love what you just said.

Charles Moser:
Because you can't turn the switch, right Noel? You really can't. Once you learn those bad habits, baby, they're there, you know. They are there. So I understand that being an associate is viewed by many as quote-unquote practice, the warm-up or the B team, or whatever you want to call it. But let's use it as practice. But let's make practice our perfect practice.

Noel Liu:
Exactly. You know, like I always keep saying whether it's a solo practitioner, if it's a group practice, or if it's a corporate right, if we have the right habits, we have the right mission. Like you just said, you have the right vision, of what you want to do for your patients, it doesn't really matter whatever setting you're in. And I think people with the solo practice guys they need to start looking outside the box and having a little bit more wider mindset than to just have this narrow frame of mind that only these guys can do it better than anybody else.

Charles Moser:
Well, let me ask you a question. Where are we in the bell curve of consolidation right now? What do you think? Are we on the downside of it or where do you think this bubble is right now?

Noel Liu:
My thing from the last time I checked, we were still climbing up. I mean, last time we checked, it was around 20%. And I believe like today, somewhere around like 27 or 28, maybe even 30% at this point in time, maybe even more. We just need to understand it's coming.

Charles Moser:
Yeah, right. Well, it's here, it's here.

Noel Liu:
Right? Yeah. It's here. You're right, it's here. And whether we embrace it or we fight it, I mean, I would say we just go with the flow and just try to do the best that we can as dentists. And eventually these roll ups are not going to stop. It's just going to get even more and more.

Charles Moser:
I'll agree with a caveat to that. And by the way, I think that it does take us back right to our core values and our mission of I don't care where you're practicing, do great dentistry, and if you can't do great dentistry, find out how to do great dentistry, and don't settle for less than what you would settle for. As I said earlier, as if your name was on top of the building. Okay, so let's keep that in mind no matter where you're practicing. Having said that, I think the dumb money has left the building as far as private equity and venture capital and those types of things, I think we can still see big multiples, but we're not going to see big multiples for these duct tape type of roll-up DSOs. If you've got 15 practices with five different practice management systems, no real sense of training and onboarding, no roles and responsibilities in place, and the margins are all over the place at every different location, then I think you're going to have trouble getting rid of that. And in my opinion, what's going to happen to those DSOs or those group practices is they're going to get sold off into chunks to individual people like, you know, like I said, okay, well, I'll buy three of them type of thing. I'll buy the three that have open dental, and Noel will buy the three that have Dentrix and somebody else buy the three with Eagles often.

Noel Liu:
Let's talk a little bit about this.

Charles Moser:
Okay.

Noel Liu:
This is an interesting point that you just brought up duct tape DSO. Yeah. You know, number one, why would somebody do this. Number two is what are group practices or bigger DSOs or even private equity or venture capitalists. What are they looking for when they're looking into buying a dental deal. So you're the expert in this. I want to hear you.

Charles Moser:
Yeah, well, I'll put it into I always talk about hamburger places, you know, it's like if you're an investor and you want to buy some hamburger joints, you're not going to buy five McDonald's, five Burger Kings, five In-n-out's, and five Whataburger's to make 20 and then say, I've got 20 locations and then take that to your team and say, we've got 20 hamburger joints, right? He's like, no, you don't. You have four groups of five is what you have, and your COO is going to hate you, right? Because he's got five different operating systems to deal with and five different systems to train on. And so I think the venture capitalists and the private equity groups have figured that out. And they'll pass on those 20, but they'll look for a group that has five of the system that they're already running. I think that we're on the other side of people expanding just to expand their numbers because they're finding out that's just too hard to stabilize once they buy it. So I think we'll see those types of duct tape DSOs. And again, I'm just pontificating. But I think we're going to see those 15 to 20 locations that are somewhat duct taped together get split-off. And I still think we will see consolidation, but it'll be more like let's call it NCAA football, where we're going to have super powers, we're going to have the heartlands and the Pacifics and the out of California.

Charles Moser:
We're going to have groups of 3000 or 3500 offices, and we will have some superpowers in the consolidation. World of dentistry. And I think the good news with that is if they do it right, I think Heartland does a really good job of it, actually. Didn't you work for Heartland? Did you?

