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Ensuring Long-Term Savings in Healthcare Real Estate

Summary:

Landlords, motivated by profit, often have the upper hand in negotiations, especially with inexperienced tenants. 

In this episode of the Secure Dental Podcast, Colin Carr, founder and CEO of CARR, emphasizes the importance of healthcare providers having expert representation in lease negotiations and property purchases. CARR specializes in tenant and buyer representation, helping healthcare providers secure fair lease terms, concessions, and overall profitability. Throughout this conversation, Colin highlights the risks of predetermined lease renewals and the benefits of having an independent advisor review leases and negotiate on behalf of the tenant. By hiring experts like his firm, healthcare providers can save significant amounts of money over their careers and ensure they get the best possible deals. 

Tune in for insider tips on how healthcare providers can save hundreds of thousands of dollars on their leases and property purchases! 

 

Secure Dental-Colin Carr: Audio automatically transcribed by Sonix

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

Dr. 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.

Dr. Noel Liu:
Hey, hey, welcome again to our Secure Dental podcast. This is another episode where we bring in many great talents from both inside and outside our dental profession. And today, we have a really, really great treat here. So before we get started, big shout out to my sponsor, DentVia. DentVia is a virtual dental administration company that assists our front desk and our office managers with back-end tasks such as calling leads, insurance verification, and all the back-end stuff, which we all hate. Definitely visit them at DentVia.com. That's www. D E N T Via.com. Now, without further ado, I'm going to jump right in. I got Colin Carr. He's the founder and CEO of Carr, a nationwide leader in healthcare real estate. Colin knows doctors inside out. He knows healthcare, and he helps us get the real estate as well as lease spaces to better serve our needs. Now, without giving out any further information, I'm going to pass the mic off to you, Colin, and I want you to do the intro and take it from there, man. All yours.

Colin Carr:
Thanks for having me. I really appreciate it. So, I've been doing commercial real estate for over two decades now. I started in real estate when I was 19. I got out of high school and was not sure what I wanted to do, but I knew I was fascinated with real estate and a few other things, so I jumped right in.

Dr. Noel Liu:
Did you say 19?

Colin Carr:
Yep, yep. So, I started managing apartment complexes and doing a lot of property management. And then, I got into brokerage, like helping people lease and purchase when I was 22. And the first company I worked for was basically a tenant-buyer firm, mostly for like large retailers. So we did Walmart, Wendy's, fast food like Wells Fargo, Blockbuster. We had a coffee franchise that competed with Starbucks, so it was stuff like that. I did that for a couple of years, enjoyed it, but I started just by default. I started working with a lot more business owners. I started doing office and industrial tenants, and then I found myself involved in a handful of medical and healthcare deals, and I had a couple clients that I'd worked for that owned industrial buildings, that purchased some medical buildings, and so I got thrust into the medical space just by default. And I realized that I really liked working with healthcare providers. And so I started doing more and more healthcare, more and more medical, and I got to eventually to the place where I was doing almost exclusively healthcare. And I had a series of deals that happened sequentially where, I knew this is how the game was played. I had lived it, I had done it. But just for me, I had this epiphany like, hey, we need to adjust the business model and shift how we're doing things differently. And so I'll give the quick little story about, you know, I had a couple of medical buildings that I was listing. I actually had quite a few, but I had these specific ones that I was listing for this landlord, and we had a couple doctors who had leases coming up for renewal. So they'd been in the property for a long time. They had thriving practices, and I was talking to the landlord, who was a large publicly traded REIT that owned the real estate, and the asset manager called me one day, and he said, hey, let's talk about Doctor So-and-so's lease. It's coming up for renewal. And he said, have you met with the doctor? And I said, yeah, I met with them last week. And he said, does he have a broker? And I said, no, he's doing it by himself. Then he asked me, does he know the market? And I said, you know, he thinks he does, but he doesn't know the market even close to what he should. And then he asked me, do you think he's willing to move? And I said, I know he's not willing to move because he told me that he shouldn't have told me that, but he told me that. He told me he didn't want to move and he couldn't move. And so he was already paying like $4 or $5 a square foot above what we were asking for new tenants at the property. Like, if this guy would have just gone on our website and looked at the marketing materials, he would have seen we're marketing spaces that are vacant in the building, like $4 or $5 a foot below what he was paying. And the landlord says to me, go back to him at a lease rate. That was another like $4 or $5 above what he was currently paying. And so I'm like, well, that's going to put him like literally $11 a square foot above market, like $400,000 or $500,000 in excess rent from what he's going to pay over the next 7 to 10 years than if he was at a competitive lease rate if he knew what he was doing. And the landlord just said to me, he goes, get it done, or I'll find someone who will. And I got it done, got the lease done. And the interesting thing is the doctor didn't even know he was overpaying. Like it wasn't like he was kicking and screaming and yelling and sending, you know, bad emails that people and he didn't even know, he literally just signed off on the lease and went back to his business. And so I had a couple of those scenarios where I just watched landlords just completely manhandle these doctors. And the landlords were professional negotiators, professional investors, and then they were hiring me as a professional negotiator. And then the group of us is going up against these doctors that are incredibly intelligent. Like, you can't become a dentist or a physician if you're not intelligent. But they had no idea how to play the commercial real estate game, and it is truly a game. So, after a number of those deals, I just realized it is a fair fight. Both sides are ready, willing and able. No one forced the doctors to lease a space or to sign a lease. But I just realized that these guys need our help. So 2009, I launched our company, which is called CARR, and the idea was we would do only healthcare, and we would do only tenant and buyer rep. So we'd always be advocating on behalf of the doctor that the practice and we would eliminate conflicts of interest. We wouldn't have one person pretending like they're working for one party, but they actually have a fiduciary with the other. We just draw a clean line of separation where only on the doctor's side. We're going to protect their interests, level the playing field, help save them a couple hundred thousand dollars per deal, if not more, save a ton of time, and we launched it in '09. And today, we're now licensed in all 50 states. We have over 5000 clients that we're doing. I think actually we have over 5500 clients that we're actively doing work for right now where we're helping them renegotiate a lease, buy a property, start a practice, what have you. And our whole focus is just protecting the doctor's interests and helping them to maximize their practices' profitability by getting the best possible terms.

Dr. Noel Liu:
So you've seen both sides. I mean, you know, that's a big, big, huge plus because you were working for the other side before. So you know exactly how these guys are going to be treating, you know, us professionals. And then now you're working on this side. So, what do you think has changed? Like, you know, from the time when you were working for them in this time. Is it like pretty much the same deal if it's a, you know, owned, like, let's say, real estate or if it's like a mom and pop owned real estate, or do you see like a difference in like how they handle their leases?

Colin Carr:
Yeah, you know, I mean, there's definitely different types of owners. You get somebody that maybe inherited a building, it's their only property, or, you know, maybe their parents own the property, and then they inherited something like that. Then you get these guys that are, you know, maybe they own a building or two, or maybe somebody bought a property for their own business, and they're leasing it out to a few other tenants. So they kind of know what's going on. And then you get into this realm of like just truly professional landlords, like institutional landlords, whether it's a REIT or it's an insurance company or just a very well capitalized investment group. And so you deal with different tendencies as far as how they operate. But the one thing that's the same, no matter who you're working with, is everyone wants to make the most amount of money they can. And this is not like limited to landlords. Like no dentist wants an insurance company to reduce their reimbursements. No dentist is going to tell an insurance. No dentist is going to tell Delta Dental. Hey, listen, if you guys want to pay me 20% less next year than you pay me this year, it's not a problem. Like everyone wants the most they can get. You want to do it with integrity. You want to do it fairly, but nobody wants to have their money. Give them an average yield, you want the highest return from the stock market. You want your 401K to push out the biggest returns. And so it's a really obvious game when you think about it. But a lot of doctors approach landlords as if the landlord actually thinks that they care about them. Like, landlords will say stuff like, you've been a great tenant, we want to keep you, we'll treat you fairly. And they're saying that so the doctor puts their guard down and then signs off on a lease where they overpay by a quarter million dollars in a 5, 7, or 10-year period. So, the tactics haven't changed a whole lot. You get savvy landlords that want to make as much as they possibly can. They might even be a patient of the doctor. They might send them a Christmas basket. They might take him golfing every couple of years to try to keep that relational equity there, so to speak. But at the end of the day, these landlords, they want the highest return. They want to make their properties worth as much as they can. And that only comes through increasing lease rates, reducing how much you give in concessions. And so landlords are savvy, and they play the game well, and they are in it to make as much as they possibly can.

