Secure Dental_Dr. Tarek Aly: Audio automatically transcribed by Sonix

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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, everyone! Welcome to another episode of our Secure Dental podcast. And today, we have a very special treat here, and we have Dr. Tarek Aly. He is a periodontist or was a periodontist. And currently, he is owner and co-founder of several dental organizations. So, without me stealing any of the thunder from him, I will let him introduce, and give a brief background about where he came from, what is he doing, and the whole nine yards in between. So, Dr. Aly, go ahead. The floor is yours.

Dr. Tarek Aly:
Well, good morning, good afternoon, or good evening, wherever you are. First of all, I am very grateful to be on your lovely and insightful podcast. Thank you so much for spending time with me today. My name is Tarek Aly, and I used to be a periodontist in a previous life and then I went to rehab and recovered. I'm joking. I enjoyed the dental world. It started with my parents wanting me to be a doctor like them. And if you know anything about Egyptian parents, you don't negotiate with them. They say you got to be a doctor, and you say, I, captain, I will be a doctor. And then later I really fell in love with the profession. It's such an amazing profession. You make a difference in people's lives every day. I wasn't a big fan of the clinical world. I was more in love with the marriage between the business and the clinical, how to make an impact in so many people's lives and not just the patients you see every day. So, I started building and buying dental practices. I co-own about 94 dental offices between multiple DSOs built and bought multiple practices over the years. I'm also a coach, and I'm very involved in the DSO space. You'll see some of my work out there, and I'm very grateful to be here with you guys.

Dr. Noel Liu:
I love it. So, when did this dental journey of yours start? Let's take us back in time. When? Before pre-dental school.

Dr. Tarek Aly:
Yeah. So it started actually in Egypt. I grew up in Egypt, and I went to dental school in Egypt. And I realized how much of a difference we actually do as dentists in people's lives. It's not just a healthy smile. It's a lot more than that. And that that difference is what you make in people's lives have really impacted me to a deeper core, which I made it a mission to impact as many lives as I possibly can. And that's where the dental journey started.

Dr. Noel Liu:
Got it. So you were a dentist in Egypt then, before you came here, correct?

Dr. Tarek Aly:
That's right. Yes. I was a dentist in Egypt first, and then I came here. And after I've done my board exams and all the fun stuff, I started the business journey after an MBA, and a CVA, and a bunch of useless business degrees. I love that marriage between business and dentistry. It was such a lovely journey.

Dr. Noel Liu:
So you came here, and then you went to dental school again, correct?

Dr. Tarek Aly:
Yes, I came here, did my board exams, and then I realized, is this really what I want to do is to be in the chair? I thought it definitely makes a difference, to be more impactful, to impact a lot more lives than just the patients you see every day. As a dentist, you can impact ten to 20 to 50 patients a day. But as a, scaling up your business and scaling up your dental practice or practices, you can impact 200, 500, 2000 patients a day.

Dr. Noel Liu:
Love it, love it. So, from dental school, you became a periodontist. And then from there, what made you decide at that time that, hey, you want to get an MBA done, and then you want to do the business side of dentistry? How long into the clinical world? Like you would say, roughly about, what, a few years, a decade?

Dr. Tarek Aly:
Yeah. About 4 or 5 years is when I realized that we are lacking so much in entrepreneurship coming out of dental school. Oh, they teach you how to be an amazing clinician, but you really don't know how to run a business. You don't know how to read a PNL; you don't know how to do marketing. You don't know how to actually be a leader in your organization. In dental school, you're working solo, impacting that specific patient, but you don't know how to work with assistants. You don't know how to work with front office. You don't know how insurances work. You don't know the holistic approach. So, I realized that there's so much to learn, and we only know a sliver of it.

Dr. Noel Liu:
So is that why you went and did your MBA after you became a dentist, or was it, were you done it before?

Dr. Tarek Aly:
Yes. I was always a big fan of business and understanding the bigger picture. But then I realized that we are so defective in the business world and the dental community. And that's when I thought, hey, what about an MBA?

Dr. Noel Liu:
I love it. So tell me something real quick. You said something about scaling, right? And we're going to fast forward into a little bit about the current situation. Why scale? I mean, like one of the aspects, you said that yes, you want to affect patients' lives, right? But you got to have a bigger why of taking up so much challenges and so many of those entrepreneurial, sleepless nights. Why scale, in your opinion?