Noel Liu:
No. No,

Charles Moser:
No. Okay. They have a really robust training program. If you come into Heartland and you want to be a great dentist, Heartland creates that opportunity for you. My hat's off to them. So I think that's a really great avenue. And we can have that. Now how does Heartland get out? You know, once you've got 3500 locations, you know, that's another podcast. But yeah. So I think that's where we are. I think that private equity has gotten smarter. There will still be some really nice multiples if you have something of value for them to buy. There's still plenty of money on the sidelines out there, but they're not giving crazy multiples for bad deals anymore.

Noel Liu:
And how important is management in a group?

Charles Moser:
Well.

Noel Liu:
or it's not really important?

Charles Moser:
Give me more to that. So in other words, if I'm buying something how important is management.

Noel Liu:
Correct. So let's say if you are a private equity guy and you're looking into a deal, let's say eight locations, for example, how important is the management company like in terms of managing all the offices like oh, it's probably managers.

Charles Moser:
Well, as far as the org chart goes, I don't think that the management company is going to be that important because they're just going to dissolve your management company and put everything underneath theirs.

Noel Liu:
Okay.

Charles Moser:
You know, I mean, I think certainly. But would that.

Noel Liu:
But would that consider them like it's not a duct tape DSO and it's like a little bit more aligned with what they're looking for rather than just everything clumped up together.

Charles Moser:
I think the big things that they're looking for are what is your practice management software. That is first and foremost. So if you're listening to this and you've got multiple locations and you have multiple practice management software, you need to be looking by the end of 2024, or at least the end of 2025, if your goal is to sell it. And that's your exit strategy, which is fine. It is a business. That's the first thing you should be looking at is, how do I get all of my practices on the same software. That is first and foremost, from a private equity standpoint, what they're looking for. The next thing that I think they're looking for is what are your onboarding and training systems. Because I think that COVID is well behind us as far as from an employee standpoint. I love what I heard not too long ago at a seminar where they said, the labor war is over and labor won, okay? They did at $20 for minimum wage in California now. And we know what hygienists are making. And I don't know how you put that toothpaste back in the tube. So labor won. But having said that, we do have people now that are looking for jobs.

Charles Moser:
People are coming back into the workforce. We are paying a lot for it, but at least we have options. Now, having said that, I do think that we still see a certain amount of turnover. And again, if you're listening to this and you want to know how to win the game, you have to figure out how to train and onboard people to be productive fast. That's the key. When you lose an office manager, when you lose a regional manager, when you lose a dental assistant or hygienist, whatever it is, the faster you can bring in somebody new and train them and onboard them to be productive, the better off you are and you win. Because now you're not a slave, you're not held hostage or whatever. I don't know what I can say politically correct. You're not at the beck and call, right? Thank you. You're not at the mercy of the employee anymore. You could take somebody and you can onboard them, train them. And if you want to go just another layer deeper into that, I'll maybe give somebody a nugget here. Ask yourself the question, what position are you training and what are they going to be doing 75 to 80% of the week? What is their role look like that they do 75 to 85% of the week trained to those things?

Charles Moser:
Don't necessarily put somebody next to somebody and say, hey, sit next to Doctor Liu and watch what he does. That person may not be doing what Doctor Liu does, right? So why are we training them on something that they're not going to be doing every day, all day? The idea is to get them trained on the things that they're going to be doing every day, all day. You have to recognize when you turn people over to train people, what are they going to train them on? They're going to train them on the things that they do well, which, again, might not be the things that person is supposed to be doing. So again, big gold nugget for people out there right now. If you've got somebody that's new that just started or is starting tomorrow, ask yourself the question what is their main function? What are they going to be doing 75 to 85% of the week and train them on those things? Get them proficient as fast as possible.

Noel Liu:
Love it. So onboarding number one is practice management and onboarding. What else?

Charles Moser:
Yeah. So I think that, you know, a good healthy new patient flow.

Noel Liu:
Are they also looking to the retention of associate doctors or?

Charles Moser:
I mean I think they are. But again I think that is probably the biggest unknown out there. So look I think that you can't talk about that in a gross generality type of thing. So let's talk about the extremes. I was a dental director for a Medicaid, DSO. We do 12 things, we just don't do a lot of stuff. So our onboarding and training was what I just said. We trained, we took new grads, and we trained them to do sealants, trophies, composites, pulpotomy, and stainless steel crowns. And if we could get them proficient at that, they could be a great asset to a Medicaid DSO. Flip that around. And now you've got these super GP DSOs, and you've got people that are doing all on X, sedation, all these kind of really fancy things, the veneers, and just really complex dentistry. You better have a path to partnership in place for those people because it takes you way too long to get those people up and running to do ten, 15, $20,000 a day, right? But in our case, when the Medicaid DSO, nobody was a partner, we had 200 associates. None of them had partnerships because they were easy to replace. So we got bought three times. We went through three flips, and associate retention was not an issue at all, because we could take a new grad and get them up to speed in a matter of months.