Dr. Noel Liu:
Great. Let's talk about this here, like renewals, lease renewals, like a lot of the misconception, is like, hey, you got this two five-year options or, you know, coming up, is that somewhere whereas a tenant we can still negotiate, or is that set in stone?

Colin Carr:
Yeah, that's a great question, truthfully, because a lot of people will get a lease renewal option, and there's two main types of options on a lease renewal. There's one option where you have predetermined lease rates for a predetermined amount of time. So you might do a ten-year lease and then have two five-year options to renew. And then, in the lease, it will say that the first five-year options would be maybe year 11 through 15. It'll start where your ten left off with a 3% increase or a 4% increase. And so year ten ends, and then it just ratchets up for the next five years and keeps going up. So a predetermined lease rate over a predetermined amount of time. The other type of lease renewal option is what we call just an option, where the landlord has to negotiate with you in good faith. So typically, I'll say things like then market rents or to be negotiated terms, that's typically a much more favorable renewal option because when you just sign off on that predetermined numbers, like on a five-year option with set lease rates, number one, you're probably above market. I mean, most leases have an annual increase, and that annual increase outpaces inflation. Now, we've had record inflation the last couple of years. But even so, typically, those leases increase at a rate each year. That outpaces where the lease rates would be if you vacated that space, what would the landlord go to market and try to release that? Typically, you're paying more than they would charge a new tenant. So we've got to get that lease rate back down to a competitive lease rate. And then, on top of that, savvy tenants don't sign off on lease renewals without getting concessions, free rent, renovation allowances. And so if you just exercise a renewal option and you're an above market lease rate and you get no free rent, no build out or renovation or tea allowance, you probably just lost $100 or $200 or $300 grand like that. Starbucks is not going to sign another 5 or 10 years and give a landlord another 5 or 10 years of guaranteed cash flow and make their life super easy. They don't even have to release the space. They just sign a document without capturing concessions. So savvy tenants need to realize every economic concession that's on the table, for a new tenant, doing a new lease is on the table for renewal. Why wouldn't it be? It's the cheapest, easiest, fastest with the least amount of risk deal a landlord could do. Why would a landlord not give you some level of concessions? Yet landlords tell tenants all the time, oh, we don't do that on renewals or.

Dr. Noel Liu:
Right, right.

Colin Carr:
Stuff like that.

Dr. Noel Liu:
But you've seen it happen, right?

Colin Carr:
... everything.

Dr. Noel Liu:
Right.

Colin Carr:
And that's the thing. When you deal with institutional landlords like the REIT that we were dealing with on that one specific renewal that I mentioned earlier, they had budgeted like they had literally several months of free rent budgeted. They had commissions for the tenant to have a broker even though they didn't. So, I got a double commission on that one as the landlord agent. They had free rent; they had a lower lease rate scheduled. And then when the tenant didn't have a broker, didn't know what he was doing, and wasn't going to move, the landlord was like, I'm not going to give this guy anything. In fact, I'm going to charge him a premium. So that deal, literally, if that doctor would have had an expert advisor helping him, he literally could have cut his rent down to $10, $11 a foot lower. He could have gotten 4 or 5 months of free rent. He could have gotten enough money to fully renovate, like flooring, paints, you know, upgrade some millwork, you know, window treatments, lights, etc., and instead, he just signed off on it.

Dr. Noel Liu:
So in a case like that, is a doctor paying you guys a commission there or is it the landlord still?

Colin Carr:
That's the beautiful part of it is commissions and commercial real estate are paid just like residential real estate typically is paid. They're paid by the landlord. And so, like in residential, anyone who's ever bought a house that's hired an agent or broker to help them, they know that the seller has a commission set aside for the deal, and they offer half to their agent, the listing agent, and then they offer half to the buyer's agent because they're trying to attract agents to bring them, buyers. Commercial real estate is the same thing. Landlords want tenants, they want to lease spaces, they want to sell spaces. So they hire brokers typically, or they do it internally. And there's almost always a commission set aside for the buyer or the tenant, in this case, the healthcare provider, to have representation. And if the healthcare provider doesn't, the landlord's agent just gets a double commission. So it's not hard to figure out why a listing agent would want to make you think they're helping you, but they're actually not. Or why the landlords would say things like, hey, if you don't use an agent, we'll give you a better deal. I mean, it's complete nonsense. Like literally what they're saying is if you don't use an agent, I'm going to save myself the money, put it in my pocket, and then I'm going to overcharge you by $200,000 but make you think you got a deal.

Dr. Noel Liu:
So and so. Let's say, if the doctor wants to renew now, right? And they want to look for some sort of representation now. So that would be the doctor's responsibility then, correct?

Colin Carr:
Correct, yeah. Because the landlord's not going to say, hey, call Colin or one of his guys because the landlord knows that we're going to hold them accountable. We're not going to disrespect them. We're not going to take advantage of them. But the landlord knows I can't pull the wool over this guy's eyes. I'm going to have to treat him fairly because Colin knows the market. He knows what other landlords and sellers are willing to do, and he's not going to allow the doctor to take a bad deal.

Dr. Noel Liu:
Love it, love it. And what happens, like, in a predetermined renewal when you're doing, like, let's say everything is figured out, is there a room for some sort of negotiation there, or is it like?

Colin Carr:
Yeah. So the best way to handle that, that's a good question to kind of bring this all together for this topic. The best way to look at it is contact an expert real estate advisor that specializes in healthcare tenant-buyer rep. Let them look at your current lease and the renewal option, and then let them do a market evaluation for you. If, for some reason, that option to renew actually is competitive for some reason, let's just say that your original lease was so competitive, and the renewal option terms are so far below market. Just because the market's gone up so much, there's a possibility of just signing that renewal option could make the most sense for you and waiving any options for free rent or TI, because the lease rates are so much lower, and the landlord would not give you that lease rate if you negotiated. But typically, you're better off to waive that option and just have your agent rep negotiate a brand-new deal. Because here's the reality. The tenant might say, well, yeah, well, I don't want to move. Here's the reality. The landlord doesn't want you to move worse than you don't want to move, like the landlord doesn't want a vacant space. If the space goes vacant, they're going to spend 9 to 18 months waiting to release the space. Then they're going to have a new tenant come in. That's not going to sign off on a bogus lease rate and pay above market like you are. They're going to be more competitive, and they're going to negotiate harder. And so the landlord's going to have to bring that lease rate down to get that space leased. Then that new tenant is going to want to renovate the space anytime. I don't care how nice the space is when someone moves out of it. You see every floor. You see, the flooring needs to be replaced. You see, all the walls need to be touched up and repainted. You see chips and cabinetry. And so that landlord is going to sit vacant for 9 to 18 months. They're going to end up with a lower lease rate, typically, for a new tenant, they're going to have to give free rent and other concessions. The landlord would rather just have you stay in that space, sign a renewal. And so, the game plan is to educate the landlord on we know how the game is played. You're going to lose $100, $200 grand if our client moves out. We're not trying to take advantage of you, but you've got to give us a fair deal. It's got to be you winning and us Losing is not a fair deal. We've got to both win. You keep a tenant, you dramatically reduce your risk factor of having a space go vacant for a longer period of time that you want. You cut down your exposure on what the new deal will cost, but you've got to give us concessions. You got to give us a fair deal. And when savvy landlords know that you know how to play the game, they just cut to the quick. It's kind of like if an attorney is working with another savvy attorney, they talk to them totally different than if an attorney is talking to someone who's not represented, like they know that the other attorney is not going to play that game. If the IRS is doing an audit and they're talking to an individual, they're going to talk to them differently. If they're talking to a savvy tax advisor, it's just it's not hard to figure out. Judges talk to attorneys different than judges would talk to an unrepresented person. And so it's not to escalate it to a lawsuit or to a tax, a tax situation, or an audit. But it's just one of those things where the landlords are asking themselves, is the tenant in the know, or can I get whatever I want to accomplish here? When they know that the tenants are represented, they just handle the entire transaction a lot more intentionally with respect. And ultimately, you typically get better terms.

