Secure Dental-Dr. Vivek Solanki: 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 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 this podcast, and I'm so glad you're joining in.
Dr. Noel Liu:
All right, everyone, welcome to another episode of our Secure Dental podcast, where we bring in many different talents from both inside and outside our dental industry. So, today we have a guest. He's not only a guest, he's also a good friend of mine who helped me set up my perio program in my offices. I got Dr. Vivek Solanki. He is an entrepreneur with multiple specialty practices all across Florida. And what Maryland now, right? And he is expanding. And now his new role with Polaris Healthcare Partners. I am so excited because he's going to be sharing some great, great tips and nuggets for us to scale our practice, to find efficiencies within our practice or practices, and also how to enhance and grow. So, without further ado, introduce you to Dr. Vivek. So, hey man, let's take it away.
Dr. Vivek Solanki:
Yeah, thank you so much for having me. It's good to connect with you again.
Dr. Noel Liu:
Absolutely. So, tell me a little bit about your background. Let's, let the audience hear from you, from the horse's mouth, right? What's your background? How did you get started with dentistry, and why did you grow your practice?
Dr. Vivek Solanki:
Yeah, so I grew up watching dentistry. My parents are retired GPs and Jacksonville, Florida. So, daycare growing up was in the dental office. I got to see how a GP mom-and-pop shop GP practice worked. It was a classic referral model. I got a chance to learn a lot about dentistry growing up. And then after I went to University of Florida for college. So, dental school for me was at Howard University in D.C. and then after dental school, like during it, I always felt like I didn't get enough out of school where I felt like I could just go back and be this value add to the practice if I was going to join my parents practice. So, I said, let's do a general practice residency. And at that time, since like 2011, I think I want to do something with implants. You know, implants were getting big into dentistry. And at that point in time, it was still pretty specialty-driven. But GPRs were highly sought after. I think the VA programs, there's one in Palo Alto, there's one in Philadelphia, Einstein Medical Center. So, there was these hubs around the country that were pretty intense, clinical driven programs with a big focus on full mouth rehab implants. So, I said, okay, let me spend some time shadowing the program. Luckily, I got into Einstein Medical Center. I stayed there for two years. I was chief resident there. And then after.
Dr. Noel Liu:
How long ago was this?
Dr. Vivek Solanki:
This was 2011 to 2013.
Dr. Noel Liu:
Oh, wow. Okay. Okay. Yeah.
Dr. Vivek Solanki:
And then I said, okay, after doing all that surgery, I was starting to gravitate towards like perio pros, like soft tissue management, and perio disease and how it affects implants. So, I applied for perio residency program, and I wanted to go somewhere where I don't want to pay that large tuition bill, right? So I applied to a very few programs, and I was very fortunate to get into the VA Los Angeles program. And then that took me all the way over to California, where I ended up staying for a decade. And that is where a lot of these intros that you had mentioned, you know, where did it all begin? How did it all start? That's the foundation for me. When I was in residency, when I got out of residency, many specialists in Los Angeles and some big cities, as you know, a lot of them travel. We'll have everything in our trunk. A centrifuge in your trunk. You'll have enough to run a mini-surgery center in your car, but it's so common because specialists would travel from office to office. There's mutually beneficial gigs. You know, I would come to your office and we would treatment plan cases together. I would have cases to do. We both take care of them, and I would be back in based on frequency and volume of your practice. That would be back once a week, once another time, once a month, and that was the norm.
Dr. Noel Liu:
Did you also go back for follow ups or would you just?
Dr. Vivek Solanki:
Oh, yeah. Yeah, absolutely. Yeah, that's a great question because I didn't do well in the one time per month offices. What it ended up doing for me is just making me a little bit more conservative because I was always a little bit cautious. When am I going to see this person again? You do a lateral window with immediates, and then. Okay, bye. I wanted to see people at least every two weeks for a post op.
Dr. Noel Liu:
Got it.
Dr. Vivek Solanki:
So, I think that happy medium for the offices that I was in was twice a month, biweekly. That way I could still see them for a two-week post-op and my GP colleagues or the group practices could see them as well.
Dr. Noel Liu:
Oh, nice. So this was 2011 to 2013. So, when did you actually move to Florida?
Dr. Vivek Solanki:
I moved back to Florida in 2022. I spent about, actually 2013 is when I moved. Philadelphia was 2011 to 2013.
Dr. Noel Liu:
Okay.
Dr. Vivek Solanki:
And then LA was 2013 to 2022.
Dr. Noel Liu:
Got it.
Dr. Vivek Solanki:
It moved to Florida at the end of 2022. Like about the end of '22 and started growing group practice here in Florida.
Dr. Noel Liu:
So in 2022, you were when you moved, you were still doing your specialty rounds in LA.
Dr. Vivek Solanki:
Yeah. So, I had, we had grown up a couple practices out there, and Polaris had helped me with the sales side in California. California went through a lot of changes with COVID, and it was just, you know, felt like my family was back east. Maybe this is a time to, you know, the universe telling me this is the time to come back to Florida.
