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EPISODE 145: A Healthy Practice Makes Money

It's a brand new year. Casey and Jarrod return from break to discuss healthy habits and the effects they can have on a dental practice.

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EPISODE 145 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 co-host Jared Bridgeman. Happy New Year.

Jarrod Bridgeman:
Hey, happy New Year. How was your break? How was your time away?

Casey Hiers:
It was good. Sharpened the ax. Spent time-

Jarrod Bridgeman:
Sharpened the ax, that's a weird way to talk about your wife.

Casey Hiers:
Stephen Covey's Seven Habits of Highly Effective People, sharpen your ax, I guess I should probably say. Sharpened my ax, relaxed. It was good, family, friends. Yeah. Got recharged. It was fantastic. How about yourself?

Jarrod Bridgeman:
It was a nice break, but as you know, we took a week off, but so did the kids, so it's not really a big, quite a vacation when you have a five-year-old and a nine-year-old running around the house.

Casey Hiers:
They just want daddy's attention.

Jarrod Bridgeman:
Yes.

Casey Hiers:
What do you want to talk about today?

Jarrod Bridgeman:
I want to talk about you, Casey, and my love for you.

Casey Hiers:
It's a terrible topic.

Jarrod Bridgeman:
It's a terrible topic. You came in this morning full of piss and vinegar, as usual, and you were talking about... We kind of chatted about health and how you do supplement stuff to help, especially in the winter times with colds are floating around, kids going to school and coming back with stuff. You tend to kind of take some supplements and vitamins.

Casey Hiers:
Fact.

Jarrod Bridgeman:
Right. We jokingly said what we do and how we talk to potential clients and clients is like a vitamin or a supplement. I was like, "Hey, why not make a podcast talk about how we-"

Casey Hiers:
I see where you're going.

Jarrod Bridgeman:
Right?

Casey Hiers:
Yeah. I see where you're going with that. What do you take? You just take a multivitamin?

Jarrod Bridgeman:
I do, yep.

Casey Hiers:
Is that it?

Jarrod Bridgeman:
Yeah, pretty much. I have these little tablets that you drop into water and they kind of fizzy and I drink it.

Casey Hiers:
Yeah, water's soluble. Maybe it gets absorbed better.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
That's good. Yeah, I got a B12 shot yesterday.

Jarrod Bridgeman:
Where?

Casey Hiers:
The location of the place or the anatomy of-

Jarrod Bridgeman:
The anatomy of the butch body part?

Casey Hiers:
It was very direct. It was a direct shot. I actually take my, I'll take one of my kids. Just they laugh when daddy gets a shot. Anyway, yeah, I take a lot of vitamin C, a lot of vitamin D, a lot of vitamin B, zinc, probiotic, turmeric, just to name a few.

Jarrod Bridgeman:
At lunchtime you just sit down with a plate full of pills?

Casey Hiers:
Just massive doses, yeah. It's a 10 process in the morning. But as I look through these, and even on Friday, I could tell my body was fighting something. Right? Saturday, same thing. Thought I had a fever, didn't have a fever, and just took a grizzly bear's dose of all these things again, and felt better on Sunday.

Jarrod Bridgeman:
Good.

Casey Hiers:
But when I look through all the things that I take and what they do, and there's a place for each of those, some turmeric, anti inflammation, probiotic, toxic employees, probiotic. There are some things here that I think have a lot of crossover, but the point of talking about taking supplements or sleeping supplements is for me is what keeps-

Jarrod Bridgeman:
It's pretty high on the list of-

Casey Hiers:
Keeps me healthy. People talk about all these things for health, and if you take supplements and get some sleep, that's probably good. That's not why we're doing this podcast. This is a dental podcast. When you think about supplements, we think about a practice. There's not one supplement I take that helps, helps me. It's cumulatively and it's consistent. Practices going up to present to a dental society this week, and inevitably in the crowd of 45 practice owners, two or three of them are going to want to come, and they're going to want that magic bullet or the magic wand that's going to fix everything. That doesn't exist in the practice. We've talked about that.

Jarrod Bridgeman:
Yeah.
There's no cure all.

Casey Hiers:
No. We'll get into this whole, take these supplements that helps the body. What can practice owners do in the practice to help their dental practice health? We touch on some of these along the way, but let's take it that way.

Jarrod Bridgeman:
Well, you'd mentioned probiotics, and that is something I have taken in the past. It's good for digestion and it's good for kind of expelling unwanted things in your body. You mentioned how probiotics, these are one of the things could potentially represent toxic employees.

Casey Hiers:
Yeah. I think when you look at your practice, hopefully everybody has a good culture and has a good team. It's been, since Covid, challenging to have enough help, but at what cost sometimes do you have people that aren't good for the office? You want a good culture, you want a good vibe, you want a good flow. You want people to get along. Let's be honest, it can be adult babysitting sometimes, but if you have a lot of good folks to watch over, it can be a lot more fun.