Dr. Noel Liu:
That's huge, man, what you just said. I mean, it just makes total sense what you just said because this is like kind of deal like where you're going to be saving them so much capital upfront and along the way that is automatically going to pay for your services.

Colin Carr:
Yeah, it does. I mean, people always say, well, they'll say, all right, well, if the commission is built into the deal, can I still save money if I'm not? And it's like, no, because you're not the one cutting the check as the commission payer. Like if you were the landlord or seller, sure, you could choose not to pay commission or only to pay one. In that case, you would save money. But if you're the tenant or the buyer and the landlord is paying the commissions, you're not saving money by going it alone. You're literally just patting the landlord's pockets, or the listing broker gets a double commission. So the best example I can give you is this: every single dentist who has patients that have dental insurance, they run a report like in the, towards the end of the third quarter of the fourth quarter. And they see which patients still have benefits they have not used yet. And then they contact those patients, and they say the patient will call them and say, hey, listen, you've got enough money to do this, or let's get that filling taken care of, or let's get this done. Because if you do not use it, the insurance company is not sending you that check if you don't use it. They're not going to pay me for the unused portion. They're not going to reimburse you for the unused to use it or lose it scenario, right? And so that's the best example I can give is if you don't use a broker, the landlord just keeps it or pays their broker a double commission. And so it's really when dentists would look at how many patients didn't come in and use the remaining benefits that year, they're like, man, you just lost it, and so there's really no reason not to.

Dr. Noel Liu:
Exactly, exactly. Well, that was such a great nugget that you dropped. I mean, I think this is something which we should highlight, definitely. So, let me ask you this here. Why healthcare? And how do you know so much about dentistry?

Colin Carr:
You know, I've done a pretty broad segment of real estate. I've done the large retailers like Walmart. Like we said before, I've done large international companies like Honeywell and, you know, large publicly traded companies. I just liked working with the doctors. We definitely do large groups of practices and people that have dozens or hundreds of locations, and those guys function on a more institutional level, but I just like to work with the doctors. I remember the first dentist that I helped save him like $350,000 on a leash. You know, he'd been trying to negotiate with his landlord, was getting just completely annihilated in the negotiation. And someone said, hey, bring Colin. He did. I saved him $350,000. Like, that was super meaningful for me. I got him a nicer space. A bigger space saved him a ton of money. And just from a relational position, it was more meaningful to me. And then Walmart saving a little bit of money. That's great. But they don't really care. Like, right? You are a number to them. Where for me, my very first dental deal. I wasn't a number. The guy really cared about me, and I was it was very intentional about how Pam and I knew that it would make a difference for him and his family, and so for me, it just felt more meaningful.

Dr. Noel Liu:
I love it, so I have an example for you. I'm looking at a practice right now, and the space is leased. The practice is for sale, right? And what would you recommend, you know, going over there, speaking with a landlord directly or somebody like your caliber, going in there and looking at the lease for us, what's in place, and what needs to be done?

Colin Carr:
Yeah, that's a great question. So you never want to talk to a landlord until you know what's going on. And people say, well, I'm just going to ask them to send me this or that. Don't do that. Let the current practice owner give you their lease, or the practice broker give you their lease. That's step number one. Step number two would be to have someone like me or someone else review the lease for you and then give you feedback on the quality of terms. It's again, it's not uncommon when a lease is getting ready to renew in a year or two for it to be above market, so we're not concerned if it's above market. That doesn't stop a transaction from happening. It just gives us insight into what's available as you move forward. Now, if that doctor just signed a new ten-year lease and there's nine and a half years left, really, the only reason you're evaluating is just so that you have information to realize if you have a good, bad, or average lease. But if that lease is coming up for renewal in the next year or two, or it's coming up for renewal in six months, and you're going to have to deal with it, then the person you're talking to can say, let's put together a strategy and figure out how to get you back to a competitive lease rate, or let's figure out how to get you money to renovate the space. It could be a fair lease rate, but the space could need some upgrades. And so that stuff's all on the table. Sometimes, people buy a practice. Ten years left, seven years left. You just inherited. And then you live to fight another day. You wait till you get inside 12 or 18 months in the future, whether that's 5 years away, 8 years away, and then you renegotiate it. But if there's a chance for you to renegotiate that lease in the next, you know, year or two, probably you're going to be doing that simultaneously to buy into practice. And then a couple other quick pointers. You don't want the current doctor renegotiating that lease for you. Okay. They're not going to be there. You want to keep them out of that process. You also do not want the practice broker renegotiating that lease for you because they do not work for you, right? They have a legal obligation to help the selling doctor make as much money as possible in the transaction, and they might make you think that they're helping you because they're giving you information, and you can call them and ask them questions, but that's not your advisor, right? This is a person who has a legal obligation to help the selling doctor maximize their profitability. So you want an independent, neutral person that's not tied to the landlord, that is then tied to you. And that person will help advise you. Talk about how to handle the process. And again, ultimately, it's the same scenario. This current landlord does not want to lose any tenant, whether it's the current tenant they've known for 5, 10, 20 years, or it's you coming and buying the practice. They don't want a vacant space. And so we just want to make sure it's a fair trade. Good terms. And if we need to renovate the space, if you're going to get that landlord another 5, 7, or 10 years, that landlord needs to contribute financially to the deal.

Dr. Noel Liu:
Awesome. I know you mentioned about like you're helping like big groups as well, right? It's DSO, one of your specialty as well.

Colin Carr:
We do a lot of DSOs. Yeah, we do a lot of DSOs, MSOs, VSOs on the veterinary side; we do a little bit of everything. Our bread and butter has always been the sole practitioner, individual doctor, whether they own a practice or 2 or 5. But we have so many clients that we've taken from 1 to 20 practices, or 1 to 10, that we've just entered that space kind of automatically by the nature of how we help them. But we also do a lot of DSOs as well.

Dr. Noel Liu:
Great. Well, Colin, I mean, this is huge, man. I mean, you've changed my mind about getting help.