Noel Liu:
Makes perfect sense. Yeah. So for someone to start with a group practice, I mean, somebody who has one practice and now they want to be like, hey, I want to open up a second or a third. What is one of those main things you see in the industry that's the why. Why do they want to do it?

Charles Moser:
Ego.

Noel Liu:
Love it.

Charles Moser:
I think come on now. Let's be fair, I'm not saying that as a negative either. I'm just saying that we all just again, let's be honest, okay? A lot of ego out there, which is fine. Again, I think it's my bias from the seat that I sit in is how many people call me during the week and say, how do I get out of the chair? And I've had dentists, three or four years out-of-school tell me, I don't like this. How do I get out of the chair? It breaks my heart, okay? Breaks my heart because I injured my hand and I had to quit at 16 years or I'd still be sitting there and I would have never met you, which would have been a terrible thing. But, you know, I'd still be cutting teeth and taking care of people, right? So when people call me and say, how do I get out of this? And there's a couple of Facebook groups out there that are posting things from dental students, right, that are already talking about, oh my God, I hate this. You know, what should I do? Like, man, I mean really, it just breaks my heart.

Noel Liu:
And then dental school, they can always just say, hey, I'm going to call it quits rather than going through the whole nine yard and then quitting afterwards. Right? I mean, the sooner they quit, the better, right? Because you and I, we both know dentistry is not for everybody.

Charles Moser:
So it is not.

Noel Liu:
It is not these guys they got in by mistake or they thought, you know, the money was good and now they're finding out that, okay, it's a lot of back-breaking kind of procedures.

Charles Moser:
It is hard. Yeah. So I mean I don't know I think that maybe there are more entrepreneurs in the dental space than there were 20 years ago. And so that's why they want to create a group practice.

Noel Liu:
So going back to your first statement that you said, do it for the love of patients and do it with the patient care and patient-centric, these guys who actually hold the dental degree. And now they want to open up a good practice because they just don't want to practice dentistry. Do you think they are contributing to the problem, the issue, or are they solving the issue? Not to name anyone specifically, but just kind of pointing it out.

Charles Moser:
Don't have anybody specific to name. I mean, look, there's good guys and bad guys in every industry.

Noel Liu:
Sure.

Charles Moser:
But I can tell you is that dentistry 30 years ago was, I believe, third in ethics perceived by the public.

Noel Liu:
Correct.

Charles Moser:
That's not the case anymore. So that says a lot. Yeah, it says a lot. And the problem is, is that low quality dentistry is so damaging to people. If you get a bad haircut, a bad manicure, you buy a bad suit, a bad car, or whatever, you know, I don't care if you buy a $75,000 Mercedes, right? And it's a bad car, you can still get out of that if you do bad dentistry. You cripple people for life. There's some serious consequences to it. One of my mentors used to say surgeons bury their mistakes. Dentists have to see them every six months, you know?

Noel Liu:
Right. Let's just stick on this for a little bit because, you know, you and I, we both know. Like even I had associates in the past where they burned those patients. And, you know, we get to deal with them still. And my new associates are getting to deal with them. What do you think is going on? Is it because of one of those scenarios where you felt like this guy went to dental school, and now he came out, now he doesn't want to do dentistry anymore? Or is he just like doing it for the money, or is he just doing it for. You know what, I don't care, it's not my mouth.

Charles Moser:
I think there's a lot to be said about what we were talking about earlier, about if I were you, I would take that expression back to your associates and say, I want you to pretend like your name is on the top of the building. Every time you see a patient, I want you to see your name at the top of the building. And it'd be interesting to, I don't know how you do this study, but my office, the name of my office was Charles S. Moser, DDS. It wasn't Apple dentistry, best case scenario dentistry, or amazing dentistry, right? I mean, it was personalized. My brand was my name, not some fancy elite dental partners type of thing right?

Noel Liu:
Right.

