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Backwards Decisions: Why Your Dental Practice Growth Might Be Failing

Before hiring an associate or opening a new location, are you truly ready? In this episode of The Millionaire Dentist™, we dive into the critical importance of proper sequencing and planning in dental practice management. Learn how to get your core operations and financials in order, avoid costly "backwards" decisions, and leverage expert advice from accountants and advisors to build a sustainable and profitable practice.

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EPISODE TRANSCRIPTION

Announcer:
Hello, everyone. Welcome to The Millionaire Dentist Podcast brought to you by Four Quadrants Advisory. On this podcast, we break down the world of dentistry finances and business practices to help you become the millionaire dentist you deserve to be. Please be advised, we do speak with an honest tongue and may not be safe for work.

Casey Hiers:
Hello, and welcome. This is Casey Hiers, back at The Millionaire Dentist Podcast. In studio with cohost Jarrod Bridgeman.

Jarrod Bridgeman:
Casey, how are you today?

Casey Hiers:
Doing well.

Jarrod Bridgeman:
Doing well? You look like you've had a busy day today. I've barely seen you. It's made me sad. You're the light of my life. You just come in, you're the sunshine to my day.

Casey Hiers:
Oh, man. Compliments early. I'd better be on guard for what's coming. No, this is fun. A lot of events, a lot of traveling.

Jarrod Bridgeman:
Right, right.

Casey Hiers:
A lot of dental organizations want us to come in, we do our own. It's all good busy.

Jarrod Bridgeman:
Yes.

Casey Hiers:
A lot of conversations with the practice owners.

Jarrod Bridgeman:
You were out in Scottsdale very recently. I've never been to Arizona. I've always like to go visit at some point. How was your time out there?

Casey Hiers:
I love Scottsdale. If I was a tattoo person, I'd probably tattoo Scottsdale somewhere. I love it. Got in and out, was a good boy, didn't bring my clubs.

Jarrod Bridgeman:
Right, right.

Casey Hiers:
We were there for business. But I love that area.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Oh, 76.

Jarrod Bridgeman:
Oh, yeah. Yeah.

Casey Hiers:
When I left Indianapolis, it was four.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Got some In-N-Out Burger, got some Coffee Bean.

Jarrod Bridgeman:
Okay, okay.

Casey Hiers:
I used to live out west, so some of my favorites.

Jarrod Bridgeman:
Yes.

Casey Hiers:
Got to enjoy.

Jarrod Bridgeman:
Your staples you got to hit while you're there.

Casey Hiers:
Yeah. Then great event. Then, boom, airport.

Jarrod Bridgeman:
That's awesome. I'm glad you had a good time.

Casey Hiers:
I told my two daughters and my wife, "Hey, I came back to be a family person."

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Where's my medal?

Jarrod Bridgeman:
Yeah.

Casey Hiers:
I wanted praise.

Jarrod Bridgeman:
Did they get you one?

Casey Hiers:
No.

Jarrod Bridgeman:
Did they even pay attention to you?

Casey Hiers:
Apparently, that's just part of the thing you're supposed to do.

Jarrod Bridgeman:
Oh. Yes.

Casey Hiers:
I wanted extra accolades.

Jarrod Bridgeman:
Yes. Yeah. I'm that way. My daughter is 11 now. Just doesn't seem to really care about anything I have to say.

Casey Hiers:
Yeah. It's coming.

Jarrod Bridgeman:
Whatever. My boy's still around, he's seven.
Casey, one of the things I wanted to just mention real quick, a quick little PSA for our listeners out there. You've heard us mention in some previous podcasts the BOI reporting. That originally was due back on December 31st. It kept getting pushed back and there was litigation. Currently, it is back on track and there is a due date of March 21st. If you have not done that reporting, you need to, or have someone on your team take care of that.

Casey Hiers:
As a business owner-

Jarrod Bridgeman:
Yes.

Casey Hiers:
... the government wants this document.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Not doing it can be problematic.

Jarrod Bridgeman:
Penalties and fines.

Casey Hiers:
There's been litigation in courts and different things. But March 21st, it is due.

Jarrod Bridgeman:
Yeah. Who knows? It may get pushed back again, but keep an eye on it because if you miss it, it could cause issues. Just keep an eye out for that.