Colin Carr:
Yeah. I mean, there's a lot of analogies I could give, and people don't usually think this way, but, I mean, it's not hard for a dentist to look into someone's mouth and to see if they have a receding gum line. It's maybe not as obvious for a patient to see their own receding gumline or understanding what's going on. Most patients aren't going to be able to tell you if the color of their gum is right or if it's incorrect. You X-ray their teeth, and you can tell if you need to put a filling in or not, or if the roots that I mean, you just know these things because you have the instruments and tools, and certainly there's a very specific skill set that you employ when you perform the work. But analyzing someone and saying, hey, listen, we have too much crowding here. This is not right. We need to remove a molar. Like that's what you do every day. A really good real estate agent that knows the market, that understands how healthcare, real estate deals work, that understands the landlord's motivations. They're going to be able to analyze your situation very quickly, and then they're going to give you information and give you options. So no one makes the decision for you. No one forces you to sign a deal or not sign a deal. They're just arm you with information saying, let's come up with a game plan. Like if you want to stay in the space, that's great. But we've got to have other options that we compare it to. We've got to know what it looks like if you wanted to own real estate and purchase. If you want to look at multiple locations to expand, like we can't just pick one property and negotiate with one landlord; we've got to go at the entire market, look at 4 or 5 options, eight options, and then negotiate with 3 or 4, because we don't have a basis to compare any deal unless we have multiple options. Like if you pick one landlord and you start negotiating either on a renewal or a new deal, the only basis you have for comparing the terms are where they started versus where they end. But that's a terrible way to measure the deal. If you look at eight properties and you can do that literally in an hour and a half, two hours, you don't have to spend half an hour on every property. You can do it very efficiently. And then if your agent negotiates with 3 or 4 landlords simultaneously on a non-binding basis, if one landlord is giving $50 a square foot and build an allowance, the next one's giving $45, the next one's giving $55, and then one tries to say, we'll give you $10 a foot. Well, ten is better than zero where they started. But that's a terrible deal. You're leaving literally $180,000 to $200,000 on the table. And so having that information just helps you realize this is what's possible. And you can get away from things like, well, we never do that, or we've never done that before. That's not how the game is played. I wish I could, but my bank won't let me. Like, landlords throw all these like completely arbitrary and unilateral statements that have no basis, and then they're waiting to see if the doctor honestly is ignorant enough to believe it. And typically, they are. And so when you have someone who's savvy, they're like, that's if that's your stance, you don't have a deal to make here. We're going to move on to the other three landlords that are competitive. When they hear that, they instantly change their tune. And here comes the revised proposal with what you asked for. And so it sounds, you know, pretty straightforward. But it takes a strategy and it takes a way of saying things. So again, it's always done with respect. It's done with dignity and integrity. But if you don't hold the landlords accountable, they will steamroll you, and they'll do it with a smile on their face. And they'll send you a Harry and David gift basket with some pears after you signed a lease. And I've never had a landlord send me a gift before, and it's like, yeah, you just overpaid by $300,000. Like they're $40. Harry and David basket saved them, you know, saved them $300 grand. Like, it's amazing the way that people don't see what's actually happening.

Dr. Noel Liu:
Now, one last question for you. So we spoke about leases. What about triple-net? Like a lot of times, I see like these leases, they have like humongous admin fee management fees. Like they just kill it. I mean, like, they're almost equal to the size of the rent on the lease itself. Is that negotiable or is that just set in stone?

Colin Carr:
It's very hard to negotiate triple-net leases. It's very hard to negotiate any of the operating expenses. But what you can do to make sure that you're not setting yourself up to get taken advantage of is start by just asking for a line item breakdown of the operating expenses. And that plays whether it's a full-service lease or a modified gross or a triple-net lease, because what you're going to get from most people that are running their properties properly is you're going to get a like an Excel spreadsheet or like a QuickBooks printout, but it's going to have everything, and you're going to see the property taxes, property insurance, property management, and then you're going to see like historicals on electrical, on water and sewer, on janitorial, on landscaping, on snow removal, and then you can start to get a feel for if these numbers make sense. If you see a management fee, and the management fee is, let's say, the equivalent of like $1, $1.50, a square foot on the property, that's a regular fee or a 3% fee. That's a fair fee. If they're charging, you know, a 20% management fee, that's probably going to be egregious, and it's probably going to be an unrealistic amount of money, and the landlord's just pocketing that as more profit. So you can determine if you want to do business with those people or not, or if you want to try to address that. A lot of things, though. A lot of times, the triple nets are made up of the three-nets are taxes, property insurance, and then operating expenses. And it's not uncommon to see property taxes account for even half of the operating costs. Like our office that we have is in South Denver. It's in a suburb called Lone Tree. The taxes alone in our office space are $10 per square foot per year. I mean, you look at just astronomical and it's a complete abuse of the tax system. I'm not here to get political. I'm just saying like $10 per square foot, just on property taxes. I mean, a 4000-foot space, and we're paying over $40,000 a year to the county in taxes. I mean, that's I feel like it's personally egregious, but that helps to make more sense when you see what the operating costs are $15 a foot. Well, 10 of the 15 are taxes, so it's a little bit more palatable from that standpoint because we can't do a whole lot with the county. Then we break down that $5 a square foot and figure out all right how much that's going to utilities. That's a direct pass-through. How much goes to snow removal direct pass through. And so then you get down to the areas of management fees and reserves. Those are the two areas that may have a little bit of play. So management fees and then how much you're putting into reserves for the property, those concepts are able to be addressed or discussed. And if you're going to have any success on capping something or negotiating, it would come there. But I will tell you this: most landlords won't touch those things even when they're charging excessive amounts. They'll just say, that's the way I run the property. If you don't like it, go somewhere else. So at that point you're looking at how does this property compare to other properties? And even if it's higher than you want to pay, if it's still the best property, the best terms, it just kind of comes with the territory.

Dr. Noel Liu:
And you always recommend doing it before signing the lease, right? Getting the itemized breakdown.

Colin Carr:
Absolutely, because there's zero you can do afterwards. I mean, you can audit the operating expenses for most leases. You can ask questions, you can get a CPA involved and make sure they're not, you know, violating accounting laws. I mean, they are under accounting principles and laws. I mean, they can be found to be fraudulent or to be, you know, stealing money and so forth from the association or from the tenants. But you're just better off to do it ahead of time. Like most things, you're better to measure twice, cut once, and this is one of those areas for sure.

Dr. Noel Liu:
Well, Colin, I think that's it from my side. What else you got to add, man? I mean, you gave like a ton and ton of info. This is something which I think a lot of our healthcare providers, as well as our dentist colleagues, they'll definitely find it helpful for sure.

Colin Carr:
Yeah. I mean, the final advice I would give is simply this. Just hire great people in every area that you're not an expert in. And there's a reason that people, you know, go to an oral surgeon to have a tooth removed or an orthodontist have braces put on or do Invisalign. You go to people that are trained in an area that have a history of better results. And in real estate, typically, you're not actually cutting a check for their services, which is fantastic. But even in other areas, like you hire a really good real estate attorney, you don't hire your brother-in-law who does family law in Iowa if you live in California, like you hire people that are qualified in your area. You hire a good architect, good contractors, good attorneys. You get good insurance, you hire good marketing companies, you hire good real estate brokers like the top practices in the country. This is how they operate. And it's the same thing for the top companies like go outside of healthcare. Like Chipotle is not going to get taken advantage of on a lease because they hire the best brokers. They have the best attorneys. You know, you're not going to see Starbucks sign a bad lease. They just don't do that. Like they hire really good brokers, they know what they're doing, and they have a strategy. So if Lockheed Martin, or Charles Schwab, or any office or retail user is going to handle real estate with a very specific focus and make sure they maximize the opportunity, just do the same thing. It's literally once every 5, 7 or 10 years, no one's asking you to dedicate your entire life to a new skill set or a new career. Just hire someone who's really good. They'll help protect you. And then if they save you $200,000, $300,000, you do that 4 or 5 times over your career, and you'll find out that you've got literally millions of dollars of savings cumulatively over a 20 or 30 or 40-year career. And that's meaningful for most people.

Dr. Noel Liu:
And a peace of mind.

Colin Carr:
Absolutely. I know we're ending it, but I would say this, that peace of mind is honestly worth almost more than the savings. Nobody wants to wonder if they got a good deal or a bad deal for the next 10 years. Like having information, having the ability to just say, hey, I know that I got the best terms at the best properties that fit my budget that I could afford. That made sense, like I did the best I could with what I had. And that's a great place to be in any position, but especially in real estate.

Dr. Noel Liu:
Well, Colin, you just changed my mind, honestly. Like, you know, thinking about, okay, I need to get professionals because the way I look at it is I like to delegate all my weaknesses. Honestly, if I have an HVAC problem, if I have an electrical problem, who am I going to call? I'm not going to tackle it myself. So, like you just put it, man. You put it. I mean, like, I don't think you can put it any nicely. Because we, as dentists, we're always trying to see like, hey, we delegate everything. But when it comes to lease negotiations, we want to do it ourselves.