Charles Moser:
So there was an old commercial as a car commercial that said, would you do your job differently if you had to sign your name to everything that went out of your office? If you had to put your name on everything that you did, would you do it differently? And so I think that's what I'm saying to you, is that people should tell their associates, I want you to practice dentistry like your name was on the building, and as if you had to sign everything.

Noel Liu:
And that changes a perception.

Charles Moser:
I mean, yeah, yeah. You know, so that's number one. But we were talking about.

Noel Liu:
So we were talking about like these guys who are actually got into the dental field, let's say by mistake or they don't like it or they change their mind, they cannot do dentistry anymore or, you know, various reasons. And they want to go and start group practices. And now they are looking at the hard work in group practices where profit is all of a sudden is dipping because it can't be everywhere at all at the same time. And now they are like, all right, cool, I hate dentistry, I don't like to be in that dentist. And now I got to run this business and now I'm in a dark zone. So with this whole circle of cloud, how do you analyze situations like this? Because since you are coaching a lot of people, I'm sure you come across guys like this.

Charles Moser:
Oh yeah. Well, all you're doing is shifting your challenges. You're just shifting your problems. You know, if you want to create a group practice and build a network of offices with a bunch of associates and not be at the chair, if you think that's easy, then you need to think again. It's just a different hard, you know, it's just not practicing dentistry. Which by the way, at least practicing dentistry is within your control, right? Your associates practicing dentistry is not in your control.

Noel Liu:
That goes back to the core value that you just said. Right. Patient centric. But let's say these guys, you know, they don't care about their work. They don't care about their name. They're just like doing like crappy work, for example. And now they have a group practice. Now I can see what the culture is going to go and now when they get in trouble. So basically it's like, hey, what about patients, right? Patient first or is it the profit first?

Charles Moser:
If you do great dentistry and create great experiences for people, and you understand how to lead teams of people, inspire them and value them, and empower them to make decisions, you'll find that you'll make money. Just figuring out how to make money without those things means churning patients, right? Just a whole bunch of new patients, a whole bunch of same-day dentistry, and just churn, churn, and churn. By the way, when I was practicing dentistry and when my clients told me about the same-day dentistry that they did, I said, that's great, but I want you to know, my goal is that you don't do same-day dentistry. That's my goal because I'd like you to have a schedule of patients that come in to get their work done. And it's predictable. That's the work you're doing. You already know what your production is. All the insurance is taken care of. This whole idea of same-day dentistry is Russian roulette. You know, it's just mind-boggling to me. So the goal should be not to do any same-day dentistry. The goal should be to treat people well. Look, man, when was the last time you bought something for $5,000 that you took 45 minutes to think about? We don't. I mean, we research the shit out of things. We got to go talk to people. We're going to get on the internet. We're going to look it up. We're going to look at reviews, and we have patients that come in and we create five, ten, $15,000 treatment plans, and we put them in a room with a treatment coordinator and expect them to close that case. And we do it. I mean, it's done. I think that's pretty incredible, frankly.

Noel Liu:
But well, I guess it depends. What's the patient's goal and patient's outcome like, you know, what are they looking for? If they're looking for somebody who wants to get it done the same day, that's a different story, right?

Charles Moser:
Well, if you have an emergency or something like that or some small dentistry that you can fit in. Sure, absolutely. But when we talk about same-day dentistry being 50 to 60% of a person's production, everyday. That's a tall order. I think what I heard just the other day was that same-day dentistry should be about 15 to 20% of your day. And I was like, okay, I can handle that, right? That's the emergency that walks in or something like that, or something that comes out of hygiene, that you turn around and put them into a restorative chair. But they've already been a patient of yours. It's not that new patient that came in at 9:00, and at 3:00 they're still in the chair. You know, they've spent all day at the dental office. Correct, correct.

Noel Liu:
There are those days where these doctors will be, you know, seeing patients for at least like 4 to 5 hours. Yeah, that's a little bit excessive I agree, I agree 100%.

Charles Moser:
Yeah.

Noel Liu:
So switching gears a little bit now since we spoke about the group practices, what is a good part about a solo practitioner and they're partnering up with let's say a DSO or maybe like a group practice with multiple offers? And they want to grow still. Where do you see like the collaboration? What are some of the good and the bads that you're seeing?