Dr. Noel Liu:
Smart choice.
Dr. Vivek Solanki:
So, after that, I still went back and forth between LA and Florida. I would go back maybe five, seven times a year to go in and check on things, how things were going, and then setting up a new platform here in Florida.
Dr. Noel Liu:
So, let's talk about fast-forwarding to Florida. Now, when you came to Florida, when you sold to the group, whoever you sold it to, did they kind of restrict you from practicing or from opening up?
Dr. Vivek Solanki:
Yeah. So, it was a very good agreement that we had. I was in a materially responsible producer in the practice prior to the strategic partnership, I had already brought in other surgeons. You know, in LA, there are a lot of people who travel, right? So we had built like a very nice multi-specialty practice. We had about 14 ops in this practice. So, we had three, four GPs. We had 3 to 4 hygiene. We had perio once a week. We had oral surgery coming into sedate. We had cross-involvement for all on X. It was a beautiful program to take care of patients. And I was now the managing partner of the practice. So, when we brought in a strategic, I wanted to function in the same capacity that I was functioning, which then allowed me to start transitioning to move myself, my wife, we moved back to Florida.
Dr. Noel Liu:
Nice, nice. So, how was the transition like for you when you moved to Florida?
Dr. Vivek Solanki:
It's always different. Pros and cons. The weather is a lot more different here in Florida than it is in LA. LA is a very busy place, and I feel that the opportunity and the ability to grow in Florida, let's say, it's a little bit easier right now than what we experienced in LA, just because of how busy and saturated things were in LA and deal flow. There are a lot of practices here. Florida is, you know, it has been since COVID, a place of growth, right? There is a lot of people from the northeast moving down to Florida. There's a lot of growth in Florida, and with that growth comes access to care. So, growing here has made it a little bit easier, maybe because of the economic environment and the growth that the state has to offer. People do need dentistry as well, yes.
Dr. Noel Liu:
So where in Florida are you or most of the practices? Is it all kind of clustered? Is it spread out?
Dr. Vivek Solanki:
Yeah. It's clustered but also slightly spread out. So, we are in the greater Tampa area. Our most north practice is in New Port Richey, and then New Port Richey is about 45 minutes away from Tampa. And when we come down into Tampa, we have Tampa. We have some practices in Tampa, East, out in Valrico, Brandon. We go all the way south down to North Port, which is near Venice, south of Sarasota. So, we have a pretty nice stretch that we have, but they're all very easy in terms of driving distance. Our furthest practice that we run and manage together is about an hour and a half away.
Dr. Noel Liu:
That's not bad at all. So, I'm going to take you back to your, after you moved to Florida, okay?
Dr. Vivek Solanki:
Sure.
Dr. Noel Liu:
When you went in with your family, so, first the transition for the family, right? You have to get your kids to school. New environment, new school.
Dr. Vivek Solanki:
No kids yet.
Dr. Noel Liu:
Oh, sorry. I'm sorry. I thought you had kids.
Dr. Vivek Solanki:
My wife, my wife and I, no kids yet. My wife and I, that's why this was easier.
Dr. Noel Liu:
I always assume you have kids. Okay. Okay.
Dr. Vivek Solanki:
That's why. That's why it was easier. Because it was just us, and we had, you know, made the decision to move and set up. So, I can't imagine having to uproot everybody and do this. Like, you know, that could be a serious challenge.
Dr. Noel Liu:
So you did your first practice there, or did you buy a group practice? What was your?
Dr. Vivek Solanki:
Yeah. So, my good friend from college, he was a general dentist in Florida, and we both went to college together at University of Florida. He went to Nova for dental school. He was a GP here, classic referral-based model. And then what I saw in Florida was that very interesting. It was like almost the opposite of what I saw in LA, where I came from, this multi-specialty traveling background. And here we are in Florida, and it's the referral model is still 100% alive. You know, now that we're seeing DSOs come in, you see Pacific Dental Services, Heartland has a very big presence. Heartland runs some really good offices in Florida. There's a lot of, I guess, corporate dentistry that's moving in. And with that comes this multi-specialty model and many group practices that they have. So, I started to see things change. And my partner and good friend said, hey, you know, I've always wanted to do this multi-specialty model. Why don't we look at this, doing this together? So, the first step was me. The same thing that we do at Polaris is we analyze a practice, right? What is the value add here? Like, how can we help patient care? Everything that I do from a business lens is always first. What can I do to maximize and do the best patient care? And then everything just kind of falls in place right around it on the business side. EBITDA will grow, your metrics will grow. So, looking at his practices, I saw like a tremendous opportunity for us to grow because he had the space, but also to bring in specialty so that patients didn't have to feel this pinball effect of trying to bounce around and try to seek the care they needed, if they wanted that specialty care.
Dr. Noel Liu:
Exactly.
