Strategies, Spells, and Success: Navigating the Dental Practice 'Game'

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 with a mildly raspy voice in studio with co-host, Jarrod Bridgeman.

Jarrod Bridgeman:
Casey, it's good to see you, and your raspy voice is really selling it to me. Just listening to you talk right now is firing all kinds of cylinders.

Casey Hiers:
It's a good thing then?

Jarrod Bridgeman:
Yes.

Casey Hiers:
All right.

Jarrod Bridgeman:
Yes.

Casey Hiers:
Well, it's been... Indiana, where it's snowing, then we're in the 70s, and then it's who knows what?

Jarrod Bridgeman:
Rainy, and... Oh, gosh.

Casey Hiers:
I take a lot of supplements. I pride myself on getting my rest and being healthy, and the mighty can fall.

Jarrod Bridgeman:
Yeah, it still hits you.

Casey Hiers:
Last week I started feeling like, "Uh-oh."

Jarrod Bridgeman:
Uh-oh, boy.

Casey Hiers:
What's this? Then my gosh, there was three days where I was rough. No strep. No fever. Came from my daughter's second-grade basketball game. They took my blood pressure. I thought it was going to be high.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Great blood pressure.

Jarrod Bridgeman:
Okay.

Casey Hiers:
They're like, "Well, you seem fine." I'm like, "I can't swallow. My throat's raw. I am not okay."

Jarrod Bridgeman:
Also, what did my sore throat have to do with the blood pressure?

Casey Hiers:
Yeah. Yeah. I guess they were looking at the positives, but they gave me some prescription cough syrup and steroids.

Jarrod Bridgeman:
All right.

Casey Hiers:
My wife says I'm quite impatient, so I might be...

Jarrod Bridgeman:
Yeah, but I've noticed the gains. You got some big muscles going on now. It's looking good.

Casey Hiers:
I did my five pushups this morning-

Jarrod Bridgeman:
Whoa.

Casey Hiers:
... and they were in a row.

Jarrod Bridgeman:
That's more than I can do.

Casey Hiers:
Yeah. I'm a little impatient, so if I'm edgy, my apologies.

Jarrod Bridgeman:
Well, you and I were chatting. Over this weekend, I did something. I'm a big nerd. I don't know if anybody realizes that when they hear me talk or see my picture, that I'm not as cool as I seem sometimes. Over the weekend, there's this card game I play called Magic: The Gathering. I've been playing it. It's been around for 35-

Casey Hiers:
Magic Gathering?

Jarrod Bridgeman:
Magic: The Gathering.

Casey Hiers:
The Gathering.

Jarrod Bridgeman:
It's been around since 1993, I think. Basically, it's a card game. You buy packs of cards, like baseball cards. Then you take your cards, and you make a deck of 60 cards, and you play against other people. Over the weekend, I did a-

Casey Hiers:
Are they like pictures or they're like poker cards?

Jarrod Bridgeman:
Yep. It's pictures with words, and there's creatures and spells.

Casey Hiers:
Okay.

Jarrod Bridgeman:
You're basically a wizard kind of a thing.

Casey Hiers:
Okay.

Jarrod Bridgeman:
Real cool stuff, but over the weekend I participated in this tournament thing. It was like 50 bucks to enter, and you got a box of cards. Everybody had a different box, and you had to build your card deck out of these cards.

Casey Hiers:
How many were in the box?

Jarrod Bridgeman:
Maybe 120, and you had to make a 60-card deck out of those 120 cards.

Casey Hiers:
Okay.

Jarrod Bridgeman:
I thought I was going to do pretty well. I've been playing for a while. I know all the rules. Everybody was on the same level playing field, and I got spanked pretty hard. I won one round out of three, and I really thought I'd do better.

Casey Hiers:
What'd the winner get? If you're putting 50 bucks in, were there prizes?

Jarrod Bridgeman:
You got to not only keep the cards that you got in the box, you won other packs of cards for each round.

Casey Hiers:
Okay.

Jarrod Bridgeman:
Basically, it was free cards.

Casey Hiers:
Did you at least have fun, or is that $50 down the drain and you walked away angry?

Jarrod Bridgeman:
I had fun. I was still upset that I didn't win more, but it made me feel better that I was the youngest and best-looking person there.

Casey Hiers:
There you go.

Jarrod Bridgeman:
Which is not saying a lot.

Casey Hiers:
There you go.

Jarrod Bridgeman:
But it got me thinking like-

Casey Hiers:
You're a young nerd.

