THE MILLIONAIRE DENTIST™

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From Hinman to Your Practice: Mastering Overhead, Insurance, and Cash Flow

Fresh from the Thomas P. Hinman Meeting, Casey and Jarrod dive into the critical aspects of running a successful dental practice. They address the common struggles of managing overhead, navigating insurance adjustments, and optimizing cash flow. Discover why seeking experienced advisors and adopting a holistic approach are essential for building a sustainable and profitable practice and overcoming the resistance to change that can hold dentists back.

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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 co-host Jarrod Bridgeman.

Jarrod Bridgeman:
Casey, long time no see. How you been, pal?

Casey Hiers:
Been great.

Jarrod Bridgeman:
Doing well? You just came back just the other day. You were out of town. You were out there shaking babies and slapping palms?

Casey Hiers:
Yeah, there's a meeting, the Thomas P. Hinman Meeting in Atlanta.

Jarrod Bridgeman:
Did you get to meet him?

Casey Hiers:
I don't think he was available.

Jarrod Bridgeman:
Oh, okay.

Casey Hiers:
Yeah, I'd say, I don't know, probably a top five, by the numbers, national meeting that's down in Atlanta, Georgia.

Jarrod Bridgeman:
Yeah. And so you went down there. And the night before, we hosted this fun social event, where we invited practice owners from around the area to join you. And that was, from what I understand, and what you talked about, this really cool steakhouse.

Casey Hiers:
Little Alley Steakhouse in Buckhead. Wasn't familiar with it. Overall, I'm familiar with steakhouses and what's good or not. We have St. Elmo's in Indianapolis, it's pretty bad ass. But-

Jarrod Bridgeman:
How does that compare to Longhorn?

Casey Hiers:
Probably a different level.

Jarrod Bridgeman:
A little different vibe.

Casey Hiers:
Nothing wrong with good old Longhorn.

Jarrod Bridgeman:
That's right.

Casey Hiers:
No, it was a really, really unique and excellent steakhouse.

Jarrod Bridgeman:
That's awesome. I mean, I'm glad that you and a couple of your team went out there with you. So you went out there the day before, had the social. The next day we had a booth set up for the exhibit hall. But then on top of all that, you actually had, I don't remember if it was an hour or two, but you actually had a presentation and spoke in a class, a setting.

Casey Hiers:
Yeah, the exhibiting is a necessary evil to have the opportunity to present our course. We just did our one hour. But to present our course at the Hinman Meeting was excellent. From what we were told, we had really good attendance. I think there was around 45. It was nice. It was good. It's tough to get around Atlanta. There was a lot of challenges with this meeting, logistically, for those folks that run the meeting.

Jarrod Bridgeman:
I heard there's a lot of road construction happening around the place.

Casey Hiers:
A lot of construction, a lot of-

Jarrod Bridgeman:
And Atlanta is not a city that's funded to drive when it's a normal day.

Casey Hiers:
It took us 40 minutes to go one and a half miles. And we weren't the only ones. I mean, the frustration level that first morning, and you could tell different... Our course wasn't affected, but other courses' rooms had changed. I think, in the Georgia World Congress Center, the convention center, there was a car show, a volleyball convention, and a dental convention. So you had all walks of life.

Jarrod Bridgeman:
Right. And if you didn't know where you were going, you might've ended up in the wrong room, huh?

Casey Hiers:
Yeah, no, it was nice. And we talk about our events. But typically, when we present at a larger meeting, we like to offer that. It's fun. Maybe we get to meet 15 or 20 dentists. We'll do the bourbon tasting and have some excellent tomahawk.

Jarrod Bridgeman:
Right. And actually spend time conversing and getting to know practice owners, as opposed to maybe presenting and getting two or three minutes.

Casey Hiers:
Yeah, we cover about 15 minutes worth, a summary of what we do, what we talk about. Which, they want more, because it's overhead, it's insurance adjustments-

Jarrod Bridgeman:
You're breadcrumbing them.

Casey Hiers:
... it's cash flow. It's those things that they're like, "Yeah, we saw that on the invitation. That's why we came." But it's not comfortable. So we like to have it at comfortable places with excellent food and drink, and-

Jarrod Bridgeman:
And a little social lubricant-

Casey Hiers:
Yeah.