Dr. Vivek Solanki:
So that's how things started changing. He had two to begin with. Two years later, we had seven now running here, and we're just continuing to grow as well. Yeah.
Dr. Noel Liu:
Excellent, excellent. So, you said something about we mentioned earlier, you went to Maryland and Virginia also. You have practices, right?
Dr. Vivek Solanki:
Yes.
Dr. Noel Liu:
So, how did that transition come about?
Dr. Vivek Solanki:
Yeah. So, I've always been really passionate about keeping all of surgery in one place, right? And so when you look at the environment in certain areas, the referral-based model is very much so there, right? And if we look at consolidation, if we look at group practice, there are many groups that have GP-based multi-specialty group practices, which is common where the GP office is the predominant like source, right? And multi-specialty will come in to help patients. But now there is this need and this larger presence that's developing of specialty-based groups. And how do we place an oral surgeon in a periodontist in the same building together, leaving the egos at the door, where both people can help the patient and the referral-based community? And so I have my colleagues from schools, some great friends of mine. He's an oral surgeon with a partner, is an oral surgeon, and they very much are passionate about this model as well. So, the goal here is to make life easy for the referring doctor and make life easy for the patients. It's a one-stop shop. How can the patients come to one place? Whether it's surgery for perio, whether it's surgery for implants, there is really only a small overlap when you really look at OS in perio. And that's going to be ... and implants, you know, anything related to implants. But if you actually look at the pie chart? There are so many things that OS does that is so different than perio, and there is so much that perio does that is different from OS. And so, the beauty about that is if we can, if groups can leave that ego aside, these specialties will end up learning from each other, and they can therefore help the patients better. They can guide their referrals better. And so, that works out really well. It's a beautiful model.
Dr. Noel Liu:
So the offices in Maryland and Virginia, those are just oral surgery and perio.
Dr. Vivek Solanki:
Correct.
Dr. Noel Liu:
Got it. Okay. No, that's nice. So, I want to talk to you about there are many people that ask me, hey, listen, I want to start my first practice. I want to open up a DSO. What is the best way to get started? And I almost say that that should not be the frame of mind when you're starting off the first practice. I want to hear your thoughts on when you started this group practice. I think like, you know, it happened organically, right? But if you go with that intention, this is what I want to do completely, like day in, day out, regardless of patients or anything else. I feel like you run into problems from my experience. What is your take on that?
Dr. Vivek Solanki:
I would have to agree with you on that 100%, the goal has to be patient care first. So, if the goal is I want to scale. It's nice to know that you want to get somewhere. And I did this lecture at a group of dentists, entrepreneurial dentists that were asking similar questions. And I asked the audience a question. I said, well, when you're in dental school, there is this looming cloud over your head about requirements and the degree, right? If you don't finish your requirements right, you're not going to get your degree. So, there was a deadline. There was a common denominator with everybody in this room that there was a deadline. So, those of you who are in specialty boards requirements again deadline. Now we're in private practice. There's no quote-unquote game to play. There's no deadline. So, what ends up happening is so many people get complacent and they just let things go, right? So it's nice to know where you'd like to go. But I agree with you that the starting point must be patient care and proof of concept. You can't scale something unless you've done every part of that business, and you can teach it to somebody else. So, to answer your question, for those of the audience members who are looking to scale, the first thing that they have to do is they have to be able to replace themselves.
Dr. Noel Liu:
Oh, wow. That's huge.
Dr. Vivek Solanki:
In one location.
Dr. Noel Liu:
That's huge, man.
Dr. Vivek Solanki:
Because what's going to happen is running a business is a full-time job, and taking care of patients is a full-time job. So, are both going to be done meteorically well, or is one going to supersede the other? And so the methodical way to grow and scale is to take ownership of control of one location, right? And a lot of your members and a lot of my friends and colleagues, they own a single practice, whether it be GP or specialty, and then they have a desire to get to like five locations. Well, you don't have to sell somebody in your office to begin with for a first one. So, where I try to find that happy medium is if you are a strong clinician, a strong clinical leader, your goal is to try to get 70% of you. So, if you can bring somebody in, you're going to learn more when you teach. So, that exercise of teaching is so important, right?
Dr. Noel Liu:
That's huge, man. I love that 70% because I follow the same thing called the 70% rule. And I'm like, if you find somebody who's 70% as good as you delegate, and if you can give away part of your 70% to somebody else, get it away. You know, I had the same conversation with Dr. Walker, and he said something about between 3 to 5 practices. That's what the dark hole is. And I think you nailed it right in the head. Because if you cannot get out of the chair, you are not able to grow or scale. Forget about it. And once we hit that dark hole, everything is uncertain, and everything goes down the hill because I did it.
Dr. Vivek Solanki:
We all do it, you know?
Dr. Noel Liu:
It was hard, right?