Dr. Tarek Aly:
So, scaling, there's a lot more aspects to providing quality of care. When you are in your practice, seeing patients every day, I can guarantee you that the patients have different experiences, different times of the day, and different days of the week. Not every patient that walks in your door has the same exact experience. Monday morning patient could have a different experience than the Friday afternoon patient. And that comes because of a lot of other factors like your moods, your front office person's mood, your dental assistant, how to fight this morning with their spouse, so their patient experience is different. So, how to create consistent patient experience on a scale for every single patient? You treat every patient like they're president of this country. You treat every single patient like your parents or your family members that are coming, and you want them to feel proud of you, the work that you're doing. So you treat every patient like extreme VIP. How to create that experience on a bigger version for every patient. That's what scaling is about.

Dr. Noel Liu:
And what is the mindset behind it? Like when you are doing something like that, the task is so big at hand that it really becomes almost people think in their minds like, hey, it's so impossible. I can do it in a single practice. But how do I replicate into 94 practices?

Dr. Tarek Aly:
It's definitely hard. I'm sure you've heard the term standard of care. Well, big newsflash, standard of care is never standard. There's always these discrepancies. Do you know that 150,000 Americans die each year in surgeries? And do you know that 75,000 of them, 50% of them die because of avoidable human errors? Things like someone didn't wash their hands properly, or they brought the wrong blood type, or they didn't do an allergy test before. So we think we do the same. That's why we have checklists and systems and processes, and that's why industries like aviation and construction have a very high accuracy rate because they have standardization. So it is hard, but it's doable. We can learn from other industries. And I can guarantee you today, if you do mystery shopping and go to any dental office, not just one location or 5 or 15 or 20, even in just one small practice. Standard of care is not standard, and we have to work constantly, day in, day out, to standardize that care.

Dr. Noel Liu:
You said you're a pilot, too, right?

Dr. Tarek Aly:
Yes, I fly, and I love aviation. It's a miracle in our time.

Dr. Noel Liu:
Who would know better than you what a checklist would be, correct.

Dr. Tarek Aly:
I love checklists; I have checklists for everything. Yes.

Dr. Noel Liu:
No, I love it, I love it. So, in terms of mindset, now I want to get a little bit deeper in your head when you are managing these practices. Number one, like a lot of people ask, is when they're coming out of dental school. They're like, hey, I want to I want to open up a DSO, and I want to do like how the DSOs are doing. I want to own multiple practices. What's your experience and your take for guys like these that you know, who just want to rush out of school and just get into dentistry and not having anything in terms of business, right? And they just want to open up practices. What is the mindset behind you that what you did in your experience and what would you tell for a younger generation that wants to come out and do the same thing?

Dr. Tarek Aly:
Well, first of all, we have to celebrate that ambition. A lot of times, I see leaders in the community putting down these thoughts and saying, hey, you can't do it, or it's hard, or it's doable. The ambition is admirable. Let's keep that fire going. First step is the mindset. Then second is it's okay to realize that we are defective. A lot of times I look in the mirror and I say, you suck and it's okay to suck. It's fine. We don't have to know everything. We're definitely don't know everything. And it's okay to suck. But what's not okay is to keep sucking and to not improve, right? So, step one, the mindset. Let's have that ambitious, optimistic, I-can-do attitude. Step two is it's okay to realize we are defective. There are so many things we don't know that we need to know. And then let's say you want to start a DSO or you want to want to start a business. First ever step you need to do is the mission, the strategy, the mission, vision, core values, objectives, and goals. That's the first step. Why do you want to do this? How are you going to do this? What's your core values? What are your objectives? Objectives can be like, hey, I want to be the best employer in town, or I want to see that many specialties, or I want to serve this many patients, or I want to have $10 million when I buy the term by the time I turn this old. So, let's set this clear. And I know it sounds cliche and everybody talks about, oh, you got to have your mission. It is very essential and a key component. Step one: mission, vision, core values, objectives, and goals. Step two, well, you got to have the know how to do that right. So, we have to create processes and systems. What am I going to do? What's the patient experience going to look like? Do you have a patient experience checklist? When a patient walks in the door, do you have a checklist that tells you exactly what you're going to be doing? Do you have a team member checklist for every single team member to tell them what to do? Do you have your KPIs and all the metrics to assess the health of your systems and processes? Step three: build a strong team. You're not alone. We're never going to do everything. You have to have a strong team even stronger than you are. A good leader has a stronger team than even themselves. Then five, so mission, vision, objectives and goals, systems and processes and standardizing them, building a strong team, track the KPIs, and then, secure financing. Because remember, it's not going to fund itself, right? You're going to have to fund it somehow. It's not we don't live in a dream world. We live in reality. And if you don't have the money to fund it, well, guess what? It's just going to be an idea in your head, and you will live and die with that idea without it being materialized.