Jarrod Bridgeman:
... never hurts.

Casey Hiers:
I will say, the nice thing about most of the events we do, while, yes, we have an open bar and we do a bourbon tasting, people have a drink and a half or two, it's just fun to try new things and just kind of relax. But ultimately, get into some real one-on-one conversations about some heavy, heavy subject matter-

Jarrod Bridgeman:
Heavy duty stuff.

Casey Hiers:
... that ultimately, like we always talk about, is worth millions of dollars over the course of a practice owner's career. That was a really fun time well spent.

Jarrod Bridgeman:
Going from that, and then of course the presenting, I always love to hear how the crowd, how the audience reacted to your presentation. Was there anything that may have stuck out to you? Something... There's always a Joe Peanut in the back doing something, but what about this event, what kind of stuck out to you for this one?

Casey Hiers:
No one fell asleep.

Jarrod Bridgeman:
Hey, you did it. You did it.

Casey Hiers:
Typically, people don't. While it's not the sexiest topic, it's important. Yeah, no one fell asleep. Probably more head nodding than I had seen in a while. And again, people have a hunger for this information because it's hard to get.

Jarrod Bridgeman:
People are feeling the-

Casey Hiers:
There's companies that do tax, there's a company that'll do insurance, there's a company that'll do advisory. But to have that all encompassed, and get to learn about that, it's pretty unique. A lot of head nodding, a lot of notes, people with laptops out just hammering notes down. A lot of screenshots.

Jarrod Bridgeman:
Sounds like they're writing their memoir, just typing away?

Casey Hiers:
Met a really excellent gentleman. I don't want to say he was 90, but he was probably close. And he had the sport coat and the Hinman badge, and he ran the show 20 to 25 years ago. Still helps out. Great energy for an older gentleman. He was awesome. Such a nice dude. And afterwards, he goes, "Man, if I would've met you guys 50 years ago, that would've really been something."

Jarrod Bridgeman:
Did you say, "I would've been not even around yet, but..."?

Casey Hiers:
Yeah, if we had a dollar for every time we heard that, right? It's that hindsight's 2020.

Jarrod Bridgeman:
Right.

Casey Hiers:
But he was really lapping it up. And he had sold his practice and been retired for quite a while. But it's interesting when you're forest and trees, he's out of it. He's retired. Looking at it holistically, he just goes, "Man," he's like, "how many business cards? I want to tell people. This is so important. This is the part that I didn't necessarily get right in my career, but yet I now know how damn important it is." And I'm like, let me just give you a mic and start talking because sometimes it's more impactful.

Jarrod Bridgeman:
It makes me think of that Rod Stewart song, which originally was a song by The Faces, when he was the lead singer of that band in the '70s. It's, "I wish that I knew all I know now when I was younger." And I feel like that applies to everybody. Of course, that song's about women, which, money, women, it's all kind of the same thing.

Casey Hiers:
There's some crossover.

Jarrod Bridgeman:
Yes. Yes. And I feel like that's in everybody's work, everybody's business, even home life. In hindsight, maybe when my wife told me that she felt very happy about all the working out she's been doing, and I said something along the lines of, "Well, I'm glad you feel better." Maybe in hindsight I should have said something nice, like, "You look great, honey."

Casey Hiers:
How'd that land?

Jarrod Bridgeman:
It did not go well for me. And it's the same thing here. When I'm building the website, and I'm building these systems and things, and I look at something I made 2, 3, 4 years ago, I'm like, I can't believe I didn't just do this one or two extra steps that would've saved me hours today.

Casey Hiers:
Yeah, no, that was the sentiment. Ultimately, the most successful practice owners we know or work with put significant importance, and time, and effort into getting the business and financial side right. And so many don't, and it's unfortunate. But it was refreshing, the gentleman that was saying those things. And he's a big hitter because there were some other people involved with the Thomas P. Hinman meeting that were in there. And they go, "Wow, he is a thought leader and somebody people respect, and he was really smitten with your guys' presentation." And that was-

Jarrod Bridgeman:
It's because you're so cute.

