The Million-Dollar Cost of Inaction

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, I don't want to make up stories here but you are a liar. You are not in studio, I am.

Casey Hiers:
That's right, I'm calling in remote. Got a little travel going on this week to speak to some wonderful practice owners in the Midwest. Is that what you call it?

Jarrod Bridgeman:
Yes, yeah. That's still concern part of the Midwest. So, you're heading out to Wichita right now?

Casey Hiers:
Yeah, got a Wichita event. We have not been in that geography in a long time and who knows when we'll be back but we've got some good interests so very exciting. But yes, I am a big liar, I'm not in studio today.

Jarrod Bridgeman:
It's nice for you to get out that way. I think the last time we may have been in that area was around Kansas City. For you listeners out there who are tuning in as this podcast drops today, we're going to be in Leawood, Kansas which is right outside Kansas City and that one has sold out. But if you're listening to this and you're like, "Oh, I forgot and Casey's going to be talking in Wichita," come out that way and grab your registration and come see us. We'd love to have you out and have you learn some more about how to improve your practice, what we do, enjoy some bourbon and have some great food.
Casey, if someone doesn't do those kinds of things because they're worried ... Let's be straight up here. We have a $50 registration fee for our dinner events like these and it's refundable but to someone who may even balk at the idea of putting down $50 to potentially learn something or improve their home life, improve their practice, what do you think about in terms of that cost versus everything else?

Casey Hiers:
There's a lot of hands in a lot of practice owners' pockets and so I think, after the honeymoon phase of buying equipment and getting everything rock and rolling, there's always people still coming around with their hand in the pocket. So, I understand, sometimes, when you reach for that credit card or that payment, it can be a little frustrating. For practice owning dentists and specialists, it's very simple. The analogy is, when your office has no call, no shows, it wrecks your day, it wrecks your schedule, it's not respectful, it's very frustrating for dentists [inaudible 00:02:43]. So, for us, same thing. These seats are valuable, there's limited space. We typically have, what, between 15 and 45 people that come depending on venue but I get it, there's a lot of hands in pockets, is this going to be worth my time or no.

Jarrod Bridgeman:
Now, is there any ... Let's say I decided, "Ugh, you know what, I'm not going to put down that 50 bucks, I've got everybody and their dog trying to get money out of me left, right and center." Is there a cost to, let's say, not attending?

Casey Hiers:
Yeah. Well, to your point, once people attend, once they darken the door, once we meet them and check them in, the next day, they get refunded. It's not a revenue stream, it's to keep those who just click yes to everything and then not show up. So, ultimately, that gets refunded but it's a placeholder because there is value to this. How do I know that? Because professors from dental schools have told us this, 80-year-olds, 60-year-olds, every age in between, they just said, "We have so much CE, I'm glad I came. I thought the bourbon and the venue was full, I didn't realize how deep you guys go with the business side of dentistry covering topics that I've always struggled with and nobody really covers." I like to ask what's the cost? Well, it's $50, it's refundable. Well, what's the cost? Time. Time is very valuable.

Jarrod Bridgeman:
For sure.

Casey Hiers:
You're going to take probably ... Probably a couple hours is what it takes, we spend 75 minutes on it. But there's a cost to everything, time and money is important but, ultimately, when we're covering cashflow, overhead, insurance adjustments, retirement planning, personal financial planning, practice advisory, how to make profitable decisions, decision making, comprehensive plan, I could go on and on and sound like an auctioneer but it's a very robust topic that's underserved and costs practice owners millions of dollars over the courses of their career.

Jarrod Bridgeman:
Right.

Casey Hiers:
So, two hours and $50, it's laughable, that's laughable. As a dentist, if you see a tooth that's abscessed and just failing and everything about it is bad, the dentist knows, hey, that tooth's got to come out. What that's going to do to them long term is going to be devastating. The dentist can know that, sometimes the patient just says, "Well, I don't want a shot in my mouth and I don't want to pay any money so I'm not going to do it." The dentist knows, oh, my gosh, the cost will be so much more if they don't do it.

Jarrod Bridgeman:
Now, sometimes that might be, I would say, for not a good enough term to pop in my head, but almost like a sticker shock sometimes where it's, yeah, it's going to cost money to get that tooth pulled, to get that tooth taken out but, again, the cost of you not suffering with pain and getting infections and all that for years to come is worth it but sometimes that's a hindsight kind of a thing. At first, you're just thinking, shoot, I don't have, potentially, the cash to do that in terms of the procedure. Now, when it comes to the $50 for our thing or any other type of course you may take or a business you may have come in in a practice management type place, there is, I would say, a long term, again, like you said, cost involved in not addressing, fixing and/or realizing potential infections or problems in your practice.

Casey Hiers:
Yeah. And we can even dive a little deeper on that, Jarrod. So, even recently, we give some tips and pearls of wisdom and really open up thought and mind in terms of how to have a profitable practice and change in life, right?

