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3 Questions We Ask Every Dental Practice Owner

Before we even start the process of looking into a practice's finances, we ask 3 simple but possibly hard-to-answer questions. Casey and Jarrod go over each question, the purpose behind them, and why they are so important to all parties involved.

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EPISODE 166 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 Jarrod Bridgeman.

Jarrod Bridgeman:
Casey, how are you?

Casey Hiers:
Good. It's client day. We're in suits.

Jarrod Bridgeman:
Yeah, you're looking sharp.

Casey Hiers:
Look good, feel good.

Jarrod Bridgeman:
That's right.

Casey Hiers:
Feel good, podcast good?

Jarrod Bridgeman:
Yes.

Casey Hiers:
Something like that.

Jarrod Bridgeman:
Record well.

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

Jarrod Bridgeman:
I wanted to talk about when you are out in the field, talking with practice owners, talking with dentists, before they even start in the process with us, are there some common questions you ask right away, stuff that you need to know from them right now to even get moving to step one?

Casey Hiers:
Gotcha. What are some of the questions that I wrote down that you have?

Jarrod Bridgeman:
Oh, I see how you are. So your first question that you ask is this, "What are your biggest challenges?"

Casey Hiers:
So there's two reasons why that question is important. And again, this is not necessarily in process with us, but just conversations with practice owners. But the first one is, do they know what their challenges are? Some don't know, others aren't willing to admit them. That's a big one. I mean, think about none of us really criticism or to acknowledge our faults, and so I think maybe as a kid or in your twenties or whatever, at some point in our lives, we've all probably been in denial about a fault. Is that fair?

Jarrod Bridgeman:
Oh, for sure.

Casey Hiers:
Any examples you'd like to give about your faults?

Jarrod Bridgeman:
If you've been listening to this for a while, I'm sure you've picked up on some of those.

Casey Hiers:
Well, you see what I just did. I don't want to talk about mine. Nobody wants to talk about them.

Jarrod Bridgeman:
No one wants to show weakness. They don't want to show frailty, if you're a practice owner, you're inherently in a leadership position.

Casey Hiers:
Yeah, we say this a lot. You've been an overachiever your whole life, so it's kind of against your worldview to need something or not know something. So that's important because first off, do you know what they are? Because some, they know that their practice isn't performing optimally or the most profitable, but they're not sure why. And then if you do know why, can you talk about it and can you admit it? Those are really more important than the actual what they are, because typically it falls under, I don't know, half dozen to a dozen areas, big buckets. And so, the actual question isn't as important as the things I just mentioned.

Jarrod Bridgeman:
Let me ask you, I mean, this is something that reverberates through a lot of different conversations of fields, but why is it important to know what your challenges are? Why is it important to reflect on that?

Casey Hiers:
Well, I ask folks what their insurance adjustments are, if they're indeed in network with insurances, and a lot of times they don't know or, "What's your overhead?" "I think it's 65%. Oh, it's actually 81." And so, being able to identify insurance or overhead or employee wages or a lower income, fees, whatever it might be, patients per day, production per day, referring out things, all these data. You need to be aware of them, but typically, if you're not, it's worse than you think. And if it doesn't get addressed, what do we say? It typically doesn't get better, it gets worse.

Jarrod Bridgeman:
And if you don't know what the challenges are, how do you work on them? I mean, for example, but is this dentist anonymous? You have to admit there's a problem before you can work on it.

Casey Hiers:
Hello, I'm a dentist and my overhead is terrible and I don't know why, or I don't know how to affect it.

Jarrod Bridgeman:
Right. Because you should know, Hey, I'm having this issue, obviously you don't have it pinpointed exactly, but you should know there's an issue, if that's the issue and potentially what your goal or what you'd like it to be.

Casey Hiers:
Here's another reason why they won't admit their challenges, they'll say, "Well, my overhead side, but I'm not getting rid of any employees and I want my stuff." It's not about that all the time. Most of the time it's not about that. Or they go, "Well, I have to take insurance because of where I live, there's a huge employer." You're justifying the problem so that you then don't have to address it. Sometimes there are very good reasons why your challenges are your challenges, but being able to admit them, acknowledge them, pinpoint them, and then determine, is this something I can fix? Is this something fixable? Is this something that I need to delegate? What are my options?