Charles Moser:
Well, so there are a lot of good, frankly. I mean, dentistry for so long was a cottage industry, the whole shingle thing, right? And we were on our own island and we didn't talk to the dentist down the street. We really were very isolated, which meant that we didn't share ideas, we didn't share concepts, we didn't share out of the box thinking. And so I think it delayed the industry's growth medicine. You had these hospitals, right? So you had these just huge, abundant amounts of clinicians. If you've ever been in an operating room setting, you know that there's this room where all the surgeons sit, right? And they all eat their donuts and drink their coffee while their patients are being prepared for surgery. And they get to sit there and talk about things. And maybe not all of it's medicine but at least they have a way to share. And we didn't have that. So I think the group practice, the larger practice settings, create an environment where we're much more willing to share information and collaborate and ask people. And again, if you have the ability to be vulnerable and say, hey, this didn't come out so good, you know, how do you handle this situation? Right? So I think that's been a really good thing. Now, why hasn't that happened? Well, it hasn't happened for the most part, because people won't drive 50 miles to go to the dentist.

Charles Moser:
They will drive 50 miles to go to a hospital to have surgery. But we want our dentists to be close by. So we're having to move that patient mindset out of this dentist on every corner type of thing in this consolidation realm. And I think that probably in 30 to 50 years from now, you will see people driving further to go to the dentist, because we'll have more dentists in one location type of thing, and we'll be able to share expenses and share some costs and hopefully control the price of dentistry these days. So I think that's a really big plus about group practices, is being able to share ideas and learn and have a mentor, maybe even just somebody that's 2 or 3 years out of school ahead of you. Right? But just someone that you can I used to call it a hand that you can high five and a shoulder that you can cry on. You know, they filled the bill for both of those. So that's a really good thing. And I think that also look, dentistry is a business. And clinicians who go to dental school are not trained to run businesses. So I do think there is definitely a need for corporate dentistry. I think that absolutely, we should be letting business people run the business, and we should be letting clinical people run the clinics. And when you have that synergy, when it works well, which we did, we had a really great CEO.

Charles Moser:
It worked very, very well. We made money and we like to call it. We put enough pressure on each other to create a diamond, right? Because they would push us and we would push them. But neither one, the clinicians, had 51% of the decision-making power. That's the way it was set up. We told the business guys, you can decide what number two pencils we buy. You can decide what computers we use, but you do not walk into the laboratory. And so I do think there's a need. I mean, we do need to be teaching these clinicians business. They need to understand what the metrics are. They need to understand what the baselines are. How much of your PNL should be your staff, how much should you be spending on labs? Because, look, a percent is a big deal.

Noel Liu:
Of course.

Charles Moser:
A percentage is a big deal. People don't think it is until you say, okay, well, what'd you do? Like what was your production last year? We did $1 million. What's 1% of that? It's $10,000. It's like, okay, well, give that to me. Like you're crazy. So evidently 1% is a big deal. You know, if you don't want to just give me ten grand. If it's not that big of a deal, then I'll take ten grand.

Noel Liu:
That's a big deal, right? Exactly, exactly. So how much of it do you think it's supposed to be? Like a school's responsibility to teach those students? Or is it something that should be like part of the curriculum, or should it be like part of the CEE or something where these guys should just, like, collaborate and just let him do it? Or should a dentist even learn all these financials?

Charles Moser:
No, no, nobody should be teaching it. They should all go to www.bluehorsepersonal development.com and reach out to me and let me help them with that. So.

Noel Liu:
No definitely. Definitely. I don't think you've been coaching right. You've been coaching for a while. Yeah. And you know some of the drawbacks that, you know, we all go through.

Charles Moser:
Oh yeah. No, I so you asked a question earlier that I didn't answer properly. It was about some of these clinicians deciding to go into group practice and how to do it the right way.

Noel Liu:
The right way. Yeah. And avoid some of the pitfalls.

Charles Moser:
Yeah. So step number one is you need to evaluate what your risk tolerance is. Okay. And that's a question that a lot of people don't ask themselves. It's like so I used to ask my patients. Because selling dentistry and I don't mind the word sell, what I was selling was moral and ethical. Selling dentistry was a matter of creating a treatment plan that met the needs of the patient, such that they were able to do the things that they valued with their teeth. I would say to them, what's the most important thing to you about your teeth? And they'd say, well, I want to keep them. I like to eat, I like to smile. Everything that I've designed for you is designed to do just that, to keep you eating, to keep you smiling, and to keep you healthy. Would that be okay with you? And the patient would say, of course, it is. The next thing I needed to figure out was what is their risk tolerance. And so I would say to them, would you drive your car from Houston to Dallas, which is a 220-mile drive? Would you drive from Houston to Dallas on a bald tire? Now think about that. Would you drive yourself? Would you drive four hours on a bald tire on the highway?