Casey Hiers:
... always nice to hear. I'm still carrying my holiday weight, and not from this past.

Jarrod Bridgeman:
Right. That's right, from the March Madness holiday was a big part of it too. No, and that's always amazing to me to get that. We've had people that we spoke to that have gone through our process, that may on the older edge of retirement.

Casey Hiers:
The back nine?

Jarrod Bridgeman:
The back nine. And had wished, even five, 10 years earlier they had come across us.

Casey Hiers:
Yeah, no, we hear that all the time. Specifically, with working with a firm to do these things. There's always a leap of faith. It's hard, it's challenging; change is hard. But then so many people that maybe were on that back end of their career that found us, and mastered this, and saw what it was worth. And inevitably, what do they say? "I wish I would've done this sooner."

Jarrod Bridgeman:
What do you say to the people that are in the room now listening to the presentation, who gleam, okay, yeah, I understand these are some of the red flags I should look out for, but then don't do anything?

Casey Hiers:
Yeah. I mean, we have the objectivity of nationwide, and talking to hundreds, and hundreds, and ultimately, thousands of practice owners. And there are some out there that, again, want to try to do it themselves, or just figure it out, or try to produce their way to profitability. And then they look up and they produced another $200,000 in dentistry, and it didn't do a damn thing to their money, to their income, their savings. Maybe helped the practice a little bit-

Jarrod Bridgeman:
Sure. Sure.

Casey Hiers:
... but when you're running high overhead... And so, ultimately, it's, again, the one or two things to try to change. It really needs to be a holistic overhaul to master everything, to be able to retire early, with many, many, many millions more dollars than you would trying to do it yourself. But you can see that sometimes, like the startup. A lot of times the startup, they want to start the right way. Well, the first step is you do need patience and production.

Jarrod Bridgeman:
Correct.

Casey Hiers:
For us, we need people to have that part down. We don't do dentistry. But once that is checked, my goodness, now you've solved one challenge, you now have dozens of new challenges. So a lot of times the startup people want to get it right from the beginning. But it's those folks, maybe in their late thirties, early forties, and they want to get some information, and they want to, again, try to figure it out and do it themselves.

Jarrod Bridgeman:
Right. And that comes from years of maybe being near the top of their class, and studying, and being rather intelligent, that I think sometimes even in my own mind, I'm like, "Oh, that's easy. That's money stuff." And then you look at my track record, you're like, "Oh, boy. Jarrod's buying another $200 Lego set." I got the new 1966 Batmobile Lego set. It's awesome.
But you've got these folks who are so used to doing it themselves, and they don't know any other way to accomplish it. Outside of, maybe as you said, this gentleman, maybe a thought leader that they're aware of, told them to try X.

Casey Hiers:
Yeah. Our best clients typically come from referrals because they trust that person. It's tried and true. They share their experience. Ironically, how we help a referral is most likely going to be different because everything's custom. It's going to be a little different than how we help them. But yeah, that gives people peace of mind sometimes.
And then, again, like I said, change is hard. When you have a company that can achieve these things, well, we are not a charity. We're not doing it for free. There is cost involved. And that's an obstacle sometimes.

Jarrod Bridgeman:
The crazy point is, at the end of the year, at the end of the time, what you spent on us is nothing compared to what you actually end up getting out of it.

Casey Hiers:
On average, within 36 months, overhead drops 11%, and that includes our fees. It's numerically a no-brainer. However, change is hard. We're sensitive to that.

Jarrod Bridgeman:
What happens if you have a brainer? Actually, that makes me think, especially those maybe, say mid-thirties, early 30 docs who have a newish practice. Sometimes, it almost feels like they're the teenagers of the dentist world. They feel like they know more than you. "I know more than my parents, and I'm invincible. I'm going to go and drive my truck through the cornfield," kind of thing.

Casey Hiers:
Oh man, I got my Jeep stuck in the middle of a cornfield on a soggy day once because I thought I was invincible. And it's four-wheel drive, no problem.

Jarrod Bridgeman:
Yeah, sure.