Dr. Noel Liu:
So for funding, what is the best strategy? Like, there are so many avenues out there, right? And number one, everybody picks bank debt. First and foremost, would you ever decide into doing like a fundraising or maybe capital raising or something along those lines where you get like some equity firm involved, or would you just strictly stick with friends and family and banks?

Dr. Tarek Aly:
So there's no right or wrong answer here. The answer, it depends. So if you, let's say, you and I are going to start a DSO together to have ten locations with five different specialties in two different states, we're going to approach funding completely different than if we're going to do one location, let it grow and prosper, and then build the second location, or buy it and let it grow and prosper and so forth. You can do self-funding. You could do bank funding, you can do private equity. All that depends on the mission. For first-timers, those who are starting fresh work for a few years as an associate, build some cash reserves, learn the know-how, work on your mission and all the systems and KPIs. And then you can go to the bank, and they will gladly lend you based on your debt to income ratio and all that fun stuff. Your covenants.

Dr. Noel Liu:
How is one practice versus like having a mindset of opening up multiple practices, and why different?

Dr. Tarek Aly:
Yeah, so it has to do with your mission. So for me, for example, I wanted to have the highest amount of impact on so many communities in the lowest possible time. I've realized some in some cases, we had patients that didn't even have shoes, and they barely had enough means to come to the practice. And in other cases, they were in high-end communities where they can afford all the treatment. So, I realized that if I'm going to make an impact, I really needed the scale or the volume. That was my mission. The mission is let's impact as many people as we possibly can. Others are different. Some of my friends are more on the higher end stuff. They want to do the big cases, the implants, and all that. Some are more of the transformational thing. I want to take patients from zero to hero. So it depends for scale. To answer your question, I think the most important piece here is once you define the mission and how you're going to do this, how are you going to fund it makes a big difference. So now you may need to go to a private lending. Finding a private equity group or whatever it is private money because they will be less inclined to be sticklers with your covenants and more believing in your mission. It's kind of like.

Dr. Noel Liu:
Selling a dream, right?

Dr. Tarek Aly:
That's right. Yes, they believe in your dream, so they would be more inclined to take the risk with you.

Dr. Noel Liu:
Love it. So as we start our journey, we are first entrepreneurs. We put everything on the line. We spend our last dollar, right? We have those sleepless nights. Then we transitioned to becoming an operator where we are the ones who's treating patients clinically, and we are on the chair. If we're not on the chair, we are not making any cash flow. And then from there, I think about it this way. Like from there, then you would transition to becoming owners, where now we have associates working and then we become owners, right? And from there, I think another transition after that would be becoming investors and being completely out of it. So, with your expertise, is there like a goal or a timeline where one needs to proceed in order to scale? Because many of our dentists, we get stuck into the operational area, and we never seem to get out of it, right? And we are always trying to micromanage every single thing. So, in order for us to scale, there's no way we can be on the chair and managing and doing the whole thing. How would you differentiate that, and how would you set it aside, like with people and processes? What would you do?