Colin Carr:
Absolutely.

Dr. Noel Liu:
And that's crazy. I love it. Well, Colin, hey, thanks so much for coming in. We're going to land the plane here. We'll definitely have your info there. Just verbally. How would they reach you or your agents?

Colin Carr:
Yeah. Best way to get in touch with us is our website. It's CARR.us. So C A R R.us, upper right-hand corner or on the nav bar. If you're on mobile, click to find an agent, and then you can pick your state. Pick your market. You can start a conversation with anyone that you want to. You can see different bios. Some markets, we have a lot of agents, some markets, we have a few. But you can see the different agents, or if you want to keep it simple, just click the Contact Us button. Basically, like literally, like check 3 or 4 boxes, and we'll have someone get in touch with you within a matter of literally a couple hours, and they can start the conversation. And whether you have a need coming up in the next year or two, or even if you just signed a ten-year lease, but you're just curious how you did, we'll give you the time you deserve and set you on the right course. And even if you're ten years out, we'll still give you the time, the conversations and give you a few tips in the meantime.

Dr. Noel Liu:
Awesome. Thank you so much. Appreciate all your info. All right. Great. So ladies and gentlemen, make sure you like and subscribe. We know Colin was a great, great help. Make sure you look up for his agents. And if there's anything that's coming up related to leasehold improvements or lease in itself, definitely hook them up. All right, Colin, thanks so much.

Colin Carr:
Thank you.

Dr. 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 Colin Carr:

Colin Carr is the founder and CEO of CARR, the nation’s leading provider of commercial real estate services for healthcare tenants and buyers. Every year, thousands of healthcare practices trust CARR to help them achieve the most favorable terms on their lease and purchase negotiations. Colin has been involved in commercial real estate for over two decades and has personally been involved in thousands of transactions.

Things You’ll Learn:

  •  
  • Even with predetermined rates, lease renewals offer opportunities for negotiation, and tenants can benefit from expert representation to secure better terms and concessions. 
  • Having an independent real estate advisor specializing in healthcare is essential for reviewing leases, evaluating market conditions, and negotiating on behalf of the tenant. 
  • Hiring an expert healthcare real estate advisor can save healthcare providers significant amounts of money over their careers by ensuring they get the best possible terms on leases and purchases.
  • When considering purchasing a practice with an existing lease, it’s crucial to have the lease reviewed by an expert to understand the terms and potential for renegotiation.
  • Triple-net leases, where tenants pay a portion of operating expenses, can be challenging to negotiate, but an expert can help analyze the expenses and identify areas for potential savings.

Resources:

  •  
  • Follow CARR on LinkedIn.
  • Explore the CARR website
  • Visit Secure Dental’s website and learn more about them!  
Categories
Podcast

Resilience and Revolution: Transforming Dental Implant Success

Summary:

From navigating intense surgical training to developing cutting-edge AI solutions, this conversation reveals a remarkable journey of innovation, perseverance, and redefining success in healthcare.

In this episode of the Secure Dental Podcast, a renowned oral and maxillofacial surgeon and founder of WiseImplant, Dr. Dan Kopeliovich, talks about his professional journey, including his education and training in maxillofacial surgery, his experiences with challenging work environments. After relocating to Washington, DC, he founded WiseImplant, an AI platform designed to help oral surgeons improve implant success rates by analyzing data from patients, implants, and surgeons. Dr. Kopeliovich explains how the platform operates independently of implant manufacturers to ensure unbiased results and aims to enhance implantology outcomes through real-time insights. He currently works at a high-end dental clinic in Cancun, Mexico, where he performs advanced surgeries for international patients.

Tune in as we explore an inspiring journey filled with personal insights on innovation, overcoming challenges, and redefining success in healthcare!

Secure Dental_Dr. Dan Kopeliovich: Audio automatically transcribed by Sonix

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

Dr. 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.

Dr. Noel Liu:
Hey, hey! Welcome everyone, again, back again to our Secure Dental podcast, where we bring in many different talent from the dental industry as well as from outside. And today, we have a great, great treat here for you guys. I have a special person, Dr. Dan Kopeliovich. I hope I said it right.

Dr. Dan Kopeliovich:
That's the right way.

Dr. Noel Liu:
There you go. And Dr. Dan is from Israel, Tel Aviv. He is an oral maxillofacial surgeon and founder of WiseImplant. Now, before we get started, I just want to give a shout-out to our sponsor, DentVia. DentVia is a virtual dental administration company that supports our front desk, our managers, all the back-end tasks, such as insurance calling, verification, call leads, etc., to help supercharge our front desk in our dental offices. So visit them at www.DentVia.com. Again, it's www. D E N T V I A.com. Now, let's get to the show. Dr. Dan, tell us a little bit about how you got started, and give us a little bit background about what you did in Israel.

Dr. Dan Kopeliovich:
First of all, I know I'm really excited to be here. And, you know, I feel like a 16-year-old before a new date.

Dr. Noel Liu:
There you go.

Dr. Dan Kopeliovich:
All the flight and fight symptoms and dry mouth and stuff are really excited and happy to be here, and it's really exciting. So, and it's a much honor, you know, especially after completing my high school in Israel, the course of slice of life is a bit different. I did my military service. I was an officer in a combat unit. And then, I went to find myself in South America for around a year. So, essentially, around '22, '23, I decided to start learning something, and the, but there was a problem. I wasn't a good pupil in high school, so my grades were. And how to say it, not the best in the class, more of the less than average. But we have really good courses in Israel that a pre-academic in the university itself. And I went to one of these programs, and they, I finished it for one year. And this way, I managed to enter the dental medicine faculty, and I finished it in the Hadassah in Jerusalem, Israel, in the Hebrew University. And then, I won't lie, I didn't connect to the general practitioner or the general dentist's work. It was really hard for me. I know something with my maybe perfectionism or, I don't know, something didn't work out, like trying to do a crown for 2020 or something. I will say, it was awful. And I was thinking to myself, I'm trying to be short. Yeah, but it's a long story. I was thinking to myself, okay, what am I doing? I'm doing with my life. I, already almost 30, I don't know if I want this career in dentistry. And I knew that I like endo and surgery. And essentially, after I told myself, okay, Take a year to work in dentistry and then decide if you quit and go find another career, or if you go on this route and everything will be okay.

Dr. Noel Liu:
So, how old were you? You were 30 at that time?

Dr. Dan Kopeliovich:
Yeah, I was already 30. Now, in America, it's already like, really old person.

Dr. Noel Liu:
Oh, no, no, no. ... School. Okay. Love it.

Dr. Dan Kopeliovich:
Essentially, I said to myself, okay, give it a chance for one year, and I worked in Syria and say, okay, no way. There is no chance I'm ... going to different career. I know medicine, maybe different stuff in computers, because I always liked computers as well. And essentially what happened is that I got accepted to a residency, maxillofacial surgeon. I tried to get to different residencies, and then I got to a residency in Ashkelon. It's a place led by a then professor .... He was a pioneer in salivary glands and endoscopy, and he has a brand name in this area. So I went to be.

Dr. Noel Liu:
What's his name again?

Dr. Dan Kopeliovich:
O... N...

Dr. Noel Liu:
N..., okay.

Dr. Dan Kopeliovich:
Yeah. He is a brand name in the, in this area of endoscopy, of salivary glands.

Dr. Noel Liu:
Gotcha.