Casey Hiers:
Oof, that was a flashback I won't bore the listening audience with. But now there is a little bit of that, for sure, that teenage analogy. Or coaching, you can watch a sporting event, and from the stands you can see, just like the older gentleman, you can see, "Oh, if they would just do this, this, and this." But when you're in it, when you're the forest, it's hard-

Jarrod Bridgeman:
When you're running down that football field, you don't see the guy that's at your six o'clock.

Casey Hiers:
Yeah. Oh, you should have zigged when you should have zagged. It's hard to see that when you're on the field running the ball, versus, again, that's why-

Jarrod Bridgeman:
By the way, you're supposed to do that when you see, is it a crocodile or an alligator? You should zigzag.

Casey Hiers:
Yeah, I've heard that. We were down in the Naples area, and there was a large gator floating. And I took out the trash one night, and it was dark, and I just had that moment of like, "Oh, jeez." And I went to that. I was like, "I think you're supposed to zig or zag." I probably just would've screamed, pissed myself a little bit, and maybe tried to jump on top of the car.

Jarrod Bridgeman:
You crawled into a ball [inaudible 00:13:40]. Yeah, yeah, yeah. But yeah, like you mentioned with getting your car stuck in the muddy cornfield, sometimes it takes getting knocked on your ass to learn a lesson. And that's unfortunate, but that's most people, really.

Casey Hiers:
That's why we like practice owners to have owned for at least a couple years, two, three years, because they've experienced enough to, not wave the white flag in retreat, but just go, "You know what? I'm not willing to sacrifice my family time or my hobby time to try to figure this out." Yeah, that's a factor.

Jarrod Bridgeman:
So when they go to your course, and they see some of these red flags, and they realize, "Oh, shoot, I've got some of these," what do you say to them when they know, let's do an analogy of their house is on fire? And let's compare that to the system. Maybe the system is kind of broke, there's smoke coming out of it. These people are afraid, in the system world, "I've got the system kind of going, it kind of works, I'm afraid to change any of it because it might screw up everything."
But when your house is on fire, I'm not going to not call the fire department and have someone come take care of it.

Casey Hiers:
It goes back to that change is hard. And it can make people uncomfortable. So a fire truck, they're loud, so the noise is uncomfortable. Might wake up my neighbors, might wake up my family. If they have to go into my beautifully manicured lawn, it might tear up the lawn. Well, I don't want those two things to happen. Okay, that's fair.

Jarrod Bridgeman:
Listen, my kids are real crabby if I wake them up in the middle of the night, so I get it.

Casey Hiers:
But it's like, okay, yes, the loud siren and the yard getting tore up, yeah, those aren't ideal, but your house is going to burn down. Can you see the big picture? Your path is not sustainable. Your overhead, whatever, cashflow, whatever that is-

Jarrod Bridgeman:
You're paying to practice now.

Casey Hiers:
What's coming is not good. So yes, there might be some inconveniences along the way, but the alternative is much, much worse. Unfortunately, a lot of practice owners will just keep on keeping on. And then-

Jarrod Bridgeman:
And they're too focused on the minute now details. Like this is-

Casey Hiers:
Well, at this meeting, there's a lot of cool technology and equipment. And so it's amazing what people will spend for this new big piece of equipment.

Jarrod Bridgeman:
Right, I love toys.

Casey Hiers:
Exactly. And almost not even think twice, because most of their peers are doing it. That's what you do. You go to the show and you go spend some money. Literally, one of the people at our event, they're like, "Yeah, we're going to go spend some money tomorrow."

Jarrod Bridgeman:
Okay.

Casey Hiers:
And I'm like, that can be a good thing. That can also be a bad thing.

Jarrod Bridgeman:
And we've talked about that in the podcast before, whether it's you bought something that you're never going to use or you bought it because you wanted to try and do something with your taxes.

Casey Hiers:
What are your criteria? Why are you buying it? What's the strategy? How are you going to pay for it? What's that look like? How's it affect the other areas of your life? "Oh, I don't know. I'm going to spend some money."

Jarrod Bridgeman:
That's a future me problem. And the problem is, the future comes quicker than you think.

Casey Hiers:
Wow, that's profound.

Jarrod Bridgeman:
Hey, I'm going to retire. I'm done.

