Are your insurance adjustments causing you concern? What about your overhead costs and employee salaries? Have you been feeling overwhelmed by how high everything seems lately? Join Casey and Jarrod as they delve into these aspects and more, exploring how they can leave practice owners feeling defeated.
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, it's so good to see you.
Casey Hiers:
Ah, I love that color. It's like a Dreamsicle orange, that color.
Jarrod Bridgeman:
Casey, you just got back from Chicago, just a couple of days ago, and you've been out and about a lot lately. Going to Charlotte, going to Houston, going to St. Louis, and presenting and spreading the good word out there. When you're out there and you're speaking with these dentists, do you often find that within the room you can fit certain dentists into certain buckets?
Casey Hiers:
Are you asking me, do I stereotype? No.
Jarrod Bridgeman:
Yes. Okay.
Casey Hiers:
No, I think I get it. Yeah. First of all, the crowds that we get are majority awesome, great people, fun people. The subject matter we cover is very serious. It doesn't make you feel real good, but it's needed. So we like to have some fun. That's why we'll do great food, we'll have it at a great venue. We'll have a bourbon tasting or whatever, but-
Jarrod Bridgeman:
Or some Topgolf or something to kind of ease the pain that's ahead.
Casey Hiers:
Yeah, I mean, we want to have some fun, but yeah, ultimately we'll have younger people who, they're astute enough to know that this topic is important. And they're also scared of it a little bit because they've heard maybe some older dentists share some more stories. But younger, maybe not an owner yet, but boy, those folks, I look at them, I go, "They at least realize this is an issue."
Jarrod Bridgeman:
Well, and they're also in the room, which gives you the idea of like, "Oh, they're wanting to own."
Casey Hiers:
Yeah, a lot of them do. I had a side conversation with a couple, and the associate deal for her was so sweet, they're like, "We haven't seen one like it." And I'm like, "I've not heard a lot like it." And they're like, "Well, worried ownership will be not as good." But yeah, you've got that group, you've got some of the folks ... Maybe you're kind of it. They're in their mid to late thirties to maybe early fifties, and so they're in it.
Jarrod Bridgeman:
Now this group of people who are maybe younger-ish, maybe not own, when you're presenting and you're asking questions, and I know sometimes you might get some pushback, do you get a lot of pushback from that group? Are they the Waldorf or whatever from The Muppets? Are they the ones out there yelling something back at you?
Casey Hiers:
Wait, like the old men in the balcony?
Jarrod Bridgeman:
Yes.
Casey Hiers:
I don't know what their names are, but I do remember them.
Jarrod Bridgeman:
One's Waldorf, but yes.
Casey Hiers:
No, no, they're young, like a sponge. I mean, they're really just sort of ... They have a lot of questions and they're inquisitive and they're listening very intently.
Jarrod Bridgeman:
Good, yep.
Casey Hiers:
Versus, it only happens maybe one out of five times with the guy with 80% overhead that's fallen asleep in the corner. You're like, "Hey, pal, you may want to write this down." No, and then ultimately, there's some people on the back end of their career, and I hear a lot of, "Oh, I wish I would've heard this 15, 20 years ago." A lot of our clients go, "I wish I would've started working with you 15 to 20 years ago."
But yeah, you'll have some of those folks as well. And sometimes it is too late, but a lot of times it's not. But then you also see the defeated practice owner, and sometimes that's because they've tried to grow and they just haven't been able to grow.
Jarrod Bridgeman:
I guess, when you use the term defeated dentist, what do you mean by that? Like defeated in life almost?
Casey Hiers:
Dentistry is not what they thought it would be and they're bordering on ... What's that negative? There's like a negative ... They're cynical, they're jaded, they're-
Jarrod Bridgeman:
Right. They're kind of just going through the motions of-
Casey Hiers:
They feel like they've been burnt. They seem very frustrated. Basically, "If I couldn't do it, nobody can." I mean, we break it down, as a practice owner, regardless of where you're at, are you in a survival mode or are you in a growth thriving mode? And that's how we look at it and divide them. If you're just surviving, you have a lot of uncertainty. You have sleepless nights. Those two things affect decision-making. You talked about it earlier.
Jarrod Bridgeman:
And health.
Casey Hiers:
Oh, well, no doubt. But if you have sleepless nights, uncertainty, stress, your decision making, you might be looking for an immediate gratification decision making, because you almost don't have the capacity to look and understand what a decision might mean long term.
Jarrod Bridgeman:
I mean, that's the kind of stuff that affects people in certain areas where they have those quick loan, cash loan places. "I need that 100 bucks right now."