Casey Hiers:
Yeah. Well, it's the time of year for accounting, and taxes, and things of that nature.

Jarrod Bridgeman:
Dude, less than two months.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
A month-and-a-half now, almost the end of February. Tax day is coming up. I personally dread tax day just because I don't like messing with numbers and things too much.
You've been here longer than I have, you've been around our accountants. You've obviously done taxes in your lifetime. You're not a super young man anymore. My question for you is what would be a major difference, something to catch on very quickly of knowing if you have a proactive accountant versus an accountants that just reacts to news as it comes?

Casey Hiers:
Yeah. When there's smoke, there's fire sometimes. Specifically with practice owners, they provide a good product to their patients.

Jarrod Bridgeman:
Right.

Casey Hiers:
They expect those that they employee to do things for them to do them well. Unfortunately, that's not the case. We've talked about a lot of these things during the life of the podcast. During tax time, if it's being extended.

Jarrod Bridgeman:
Right.

Casey Hiers:
If your QuickBooks are months behind, if your profit-and-loss statement and balance sheets are behind. If your QuickBooks say one thing, your financials say one thing, and your taxes say one thing, that's not good.

Jarrod Bridgeman:
Right, right.

Casey Hiers:
If you have a shareholder loan on your balance sheet, what the hell's going on?

Jarrod Bridgeman:
Where'd it come from? Why do I even have it?

Casey Hiers:
Yeah. The BOI, your CPA should be handling that.

Jarrod Bridgeman:
Yes.

Casey Hiers:
Or reminding you because that's just how it should be. If you're experiencing some of those things, that might be your sign that you have a-

Jarrod Bridgeman:
Here's your sign.

Casey Hiers:
You have a nice person, you like them, they work with 15 other dentists, but you might not be getting the expert tax advice that you need.

Jarrod Bridgeman:
Forrest Gump was nice. I wouldn't have him do my taxes.

Casey Hiers:
What?

Jarrod Bridgeman:
Listen, one of the things I wanted to bring up is every once in a while, you got a business owner out there making several hundred thousand dollars a year in terms of their collections, and they're still possibly using one of those online ... I don't want to name the companies, but you see commercials for them. What about those people that are just trying to file not only personal, but their business through a simple software like that?

Casey Hiers:
Oh, like TurboTax and H&R Block?

Jarrod Bridgeman:
Yeah, yeah.

Casey Hiers:
No. We've run across that, it's typically newer owners.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
They're trying to get their taxes done, they're still thinking as a civilian not as a business owner.

Jarrod Bridgeman:
Right.

Casey Hiers:
Yeah, you get what you pay for.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
As a business owner, that should give you ...

Jarrod Bridgeman:
Yeah. If that's what your plan is this year, you may want to reconsider.

Casey Hiers:
Well, tax strategy is a big deal. Again, we don't hang our hat on one singular thing here. But just recently, some of the folks that we're working with and looking at their information and data, just by what we do as a standard of care, we're lowering people's tax liability, one person $15,700 per year.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Another person, it's 21,800.

Jarrod Bridgeman:
That can almost get you some eggs now.

Casey Hiers:
It's nothing different, it's just structuring it in a way that masters the opportunity for good tax management for a dentist.

Jarrod Bridgeman:
Don't get me wrong, it's a confusing world. Taxes can be very confusing. There's 100 forms for every one thing. That's why having a team or somebody who's an expert in the dental field in terms of taxes is important.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
Yeah. Casey, you wanted to really bust my chops about something.

Casey Hiers:
I did?

Jarrod Bridgeman:
I don't know, it could be. What did you bring to the table for me? I brought all the other stuff.

Casey Hiers:
No. The topic for today is ass backwards.

Jarrod Bridgeman:
Yeah. Back asswards.

Casey Hiers:
There you go. Typically, for anything, there's a sequence of events that needs to occur.

Jarrod Bridgeman:
Right.

Casey Hiers:
If you do something too soon or too late, it's not good.

Jarrod Bridgeman:
Right.

Casey Hiers:
What am I talking about? Here's the big one. A lot of times, a practice owner will want an associate, but everything else in their practice isn't great.

Jarrod Bridgeman:
Right.

Casey Hiers:
They get an associate, where the order of things should have been different. We'll get into that a little bit later. But there's a lot of real life examples.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Of getting out of order, of doing something ass backwards. The first one that came to my mind was, this was a long time ago. On Spring Break in South Padre, I met a lovely lady.