Jarrod Bridgeman:
Sometimes it's tough. I mean, if your practice is on the top of Mount Everest, you might have low patient volume.

Casey Hiers:
Actually, the ones that are out in the rural areas that are [inaudible 00:04:56].

Jarrod Bridgeman:
I meant mountain [inaudible 00:04:57].

Casey Hiers:
[inaudible 00:04:57] not as saturated, typically [inaudible 00:04:59]. But no, that's a big one. And again, for our listeners, what are your challenges? Have that honest conversation with yourself. And it's okay if you don't know.

Jarrod Bridgeman:
And in your experience, a lot of the biggest challenges tend to be relatively the same across the board. I mean, different areas and different people have their own challenges, but there are a lot of times very similar ones from practice to practice.

Casey Hiers:
Broad strokes, you can put them in the, like I said, 6 to 10 buckets of what they are, the reasons why and how to fix them can be very different, very custom. But no, we typically know what the big ones are. And so again, when I ask that question, I can hear of somebody posing, is somebody in denial, is somebody real, does somebody want to fix it. I can pick that up pretty quick. What's something else that I wrote down or you wrote down that I can't read?

Jarrod Bridgeman:
Yes, because of my wonderful handwriting. Casey, let me ask you. You're the dentist right now, are you frustrated that your income doesn't reflect your hard work?

Casey Hiers:
That's a question we like to ask around here, because again, it's a testing question. Are you able to admit it? Well, we're doing pretty good and it's in the bank or it's here. I know why I'm not making more, so I'm going to just rationalize or justify why I'm not making what I should be making. Versus the practice owner that's making 400 and they go, "Man, I've put in a lot, I don't feel like I'm reaping what I should. I want it to be better. Can it be better?"
I love that and I hear that all the time. A lot of times the people that are making between 4 and $700,000 as a practice owner, those are the ones that know it can be better and are ready to do what it takes. The loudest cries come from the cheap seats. And if I'm offending somebody, hopefully it's a catalyst for action. But the people in dentistry that don't pay themselves or make between 120 and say 250, they have got so much... That's where I hear the loudest cries, the excuses, the justifications, the denials, all that stuff. And then I talk to somebody who's making 600 and they're like, "Yeah, no, I stink at these two things. I need to get better. Can you help?"

Jarrod Bridgeman:
In your opinion, why is it that someone making 250 is more defensive about what they may compared to the 500,000 guy who knows he can do better?

Casey Hiers:
And it goes back to they're great at dentistry, they're a high achiever, they've tried some things and it hasn't worked. So if they can't figure it out, it must not be possible to figure out. That's similar to my eight-year olds mentality. And again, if these are my veiled shots, our listeners then get better. But my eight-year old at different sports that she's doing, she thinks she knows everything. And then we'll go through something or she'll fail and then she'll go with excuses. And then I have to sit her down and walk her through it for her to get it. There's a lot of practice owners that have that same mentality. It's not just practice owners. It's all of us. There's a lot of us adults that do these same techniques. But yeah, that's what I see.

Jarrod Bridgeman:
It's same as me when I'm playing a video game, if I'm not into it right away, I'm just like, "I'm done."

Casey Hiers:
Yeah.

Jarrod Bridgeman:
That's a terrible example.

Casey Hiers:
But sometimes it's, again, I've tried everything and it must not be possible, because I can't figure it out.

Jarrod Bridgeman:
When you've tried maybe one or two avenues and not really dug into it.

Casey Hiers:
Yeah. Well, I mean, it would be like me having eating caramel corn and having a kernel stuck in my tooth and can't get it out with flossing. Well, I guess it's just going to have to be there forever, because I can't get it out. Well, a dentist can get it out in two seconds. Same cheesy analogy.

Jarrod Bridgeman:
Do you think it also is the mentality of it's the money you're making yourself, so you're the owner versus employees, because I feel like employees are much more apt to be like, "Where's my raise? I should be making more."

Casey Hiers:
Ooh, that's interesting. I read something recently where it said, and this can go to ownership, I'll kind of tweak the analogy, but it basically said, "As a W2 employee, I just never understood certain things and I was frustrated at this or that. And then you go to being the owner or an executive and all of a sudden you're privy to a whole bunch more information and you understand the why." So yeah, I think there's a little bit to that.