Noel Liu:
Personally, I wouldn't, but okay, somebody would, right?

Charles Moser:
Somebody would. So the person that says no has a low-risk tolerance, right? The person that says yes has a high-risk tolerance. If I've got a patient that's got a three-surface restoration in their mouth, that's got a little bit of an open margin or whatever like that, and they have a high-risk tolerance. Do you think I have a real good chance of converting them to do a build up in a crown? No, because they're going to say to me, I'll come back when it breaks. I'll come back when it hurts. Right? It's like, okay. I mean, I'll explain to them the ramifications and the consequences, but I'm also going to just write in their chart that this person is willing to take the risk, and we will be here for them when they need us. But when Doctor Liu comes into my office and says, hey, man, if anything looks like it's going to blow up in 2 to 3 years, I want to fix it now. That is a low-risk tolerance. So I'm going to present the treatment plan to you. I'm going to quadrant it out to you. And I'm going to say we're going to do this. And each quadrant is going to be two appointments and an eight appointments. Three months. We're done. And you're on re-care.

Charles Moser:
Here's what it costs. Here's how you can finance it. When would you like to start? We have Thursday at 8 a.m. open-type of thing. So the clinicians who are going into business and who are going into group practice need to ask themselves the same question, what is your risk tolerance? When your banker calls you and says, hey, that balloon note that you took out 12 months ago is now due and your line of credit is maxed out. How does that make you feel? Because that happens. It's fixable. You can solve it, you can take care of it. But if that's going to cost you stomach lining and sleep, you need to think about slowing your pace down a little bit, right? Make sure you've got the cash in the bank to do these deals. Don't be taking loans from people named whatever. You don't want to end up in the bottom of Lake Michigan because you can't pay your loan.

Noel Liu:
Correct.

Charles Moser:
So what is your risk tolerance? And if you can take a lot of risk and you can get the money and dentists can, then go for it, man. Have a great time. Do quality dentistry. But you're taking a big risk. If you are not a risk taker, then you want to go slower.

Noel Liu:
And so with that being said, how important are mentors and coaches?

Charles Moser:
They're everything right now and I love what I do and I am one of so many great ones out there. There are a lot of, again, I don't care who your coach is, I don't care if it's me or not but you got to get one because you will have so, let's take it into the positive, things will be so much easier for you if you have an objective opinion that can push back on you and say, no, why are you buying this office? Your other three practices are not even close to maximized. Why are you looking at a fourth practice? It's kind of like what we were talking. When we were talking about how do people train people? They train people on what they do. Well, well, you're buying this practice because you get excited about buying practices, not because it's the right thing to do, because it excites you. And that null ego, right? It's like, oh, now I have four practices. Now I have five practices. Right? And that's a great thing to say at a dental convention. But it's a crummy way to be if you are taking money from practice one and two to pay the bills for practice three and four, that is not a good place to be.

Noel Liu:
So got it.

Charles Moser:
That's definitely a need to get a coach. You definitely need to get somebody who will push back on you. And if they're not creating pain for you, they're not a good coach. They need to be pushing back enough on you to where you're kind of pissed off at them every once in a while.

Noel Liu:
I love it.

Charles Moser:
No, no, seriously, because you don't want to hire just a yes man. I mean, this is not a job where you just, oh, you're amazing. Every once in a while, they're going to tell you something you don't want to hear, which is typically you're the problem, not your team. That's typically what they don't want to hear, so yeah.

Noel Liu:
It kind of reminds me of the analogy of when Jordan was playing and Grover was his coach or his mentor, right? I mean, he used to pick stuff out, which used to piss a crap out of Jordan. And I still remember this time where, you know, he's considered the greatest basketball player of all time, but yet his coach knows his weaknesses.

Charles Moser:
Yeah

Noel Liu:
I love it. And I love it. What you just said.

Charles Moser:
One of my favorite stories was Jack Nicholas in The Masters. He was on part three, and his son, Jack Jr, was his caddy. And Nicholas looked at him and said, you know, what's the yardage to the pen? And he said 182, or 183, something like that. And Jack Nicklaus looked at his son and said, which one is it? I mean, you know, right, if you're not going to give me a number, then I don't need a range. I can see, right? I need a number. So, wow, that's what your coach is for, is to tell you, hey, this is not about blind spots. Yeah, it's not about getting close. This is about getting it, you know?