Jarrod Bridgeman:
That's right. That's right. Everybody came out on the same playing field. It's like you have to play the cards that you are dealt. It made me think about, let's say, you and I graduated from dental school at the same time. Let's say we have the same economic background and status and all that. 20 years later, you could be the winner, and I'd be the guy sad. I got a couple wins here and there, but you're retiring at 50. I'm 65, still going.

Casey Hiers:
A saying I heard years ago, "Equal opportunities. Not equal outcomes."

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Everybody had the same opportunity in this tournament, but yet the results were vastly different.

Jarrod Bridgeman:
Yeah. We were all, again, even playing field.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
It just makes you think. Let's say I bought a practice and you bought a practice after school, but yours was more fee-for-service, a little bit lower overhead, a little bit less insurance. I went through the other route. Yeah, you and I had the same skill levels and came out the same way, but our hand was vastly different.

Casey Hiers:
Yeah. This is interesting because there's a lot of analogies. The older I get, I love them. But I will say we've had... A lot of times, let's say in dentistry or this tournament you were in, those that maybe don't finish as well are like, "Well, this tournament was rigged," or, "Nobody could do it." A lot of people in dentistry, I do hear that because of insurance and all the headwinds that we speak about on this podcast, sometimes they'll go to that, "Well, it just can't be done. It's too hard," because that's easier than looking in the mirror. We have had... I've shared this story before, been at dental events or dinners, or cocktail parties, we've had a client who retired at 49. His classmate, who had a little ego, and his wife was in banking, they thought, "We don't need to pay for somebody to do these things for us. We'll figure it out. We're smart."

Jarrod Bridgeman:
Did they figure it out?

Casey Hiers:
Literally, that guy... I was so happy I was in this conversation. He looked at the guy who retired at 49 and said, "I know I'm a better dentist than you. I know people like me more than you, and I'm going to have to work until I'm 60, 62. Here, you're retired at 49." In that moment, I could just see it. He admitted defeat. He was dejected, and the excuses were over.

Jarrod Bridgeman:
But he still had to stick him a little bit. "Oh, I'm still better than you, and people like me more."

Casey Hiers:
Oh, sure.

Jarrod Bridgeman:
Okay. It's like those guys who're like, "I'm a nice guy."

Casey Hiers:
But it is a real thing. Your tournament was interesting, and then it got me thinking about old man analogies and how they can compare to life. They can compare to, in this scenario, dentistry. The first one, this was probably the most common one ever, and I'll read it. But for us, it's so applicable because we get into the technicals of the business and the numbers. We can see opportunity. We can see need, and we prove that, but too many times practice owners refuse to take the help. You can lead a horse to water, but you can't make him drink, or you can't force him to drink, him or her.

Jarrod Bridgeman:
Have you tried to make a horse do anything? They'll kick you.

Casey Hiers:
The last time I rode a horse, it was in the Hollywood Hills. I got an angry horse, and it was with my now wife and my dad. It was supposed to be a joyride. I was scared to death because I'm like, "There's a cliff." I didn't quite trust the horse, but I said, "That's the last time I'm going to do any horseback riding."

Jarrod Bridgeman:
It's like a 500-pound animal with metal feet.

Casey Hiers:
I didn't feel like I controlled it, and-

Jarrod Bridgeman:
That's right.

Casey Hiers:
... there was cliffs and edges. I did not enjoy the ride. Well, ultimately it did keep me safe and knew what it was doing. I just didn't control. A lot of practice owners, they don't want to lose the control. I didn't enjoy the ride. I was tense and stressed.

Jarrod Bridgeman:
Well, as you're riding because you're looking over there and there's cliffs, you're worried that you're going to fall off it.

Casey Hiers:
What are you doing? What are you doing? What are you doing with this one?

Jarrod Bridgeman:
At any point, and that's how these practice owners can be, they are so afraid of giving up some control because they might teeter off that edge.

Casey Hiers:
It becomes they're less resistant, typically the older they get, right? For me, that horse has done it many times. Just because I was uncomfortable for a second didn't mean that we weren't going to... What was the result? A beautiful ride that I missed out on because I didn't like the way I felt. You know what? Maybe I will go horseback riding again.

Jarrod Bridgeman:
Try it one more time.

Casey Hiers:
I think I may have just talked myself back into it.

Jarrod Bridgeman:
Try it once now that you're a little older.

Casey Hiers:
But when it comes to some of the serious things that we help practice owners with, it's sad, right?

Jarrod Bridgeman:
Yeah.