Casey Hiers:
That is profound. But I think even harder, we don't talk about this a lot, but when we talk to people, and for whatever reason, again, we say no much more than we say yes, meaning bringing on a new client. Because the personality, and the mindset, and the practice, and all those technical details in a practice, and a tax situation and all that, if it's not a situation where we can help somebody in the way that we hold ourselves accountable for, then we just tell them, and we move on, and we don't offer to work together. That's hard for folks to swallow, too. That's the best outcome sometimes. But those are hard conversations because most dentists and specialists aren't told no. They've got the cheerleaders. And sometimes-

Jarrod Bridgeman:
A lot of people are surrounded by yes-men. And-

Casey Hiers:
Or women.

Jarrod Bridgeman:
Or women. And sometimes you have to come across and be the no man, or no woman.

Casey Hiers:
And its timing. Oftentimes, it's, this doesn't make sense now, and this is why. If you can tackle some of these things that aren't in our purview, the timing could be better. Now, it's always that jilted situation-

Jarrod Bridgeman:
Listen, we're not going to come and install new carpet in your house that's on fire. Eh? No?

Casey Hiers:
Hold on, I think I'm going to connect the dots.

Jarrod Bridgeman:
Okay.

Casey Hiers:
Yeah, that's a good point.

Jarrod Bridgeman:
Sure.

Casey Hiers:
Yeah. You either want to put the fire out, then put in new carpet. Or, on the rebuild, put in new carpet. Okay. Yeah, we're full of analogies today.

Jarrod Bridgeman:
Yeah, we got it today. Casey, for folks out there who are listening to this, and like, "Damn it, I should have went to the Hemin. I should have gone to your guys' social," it's going to be a little too late to go to register for our Wheeling Illinois event, because that's happening this week on a Thursday. But looking forward, we're going to be in the Buffalo, New York area in Williamsville, New York. We're going to be in Charleston, South Carolina, as well as Columbia, South Carolina. And I know we're going to be in Denver, Colorado, another social we're doing the night before a big pediatric meeting. So we're popping up all over the place. And the goal really is, we do want to go out, and we do want to educate people on the things that you may be doing well, things you may not be doing well. And it's all a common string, that no matter where you're in the country, these are issues that every practice owner seems to face on some kind of level.

Casey Hiers:
At minimum, you're going to have a great time, and you're going to learn a little something. And sometimes the takeaway is, I've got a decent team, but I need to challenge my external existing team better, my accountant, whomever. Sometimes that's the case, they just needed some information and some courage.

Jarrod Bridgeman:
Worst-case scenario, you're going to go home thinking.

Casey Hiers:
Yeah, in full. And people have a great time at these events. And again, we've been doing this for 21 years. And I'd say over the last five to seven, we've been educating the dental community on a pretty aggressive basis because it's needed. And ultimately, some of that is finding great practice owners to help. And as a firm, we're only going to grow at the pace that makes sense for our firm and for those we're helping.

Jarrod Bridgeman:
We don't take on every Joe that comes in the door.

Casey Hiers:
No. But yeah, no, these events are great. Selfishly, it's fun to meet these people. But inevitably, I hear a lot of the same challenges. And the question is, "Well, what are you going to do about it?" And for some people, it's just that extra motivation of, "You know what, I've never settled in my life. I've always been an achiever. Why would I start now?" But there's a vulnerability, and I don't want to say shame, but I see that some folks, when we're having these conversations, I can just tell they almost feel like, I don't know why I can't figure this out. That's okay. Not figuring it out at some point in your career is not okay.

Jarrod Bridgeman:
Don't wait until you're 90.

Casey Hiers:
Correct. Right.

Jarrod Bridgeman:
Casey, thank you so much for stopping by today. Again, folks, go to fourquadrantsadvisory.com/events, and we'll be putting up new places, new venues all the time. So, look out for that. If you're not subscribed to any of our social media, why the hell not? We're on Facebook, Instagram, X. We're on LinkedIn. I might even launch a TikTok at some point.

Casey Hiers:
Yikes.

Jarrod Bridgeman:
We'll wait and see. I know I've been working on my dance moves for that one. So Casey, again, thank you, and we'll see you next week.

Casey Hiers:
Yes, sir.

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.