Dr. Vivek Solanki:
It's a teeter-totter effect, right? Because as you're focusing on scaling and expansion, yes, the clinical responsibilities are going to kind of go down some as expected, but you can't ever fully disconnect. I have a lot of younger doctors in my organization, and I need to be the sounding board and mentorship from them. When they are unsure and nervous, there has to be someone that they can contact that's going to provide that confidence or support. So, it's never something where you're 100% disconnected. As a clinical leader, we can't do that. But it is something where, yes, there's times where it's like, oh, what's going on now? People are, I'm getting spread too thin. But you just have to keep focusing on that vision and the goal, trusting that process. And then it will slowly get to the point where your team and your doctors are becoming more confident, more comfortable. If you keep mentoring them, they're able to manage more, which then, in turn, will free up that time for you so that you can focus on the areas of your business that do need that TLC.
Dr. Noel Liu:
100% can't agree more. So, this is step one. You pull yourself out, you let operation kind of run itself, but you're still there to support it, right? I know you've mastered standardization very well and efficiency very well within your practices. Let's talk about that a little bit. Why is it so important to standardize operations and efficiencies across the board, and how does one start with the first step?
Dr. Vivek Solanki:
Yeah, that's a great question because if everybody's doing something different, let's keep it simple and let's start with clinical care. Sure, there has to be a standard process of how we approach clinical care. You know, if every patient, if we disregard money and we don't judge any book by their covers, and we say if every patient is going to get the best care one, you've got to have a clinical philosophy of your practice, like, what do we do here? We provide the best care, whether that be implant dentistry or dentures. But we have a starting point. So, that in turn, right there is a standardization. We have a clinical philosophy that we follow in our offices. So, if somebody comes in that needs a filling they get a filling, minimally invasive care. But if somebody is coming in that has 80% of this tooth surface is going to be composite. We need full coverage here, right? So that alone, on a very simple term, just saw our clinical leaders can understand you can't have somebody coming in, and it's so subjective. It could be a filling today and a crown tomorrow. There has to be this standardization in clinical care. Like if somebody's coming in with terminal dentition, let's not do this heroic crown and bridge, which is going to break in a year. There's not enough tooth structure to hold these crown and bridge, and restorations in these roundhouses. Let's get them something more definitive, something implant-related, if that's what the patient can have the means to get. If not, then we need to start looking at other removable-based options, right? So the first thing we did, because everything is driven from a clinical lens in our group, is we try to standardize our philosophy on how we manage patient care. And then once we did that, we could then go into the operations and say, we're going to stock these things. We're going to use our scanners for these things are cone beams are here are implants. These are the type of implants we use. This is what we use for singles. This is how we do all on X. So, then it starts with the philosophy of patient care, and then the operations and standardization of what we keep in the offices in terms of, well, I like these birds. I like you've been out of school for a year. How do you know what you like?
Dr. Noel Liu:
Right.
Dr. Vivek Solanki:
Like I've been doing this for 15 years now. I have a feeling I think I know what I like now, but talk to me in ten years, right? You're here to learn. So, it's very hands-on coaching. And it's the same thing I do at Polaris. Like a mentor and a teacher is somebody that's going to show you a way to do something. In this younger generation, you can't buy experience, you have to clock in the time. So, we try to give them a playbook. We show them how we standardize this. We show them, we teach them. We keep a good stock of things. But here's how we've done things clinically very well without making things more complicated in the mind, overthinking things, and overstocking things, like, you can do a beautiful job with these things, and we've learned to do it well in our careers. Let's now duplicate. It's almost like a residency program in some degree.
Dr. Noel Liu:
100%. So, that in turn would actually boost productivity, right? I mean.
Dr. Vivek Solanki:
Absolutely.
Dr. Noel Liu:
That's exactly what it's required anyways. So, what would you say on that? Like, you know, some of these associates coming in and your team members about standardizing from location to location, 2 to 3 to 4 to 5. Is there someone who is actually like a compliance person to make sure everything is being followed, or are you the person?
Dr. Vivek Solanki:
Yeah, so we have teams in our organization. We have the principals. My wife is a prosthodontist. She also serves on the mentorship side of teams. And so, we have Kelly Shimada is a prosthodontist, but she's also serves as a clinical director. So, there is somebody that is connected with the docs, and there is somebody that's connected directly to the lab, because what happens clinically goes straight to the lab, and we get a lot of feedback from the lab as well. So, we want a certain level of guidance, but we also want to let the doctors continue to grow. And we want to be able to watch the work. And we want to be able to make sure things are the quality control that you mentioned. So, we do have somebody in clinical leadership that's going to oversee as a clinical director. But then we also have operations side. We have a director of operations so that there's a level of this is what the principals want in an organization, but the principals are going to be focusing on different things. So, there's where the director of operations is managing and connecting directly with the office managers to make sure the office managers are doing what they are responsible for and the practices, whereas we kind of coordinate with the doctors most of the time. Everybody's handling what they do best.