Jarrod Bridgeman:
Your third question that you tend to ask is kind of a two-parter. They work a little bit hand in hand, but they are, "Are you ready to be better and are you coachable?"

Casey Hiers:
Yeah, and the first one kind of ties into the theme of this, it's timing. [inaudible 00:09:22] somebody ready to admit they need help, it could be better. And again, by admitting those things, it can still mean you have a good practice. You're a great dentist, you are successful. I mean, Scotty Scheffler, John Rahm top golfers in the world, they have swing coaches. They have four or five coaches, because they're awesome. But they know that they can be better. It just goes back to, are you ready? Are you ready to see if there's a better way to achieve more. Some people aren't, that's okay, some people need to stub their toe for a couple of months or a couple of years. Others need to stub it for a couple of decades before they try to get better.

Jarrod Bridgeman:
I also think it's a case of the idea, yes, why wouldn't you want to be better? I think everybody would say yes until they realize, "Oh, shit there's change involved."

Casey Hiers:
Yeah, I have to listen to my swing coach. Well, I just went out and shot a 65 on a tough course and then this guy's telling me I need to tweak something. It's ego and it goes to coachability. Again, all we work with is high achievers. Can you hear criticism backed up with data and be coachable, that's important. Great example. We're in suits, because we have a new client in from Boston. This is somebody who was in their low to mid-thirties and they go second generation dentist, but they said, "Yeah, I don't want to be the person that figures it out at 45. I want to do the right things now." Had the pleasure of meeting them at an implant course. So look at that. A young person doing implant course, because they want to be better. That's a good sign.
But just got it. And ultimately doing the right things, having a team, being good at dentistry and growing wealth in your early to mid-thirties, this person's going to be knocking on the door of $18.5 million. Now here's the thing, retirement age goal at 61, probably not going to get to 18 million because at 55 going to look up and go, "Yeah, I'm good with 13.5. I mean, again, it's a great example, this is a wonderful dentist learning implant, is a stud could be an egotistical person that tries to do it himself for 10 years and looks up and goes, "Ugh." But love that awareness and ultimately is going to be massively successful. Work-life balance is going to be great, will work four days or less to get that and just so grateful to have a team, that coachability is important.

Jarrod Bridgeman:
So again, why is coachability important? It makes sense in the initial question.

Casey Hiers:
Got a great example.

Jarrod Bridgeman:
Yes.

Casey Hiers:
Hey, I found this practice. I drive by it every day, had lunch with the dentist, "I want to buy it." "Okay, great." "We'll look at all the data and give our opinion." Well, if our opinion is, "Hey, we found some things. This would not be a great practice for you to purchase for these reasons and the timing for these reasons." And then somebody goes, "Okay, thanks. I'm going to go buy it anyway." And then a year later it's a train wreck. Well, that's just a waste of everybody's time versus you bring that to us, we go, "Not a good practice." While you might be outwardly frustrated or emotional about it because you like it. You go, "I'll respect the process." Year and a half later, practice comes by. Thumbs up from us, your team, no mistake. You buy it, you flourish. You've saved yourself so much heartache. That's an example of the coachability that just get out of your own way.

Jarrod Bridgeman:
[inaudible 00:12:35] the point of paying us money to not listen to us?

Casey Hiers:
When my dental professionals tell me I need something done. I appreciate a little bit of explanation and then I do it. Because, I'm coachable to their expertise. Same situation just flipped.

Jarrod Bridgeman:
Same thing.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
Oh my gosh. Casey, you're leaving this week to go to the Florida Dental Convention.

Casey Hiers:
Yeah. Great meeting.

Jarrod Bridgeman:
Are you excited for that?

Casey Hiers:
Yeah, get a lot of clients. Get see them. It's a fun meeting. Gosh, I think I have to present CE for three hours.

Jarrod Bridgeman:
Three hours?

Casey Hiers:
It's a lot.

Jarrod Bridgeman:
Wow.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
I mean, you sure know how to talk, so I think that'll [inaudible 00:13:09] be okay.

Casey Hiers:
It's about asking questions. Thanks, Jarrod.

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.