DSOs. A trending topic among the dental community. There are pros and cons to everything in life, including being in a DSO or owning your dental practice. Casey and Jarrod discuss the world of DSOs and how it seems there has been a recent PR push to keep the negative talk of DSOs down.
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 the one in only Jarrod Bridgeman.
Jarrod Bridgeman:
Hey, how are you?
Casey Hiers:
Good, thank you.
Jarrod Bridgeman:
I'm feeling under the weather. So if my voice sounds sexier than usual, that'd be why?
Casey Hiers:
Oh, I saw a straw coming out of a NyQuil bottle, like the movie Hitch with Will Smith, so I thought something might be going on.
Jarrod Bridgeman:
Yeah, I've been taking lots of naps at my desk, it's great.
Casey Hiers:
There you go. What do you want to talk about, pal?
Jarrod Bridgeman:
I was getting on the subject of hot topics and I don't mean your favorite goth store at the mall, kind of a hot topic with dentists.
Casey Hiers:
Look at you with your jokes, coming with your jokes.
Jarrod Bridgeman:
I worked at a Hot Topic in college for six months. Just to...
Casey Hiers:
Probably to meet people.
Jarrod Bridgeman:
Yes.
Casey Hiers:
There you go.
Jarrod Bridgeman:
Yes.
Casey Hiers:
Yeah, no. We've been in full swing traveling for quite a while, going to a lot of places or private events, public events, you name it. It's really nice to get back out there. It's funny, some of the shows, you're hearing the same complaints, "Oh, they're not busy enough," or, "They're slow." And I'm just like, "Hey, let's be grateful that we're back at it and we're getting together and sharing ideas." I've always said that the two topics I hear the most in terms of questions or concerns is typically insurance, which will make a practice owner's face fire red, and corporate dentistry DSO, I wouldn't say it's new anymore. It was new, people were learning, but now it's settling in a little bit.
Jarrod Bridgeman:
Yep. That's something that's been growing over time though, as of the past few years, in terms of people asking about that.
Casey Hiers:
Yeah, absolutely. It's one of those things, now, I think people have their arms around it. They understand it a little more. A lot of people are trying to decide what side of the aisle they're on, if they have to be on a side of the aisle, it's good for some people, not for others. I think there's a lot of positives about it. There's certainly negatives about it. But yeah, I've been in multiple places recently where it almost felt like, and we call ourselves a DSO kryptonite as a firm, that being said, there's a place for them in dentistry and we're not a-
Jarrod Bridgeman:
We'll get into it more, but I feel that their positives play against individual person's weaknesses.
Casey Hiers:
Well, that's a deep sentence. I'll just lay it out for our audience. As I've been traveling around, it's almost like there's a concerted PR push within corporate dentistry and DSOs to squash the negative talk.
Jarrod Bridgeman:
To maybe rewrite the narrative into more positive?
Casey Hiers:
It seems like it. I don't think DSOs and corporate necessarily have this horrible reputation, but there are some strong feelings about it, but I have just witnessed around the country what feels like, to me, a concerted PR push to not have negativity around DSOs from people who are attached to DSOs and have profited from DSOs and they have deep pockets.
Jarrod Bridgeman:
Kind of like a lobbyist, almost, like getting people into certain positions that have stage time, or microphone time, or whatever the case may be, to speak more positively about what's getting put in their pocket.
Casey Hiers:
Yeah. I mean, that's what I have observed, as it almost feels like, a formal effort. So, I'd be curious if our listeners have maybe seen that on the regional, state, or district level, where those that are on the side of the aisle of corporate dentistry and DSOs, if they are a little more passionate or communicating about all the positive of DSOs and that any negativity should be squashed and everybody should be more inclusive. It is probably an odd opening for our listeners. But when you see or hear certain things that just stick out, I thought it would be worth talking about.
Jarrod Bridgeman:
Let me ask you, do you think this is a trend that people are seeing or you're seeing?
Casey Hiers:
Our schedule's so robust that I think I'm going to probably have an answer to that. This might just be wild speculation, but, Boy, it felt formalized. Yeah, I think I'll probably have a better answer for that by the end of the year, but I guess for those looking or listening that are a part of it, if it wasn't formal, I guess we gave them a good idea because there is a lot of benefit to being in a DSO. If you're a young person, you have a full team behind you. Obviously-
Jarrod Bridgeman:
They come to the table with their marketing, they come to the table with their accountants, and things like that.
Casey Hiers:
On the pros and cons list, they certainly bring the infrastructure to the table. That gives comfort to a lot of younger dentists. Obviously, in dentistry, the privately owned or the partners who own a nice family dentistry office, those are great. But there's a little bit of fear that corporate dentistry with deep pockets are going to continue to expand and potentially cause problems. So, I would love to know if corporate dentistry and DSO have a formal PR push almost like paid lobbyists. There are folks out there that are really getting into the nooks and crannies of dentistry in some leadership and doing that.
Jarrod Bridgeman:
Well, I would say it's in terms of social media, it's called having either an influencer or what's called an enthusiast. You have someone that you could... Social media's called, you sponsor somebody that promote your brand. But these people could very well be their practice was bought by a DSO. Now, they're either being told to go out and speak this up or possibly getting paid.
Casey Hiers:
Yeah, is it organic and homegrown or not?
Jarrod Bridgeman:
What would be the benefit to the person speaking about it? What would they get out of telling other people about DSOs?