Casey Hiers:
Sure. And that's translated into something ... If you're in a surviving mode, if you haven't spoke to your accountant or CPA or some of your external team much this year-
Jarrod Bridgeman:
I mean, it's October. Near the end of October.
Casey Hiers:
Yeah. If you're not in a surviving mode, you might be when they tell you the you owe $50,000.
Jarrod Bridgeman:
Is this Jeff Foxworthy kind of thing? "If you haven't spoken to your CPA yet this year, you might be-"
Casey Hiers:
You might be surviving, yeah.
Jarrod Bridgeman:
"... a defeated dentist.
Casey Hiers:
Yeah. Well, but no, unfortunately, there's a lot of that out there. But surviving versus ... Okay, now let's call them just defeated, and I hate that, but insurance adjustments are high, overhead's high, employee wages are high, tax planning is reactive. They're not growing. Their income isn't what they wanted it to be.
Jarrod Bridgeman:
Or showing.
Casey Hiers:
Their stress is off the charts. Dentistry's not what they wanted it to be. Their income's never been reflective of their hard work, and they're so frustrated they don't understand why.
Jarrod Bridgeman:
And then, do they come out at you in these group settings, just because they're defensive because they know they're being called out? Or what is your opinion on what ... I know it's obviously a very emotional thing for them. I would compare it to just sometimes with a parent when you're younger or with a spouse now, sometimes some conversations can hurt, and as dudes, we can sometimes be defensive.
Casey Hiers:
Yeah. I mean, really this is probably less than a handful of times in many, many, many, many, many, many things.
Jarrod Bridgeman:
Sure.
Casey Hiers:
But yeah, I think some of that can come out. And ultimately it starts with just some questions. It starts with questions, and then it really gets kind of sad because ultimately, if they've spent multiple decades trying to produce great dentistry and master the business and financial side of their practice, chances are they're not where they want to be. And I think that realization sets in when a few factors hit. Age of course is part of that formula, but some other factors hit. They realize, "I'm not going to be able to retire like I want."
Jarrod Bridgeman:
I mean, yeah, the fact is, you might be an excellent dentist, you're probably a great dentist, but business things, in general, are very hard, it can be very emotional. And then you start getting into finance, you start getting into taxes, and taxes are not an easy thing to understand.
Casey Hiers:
No. Well, and this Employee Retention Credit, ERC, that's coming up I think in April of 2024, where that expires, and so people have to get this in prior to that. And I'm having more and more conversations where what we would call their run-of-the-mill standard accounting operation, they're coming up with a lot of excuses. They don't want to do it. They don't want to look into it.
Jarrod Bridgeman:
Isn't that their job?
Casey Hiers:
Yeah, one would think. And so ultimately we've heard things like, "Yeah, my CPA looked into it and said, 'It's too much trouble.'" And then they gave them a $2,000 bill for them looking into it, saying, "It's too much trouble." Somebody else told me their accountant goes, "Well, yeah, but then I'd have to go and amend returns." And I'm just like, wow.
Jarrod Bridgeman:
I mean, that's the point.
Casey Hiers:
So when we talk about comprehensive, our firm is looking at the entire picture of our clients to help them. If you have it piecemeal, that means that your account's looking at it going, "Oh, this is a pain in the ass and I'm going to have to amend some stuff and I don't really want to."
Jarrod Bridgeman:
Because sometimes we have Pipes on our podcast, Steve Levy, he's our tax manager here, and he's not in this week or in this podcast this week, because he's out there being proactive with taxes right now.
Casey Hiers:
Yeah, I mean, it's all-inclusive here. We're going to look and see if an employee retention credit makes sense for you and your practice, and there's three criteria and there's all these things, and-
Jarrod Bridgeman:
And you got to fill out form A and B and check this box and do these things. Sure.
Casey Hiers:
Yeah. I mean, our clients enjoy it, but I'm hearing more and more as people are realizing the deadline's approaching and they're inquiring, they're not getting the answers they want.
Therefore, you are in that survival side of things versus that growing and thriving side of things. Because we're all in one and we have different seasons, but if you're in the surviving mode, if you don't get out of it, then you're all of a sudden in the defeated dentist section of the house and you don't want to be that either.
Jarrod Bridgeman:
And it's a cycle that's really hard to get out of.
Casey Hiers:
Again, what do we always say? These numbers, insurance adjustments, overhead, employee wages, reactive tax planning, they don't get better if they're not addressed. They get worse.
Jarrod Bridgeman:
Right. You need to ask yourself, how high are those? How high are you right now?