Noel Liu:
Yeah, exactly. So it's either you win or you don't, right?

Charles Moser:
You know, that's a really great statement because I see a lot of people doing great things out there. And they're making money, and they're doing good dentistry, and they're living the life and they're having a good time. And then I see people that are just underwater, and there doesn't seem to be a lot of middle ground, you know. And here's another really interesting thing, Noel; this came to me the other day, too. It's like I have clients that have one practice. And when I ask them to do something, they'll say to me, I don't have the time. I have clients that have 20 practices, and when I ask them to do something, they say, oh, I don't have the time. And I'm like, wait a minute, what's going on here? That this guy's got 20 practices, and you've got one practice, but neither one of you has the time to do anything.

Noel Liu:
What did you make out of it?

Charles Moser:
I don't know what to make out of that. Well, Parkinson's law.

Noel Liu:
Yes.

Charles Moser:
Parkinson's law, right? Parkinson's law simply says that the time allotted that you give to the work will be filled by the work that you give the time allotted to.

Noel Liu:
And I'm a true believer in that.

Charles Moser:
Right?

Noel Liu:
Right. I procrastinate a lot of things.

Charles Moser:
Well, if I give you an hour and a half to do a crown prep, you'll take an hour and a half. If I give you 45 minutes to do it, you'll take 45 minutes. If I say to you, this patient is late, but they want to do two crowns, and you only have 35 minutes, you'll do it 35 minutes.

Noel Liu:
Precisely. It's all the goal and the target that you have set in place for us.

Charles Moser:
Let's get to work. Let's get to work.

Noel Liu:
So, last question for you.

Charles Moser:
Sure.

Noel Liu:
Let's talk about leadership. How important is leadership in practice, in group practice, and in any organization?

Charles Moser:
So, however important anybody thinks it is, quadruple it. And then double it again.

Noel Liu:
Quadruple it, and then double it again.

Charles Moser:
You have no clue how important it is unless, you know you know, you know, type of thing. Here's the proof. You can have great systems but lousy leadership.

Charles Moser:
Now, do you like that combination, or do you like average systems with great leadership? Which one of those scenarios would you prefer?

Noel Liu:
Second one.

Charles Moser:
Give me average systems with great leadership every day and twice on Sunday. Another way to put it is I would rather have everybody hitting on all cylinders, executing a mediocre plan than people not executing on a great plan. And the way that happens is through leadership. It doesn't happen through systems. It happens through leadership. Leaders do three things every day. They value the people they work with. They inspire people to do things that they never thought they could do on their own. And they empower people to make decisions, not tasks, but to make decisions that will retain your people. They will not leave you for $0.25 an hour if they get to come into a place and make decisions and know that their boss has their back. Look, man, none of these decisions that are being made are all that big of a deal. We're not asking them to make the decision. Should we buy this practice or not? But we might ask them to say, hey, I want you to evaluate the front desk of this practice.

Charles Moser:
I'm giving you the power to bring me the information on this. There's a really amazing statement that says the sophistication of an organization can be determined by the number of people who can say, yes, now think about that. If you're listening to this, I want you to ask yourself how many people in your organization can say yes to something, and if you're the only one that has the ability to say yes, guess who the problem is. You're the bottleneck, right? Every decision, if you're out there and you're like, oh my God, every day I have to make every decision. They come to me and ask me, can we buy more C-fold towels? Can I go get some more swifter mop things to clean the office? Can I order more copy paper? Can I call the IT service? If you're the only person that can answer those questions, that's ridiculous. That's why you hate dentistry, okay? That's why you hate coming to the office, is because you're overwhelmed with ridiculous decisions that you should not be making. All of that is leadership. It's all leadership.

Noel Liu:
And how does it affect the vision of that practice?

Charles Moser:
Well, you can't execute a vision because nobody has been buying your vision, right? Your team isn't bought into it

. First of all, they don't know it. I mean, if you're that person, your team doesn't know your vision. Okay? You probably haven't even established a vision yet, frankly. Dentistry is a very unique situation where we do need a vision and we do need core values because from the core values culture is created. It just doesn't happen any other way. If you want a culture of teamwork, then you have to embody teamwork every day. And I have to say to you, Doctor Liu, I would say, okay, well, how do you demonstrate teamwork every day? And if we have a team of people that embody and demonstrate teamwork every day, then our patients will walk in and say, y'all are a great team here. And guess what? That means we have a culture of teamwork. But if it's just words on a page and you're trying to build culture from words on a page, it doesn't happen that way.