Dr. Tarek Aly:
Yeah. So, going back to the mission, if my mission is to actually get off the chair and be a CEO of the DSO. Then there's a path to that. And that path, believe it or not, is well-defined. We just have obstacles to towards it, but it's well defined. Let's say my mission is to have five locations within a two-hour radius to serve three different specialties. Certain patient demographic. Certain PPO to cash mix. I have it clear in my head. First, I work as a dentist. I am delivering the care myself. I am very well aware of the micro level of patient care and the macro level, because, at that time, you're in the beginning. When you're 1 or 2 locations, you're still doing almost everything. You're the CEO, you're the clinical director, you're this dentist, and you're the conflict resolution guy. You're everything. And then there's going to be this shift between, it's a paradigm shift between the operator to a business owner. You're still a business owner, and you still have that mentality, but you're distracted. You're working eight hours a day, you're you barely have a life, and your kids are asking, like, hey, why did dad didn't come to the baseball game? So you're all these things, and at some point, you're going to have to make that transition to get off the chair. And the reason they're the biggest obstacle to getting off the chair is financial. Most dentists are high-income earners. They make good money being on the chair. So, to get off the chair now, they go from making X, from being a dentist to making Y, being a business owner, which is 10% to 20% profit from the office. So there's this drop financially. And that's the biggest reason why most dentists don't get off the chair. And believe it or not, there's a program or there's a path to get you off the chair slowly without necessarily impacting your financial well-being.

Dr. Noel Liu:
And that's where I think you say like scaling comes in, that you got to scale at that time.

Dr. Tarek Aly:
If the business is making profits and it's healthy and it's growing, there's going to be a little bit of a dip, but it's not going to be that big of a dip if it's running well. And now you can be a true CEO. So, let me share something real quick about my journey for the fact learning about success. I didn't understand what success means because coming from Egypt in the Eastern world to the Western world, whenever you ask someone in America what constitutes success, why does, why do you think this person is successful? Immediately they're going to start thinking about financial stuff like, oh, cars, houses, whatever it is, right? Because I think that's typically how people perceive success. What I realized is from observing different cultures, there is six factors to life success. There's family life, there's love life. There's health and fitness, mental and physical. There is social life, spiritual life, whether you believe in something or you don't, whether you practice religion or you don't. And there's reasonable financial prosperity in each one of these have KPIs. So we focus a lot on the material financial success and think, this is it, but you're disregarding your, exactly. Your kids are not going to be five anymore. Your wife is not going to wait on you to have that date while you're finishing up with patients, and your friends that are always inviting you to stuff are going to stop inviting you to stuff because you never show up. They call you, and you never show up. So you're like, you know what? I'm not going to call you anymore. So factoring all that, you're going to realize, hey, I really need to get off the chair sooner, I really need. It's okay if I take a little bit of a financial dip, but I'm going to get off the chair, scare my business, and I will have a better holistic life so that I can call success.

Dr. Noel Liu:
So, with the multiple tenets that you consulted in the past, what is there a certain kind of personality that they will do that? Or is it something? Is there a trend, or is there like a process that you that anybody can do?

Dr. Tarek Aly:
What I noticed those who are clear on the mission and have the willingness to pursue it, are the ones typically that reach that goal easier. So studies have shown that those who have a goal tend to get closer to it than those who don't. So let's say someone wants to lose weight or want to run a marathon or whatever it is. Those who have the goal set are closer to achieving it than others.

Dr. Noel Liu:
So, when somebody is starting off, should they always have like a location number in mind or like an EBITDA number in mind, or like a revenue number in mind, or should they just start and see where it goes? What would be your take on it?

Dr. Tarek Aly:
Absolutely. It costs nothing to dream. It costs nothing to put a goal sheet together. It costs nothing to do a vision board. You can laugh at it in the beginning when you're like, oh no, I'm just, I just graduated. How in the world am I going to have ten locations? Yes, you can make fun of it. You can laugh at it, but that goal sheet you're going to look at five years from now and say, I am so glad I did this. I'm so glad I did this. You tend to overstate or over-believe in your one-year goals, and you tend to understate your five-year goals. You're always going to crush your five-year goals, but most likely, you're going to not meet your one-year goals. So be realistic, but also dream, and you will get closer than those who didn't.

Dr. Noel Liu:
I love it, I love it, and I got a last question for you, right? It's about a lot of people talk about work-life balance, right? And for me, it's always been like, as we are doing our offices, it's always about work-life priorities at that time. Like what's your priority? So I know a lot of times like you just mentioned, I've neglected my kids, I've neglected my friends. And it's hard, right? And as an entrepreneur, you're, like, always hustling and bustling. What's your take, and what's your advice?