Jarrod Bridgeman:
Even if you're mindful and try really hard to have a very positive and great work environment for yourself and your employees. One bad seed can constantly bring everyone else down.

Casey Hiers:
Well, and it's make sure that the tail's not wagging the dog. One of the things we've been seeing, and we're not going to say, "Vitamin C equals this in the practice." We're going to move past supplements, but in totality, that helps health. In the practice, here are some things we were talking about. One of the things, and I call it cooking the books, don't bill, expect to collect. So many practices, their fee schedule, they may charge $1,200 for X.

Jarrod Bridgeman:
Okay.

Casey Hiers:
But insurance gives them $700. They just put in a 700 is what they expected to collect. That's what they collect. Everything's whole, everything feels good. That's not a good way to keep track of numbers, especially when you're running a practice. Don't put down expect to collect, have the spread. Know what the spread is.

Jarrod Bridgeman:
What's bad about it, though?

Casey Hiers:
Well, what's bad about it is you, you're not getting a true picture of production, collection, insurance. There's a lot of variables in that equation that you need to know. Especially at the end of the year or the beginning of the year, as you're assessing your practice in totality, how can it be better? You're basically blinding yourself to certain issues.

Jarrod Bridgeman:
If you have that all out in your spreadsheets, your QuickBooks, whatever you keep your numbers in, you'd be able to see potentially patterns of, "Okay, this insurance here is taking a lot more across the board. Maybe I should look into our situation with them."

Casey Hiers:
Yeah, it's important. Number one, your fee... You should be charging 80% of what your peers are in your zip code. Most dentists would say, "Yeah, I'm the 80th percentile of great dentists in my area. I should be charging that." A lot of times folks' fees are off maybe 7%, not terrible. We've also seen 45%. They were shocked and thought the very credible fee study was wrong, but know what your true fees are, know what they should be in your area. Stack rank your insurances. Know what you're really collecting, versus what your fee schedule says. These are all things that are going to help your health. They're just little shots of vitamins. Again, not to get too whatever, but when you take some of these vitamins, it might give your body a reaction where your stomach feels a little funny or you might have a little bit of a negative reaction early, but that's for the ultimate good.

Jarrod Bridgeman:
Right. As we're kind of alluding to here, there's not one fix-all, cure-all thing. It's all these things together help the overall health of you and your practice.

Casey Hiers:
Once a week I'm asked, "Okay, you guys reduce overhead 10.9% within 36 months for new clients. How?" Everybody wants to know the how. Right? It's not one thing, it's not three things. It's not five things. It's 18 to 27 things. They can vary depending on need, practice, and situation. It's exactly right. Having updated QuickBooks, that sounds pretty routine, but you need them updated and you need them updated with the right numbers.

Jarrod Bridgeman:
What are some other negatives that could come out of not having an updated QuickBooks?

Casey Hiers:
Well, you're running a business blind. You don't know your numbers. We talked about that. What, what's worse than incomplete or incorrect data? Making decisions using incomplete or incorrect data. It's incredible how many conversations I'll have with people wanting to get an associate at a second location, go into 1.4 million of debt, buying a new building and building it out. But yet they don't even have last year's taxes complete. Their QuickBooks are six months behind. It's really hard to do that.

Jarrod Bridgeman:
Not expecting potentially a very large tax surprise.

Casey Hiers:
Well, good point there. Man, that B12 shots kicking in. I'm just rattling them off. Sound like the micro machine guy for the reference for the-

Jarrod Bridgeman:
That's so funny. I mentioned him the other day.

Casey Hiers:
Our younger listeners won't know who that is. But anyway, this is the time where you want to look at last year. If you don't have your numbers, how can you know? But you want to plan for your quarterly tax estimates for this year. Well, dividing by four on what you did last year, that's a great start. But you should forecast with your external team, not your hygienist, on what you think you're going to do next year.

Jarrod Bridgeman:
Listen, she's really good with numbers.

Casey Hiers:
That's a.... Well, hey, hope that's a big bonus. But we need her to do hygiene and produce three times what you pay her. But this is when you look at last year, you divide it by four. You plan out your quarterlies, you look at your forecast. What do we think we're going to do? What headwinds, what good, what bad did we drop in insurance? Did we raise our fees? What factors are going to go into that? Then be consistent to look at that monthly and quarterly and to tweak things as needed. Now again, you should probably have a team that does that for you, but if you don't, this is something that it's just like taking that big quadruple dose of vitamin C, you might gag on it a little bit, but it's going to help you. Doing this with your taxes is going to be really, really important. Again, it's just one or two or three parts of having that good business dental practice health.

Jarrod Bridgeman:
If you're talking about practice health with your external team, I would equate a CPA to a general doctor when it's probably a good idea to find a specialist. As you know, with your own practice and having to find all the, if it's prosthodontics and [inaudible 00:10:35] and things like that. Finding a specialist that helps specifically with dental practice owners would make a world of a difference.