Casey Hiers:
When somebody maybe is paying too much in taxes year after year, or their income is 150, $250,000 lower year after year, or they have multiple millions dollars less, they have to practice longer. That's a sad thing.

Jarrod Bridgeman:
Work longer and have less.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
That sounds pretty negative.

Casey Hiers:
Here's another one. I've heard bits of this in different channels and put it together. But sometimes when we start to work with practice owners, we have to create custom systems and processes and really start from the ground up because there hasn't been a lot done. Other times, there has been some good things done. There's a lot of good things, but it needs a lot of help to have that finished product. But sometimes early on, people will be like, when we're just vetting them, "Well, but you're just changing these couple little things or moving this here and there. It's already there."

Jarrod Bridgeman:
Okay.

Casey Hiers:
Here's my analogy. Imagine a big garage, and you've got what could be a beautiful sports car, but there's engine parts all over the garage floor.

Jarrod Bridgeman:
And you're worried about changing the tire.

Casey Hiers:
Unless experts put all of those pieces and parts together with proper structure, they're just parts. Once assembled, right? Okay. Well, so now you've assembled these parts that were doing virtually nothing for you. It's assembled. It's a running engine. That's exciting. You've got this beautiful sports car. It still needs consistent oil and fuel to run properly. That's another analogy I think with... It's with life with anything. "But, well, I've got a gym in my basement," or, "I've got all Lululemon workout gear. Why do I need to pay for a trainer?"

Jarrod Bridgeman:
Yeah.

Casey Hiers:
Well, because-

Jarrod Bridgeman:
You're going to hurt yourself.

Casey Hiers:
Well, you're not using it. You're not using it properly. It's just there.

Jarrod Bridgeman:
It's like me with my shower. I'm just kidding.

Casey Hiers:
I'm not following.

Jarrod Bridgeman:
Yeah. But no, you're right. Just because you have a garage doesn't mean you're a mechanic.

Casey Hiers:
Oh, I got one you're going to love.

Jarrod Bridgeman:
Okay. Let's hear this.

Casey Hiers:
Because you love religion. Going to church doesn't make you a Christian any more than going to a garage makes you an automobile.

Jarrod Bridgeman:
Oh, yeah.

Casey Hiers:
Now, I'll take an investment spin on that because I can tell your wheels are spinning here.

Jarrod Bridgeman:
I'm holding my tongue.

Casey Hiers:
I talk to a lot of people who say, "Well, I'm familiar with investing or finance, and I like to do some day trading, or I like to buy this or that stock and whatever." That's great. It doesn't make you a successful investment advisor or analyst that can consistently get you to eight, 10, $12 million. One thing doesn't mean the other.

Jarrod Bridgeman:
We have our experts. There's financial planners and those type of people. People go to school for this. Even then, you may not be a good finance guy, even if you went to school for it. Here you are, you read an article once in Variety, and you're going at it.

Casey Hiers:
Well, I was talking, again, to our listeners, most of our conversations come from actual interactions with practice owners-

Jarrod Bridgeman:
Yes.

Casey Hiers:
... in these different areas. This isn't just what Jarrod and Casey have in their brain. It's a lot of people and a lot of geography and a lot of conversations.

Jarrod Bridgeman:
As you said before, each practice is unique, but the common issues and problems that dentists face are all relatively the same.

Casey Hiers:
From a high level.

Jarrod Bridgeman:
High level.

Casey Hiers:
Yeah. A very high level.

Jarrod Bridgeman:
Cash flow or-

Casey Hiers:
The investing thing, a lot of people get hung up on that. You've got both sides of the aisle, right? You've got some people that are like, "Well, I'm pretty good at investing, and I really like..." Then will look at it over a period of time. Like, "Yeah, that stock was up 60%." But in totality, they're up 7.25%. Again, investing is challenging. It's got to be consistent, and you've got to have... Again, we have an incredible group that are daily looking, monitoring, analyzing, actively managing money so that our clients are enjoying, because-

Jarrod Bridgeman:
I hear them talking about it, and I have no clue what's going on.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
I'm like, "Just make sure-"

Casey Hiers:
You shouldn't.

Jarrod Bridgeman:
"Just make sure my 401(k) is great, guys."

Casey Hiers:
Yeah. Yeah. You're not spending a ton of time on it. But, sure, in the last two, three years, any run-of-the-mill advisor can say, "I'm up 10 to 14%." Well, okay, how about the downtimes? Then in the 10 and 14%, well, you probably should have been up 22 to 26% in that same timeframe, and be nimble enough to hedge and make sure that you're ready to get defensive because at any time-

Jarrod Bridgeman:
We could hit a recession or something.