Jarrod Bridgeman:
Right.

Casey Hiers:
Just getting to know her a little bit. Her dad had reserved her wedding reception because there was a five-year-plus list to have it the South Fork Range in Dallas, which is where the show Dallas was recorded.

Jarrod Bridgeman:
Right, right, right.

Casey Hiers:
She was 22 or 21, and they had already reserved that wedding spot. But here's the point. I didn't know her very long and she had shared that with me.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
It's like on a second date, you're talking about how your wedding ... That's ass backwards. That's not doing things in the right order.

Jarrod Bridgeman:
Right, right. This is something that was not with me, but a family friend. They wanted one of those expensive different cats. One of those Maine Coons, those kind of things. They went and got a purebred. It was, I don't know, $2000 or something. I'm a go down to the shelter kind of a guy. But they did that. Brought the cat home and realized that their daughter was severely allergic.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Same principle.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
It's do things in order. There's endless examples of this.

Jarrod Bridgeman:
Right


Casey Hiers:
But doing something ass backwards where you're like, "Oh, I should have done these three things first."

Jarrod Bridgeman:
Yes.

Casey Hiers:
And you learn the hard way.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
But in owning a practice, holy cow.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
That's one of them. The example you just used. If you want to buy a practice and be a business owner, ahead of time you need to speak with some very, very good accountants and CPAs-

Jarrod Bridgeman:
Yes.

Casey Hiers:
... because there's so many implications. If you're using one of the basic items that we talked about earlier, you need good tax advice before you go out and do something major.

Jarrod Bridgeman:
Right.

Casey Hiers:
But then once you're an owner, it's incredible how many things are backwards in a practice.

Jarrod Bridgeman:
We've mentioned before, we've come across cases where an associate was making more money than the owner.

Casey Hiers:
That happens a fair amount.

Jarrod Bridgeman:
Or it was costing a buck-10 for every dollar they were earning.

Casey Hiers:
Yeah. Or somebody has a practice and their overhead is 75%, and they go open a second practice.

Jarrod Bridgeman:
Right.

Casey Hiers:
Ideally, you would get your first practice-

Jarrod Bridgeman:
Yes.

Casey Hiers:
... great cashflow, great income, great overhead, really, really humming. And then you would launch that second one.

Jarrod Bridgeman:
Well, heck, once you get everything rolling the right way in your one practice, you may realize, "I'm pretty happy with what I'm doing right now."

Casey Hiers:
Well, people I talk to who want extra practices because they don't make the money they want.

Jarrod Bridgeman:
Right.

Casey Hiers:
If they could make the money they want with one, they would prefer one. But it's out of order so many times with, again, the associate or a second or third location. There are things that you need to do first.

Jarrod Bridgeman:
Yes.

Casey Hiers:
Where that can be a really good idea.

Jarrod Bridgeman:
Right. There's a positive thing to set a goal. This is something I would like to do because I really do love the idea of having someone work under me or having a second practice. Set that goal, but then talk to the experts. Talk to the people and be like, "What are the steps that need to be done to get myself secured and make that happen?"

Casey Hiers:
Yeah. You need to know what needs to happen to get there.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
In the example of the talking about your wedding reception location when you just meet somebody. Okay, if you want your wedding to be some place, what needs to happen? Well, you need to meet somebody.

Jarrod Bridgeman:
Right.

Casey Hiers:
You need to establish a good friendship.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
You need to do all these things first. Then having a wedding reception at a really cool venue that's booked out five years can be amazing.

Jarrod Bridgeman:
How many shotgun weddings do you know that were successful for a long time? Maybe back in the day.
Well, I was going to make a joke about how I'm not going to enter a bodybuilding competition and go tomorrow, and hope for first place.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
I know you can't see me right now, folks.

Casey Hiers:
A lot of practice owners will bring on that associate hoping and thinking that that's going to be-

Jarrod Bridgeman:
That's going to save them.

Casey Hiers:
That that's going to be the one. Again, it's just-

Jarrod Bridgeman:
Having a baby together will save our marriage. Having an associate will save my practice.

Casey Hiers:
There you go.

Jarrod Bridgeman:
Let's just burn down everything.