Dr. Dan Kopeliovich:
And I started residency there and, you know, as soon as I started the residency, it suddenly like, like the sun struck me, and I was so happy. You know, I'm doing surgery. I'm seeing the patient, I have connections. Although it's really hard work, you know, with the shifts and the stress in the surgery, I liked it. I got really immediate satisfaction from the profession. And I knew, I knew, I'm in the right place. And in Israel the residency is a bit different. It's five years, not four like in the US, and you don't get a medical degree. And I knew I knew immediately that I want to go to a fellowship. And this is the reason why I pursued for medical degree as well after the residency. So think of it. I'm, I'm already like, after residency and I'm going to be a student of medical degree. And it was very awkward with the people, but I had fun with this. The only problem was that I had to already, to bring salary to my family and, you know, feed my kids. And so I had to also be a student in the morning, and in the afternoon, and the night shifts, as a maxillofacial surgeon. So, it was a very challenging era, but I managed to finish it. You know, I'm not a spoiled guy. I'm doing everything the hard way. I hope the audience understands me with the accent and my English.

Dr. Noel Liu:
No, no, no, you're doing great. You're doing great. I just want to get a little timeline from you. So you finished dental school at, how old were you at that time when you finished your dentist, your general?

Dr. Dan Kopeliovich:
I finished my dental school at the 30, around 30. And then I went to residency, and then I worked for one year, and then I started a residency for five years, and then, I'm trying to cut stuff in the middle, like, different stories that happened. But ... essentially, I finished the residency in 35, and then I started medical school. It's around four years. You have also an internship in the hospital. So it's like three years studying and then another year of internship. And this is the shortest program for maxillofacial specialists. So I finished this program and then I tried to pursue a fellowship in the United States. I did a couple of mistakes. I don't know if I should tell them, but I rejected a very generous offer that would maybe make my life much easier.

Dr. Noel Liu:
Right, right.

Dr. Dan Kopeliovich:
But I reject from a really good maxillofacial program to be like to come and do a third and fourth year, a chief, a senior, and chief. And I was stupid, you know, I was a bit tired from the studying, and I wasn't prepared to start immediately, and they wanted somebody immediately. So then, I tried to find a real fellowship program, and I found this program in, in Baltimore, University of Maryland, had a neck surgery, a really hard program. I know it's hard and every aspect, but I didn't know how hard it would be. Definitely one of the hardest things I did in my life. Not because the surgeries or the hard work that was expected from me, but it was harder because of the toxic work environment that I was seeing there. So I really.

Dr. Noel Liu:
Lots of politics, lots of politics, like basically, right?

Dr. Dan Kopeliovich:
Yeah, it was really, really, really toxic for me as a person because I don't want to go into it, but.

Dr. Noel Liu:
No, that's fine. That's fine.

Dr. Dan Kopeliovich:
It was like quite a trauma because I was like a bit in captivity because I moved all my family to the US and I didn't want. Yeah. So we were with, I'm very lucky to have a wife and three kids, and my wife also, I'm really lucky that she accepts all this crazy stuff to do relocation. First relocation, and then, so I will tell about the second relocation. So what happened is that I was a bit in captivity because I couldn't quit to go, because I knew that I need to transfer my kids back to to Israel again in the middle of the year. And I didn't want to do that. So I said, okay, I'm never giving up, you know? I'll do whatever it takes, but I'm not giving up. I didn't give up. I finished this year, and we, I know, like, divorced from the school. Yeah, so I finished one year. It's, it can be 1 or 2 year program. I finished one year. And then, I started a bit of a rehabilitation program for myself. I was sitting in Washington, DC, where I lived with my family, and thinking, what should I do next? And then I started my startup, WiseImplant. This is the place that I really decided that I want to pursue as part of my rehabilitation program, from the heart, ... I had, yeah.

Dr. Noel Liu:
So I want to know something, right? What was one learning thing that you had from that experience at that university? So that university you were like you said, it's toxic. Was it because you were burnt out? Was it because you did not really fit into the culture? Was it the people there? They had like different school of thought, like what was the thing that you felt?

Dr. Dan Kopeliovich:
I will tell you, I knew, I'm going to a toxic environment before because I talked with the other. I talked with the previous fellows. But what happened? I said, you know, I'm a nice guy, so I never had a place that people didn't like me, you know, I never encountered it. And suddenly, in the first or second week, I understand that the, I won't be specific about what were the problems, but I understand somebody doesn't like me in the first week. In the second week, I understand they really doesn't, don't like me. And the third, or about a month later, I said, okay, I think he hates me. And then I said to myself, okay. But as I mentioned before, I had to finish the year, so I stuck it out.

Dr. Noel Liu:
You stuck it out. That's the biggest thing that matters, you know, like trying to stay consistent.

Dr. Dan Kopeliovich:
And it was it was physically very tough. Very tough physically. I lived in Washington, D.C., and I was doing the commute every day at 5 a.m. to Baltimore. But I knew that, for me, I don't mind to suffer, but I wanted my family to have a really good environment and very friendly, of course, school and the environment. So I knew there is an Israeli community in Rockville, in Maryland, and so I put my family there. This is what my house and I was commuting. So also the, all the surgeries and all the 12 hours, 14-hour surgeries, all the stress, all the stuff together, and I was also commuting. It was a heck of a year, and so, yeah.

Dr. Noel Liu:
No, absolutely. I can only imagine.

Dr. Dan Kopeliovich:
... Behind me.

Dr. Noel Liu:
You left Israel, you left home, you relocated yourself, you relocate your family in a new country, in a new place. I mean, that's relentless, man. That's like being, it was really relentless.

Dr. Dan Kopeliovich:
And, you know, I'm not a very verbal guy, you know, and just recently, like one of my kids was diagnosed with verbal dyspraxia. And then, when he was diagnosed, I said to myself, wait, wait, wait, wait, let's see the symptoms. You know, how do you how do you diagnose it? And then, you know, I'm thinking to myself, I check, I have another check, I have another check, I have that, and then you figure out, okay, all your life you have this difficulty with the conversation and the verbal verbalism. And then you understand that the, you manage to overcome this also. So on one hand it's a, it's very, you know, gives you energy. You can overcome everything, you know. But on the other hand, it's hard. You know, when I'm talking with you, I know I could talk much, much like 100 times better if I didn't had it. Like, you know, the problem with it is to find the right words. The drawing of the words is really, really, really hard for me.

Dr. Noel Liu:
You're doing great, my friend.

Dr. Dan Kopeliovich:
Yeah, I'm trying to overcome. Yeah, I'm trying to compensate with different stuff, you know?

Dr. Noel Liu:
No, you're doing great, man. You're doing great. So, right now, so you found WiseImplant, right? So WiseImplant, it's something where it's an implant company. And I know, like, for a fact that Israelis are really good with implants. You know, like most of the components that I've noticed.

Dr. Dan Kopeliovich:
So I will, I'll try to explain because it's not a real implant company, especially in like elevator pitch WiseImplant is a platform for implantology for oral surgeons that want to make their success rate higher.

Dr. Noel Liu:
Okay.

Dr. Dan Kopeliovich:
It does so by our platform, that is, takes data from different sources, lots of data, analyze it with our AI algorithms, and produce your results and gives you, I will explain later, but it gives you essentially three, and based on three different pillars, it gives you what you can change and how you can make your success rate in implants higher. So this is the idea underneath of WiseImplant, and it's only the beginning. So my vision is going really far away.

Dr. Noel Liu:
What I would like to know from you is, how did you come up with this idea of finding an implant, okay, and what was the spark?