Dr. Noel Liu:
And I know you touch base on this here. So, by standardizing and making sure everybody is following the protocol and the standards that you've set forth, how does that affect the bottom line in terms of financial?
Dr. Vivek Solanki:
You'll see numbers grow and change, right? But for the audience, you have to trust the process. If your goal is to go from like 250,000 in EBITDA to 600,000, you're not going to get there by making every patient take a rest. And this is not the way to play this game. And this is my opinion. I'm a periodontist. I have successfully grown multiple businesses from a clinical onset. The way to grow a business is figuring out the clinical philosophy. And how do you provide the best care? And if you want to grow from there, you've got to have a rock star. You've got to have a few key players in the business that are very confident and comfortable with the clinical, because that's what everybody's going to revolve around. Somebody has to teach somebody how to close cases. Somebody has to make sure case acceptance stays in a certain region, and why it's dropping. Most people don't want to look in the mirror and say, you know, Vivek, what am I doing wrong? Like last week, I was at 90% case acceptance, and this week I'm at 50%. Most people want to point outside and say, what office is this? The staff is this. The patients are patients are the problem, right? So we have this more introspective approach where we try to create a responsibility, like how can I control this outcome? Like what is it that I can do as a provider differently so that my patient understands me, and they're just so clear on what I want to do for them that they accept this treatment, and I can help change their life. And that's the way that they will get to that finish line of growing a practice and getting to those stats to change. And when you do have the clinical on point and then the operations are built around that clinical.
Dr. Noel Liu:
Sure.
Dr. Vivek Solanki:
You will see growth. You'll see 20%, 30%, 40% growth, EBITDA will climb. Your metrics will naturally fall in line on a PNL where you want them to be. And you have a healthy practice.
Dr. Noel Liu:
And that's just by standardizing and making sure people are following. Love it. Let's talk about profit.
Dr. Vivek Solanki:
Sure.
Dr. Noel Liu:
You know, as we were growing in our personal scenario, the more the practices, the lower the profits. As a matter of fact, there were times where it was like negative, right? Now, looking back, I know what I did wrong. And looking back, we know how to make sure we avoid this pitfall. I want to know from your experience, how is it that somebody's trying to grow? They can protect the profit, not go into a black hole or go into the red, but at the same time, grow their organization? What would be some of the basic, let's say, the secret sauce that they need to watch out for or do?
Dr. Vivek Solanki:
Yeah, great question. I'll start methodically here. So, things that I would be thinking about in an expansion in a de novo, there's going to be a certain burn rate that you're going to have, and you just have to be comfortable with that burn rate, whether it's completely associate driven or if principles are going to go in to start it, you're going to have this marketing staff, payroll, rent, no patients in the chair, like you're going to have a burn rate, which could be significant. I think that was an early teacher of ours as well. We didn't realize like, oh, here's this great facility. Let's open 2 or 3 of them at the same time. That burn rate is real. So, it's very important that in scaling and expansion, that the health of the organization outside of expansion is on point. And it's running well, because a lot of times, that is going to fuel the expansion. This growth, this entrepreneurial journey. When you mentioned profit, like, yeah, it's extremely important, but it's a very fluid thing. You know, you've got to be able to have zero profit at some points in periods of time to get that level up another 50% to 100% down the line. And so, what does that look like for somebody in that scaling process? Where is it they're able to maybe live off of their clinical income? If they're doing some clinical in the chair and then knowing that, hey, I'm in a de novo phase or, you know, this acquisition phase, we're going to reinvest a lot of this capital back into the business to get the business where it needs to. And then a defined plan of it's going to take us six months. It's going to take us six months for this de novo to sustain itself. And now we shouldn't have to reinject more capital or reinvest that capital back into the business. That business can sustain itself. And so, with us, you know, we do have docs that work with us. We have a lot of associates. And I like to call them my team members. But I would like to think that the doctors that we work with are happy and that they're learning. They all come to us with cases all on X overdentures implant placement. They're all hungry to learn. So, as long as I can see their clinical growth and they're meeting their professional goals, we try to do the same thing. We try to lead by example, which is very important, right? We know that if we do the right things for our patients and we do great dentistry, that the numbers will always be there. And so, then we look at that as a macro level now as a principle running a business or an expansion. If we look at the business, if the business is doing it, the mission is right. It's taking care of its patients. Well, the doctors are doing good treatment. That business is going to cash flow. So, as long as that is doing, the mission is being met and patients are being taken care of, and the doctors are doing. We're all doing the right thing for our patients. You will then have cash flow to fuel expansion. Now, if it's not, you maybe should be focusing on getting the original locations where they need to be healthy and, you know, financially solvent before expansion. Because I think we all know days are gone where you can just roll up stuff and expect arbitrage, like you got to show, you've got to show growth now, organic growth year over year.
Dr. Noel Liu:
Correct, correct, can be depending on whatever you're acquiring all the time. So, we spoke about the financial health of a practice based on clinical. How much of it would have to do with the principal? Let's bring that out of the closet.