Casey Hiers:
... things can change. But then I'll talk to the person, "Well, I don't pay many fees, and I'm conservative. I don't believe in the stock market. I'm in cash." Here's something interesting that Will Chrisman, one of our people with a bunch of letters after their name-

Jarrod Bridgeman:
So many.

Casey Hiers:
... said, "That's great. They're not paying fees, and the idea of maybe paying a 1.5% investment fee can blow their mind." If they're in cash, just with inflation not keeping up, that's 2.7%. They're paying to not keep up with inflation. I don't want to pay 1.5%. I'm going to stay in cash. Well, that's great-

Jarrod Bridgeman:
You're paying...

Casey Hiers:
... 2.7% is now the inflation cost. Again, so many times, people don't look at it in totality. They're looking through different lenses. "Well, I can pay this fee less or that fee less." Well, how about this? In a fairly call it a 1.5 to $2 million practice, for us, we can chip away 3% overhead in our sleep.

Jarrod Bridgeman:
Right.

Casey Hiers:
It's not easy, but that's what we do. That can be worth 40 to $60,000 a year to practice owners. That's what we do. We find the money. We source the money. Then we invest the money. Somebody that's paying a lower fee, well, what are they getting? Well, they just give their investment advisor-

Jarrod Bridgeman:
Right.

Casey Hiers:
... "Please go grow this money." It's not being sourced or found or anything-

Jarrod Bridgeman:
Right.

Casey Hiers:
... like that.

Jarrod Bridgeman:
You're still providing on top of everything else.

Casey Hiers:
Yeah.

Jarrod Bridgeman:
That's such an amazing thing. Again, this is not my background. I'm the marketing guy here, but hearing all of these smart people talk and then hearing you help me digest it to something that's more easy to understand is how much work, effort, and thinking goes behind some of this stuff. It's not, as you said, just, "Oh, we're going to take the money you're investing and do something with it." It's, "We're going to help you find more already in your practice."

Casey Hiers:
Yeah. Sports analogy, right? You watched Steph Curry hit threes. Oh, that's beautiful. He's only like 6'3". I can hit some threes.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
But the amount of work put in behind the scenes to be able to get to that level is unbelievable, takes a lot of work. Unfortunately, some of us can discount the amount of work it takes to get great results. Especially for practice owners, you shouldn't feel that weight of the world on your shoulders. That's not reality, and it's not sustainable. Burnout will happen. Got a couple more for you. Let's see if we can plug it into dental. So many times we'll see practice owners, and they're trying to do so many things in their practice to improve because they at least know, I got to do something, right? They try practice management. Maybe add a hygienist. Maybe renegotiate some insurance fees.

Jarrod Bridgeman:
Or maybe they rework their lobby.

Casey Hiers:
Oh, yeah, yeah.

Jarrod Bridgeman:
New paint and new chairs or-

Casey Hiers:
Yeah. Put some lipstick on the lobby. Again, none of those things are inherently bad, but when you have a million-dollar practice, sometimes it doesn't cut the mustard, as I've heard. This is an old one, but that can be as useful as rearranging the deck chairs on the Titanic. It looks like you're doing something helpful, but really, it makes no difference in the end. A lot of practice owners, they will pay for some of these services. By the end of it, they're like, "Well, I guess it's better, but I'm not making any more money. I'm not saving any more money. It only made my overhead worse."

Jarrod Bridgeman:
You ended up being that dude that hits the propeller on the way down.

Casey Hiers:
Oh, gosh. That's rough.

Jarrod Bridgeman:
But no, you're right because you spent money to do these things. Yeah. You're increasing the overhead, hoping that this one thing is going to make you more money. It might move the needle, but it's not going to make the difference you expect.

Casey Hiers:
Yeah. Like I said, there's a place for all those things. But typically, the challenges that we talk about on this podcast, some of those one-off things don't move the needle. It's going to take an overhaul. It's going to take, number one, a complete diagnostic, number two, a custom plan, and number three, somebody to implement it. We offer that. That's very unique.

Jarrod Bridgeman:
Or just add an associate, right?

Casey Hiers:
Yeah. Second location. Third location. Bring out an associate. Just busy, busy, busy, rearranging those deck chairs. It's unfortunate sometimes.

Jarrod Bridgeman:
That's something I fall victim to in my lifetime, too, is just thinking that being busy means I'm doing well.