Casey Hiers:
Yeah. I mean, overhead, sometimes people are 70, 80%.
Jarrod Bridgeman:
If they even know that. You know what I mean?
Casey Hiers:
Most of them don't. I mean, I know that most of them don't. When I'm in a room, I know most of the time they don't know what their insurance adjustments are, their overhead, their employee wages. They do not know what those are.
Jarrod Bridgeman:
Let me ask you, is there a correlation to, if they don't know, it tends to be high? Because I feel like if they spent the time to learn it and know it, they might have at least some better control over it. Or am I just speculating?
Casey Hiers:
I've talked to people with ... That might be true, but I don't know if it's a direct correlation.
Jarrod Bridgeman:
Okay, okay.
Casey Hiers:
I've talked to somebody who's like, they go, "I don't think my overhead's too bad." So they didn't really know. It was 58%. We've seen worse.
Jarrod Bridgeman:
Right, right, right.
Casey Hiers:
But, yeah.
Jarrod Bridgeman:
Casey, it sounds like when you're out there, you run into a lot of different types of people, a lot of different personalities. Does that ever affect your presentations and how you teach and how you speak with people having to deal with ... Not deal with it, having to potentially cater to these personalities?
Casey Hiers:
Interesting. I mean, the nice thing is, when we have groups of, let's say, 18 to 30, it's cozy. So it is nice. There is interaction, and I love hearing from audiences and things like that. But yeah, I mean, certainly if people are in that defeated dentist section, it's emotional, because they've tried a lot of things and nothing's worked and they're frustrated.
And so the tone I get is, "Well, if I can't do it, nobody can." And then when I give them different examples, I mean, ultimately there is a profitable way to have an insurance shop. Your external team should be showing you that blueprint. There's a profitable way for a hybrid model. There's a profitable way for a fee-for-service model. There's ways to do it.
Jarrod Bridgeman:
You got to pick a lane.
Casey Hiers:
We have 20 years of examples of this, but just saying it can't be done is unfortunate. But no, I customize this presentation to, at least try to, to each room, each group of people the questions they ask. But yeah, no, we certainly had somebody who potentially had gotten beaten up and their realization was kind of sad, but they didn't want to accept that success could be had.
Jarrod Bridgeman:
Well, they may have lost.
Casey Hiers:
They just wanted to be like, "Insurance has ruined it for all of us." Instead of, "No, there's ways." Your margins are less. As a dentist, you could be less than mediocre at the business side of dentistry and get away with it maybe 30, 40 years ago, now you can't. The margins are thinner. Again, it just elevates what we do as a firm. And again, if you never work with us, that's okay, but make damn sure that the team you do work with is up to your expectations and you know what good should be. Because I just talked to somebody, I believe they're a listener, and they basically said, "I feel like I'm giving my external team the ideas, and they're having to have a harder time checking them out or verifying them." I go, "Which would be like me going to my dentist, walking him through how to do my exam or do the cavity." That's ass backwards.
Jarrod Bridgeman:
It feels like Dr. Nick from The Simpsons. I don't if you remember that character, but yeah.
Casey Hiers:
I'm sad to say that reference is-
Jarrod Bridgeman:
Lost on you?
Casey Hiers:
Lost on me.
Jarrod Bridgeman:
Yeah. Oh, my bad.
Casey Hiers:
No.
Jarrod Bridgeman:
So Casey, if anybody out there is listening and they maybe not get beat up, but kind of feel some of the emotional pulls that you can give in a presentation, do you know where you're going to be next?
Casey Hiers:
Orlando and Scottsdale.
Jarrod Bridgeman:
That's right.
Casey Hiers:
Got to...
Jarrod Bridgeman:
Phoenix area and Orlando, yes. So both those events will be upcoming in November. Please go to fourquadrantsadvisory.com/events, and when you click on it make sure you register, please. We'd like to keep a good headcount of who's going to be there.
Casey Hiers:
Yeah. I mean, these tend to sell out. We got to know who's coming.
Jarrod Bridgeman:
Right. Just don't show up and you might have to sit by the trash can. That sucks.
Casey Hiers:
Yeah, we typically do have some pretty nice private rooms. It was a great space and we had a great time.
Jarrod Bridgeman:
I'm not even allowed to go anymore. Casey's had to kick me out because we've had so many people in there. It sucks. All right, Casey, buddy, I really appreciate you helping me out today and understand some more of these things that you've run into.
Casey Hiers:
Thank you, sir.
Jarrod Bridgeman:
Thank you.
Announcer:
That's all the time we have today. Thank you to our guests for their insight and for sharing some really great information. And 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.