Dr. Vivek Solanki:
In the beginning. It's a lot. Culture has to change. Systems have to be put in. Things have to become standardized. So, in the beginning, I'll use myself as an example 100% of the time in the beginning. Now I'm at a place where it's like 30%, 40%. And so, how is it that a $1.2 million-grossing, two-location business goes to ten or 8 or 7 or whatever? And how is it that you can get that with principal involvement becoming less and less, and that comes from the standardization and the systems? I think in the beginning, the reason it's so high is because we're involved in every aspect of getting that set up. The team members are not so used to treatment planning a certain way, and they're not used to presenting. You know, if you go into a practice that's doing like 800, $1 million a year, and now all of a sudden you tell them, like, hey, we're going to start doing all on X here. That's a big jump for somebody presenting a $1,500 crown, a team member, and now they have to sit down with somebody and tell them why they have to spend $45,000 in their mouth. That's not something easy for a lot of team members to do.
Dr. Noel Liu:
Right.
Dr. Vivek Solanki:
So, the same thing that we do on doctor development, I took the same processes over to Polaris, the same thing that we do on doctor development with clinical coaching. We have to do those same drills and development with team members. People have to get comfortable with the new norm, and change is hard. That's why it's so important that people don't scale too fast. They have to get one location to like the model, like this is the model, and like the model is working well.
Dr. Noel Liu:
Right.
Dr. Vivek Solanki:
It's never going to be 100% passive. I don't believe that dentistry I don't believe is something that you can just. Dentistry is not mailbox money, right? You know, you have to have constant involvement. We're taking care of other human beings. So, to fully disconnect would be for me in my definition, would be a percentage of my time is still involved to make sure that patients are being taken care of, that doctors still get the mentorship they need, and that the business is still doing well in terms of its mission and its vision. I think that's a definition of passive for me in dentistry, because I just don't see how it can be completely hands off without somebody there managing. Now, if you get some really bigger and you have a clinical leadership team, and sure it can get there, but we're not at a place in our organization, we're at that size, right, where we're still helping and mentoring and still in growth phase.
Dr. Noel Liu:
Exactly. You know, I almost feel like when we open up our group or organization, we got to be at that 15 to 20 locations, sweet spot mark before and put in all the hard work at that time. I don't care how long it takes, right? Whether it takes a decade or two decades, I would say put in all the hard work, get the systems dialed in, get the people dialed in. Once when you reach a certain EBITDA, let's say $6 to $8 million of EBITDA. That's where I would say, now you have that platform where you can go ahead and start jumping like, you know, doing 5 or 6 acquisitions at a time. But before that, put in the hard work.
Dr. Vivek Solanki:
Yeah, it's no substitute for it.
Dr. Noel Liu:
You got to put in the reps like you go to the gym. And that's where I feel like a lot of people, when they see these bigger groups, including myself. When I was growing, I just got mesmerized that, hey, I'm at three locations, I want to go to 6 or 6, or I want to go to 8 or 10. And I think that's a very, very wrong approach to do it. And I loved when you said patient-centric, love it.
Dr. Vivek Solanki:
And people will know when it's time to scale. You know, when you start seeing extra time come back into your schedule. You know, we say the devil comes out when there's nothing on the schedule, right?
Dr. Noel Liu:
Right.
Dr. Vivek Solanki:
Like there's no patients in the chair, all the problems just come out of the practices, right? But you'll start to see your clawing back time because of your operations and your systems that have been put in place. And you're starting to work on things that you may not have had time to work on in your original practices and your original locations that you had started with. Oh, I have this new time. Let me work on this in the practice, where then you have to kind of prioritize what your time is worth and.
Dr. Noel Liu:
100%.
Dr. Vivek Solanki:
Stay focused. So, you'll start to see time come back. And as the organization is running well and the practice is doing what it needs to, you'll have these opportunities to continue to grow. But you got to have a team around you. You have to have a support team. You have to have people that are managing different components because it's not something that one person or you can't do it all. You have to trust, and you have to be able to get a solid team around you to do it.
Dr. Noel Liu:
And for that, like you said initially, you got to sacrifice your profits. I mean, put it all back in the business. That's how it works. Can be saying like, all right, you know what, let me pull some money out and let's go and have some fun. No, you cannot do that initially.
Dr. Vivek Solanki:
It's no different from any other CEO or entrepreneur in any other business, like Bezos lived out of the garage for so long. Why? You know, and so a lot of these founders and tech startups, they did lean startups. They did it for a reason. We're just very fortunate because dentistry is a repeat customer that patients have to come back to us. Whereas other businesses, they have to find ways to build repeat customers. And here we are trying to keep hygiene reappointment rate at 100%. When we know that they have to come back to us to keep their oral health satisfactory. So, I feel like sometimes we as a profession, take it for granted that we have this reappointment rate that's internally built in, and we're still looking for new patients, and there's already patients there. But if we use the same principles and the same mindset that other entrepreneurs and startups, and CEOs of other companies have used to scale and grow their business. There is a common denominator, which you hit on it, is you have to be willing to sacrifice. You have to say there is profit in this business. It's just that I'm not touching that profit for the next two years. And the reason is, or the one year or the reason is, is because that profit is being put back to work and is being deployed to solve a problem, to get this company where it needs to get for that next level of growth. And if you can't make those sacrifices, then maybe this isn't the game for you to play.