Noel Liu:
It doesn't happen.

Charles Moser:
It doesn't happen that way.

Noel Liu:
No one feels it, right?

Charles Moser:
No one. Feels it. So you cannot execute your team if you don't have the buy-in from your teammates on your vision, and you will not get the buy-in from your teammates if you're just managing them every day. It's carrot and stick, carrot and stick, carrot and stick. If you do it right, you get the carrot. If you don't get it right, you get the stick, and you will not get people to buy into your vision, and they will leave you for $0.25 an hour to go work for the guy down the street. And you cannot. Look, you weren't taught this stuff in dental school, right? I mean, so this is why you need a coach. They're not expensive. It's the best investment you will make. Believe me. You spent more on your lab five times your lab bill. You know, whatever. I'm just telling you, you have to do it. It doesn't have to be me. I don't care, by the way, I only have room for, like, three more clients if anybody wants to call me, so you know.

Noel Liu:
Exactly; with that being said, how did it get a hold of you?

Charles Moser:
The name of the company is Blue Horse Personal Development, and the website is www.bluehorsepersonaldevelopment.com or bluehorsepd.com is all one word, of course. Now, my friend and partner, Doctor Tarek Aly, and I are about to launch a new program, and I really can't say much more other than the first 30 people who get in will get in at a 60% savings.

Noel Liu:
Wow.

Charles Moser:
So here's the deal. If you go to my website, www.bluehorsepd.com, and you just reach out to me, you just do that contact me page. I will put you on a list to reach out to you in May, and you will be first up to be one of the first 30 people. We will not sell your information. I am not fishing for emails. I just can't tell anybody really anymore about it. But it'll be some of the biggest powerhouses in dentistry. Might even be Doctor Liu involved in this. And it is going to really stand the dentistry world on its ear. In www.bluehorsepersonaldevelopment.com just send me your email. I'll put you on the list. We will not sell it. We will not solicit you. We will just offer you first into this new opportunity.

Noel Liu:
So we'll definitely have the link us as well and the URL as well on the pod. So,

Charles Moser:
Oh sure.

Noel Liu:
Awesome. Absolutely. So let's land the plane. Well, thanks again, Doctor Moser. I mean, it was a great honor to have you and share so much insights. Great, great nuggets that you dropped.

Charles Moser:
The pleasure was mine. No, it was great to see you again. And yeah, I hope your listeners got something out of it that they can use.

Noel Liu:
100% I think they did. So, with that being said, thanks again for joining us on our Secure Dental podcast. Make sure to like and subscribe, and we will be back next month with more episodes with great talents, just like Doctor Moser.

Noel Liu:
Thanks for tuning in to the Secure Dental podcast. We hope you found today's podcast inspiring and useful to your practice and financial growth. For show notes, resources, and ways to stay engaged with us, visit us at NoelLiuDDS.com. That's N O E L L I U D D S.com.

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About Dr. Charles Moser:

Dr. Charles Moser is an executive business coach for dentists. His 16 years at the chair and over 15 years in the DSO space give him a perspective that has helped many dentists/ owners build and expand their businesses the right way. 

Whether you are looking to grow or maximize your current situation, Dr. Moser can help. 

Dr. Moser was a key member of the DEO team. And is a Certified Speaker Trainer and Coach for the John Maxwell team. 

He always has an interesting perspective on the state of our industry but will never waiver in his belief that quality patient care and an excellent experience should be the primary focus of any practice.

Things You’ll Learn:

  • The dentistry field is rapidly consolidating and morphing into powerful entities. Understanding this trend is key to positioning your practice for success.
  • The quality and vision of leadership are pivotal in driving any dental practice’s success, even more so than the systems in place.
  • Balancing profitability with ethical patient care remains paramount. Dentists must commit to accountability and prioritize patient-centric decisions.
  • Navigating the trends and understand the inevitable wave of consolidation in dentistry and what it means for your practice.
  • Discover the pivotal role of effective management and why private equity may redefine your business model.

Resources:

  • Connect with and follow Charles Moser on LinkedIn and his website.
  • Learn more about the Blue Horse Personal Development here.