Casey Hiers:
Was that a shameless plug for Quadrants Advisory?

Jarrod Bridgeman:
It sure was.

Casey Hiers:
Well, we were talking to a colleague and he was sharing a family member wasn't feeling well and having some heart issues. They were battling with at their own house on what should be done and how it should do. Then they were in the hospital and they were battling and arguing with the cardiologist, and they didn't like what they were hearing and they were disagreeing and they were... Well, ultimately this family member was going into the hospital, going into the ICU, lost 80 pounds and really heading towards a bad place. Finally they said, "Hey, can you help me? I'll stop fighting you." He goes, "You need to stop fighting me, and you need to start listening to our advice, because you're going to die."

Jarrod Bridgeman:
Yep. Stop self-diagnosing, stop self-medicating.

Casey Hiers:
Now that's a-
Stop trying to do it yourself. Right? When our colleague shared that with us, I think that really resonates because so many listeners want to... The cardiologist is going to tell you what you need to hear, not what you want to hear. Your oncologist is going to do the same thing. That's what we do here with so many people. They either don't want to hear it or they want to try to do it themselves. That can be really, really detrimental to your health. If you don't do all these things that we mentioned and you try to do it yourself, then what are you susceptible to? Supplementary susceptible to sickness. You're going to be susceptible to the corporate dentistry DSO person coming around and dangling the big check in front of you and you going, "That looks good to me. That's my only my hope."

Jarrod Bridgeman:
That's my best option. Yeah.

Casey Hiers:
Again, for some it may be the right decision. For most, they tell us we're the messenger. "It felt like I sold my soul. It wasn't great for my patients, wasn't great for my staff. I didn't go out the way I wanted to go out it. The money ended up not being nearly enough to help me get where I wanted to go in retirement. It wasn't a good move." That's what we hear consistently. Well, you're going to be susceptible to being vulnerable to that if you don't get these things in order.

Jarrod Bridgeman:
We talked about self-diagnosing. What are some common things you've seen out there with practices that dentists have self-diagnosed as being issues in their practice that's not really the actual issue.

Casey Hiers:
Typically, people will go to... They'll think about their supply costs or they will think about their employee wages. I'm just sharing the conversations I've had, and they do that because they, they'll go, "Well, I can't get any lower pricing, and I need all my employees." They basically are saying, "Well, these are my problems, but they're not really problems, and so what can I do?" They throw their hands up and act like they've addressed the issue and then continue to move on.

Jarrod Bridgeman:
Gotcha.

Casey Hiers:
Now, in the spirit of the new year and reflection, here's some other things in terms of good practice health. What procedures are you referring out? Maybe you're not referring any out, but if you're referring a whole lot of procedures out, is there maybe one or two that you look up and go, "You know what? I've been practicing dentistry for a while. It might be fun to go learn a new procedure to keep myself engaged and stimulated." Those are all areas that, again, in totality, it's going to help. To think you can do it all by yourself? Boy, if your wife and kids can't stand you, I guess, maybe.

Jarrod Bridgeman:
Wow, I told you that in confidence.

Casey Hiers:
But being a full-time dentist, specialist, practice owner, and then trying to do all these things can be challenging. But ultimately these are just a handful of things for good health and a practice, there's many more.

Jarrod Bridgeman:
You know what's even more interesting and self-serving about that? We are offering a complimentary practice financial assessment that can help find an area that needs help. We offer eight choices. You can choose one. If you go to fourquadrantsadvisory.com/assessment, take a look at that, fill out the form and schedule a call with one of our specialists. We can start taking a look and have a quick phone call. Start taking a look at your practice.

Casey Hiers:
Well, and it is a nice opportunity. Ultimately, we talk to hundreds of practice owners a year to vet out 15 or 20. This is an opportunity we are giving. We are people of our word. We will look at your data and give you some-

Jarrod Bridgeman:
Some fairly sound advice, and here's the deal.

Casey Hiers:
We'll give you professional advice, and then ultimately, maybe have bigger discussions. But that is on its face what you will get, is complimentary advice from your data.

Jarrod Bridgeman:
Yep, and this is coming probably come from my personality. There's really nothing to be embarrassed about. This is what we do all day, every day, and talk to people every single day about our issues and things that need to be worked on in practices. If you feel like, "Oh, this may be something I've been... I don't know well enough, or there might be an issue," reach out to us. Don't be scared that we're going to tell you what you need to hear, not what you want to hear. Then that's what you need. Don't be scared of that.

Casey Hiers:
Well, don't let your pride and ego get in the way of a lot of money.

Jarrod Bridgeman:
So, all right. Thanks, Casey.

Casey Hiers:
Go take your supplements.

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, and we'll see you next time.