Casey Hiers:
Well, yeah. That's kind of the thing. I'm curious to see if this is a trend and if we're onto something, hey, so be it. But I think that, again, you can have it all as a young person. People get into dentistry to not be beholden to... They want to be their own boss. They want to be able to control their schedule. All the benefits of dentistry, you give a fair amount of those up when you go into the DSO world.
Jarrod Bridgeman:
Yep. You've got a boss. You have someone that makes your schedule for you. Also, they're making a profit off of all of your hard work. You went to school and spent all this money, get all this student loan debt, potentially. Then you're doing all of this work, working in the mouth, and then you're giving them the cash.
Casey Hiers:
The infrastructure comes with a cost, but the tone was really like-
Jarrod Bridgeman:
But they're in it for the money, by the way, they're a for-profit business.
Casey Hiers:
No, as they should be.
Jarrod Bridgeman:
Yeah.
Casey Hiers:
Right?
Jarrod Bridgeman:
There's nothing you can [inaudible 00:06:56]. Personally, I would want that money for myself. Now, again, there's things that they offer that you may feel scared or weak in that area of, but that's where having a team of professionals can help. You can make your own team. You can hire your own team.
Casey Hiers:
Well, the biggest thing we can probably share for younger dentists is find out what you truly want. Don't be persuaded one way or the other by positive or negative talk on private ownership or DSO, figure out what you want and what fits your life. I think that's the key. But it seems like there's a little bit more push to persuade and influence one way or the other. Ultimately, it's got to be a custom decision for you, because, as we know, you can have it all. You can have a full team behind you. You can have the infrastructure, you can have the systems and processes. You can have the profit, you can avoid all of the mistakes and you can still be the 100% owner of your own practice, where if you want to go somewhere for two and a half, three weeks, nobody's going to say anything about it.
Jarrod Bridgeman:
Right. At the end of the day, you can retire with millions in the bank.
Casey Hiers:
Yeah, no, we were-
Jarrod Bridgeman:
Millions and millions.
Casey Hiers:
We were somewhere and somebody saw some of our branding and they did a double take. I knew what they were thinking. They were thinking, "Wait, what do they do? Or how do they do it?" And I looked at them and I go, "The answer's at least $5 million." And they looked at me and they go, "What?" I go, "You're asking what we do or what our impact is or some variation of that." And they go, "Yeah." And I go, "It's at least $5 million." We had a great conversation and certainly got them to help conceptualize what we do. But again, there's a place for everybody, but I think you need to know what you want, you need to be committed to it and then not accept mediocrity. Ultimately, the DSO corporate checks probably, opportunity's probably going to be there for you whenever you want it. We say that on the back end and on the front end, you can probably always go work at one of those spots and, again, get some good work ethic and learn some things good and bad.
Jarrod Bridgeman:
Let me ask you this, about the whole DSO thing, what do you think is... Let's put it into words, what's the attractiveness of a DSO to you?
Casey Hiers:
Of DSW, the shoe store?
Jarrod Bridgeman:
Yes.
Casey Hiers:
Or DSOs?
Jarrod Bridgeman:
DSOs. Did I say DSW?
Casey Hiers:
Yeah.
Jarrod Bridgeman:
No, DSO.
Casey Hiers:
Yeah, no, we touched on it a little bit, but I think that for those who are risk-averse, I don't want to say you don't believe in yourself, but it can be an easier route. But again, the easier route typically comes with trade-offs and the trade-offs are hardcore production goals sometimes, or you don't get to maybe do things the way you want to do them, they're dictated to you. I mean, there's so many practice owners that, when they talk to us, and they're like, "I'm not going to change certain things I use clinically," or, "I want the best." And I laugh and I go, "We stay in our lane. We don't touch the clinical, that's you." Well, if you don't have full ownership or partnership with another dentist, you're not going to be able to make all those decisions, you're not going to have the autonomy.
We like data here at the firm and I think ultimately there's a lot of things that are changing in dentistry. I think everybody would agree, even memberships with national organizations, or state, or local. There's a decline in memberships. You can get things online. There's other ways. So, everything's evolving. I think it's important to look at data and understand the growth trends of DSOs, of family dentistry, but ultimately the statistics that should matter are the statistics that, again, we tout all the time and hold ourselves accountable for, ultimately, overhead, and income, and retirement, and no tax surprises, and expert decision-making in every step you make, and if you want three practices or if you want one practice. But figure out what you want. That's the key.
Here's a real downfall. Somebody thinks they want one route and they look up one day and go, "How did I get here? Dentistry's not what I thought it was going to be." People can do that as an associate, as an owner, or certainly in a DSO. I think it's probably more frequent with a DSO. Or if you're in private practice and own your own practice, and you're doing everything on your own and your team's not helping you, that's probably the sentiment that's out there the most, "Dentistry's not what I thought it was going to be. And I'm not making what I thought," but people keep that inside. Again, this topic ultimately is to figure out what you want, talk it out, understand what you're going to do, and don't look up and have regret. But certainly don't get influenced by a potential PR push trend of, "How dare you talk bad about DSOs?" It was a little fishy.
Jarrod Bridgeman:
Well, Casey, I know you're going to be back out on the road yet again. As usual, you're out there, slapping hands and shaking babies and all that kind of stuff. I know you're going to be in Columbus, Ohio, October 7th.
Casey Hiers:
I'm not shaking any babies.
Jarrod Bridgeman:
Oh, not anymore?
Casey Hiers:
No.
Jarrod Bridgeman:
Not since the lawsuit? That makes sense. October 7th at Topgolf in Columbus, Ohio, we'll be there. Coming up after that, we will be in Charlotte and Colorado Springs as well. So, come visit us at fourquadrantsadvisory.com/events.
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.