Dr. Dan Kopeliovich:
Okay, the spark was, I won't lie to you. After the residency, I started doing implants so that implants, implants, implants. Because this is the bread and butter for oral maxillofacial to implant to get, you know, to get the salary and make, you know, make your life better. So suddenly, after a couple of months, I noticed that I get failed implants, but really weird ones. You know why they like that 46 implant. It's a lower molar, perfect bone. You can take a student blind, blindness, and he can put the implant in, and it should work. And suddenly, I get cases that are the implants are loose. I take them out, and you know it. It wasn't so easy to see, but I didn't have Excel sheets and stuff that tells me, okay, you have the drop in your success rate. I had a feeling. I don't know how to analyze it. Is it 10%? 50%? It's it's very, very subtle. You know, people don't like to discuss their failures. Everyone, I'm the best, ..., 97.8 success rate. Everything is 99% success rate. Everything. Also, you know, in the, it's funny in the head and neck surgery. So when they giving the presentation, yeah, we have 99% rate success rate. We have 90%. So I learned when somebody tells you I have 95% rate success rate and above, you should start thinking, okay, maybe there is some kind of bias, maybe there is some kind of an analytical problem there. I don't believe it. Also, how do you say what is a success rate? My view is that, you know, it's different. The literature has some success with different criteria. You get lost in it, you know, so I'll go back to the story. I have this drop in the success rate very sudden, and I want to discuss with people. And usually, people don't like to discuss. But after a couple of months, I found this in a convention. I find this periodontist. And he said the, I told him, you know, I have a drop in my success rate. I had it for two months, and it disappeared, and it's really great. And he said to me, and I had to think the same thing when it did happen. And then we, we saw it, it crossed in the same timeline. And then I asked him what brand, and he said the same brand I was using. I was saying, okay, what if not? And then and then we said, okay, this is interesting. It might be the implant. Now then, I started doing some research, and the implant companies, they don't like to give you the data. They know. Usually, they know because they have the system that you give back the implant and get a new implant, right? But they don't they don't give you the data. They don't, they don't. They advertise their oh, we have a drop of 2.5% in success rate in this slot, and this slot is 5% less. No, they'll never do that. So this is the basis for my idea of doing a system that would give all the implantology, the data regarding the implants. But then it evolved, and I have a system that is based on three different pillars: the patient, the implant, and the surgeon. And it analyzes each pillar and gives you a lot of feedback for each pillar. For example, the main two pillars that we are working with are the surgeon and the implant. The implant itself, you know if there is a, it can give you like a real-time analysis if there is a problem with any lot or in any model for the surgeon. It can give it a like also alert. You know what, you have a problem in maxilla in women in the right side. And then, surgeon can start and think, why? Why do I have this problem in the right side of the maxilla? And then you can say, okay, maybe I'm pressing more. I'm drilling in a different protocol. So, this system is essentially targeted to give conclusions and asking the question for each one of these pillars.

Dr. Noel Liu:
So, in terms of your WiseImplant, what stage is it in now?

Dr. Dan Kopeliovich:
Right now, so we are fortunate enough to have a, we planned until the end of the quarter to have one design partner. Currently we have two DSOs that we are in connection. And the, in communication to start a process to enter the, our system to the DSO, we are always open for others, you know, and we're developing it to be also connected with DSO. We did a little bit of a change six months ago, and this is the reason we took a step back because we decided to go only with the DSOs.

Dr. Noel Liu:
Oh, okay.

Dr. Dan Kopeliovich:
Yeah, yeah, at least in the beginning, until we have enough data. So we are now in the process of entering a stage with 1, 2, or 3 DSOs, and then, we'll be ready to get more and more DSOs. And then, in the end of the road, also clinics and the private practices, of course. Of course, this is one of the, our goals. I hope this in the next year.

Dr. Noel Liu:
Where are these implants made? Yeah.

Dr. Dan Kopeliovich:
Noel, so maybe I didn't explain myself well. We are not an implant company. We are a company that, or a startup that analyzes the data.

Dr. Noel Liu:
Analyzes, gotcha. Okay, okay.

Dr. Dan Kopeliovich:
... Analyze all the data that we get from the different locations. We analyze all the data. And you get like all the data analyzed by our AI algorithms, and you get different maps. For example, me as a surgeon, I get all, I get my benchmark compared to other surgeons. Yeah, not, of course, everything is totally anonymized, and I think even the data that comes to our system is totally anonymous. But our system is a data system that analyzes the data and gives you insights, AI insights, and all data, but not only your data. All surgeons that work with the system and also different data from different sources.

Dr. Noel Liu:
Oh, that's awesome. That's awesome. I mean, you know, a lot of times, you don't know why the implant failed, right? So that's a really, really great help. So are you working with like, any implant brand to give the data from?

Dr. Dan Kopeliovich:
No, we don't work with implant brands. And I'll explain you because we don't want to have involvement of this medical industry in our company. Our company is based for doctors and patients to make their lives better. We don't want money. We don't want money. And we don't want data from the implant industry. No, no. It's, totally need to be blocked because we want to be really not biased for the success rate and the quality of the implants. You know, imagine yourself that I can, I'm proving in real life that an implant that costs $400 has the same success rate as an implant that costs $100. So I don't want connection with the industry. I want connection only with the doctors that are implantology that put the implants, and that's it with the patients and make the patients' lives better, you know? Like if you raise the success rate of implant, you know, there is only in the US like 3 million implants a year annually, and you raise it by 1%. It's it's a crazy effect and we can do that. We are definitely there. And in my vision, in three years from now, a patient comes to your clinic, and you ask him, okay, you do all the medical analysis, and he says to you, I'm a diabetic. I had I was smoking seven years ago, one pack. And the system analyzes all the data from the patient and says to, okay, for this patient in the maxilla, you need to take this implant with this drilling protocol, with this amount of newtons of insertion. And you need to wait this amount of time and use this kind of abutment and stuff. So I want the system to be tailored for the patient, for his higher success rate, especially for the complicated all the diabetes and all the smokers and all the patients that has more failure rates, yeah.

Dr. Noel Liu:
So, hey, doc, walk me through the process then, how does somebody start this process? Like if they say, hey, I want to see if I can get the data or if I want to tailor it to my needs, what would be the start-up process to get involved?

Dr. Dan Kopeliovich:
We are now in a phase that we are working. We are trying to work only with the DSOs.

Dr. Noel Liu:
Right, right. Let's see, if there's a DSO that starts, right, what would be the process?

Dr. Dan Kopeliovich:
Yeah, so they can, because I'm the like the founder CEO, and they can contact me, or we are also on a website and or my LinkedIn or the company's LinkedIn or whatever.

Dr. Noel Liu:
Gotcha.

Dr. Dan Kopeliovich:
And we start, you know, some kind of expectations what the DSO wants to expect. We don't sell, you know, everyone that in the industry knows that I'm, it's not my first entrepreneurship. Noel, I'll tell you about, when I was beginning medical school, I developed an app for measuring CBCT ... So many countries don't have CBCT in office, especially like ten years ago, they had CBCT in specialized centers that you send the patient to a center, it takes the x-ray, and you get a report. Usually the report was a PDF, a PDF file. So I developed an app that you take the PDF file and you can do the measurements. You can put the implants and stuff, and I developed it by myself. I didn't have too much time because I also was in medical school, and all of us were working, but it was very, very popular in third-world countries, Yeah, Israel, in Brazil, and the different countries, and really a lot of people used it. So, this is not the first time I'm developing something in technology. So I already have an understanding of this world, you know. And the people are very good in marketing, so I'm not good in marketing. No. And I'm saying that, you know what, you know, the real world, there is also shit in the real world. And I'm saying it in front, you know, and so it's very important for me to speak with the DSO to explain them the system, to see what's their expectations. And then, if it's a match, we can go forward and, and put our platform in their systems, and they see, probably, I hope so, they will be very happy with this. You know, I think that in analyzing the data is a key issue in our world today. And we also have a problem with too much data. And we can, you know, narrow the data so exactly what you need.

Dr. Noel Liu:
Oh, that's great that you clarified because I thought it was a company, right? And so, basically, you are basically just doing the data, so that is so awesome. I don't think anybody else is doing that.

Dr. Dan Kopeliovich:
I never really found a real competitor, like doing the same, right? No, I didn't find it. There is something and then, but it's a bit far. So it's, it doesn't match to what we are planning and what we are doing here. Definitely.

Dr. Noel Liu:
So right now, where are you based? Where are you at?