Casey Hiers:
Yeah. In dentistry, there's a lot of things that need to be done a certain way.

Jarrod Bridgeman:
Right.

Casey Hiers:
People will jump steps, skip steps, ignore steps. Then they'll make big decisions and they don't like the result, they don't like where they're at. Again, it's getting things ass backwards. Get your practice and everything about your money right. Then you're in a better position to go make decisions, or take some risks, or grow, or whatever that looks like.

Jarrod Bridgeman:
It's not any different than when you perform your dental work on a patient. There's certain steps you follow to ensure that everything is sanitized, and clean, and done in the right order, and that patient isn't in pain, and all that stuff.

Casey Hiers:
Yeah. If you skip six steps and jump ahead, it's not going to turn out the way you want it.

Jarrod Bridgeman:
Right.

Casey Hiers:
So many of these examples of how it is as a practice owner, it's easy for us to talk about it, we see it a lot.

Jarrod Bridgeman:
Yes.

Casey Hiers:
Then when we bring strategy, and a plan, and put numbers to things, boy, it adds clarity.

Jarrod Bridgeman:
You're so right because we see dentists and talk to dentists all across the country, and we see all these cases. For us, there's so many common issues. It may be different a little bit here and there, but there's a lot of common issues. But to the person that we're talking to, it feels like it's just them against the world. You always say, "Do you feel like you're on an island?" They don't realize that there is people out there to help them with these things.

Casey Hiers:
Yeah. This cliché saying but it's very true. People just don't know what they don't know.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
A lot of practice owners, they're not trained or educated on a lot of the decisions they're making.

Jarrod Bridgeman:
Right.

Casey Hiers:
It's hard, they just don't know. When you add, again, the strategy and the expertise and the numbers, they quickly realize, we love to educate them.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
"Oh, that makes sense. This isn't necessarily a bad idea, but it would be a really bad idea if I did it when I thought I should do it."

Jarrod Bridgeman:
Yeah.

Casey Hiers:
"Instead, I need to do these three things. Then this will be the trigger for this action."

Jarrod Bridgeman:
Right.

Casey Hiers:
Boy, when you put systems in and have numbers to guide you, it helps. So many practice owners get things ass backwards.

Jarrod Bridgeman:
Even just being in my own little department in marketing over here, I've built my own systems and have some things going that might have taken a little work on the front end, but it's really made things better in the long run.

Casey Hiers:
Well, you could come up with a really nice marketing piece to send out that we're doing something really cool in some city. But if we haven't reserved the space-

Jarrod Bridgeman:
Right.

Casey Hiers:
... and scheduled flights, and planned accordingly, and invited people, then that action was a terrible decision.

Jarrod Bridgeman:
Yeah. Waste of time.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
Waste of space, waste of everything.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
Yeah. Casey, thank you so much for stopping in today. Folks, we talk about our events a lot. We've got way more coming up. Next week, we're going to be in Birmingham, Alabama. That's going to be pretty exciting. We just launched some events and we're going to be in Denver, Colorado in a few months. We're going to be hitting Louisville in Kentucky and Lexington. We're going to be in the Carolinas. Visit fourquadrantsadvisory.com/events, check it out. Please come, please register.

Casey Hiers:
We'll be at the Hinman, too.

Jarrod Bridgeman:
You're presenting at the Hinman, right?

Casey Hiers:
Yeah, that'll be fun.

Jarrod Bridgeman:
And the night before, we're doing a social there in Atlanta.

Casey Hiers:
We're sending off one of our clients. He was the president of a state dental association. We're going to send him off with a nice event. That's more private.

Jarrod Bridgeman:
Right, right. No, that's great.

Casey Hiers:
So I shouldn't have probably advertised that.

Jarrod Bridgeman:
We love our clients. Anyways, Casey, thank you so much. I can't wait to hear on your next trip how it went.

Casey Hiers:
Thanks.

Announcer:
That's all the time we have today. Thank you to our guests for their insight and for sharing some really great information. Thank you to you, the listener, for tuning in. The Millionaire Dentist Podcast is brought to you by Four Quadrants Advisory. To see if they might be a good fit for you and your practice, go on over to fourquadrantsadvisory.com and see why year after year, they retain over 95% of their clients. Thank you again for joining us. We'll see you next time.