Dr. Noel Liu:
Right. You know, I always call it Feed the Beast.
Dr. Vivek Solanki:
Yes.
Dr. Noel Liu:
So, hey, so, gear change here a little bit. So, I saw that you just started a new venture with Polaris Healthcare Partners.
Dr. Vivek Solanki:
Yes.
Dr. Noel Liu:
Tell us a little bit about that. And what does it entail?
Dr. Vivek Solanki:
Thanks, yeah. It's exciting project. ... is a good friend of mine. The entire Polaris team, they've always been a great sounding board and support system for me. And when we analyze what it is that both parties do and Polaris is business support, sales side by side, fractional COO consulting, everything on the business side of things, which is phenomenal. But then we have people that run CE courses on the weekend. Come learn implants with me this weekend, and go back and do them on your own. There's this vacuum in the space where there aren't too many people that are bridging both sides. Because if you and I were to look at the business being clinical side, we could go into an office and say like, wow, like this treatment plan, like really? You know, and the patient said this, and you're doing this so we can always grow a practice if we're willing to go back in the chair. And so, there's this vacuum in the space where, in order to get the business where it needs to go, There's only so much that can be done operationally.
Dr. Noel Liu:
Sure.
Dr. Vivek Solanki:
Cutting costs. We see this with the larger groups and DSOs, right, with fantastic operational support. Let's get our formulary in there. Let's cut costs down. We can save a couple points here and there. Okay, great. But like, nowhere am I hearing, like, how is this person treatment planning? Like this person's like a periodic exam and a filling doc. Like, how is it that nobody does crowns? How is it that nobody's doing an implant restoration? Look at the payer mix of this person. And then we go look at it and say, wow, like this person is just a great human being. They're great, doctor. They just desire to learn. But they've never been given an opportunity to help patients close cases and do these cases that they want to do. There's some block there. There's something that they're afraid of. There's something that they're uncomfortable about. And so, that's where this partnership with Polaris comes in.
Dr. Noel Liu:
Got it, okay.
Dr. Vivek Solanki:
Polaris Clinical Coaching is designed to help groups do what they need on the clinical side to help them achieve the business goals. It is about helping associate doctors develop in their professional careers, right? Let's just say a doctor goes up in $1,500 a day in production. Let's use simple math for the audience. We have a four-day workweek GP. So, we come in and we teach them how to treatment plan a little bit more stronger. It's never going to be pushing sales, right? So I just want to put that out there. This is not about making patients spend more money. This is about here's something that's a bridge. These are virgin teeth. And you want to do an implant. But because you're uncomfortable, you're going to just cut these virgin teeth down. Have you asked the patient what they want, right? And so this is about helping doctors develop professionally in their clinical careers and provide better care. If they go up in $1,500 a day in production. That's going to be an extra six grand a week, about $300,000 a year in top-line revenue. Production, pure production. Now, if we had to look at that, what does that do for the doctor and their family? It's going to be an extra like 100 grand going back to the doctor.
Dr. Noel Liu:
Right.
Dr. Vivek Solanki:
Our operational expenses stay the same. So, then there's about 100,000 in pure EBITDA. That goes back to the practice. So, if you have a practice of four associates, that's 400,000 in EBITDA just off of $1,500 increase in production per day from clinical mentorship. Now we're talking about a meaningful lift. When you're looking at a group that's at A67 valuation and you're talking about $400,000, that's meaningful. This is extra two something million dollars in enterprise value that we're adding back from, what, $1,500 a day in extra revenue by doing better work. So, that's where Polaris Clinical Coaching is about. It's about, at the end of the day, this is a business. But we're not approaching it from money, money, money, and business. We're approaching it from the root underlying cause, which is that we have human beings on both sides. We have a doctor and we have a patient. And how can we help both parties get the best care possible? And that might be the way we talk to them, or treatment plan, or help them understand something. Part two is how do we help the doctors get better clinically, where we're there in the office? Chairside where do site visits? We do two days in the office, and those two days, book your surgeries, and I'll be your assistant. Alright, let's get you to a place where you're comfortable placing single implants, doing some crown lengthening on your cases, extraction graphs, ... graphs, right? Because now we've just adjunct this extra surgical skill set into your toolbox, which you now have a massive range to treatment plan with and execute on. And now dentistry starts being fun. It's this approach through a clinical mindset. It's well needed in the space. You know, I have so many doctors that I've worked with on the GP side, and I put them through the same process, this internal residency, right? How do we get them to develop? Because a lot of GPs these days want to learn.