Casey Hiers:
We're all going to be busy. You have to be effective with your time. Again, at what cost and at what benefit are you busy? But then I'll talk to people who, rightfully so, they admit this is hard. Dentistry and ownership and success-

Jarrod Bridgeman:
Yes.

Casey Hiers:
... it can be frustrating. Then they go to the "We know it is. We admit it," and then it's just stress and worry, worry, worry. This one is from a great song from the late '90s. But, "Worrying is as effective as trying to solve an algebra equation by chewing gum." The worry is now the thing that they do because they don't know how to fix it, so they're like, "I at least know and admit it," but their worry is not productive.

Jarrod Bridgeman:
No. It's a time waste. All it's doing is-

Casey Hiers:
Energy. Time. All of it.

Jarrod Bridgeman:
It's energy, time. It's making you age faster. You get heartburn. You get anxiety, and all of a sudden, you're on medication. It can just 100% affect not only your mental health, but your physical health on top of your practice health.

Casey Hiers:
Then have you heard the two boats and a helicopter?

Jarrod Bridgeman:
I don't think so.

Casey Hiers:
Sometimes people... Faith is important to me.

Jarrod Bridgeman:
Yeah.

Casey Hiers:
But sometimes people will use that as the excuse. Like, "Oh, it'll just all work out." I'll butcher it, but there's two boats and a helicopter. There's this preacher, and he's in this town. It's raining hard, and it's flooding, and he's praying on his knees in the sanctuary. The water's coming up, so he goes up to the balcony. Neighbor comes by on a canoe, "Hey, Pastor, you need to get in the canoe-

Jarrod Bridgeman:
Right.

Casey Hiers:
... the water's rising." He's like, "Nope. Nope. The Lord will provide." Then it keeps going higher and higher, and he's on the top balcony. A guy in a motorboat comes by, "Hey, Pastor, the levee's going to break. It's going to be really bad. You need to hop in." "Nope. Nope. It's going to work out." He's up on the top of the steeple, clinging on, and the helicopter comes down. The state trooper said, "Sir, you need to get on the ladder and come up into the helicopter."

"The Lord will provide." Sadly, the pastor drowns. He goes to heaven. He gets his chance to speak to God. He goes, "God, I believed in you with all my heart, and this happened. Why?" He goes, "I sent you two boats and a helicopter. I don't know what else that I could have done." Sometimes people have the gifts and the discernment to make decisions, and taking action shouldn't be looked down upon. You've got the discernment and the gifts and this beautiful platform of a practice. Look around. Seize opportunity when opportunity comes. Don't feel bad about it, but don't make the excuse of, "Well, it's just all going to work out."

Jarrod Bridgeman:
Yep. The universe will provide.

Casey Hiers:
Why would you let something as important as the means that you help provide and protect for your family fall to chance? Use the gifts that you were given. We're not going too deep here, but-

Jarrod Bridgeman:
No.

Casey Hiers:
... there's a lot of analogies and things that sometimes I think can be helpful to shift the mind to, again, take action, be better. How are you going to be better tomorrow? What's the plan? There's too many practice owners; they do like the dentistry, but they feel like that hamster wheel. They're just going in day after day doing the same thing, and it's just how it's going to be. It doesn't have to be.

Jarrod Bridgeman:
Folks, I want to thank you for listening to Analogies of Casey Hires. This has been... But, no, Casey, you bring up all these great points. These analogies I think, help other people realize, again, they're not alone. These analogies apply because it's so commonplace to have these feelings and have these thoughts. So many people think that they have no one to talk to. There are people out there, ourselves included, not just make this 100% a commercial about Four Quadrants, but there are professionals out there that at least having a conversation, can at least start something. Whether that's for you, that team, that company, or that person's for you or not.

Casey Hiers:
It can be a springboard into action directly or indirectly, and both are wins.

Jarrod Bridgeman:
Casey, thank you so much. I know you're going to be in Jacksonville, Florida, this week, and we're also going to be in Gainesville. Starting after this week, we're going to be heading towards Bozeman in Montana. We're going to be in Cleveland, Ohio, Pittsburgh, Pennsylvania. There's so many awesome and fun places we haven't been to in a while. I'm hoping if you're in the area and you're listening, please sign up and come see us. You're going to learn a lot. You're going to get some CE credit. You're going to have a little bourbon, a little bit of food. It's a win-win here. The worst thing that's going to happen is that maybe you had a little too much of the sample, and you had to call an Uber. Drive safe, Casey. Thanks, guys, so much.

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.