Dr. Dan Kopeliovich:
... I never know. You're never gonna guess. After I started working on WiseImplant and essentially I'm, I wasn't working and the developing, and then, while being in Washington, I got a job offer at a really crazy place, and, your audience won't guess it, in the real world. So I gathered, I will make it short. I got a job offer in Cancun in Mexico. It's like a high-end dental clinic that treats patients from all over the world, mainly from the US and Canada. They are coming as medical tourism, and I'm here at the maxillofacial to do the bigger surgeries, the bone grafts, the all on four-on-six orthognathics, and stuff like that, and yeah.

Dr. Noel Liu:
So that's really what you do a lot now, right? In Cancun?

Dr. Dan Kopeliovich:
Yeah, yeah. And the, mainly, I was tempted by the work-life balance here in.

Dr. Noel Liu:
Tell me a little bit about that. Tell me a little bit about that. How's that going?

Dr. Dan Kopeliovich:
I want to speak out too much, you know, not to do, curse my stuff. But I start work at 10 a.m., and I finish, usually no later than 2 or 3.

Dr. Noel Liu:
Yeah? Wow.

Dr. Dan Kopeliovich:
And the environment is really, really nice. My, the founder of the clinic is great. And we are really, you know, working together, and the team there is a great team of a multi-discipline team with a periodontist, endodontist, and everything. And we are, it's really, it's fun and great to work here. And also the fun stuff, you can be with your family, and there are beaches and the attractions that I like it. So I'm really lucky that my wife is going with me on this crazy journey, and this crazy journey, yeah, and relocations.

Dr. Noel Liu:
Yeah. Love it, love it. Hey, listen, man, you went through a lot, right? You came from Israel. You went through that school, and it was brutal. And then you came out, and then you still been like, you know, just, like, consistently hitting it hard. I think you deserve a little break, right? So I love it. Love it. So tell me, what is your future? What is the future for you now? What's next? What's your next chapter?

Dr. Dan Kopeliovich:
I think I'm a, because I have a really good work-life balance here in Mexico, I can have more time to put invest in WiseImplant, and I really want this project to succeed, and this is my main goal to the next year or two. And then, you know, in the future, I don't know, we'll see. Now in Israel, it's a bit of a messy situation, you know, I hope everything will settle down, and I really hope that the hostages will come back home. Two days ago, it was the one year of the war that began, and I really hope that they will have a quieter time. And, you know, that people will have quiet.

Dr. Noel Liu:
Yeah, some tranquility, some peace, right?

Dr. Dan Kopeliovich:
Exactly, yeah, yeah, yeah.

Dr. Noel Liu:
Absolutely. Do you still have family there?

Dr. Dan Kopeliovich:
Yeah, I have family there.

Dr. Noel Liu:
Okay, okay.

Dr. Dan Kopeliovich:
Also all my wife's family there. Yeah, I'm planning to go visit there in December.

Dr. Noel Liu:
Very nice, very nice. Well, you be safe out there. Hey, doc, thank you so much for joining in. One last question I got for you. Since you are one of those relentless people that you know, I know of, and there are very few in the world, by the way, what does success mean to you?

Dr. Dan Kopeliovich:
Wow. Now, this is a really, really hard question. Wow. This is.

Dr. Noel Liu:
Define it in your terms. Let's put it that way.

Dr. Dan Kopeliovich:
First, I want to say it's a great question. I think this question has so many layers, so many layers, you know, but sometimes you want to work in your little place and get your salary and be with your family and do your fun stuff, whatever you have. I think for myself, I think the life journey, only the journey itself, it's, if your life you have to say thank you and everything is, every other thing is a bonus. If your kids are healthy and you are healthy, and your family are healthy, it's a success. And I think also it's kind of a graph. You know, sometimes you want to be more active, sometimes you want to be more passive and everything is good. You know, if you like where you are and you have good community, good friends, this is everything. Good family. I think this is the main pillars of life, so.

Dr. Noel Liu:
I love it.

Dr. Dan Kopeliovich:
Success is not being, you know, one thing I will tell you. Success is not chasing publications and chasing gratitude from other people that will ... you and say, wow, you are wonderful. I'm not searching for it. I'm searching to be full in my heart, you know, helping people also as much as they can, and then, and being full with what you do. And I think we are very, very lucky to be able to give like all people in medical profession, you know, nurses, PTs, doctors, everyone, they can give from themselves to others. So I think it's already a success to be able to give to others.

Dr. Noel Liu:
That is such a powerful statement you just said, my friend.

Dr. Dan Kopeliovich:
Thanks. I hope it was understandable with my basic English.

Dr. Noel Liu:
No, no, absolutely. You know, like, what I always say is, if you have the opportunity to give or you have the opportunity to help, that is an opportunity in itself, and I think that is what you just nailed it in the head, so I love it. And I love the fact too, that you know, you have your family first because without family you're nobody, right? I mean, your family is everything and that is why you work so hard for so.

Dr. Dan Kopeliovich:
Yeah. I'm trying. I'm trying to go on. It's not easy, yeah.

Dr. Noel Liu:
Hey, thank you so much for coming on my pod. And, you know, this was such an amazing story that I got, you know, you shared with us, so I really appreciate it.

Dr. Dan Kopeliovich:
No, it was, you know, always people saying it was a pleasure and, but really, I was really afraid from the podcast, you know, with my verbal stuff and stuff. I was really like, nervous and it, essentially, it was fun.

Dr. Noel Liu:
It's fun. It's fun, yeah.

Dr. Dan Kopeliovich:
No, but I think you give some kind of environment of tranquility, and don't worry, it will be okay, and I really thank you for that. I had a really good time.

Dr. Noel Liu:
Hey, same here! I loved it, I loved every second of it. Thank you so, so much for coming in.

Dr. Dan Kopeliovich:
Thanks. Thank you for the offer. Also, I want to thank the listeners for listening. I hope it was interesting. And if you want to, if you have any questions about what is implied about my career or whatever, feel free to shoot me a message.

Dr. Noel Liu:
Absolutely. Any of you listeners, if you are looking for any kind of more information, feel free to DM Dr. Dan. I mean, he's on LinkedIn. Do you have an IG, Instagram?

Dr. Dan Kopeliovich:
I have something, but I don't think I have it.

Dr. Noel Liu:
Don't worry. Don't worry. We'll put up the link below. We'll put up the link. But the best way to reach Dr. Kopeliovich is through LinkedIn, and that is where you're going to find him and also WiseImplant. And if you have any question, DM me. I can definitely get you in touch with him for sure. Other than that, make sure to like and subscribe. We're going to land the plane here. And thank you again so much for being on the pod. Thank you.

Dr. Dan Kopeliovich:
Thank you.

Dr. 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. Dan Kopeliovich:

Dr. Dan Kopeliovich is a renowned Oral and Maxillofacial Surgeon with dual degrees in medicine (MD) and dentistry (DMD). He specializes in surgical oncology and microvascular surgery and focuses on improving healthcare technology through AI innovations. Dr. Kopeliovich developed the CBCT-Ruler for dental surgeons and founded WiseImplant, an AI platform that enhances implant success and patient safety. Currently based in Cancun, he combines his passion for innovation with providing world-class care to international patients while maintaining a strong work-life balance with his family.

Things You’ll Learn:

  • Resilience is essential in career development, as demonstrated by Dr. Kopeliovich’s perseverance through challenging work environments and tough decisions to achieve his goals.
  • Innovation in healthcare is crucial, illustrated by the development of WiseImplant, an AI platform designed to improve implant success rates through data analysis.
  • Maintaining unbiased data is important, as Dr. Kopeliovich emphasizes the need for his platform to operate independently of implant manufacturers to provide accurate insights for surgeons.
  • Achieving work-life balance often involves personal sacrifices and adjustments, as seen in Dr. Kopeliovich’s multiple relocations with his family for professional growth.
  • Redefining success involves prioritizing health, family, and helping others, reflecting Dr. Kopeliovich’s broader perspective on what it means to succeed.

Resources:

  • Connect with and follow Dr. Dan Kopeliovich on LinkedIn.
  • Explore the WiseImplant website!
  • Visit the DentVia website!