Dr. Tarek Aly:
So, I created a spreadsheet with a checklist and KPIs.

Dr. Noel Liu:
I love it. You got a checklist for everything.

Dr. Tarek Aly:
Exactly. And I called it Factors of Life success. And I actually put these parameters in there. Family life. What does that look to me? How many times I see my parents? How many times I call my family? Love life. How many dates have you gone with your wife or partner without kids? How many gifts have you given them? And when you look at others, like social life, I have a chess club that I, chess group, aviation group, kayaking group. What I call the deep thinking group or the investor group. So, do you prosper and nourish these relationships and the reasonable financial prosperity, which is how much am I making passive income? How much am I making passive income? What's my borrowing power? What's my net worth? And I and I put the current status versus the ideal case scenario, and with steps how to get there. That was the way I did it. I'm not saying that I highly recommend this to everybody, but it worked for me.

Dr. Noel Liu:
I got to give it to you. You own. You are like co-founder and owning so many different practices. Then you have consulting business, and you are a dad with triplets. It's like when I think about it, I'm like, hey man, I want to grow up just to be like him.

Dr. Tarek Aly:
Well, my triplets are for sale. Buy one, get two, free shipping. I have checklists at home with KPIs and everything.

Dr. Noel Liu:
No, exactly. So, what kind of service do you provide as a DSO consultant?

Dr. Tarek Aly:
So one of my businesses is a consulting business. So, we, with Charles Moser, we have this group called the Dental Science Alliance. And it's basically multiple coaches, 20 coaches in multiple disciplines of dentistry. So with a subscription-based.

Dr. Noel Liu:
Is that launched now?

Dr. Tarek Aly:
It is launched, yes, and it's active. And we have, by the way, we have 100% retention rate. So all of our clients are stayed and are happy. Basically, they sign up, and they can they can have sessions with multiple coaches, HR, IT, procurement, compliance, operations, whatever it is. So that's one of them. There's another also company called the DSO Academy, which is an online platform for courses. So they, a member can join in, and they can take courses online. Are they multiple different ones? So there's operations. There is HR. There is things about clinical, just conversion rates and things like that. Closing cases. Also, different experts in the field and the really the quality of the courses are really good, like it's masterclass ...

Dr. Noel Liu:
Nice. Nice. Now, is that something you founded as well?

Dr. Tarek Aly:
Yeah. Co-founded with Gary Bird. Gary Bird is my partner. Amazing.

Dr. Noel Liu:
..., right?

Dr. Tarek Aly:
Yes.

Dr. Noel Liu:
Yeah. Okay, good.

Dr. Tarek Aly:
Yes. Fantastic human.

Dr. Noel Liu:
No, I love it. I just love the energy that you have and that you bring to the industry. It's such an amazing feeling, like just talking to you. It's like I know you for, like, years, and it's amazing. You've got an amazing personality. So, hey, Tarek, lastly, anything you would like to give, like a tip or a takeaway for our young dentist?

Dr. Tarek Aly:
Yeah. So, mission, vision, core values, objectives, and goals. Always have goals. Dream big. Two is invest in yourself. Be a good leader. There's no way you can get, can grow in life without being a great leader. Work on work-life harmony. I don't call it work-life balance because they're not always equal. Work-life harmony and make sure that you go towards your goal every day. And remember, education is everything. There are some amazing books out there. Go to DSO conferences or go to dental conferences. Read books. Network with those who have gone your path, and you'll do amazing. Believe in yourself.

Dr. Noel Liu:
I love it, I love it. Tarek, if you don't mind, I would love to have you back again like later on in the future.

Dr. Tarek Aly:
Absolutely.

Dr. Noel Liu:
You have so much to share. So amazing. Thank you so much for coming on.

Dr. Tarek Aly:
Thank you so much for having me. Thank you.

Dr. Noel Liu:
Well, ladies and gentlemen, we're going to be landing the plane now. So again, appreciate Tarek coming along out of his busy schedule. And make sure to like and subscribe. And we'll have the link for him for his DSO Academy as well as the Dental Health Alliance. And if you have any questions, hit me up. All right. Thank you very much.

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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