Dr. Noel Liu:
100%.
Dr. Vivek Solanki:
I have very rarely found somebody say I'm good. I got out of school and I'm good. I don't want to learn anything more. I don't often see that it's that they're hungry to learn. And then we as principals don't have the time because we're also in the chair.
Dr. Noel Liu:
Right.
Dr. Vivek Solanki:
So we pick and choose. They get certain cases. We do cases. And then there's stalemate. Nothing changes.
Dr. Noel Liu:
You nailed it, man. You nailed it in the head. Because this is one of those drawbacks in a lot of group practices, where the principles or the main doctor who wants to grow and scale, they are like spending all their time in the chair. And when their associates come in, they are not really performing. And then they complain about why am I so she is not performing, right? I mean, you know, I'm kind of thinking I haven't seen anybody else have this clinical side in terms of I haven't heard of any other consulting firm. Like when I'm thinking about it, I'm thinking about it here.
Dr. Vivek Solanki:
I mean, there may be people doing it. I just at our level and the tailor approach, I can comment on other groups, but I can tell you what's unique about us is that this is not a one-size-fits-all. This is very important, right? Clinical work is never a one-size-fits-all. You and me are a perfect example. We're friends. You called me and said, hey, I'm thinking about bringing a periodontist in. You remember how excited I got to do that with you?
Dr. Noel Liu:
I know, I remember, you're like, let's do it.
Dr. Vivek Solanki:
Okay, let's get the playbook together, line up the interviews. I'll be on Zoom with you. I'll coordinate with the periodontist. We'll let you. We'll set up your osseous surgery, your periodontal disease. We'll cut the, minimize of perio maintenance on residual pockets. But that was tailored to what your business needed. But I wouldn't have known that if you said, hey, doc, come do a, see with me this weekend. And then now you have to figure out the blueprints to this, and you have to go back and implement it and execute.
Dr. Noel Liu:
Right.
Dr. Vivek Solanki:
So this is like understanding when we go into a group, we need to understand what their goals are, not only from the principles, but we need to understand what the goals are from the doctors, the people who are providing the care. Because if we can understand what their goals are and we can understand where they're at at baseline, then we can develop a program to help them grow and succeed, achieving the goals that the principals wanted, the quote unquote, my associates aren't performing well. That's where I try to gently give them a mirror and say, have you looked in the mirror yet? Because there's some things that you need to be doing that you, A, don't have the time to do, or B, you don't want to do it, or C, you just don't have the means to do it, because your toolbox may not be big enough.
Dr. Noel Liu:
Love it. So I like how Polaris is doing on the top side with the principles and the organization, and how you are at the grassroots effort with these guys, because that's where the production is. That's exactly where.
Dr. Vivek Solanki:
It has to be a synergistic approach.
Dr. Noel Liu:
100%.
Dr. Vivek Solanki:
The business can never be fully disconnected from the clinical, but the business side and all metrics side needs to understand that the meaningful lifts are not going to come from operational issues if the clinical foundation is not solid. If the clinical foundation is solid, then all of that other stuff is just gravy.
Dr. Noel Liu:
Takes care of it, yeah.
Dr. Vivek Solanki:
Oh, yes.
Dr. Noel Liu:
Well, that was great, man. How can people get ahold of you?
Dr. Vivek Solanki:
So we, put Vivek, my first name, V I V E K, Vivek@PolarisClinicalCoaching.com. And, or they can go straight to Polaris Healthcare Partners, and Jamie, the whole team that they're there, we get people reaching out on both segments. And we'll sit down and we'll talk and we'll see what your goals are, what you're looking to accomplish. Like we had talked about in the beginning, what's the game? What's the deadline? Where's the urgency for you? What is your goal? And then how can we help you get there? But this is going to be from a clinical lens, right? This is going to be what we know best as doctors, right? We can have more interesting conversations. We can see eye to eye. It's not going to be this foreign territory. It's going to be based around patient care, doing great work. How can we get better? What fire can we now spark in the organization from a clinical lens? Because that becomes fun again.
Dr. Noel Liu:
Love it. Alright, great. Any last comments?
Dr. Vivek Solanki:
No. I just want to thank you for having me. It's good to see you in person. Always fun chatting.
Dr. Noel Liu:
Same here, same here. Well, we're going to land the plane here, so that was great. Great tips there. Ladies and gentlemen, make sure to like and subscribe. Vivek Solanki. This guy's an entrepreneur. He's a legend. Every single time I talk to this guy, it just boost my morale, and I just want to go out there and do more stuff. So, thanks a lot, man.
Dr. Vivek Solanki:
Thank you so much. Thank you.
Dr. Noel Liu:
All right.
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.
Sonix has many features that you'd love including enterprise-grade admin tools, world-class support, collaboration tools, secure transcription and file storage, and easily transcribe your Zoom meetings. Try Sonix for free today.