Jarrod Bridgeman:
Right, right.

Casey Hiers:
And ultimately, we get to speak with practice owners and get real specific after these meetings and learn a lot more about what they do. But yeah, those tips and tricks, there's no tricks to it but we had somebody just on the tax management portion of things just from our course, they called us back later and go, "We took some of the things you said and we talked to our CPA and our accounting team and there was just blatant mistakes that were made and the accountant never brought them to the forefront, they just kicked the can down the road with how they do their tax planning," and the dentist just thought that's how it is, that's just how it's going to be.

Jarrod Bridgeman:
When a professional tells you that, you go with the flow on it.

Casey Hiers:
Yup. But yeah, back to what's the cost. Think about any of those things we just said. Overhead. If your overhead is high, well, what's high? But so many times there's 10, 15, 18 percentage points of overhead that can be corrected just by implementing a lot of the things that we do.

Jarrod Bridgeman:
And compound that by how much your collections are. If you're collecting $1 million, 18% is a giant chunk of change.

Casey Hiers:
Yeah. But it really goes ... And ultimately, if practice owners come to our course, they're going to learn a lot. But ultimately, if we talk to some and maybe we get real specific with their practice and is there a path to help them and that's something that we can facilitate many times, not all the time by any means but, again, what's the cost if you don't exercise versus if you exercise.

Jarrod Bridgeman:
Yeah. If you don't, you'd look like ... You look like me if you don't. That's the cost.

Casey Hiers:
You got to get up early and work hard and sweat but then the benefit is your health is better. If you don't, you have more time but then your health is bad. So, if you're overhead and insurance adjustments and there's no plan and no strategy and tax surprises are common, the cost of not changing that is literally millions of dollars over the course of your career. People that work with us, we're not cheap, we don't apologize for it, we can't help everybody in the room, we're a small, more boutique, we're into results versus a quantity shop here.

Jarrod Bridgeman:
Correct.

Casey Hiers:
But ultimately, we're not cheap. Well, okay, people get sticker shock. Well, what's the cost of not correcting those things? We quantify that a lot because we'll talk to people. Maybe they're 38 years old, well, they come back three years later and go, "Hey, everything's gotten worse, I'm redlining with stress and I need some help," and then we'll get them on track. And they go, "Man, if I would've come to you the first time, what would that three years have meant to me?" and the number is large. There's a cost to not doing something, there's a cost to doing something, what is that cost and, for this purpose, practice owners need to think about that. What is the cost of doing nothing? What is the cost of an activity with improving your practice? Well, we know it's millions of dollars over the course of a career, that's a huge number.

Jarrod Bridgeman:
And I like that you pointed out that we're not inexpensive, we're not cheap and some of these people, not to put down any other professionals they may have worked with in the past, but they already went cheap. They already went to the, quote-unquote, cost-effective firm or the CPA or whoever and then they found out, oh, because of this, I should have gotten $70,000 back last year in taxes that I did not get or I owe tax surprises every year even though I've been paying quarterly, so that cost. But by that point, they're almost in that trapped cycle of now they're too afraid to change it up because now they're stuck and they're always like, "Well, now I owe, I owe, I owe."

Casey Hiers:
Yeah, no, there's a cost to everything and, ultimately, with what we do, we know how significant this is but younger people maybe haven't stroked a big check or maybe they have and they've been underwhelmed by, we've talked about this, practice management or consulting, whatever it was and so we know the reasons why. But ultimately, change is hard and, a lot of times, people will be very short-sighted. But just like with anything and in this situation a practice, what is the cost to improving, what is the cost to staying the same. Unfortunately, what people will do ...
Let's say there's a group out there that can help the business and financial side and the results and the profitability. Well, it's going to cost a lot of money but, ultimately, your results are going to be more than you pay. But so many times people go, "You know what? Oh, I don't want to pay this to fix it, I'm just going to open another practice, bring on an associate, drop in insurance." Well, those things done without expertise and deep analysis, that's like riverboat gambling.

Jarrod Bridgeman:
Right, right.

Casey Hiers:
It really is.

Jarrod Bridgeman:
Without the fun.

Casey Hiers:
Yeah. No, I agree, I think that's correct. But so many times people are short-sighted, they're looking at the next day, the next week, the next month, the next quarter and they're just looking at what's the immediate impact or cost versus long term what's the cost of an activity.

Jarrod Bridgeman:
Right. You mentioned opening another practice, you're, at the very least, doubling your amount of work and your amount of stress and you're not necessarily doubling the amount of money you're making.

Casey Hiers:
Yeah, it's fun and exciting but what's the cost of that. If your work-life balance and your stress is already high, is that going to help or hurt it?

Jarrod Bridgeman:
Probably not going to help.

Casey Hiers:
If you're running 77% overhead, is opening a second practice, is that going to improve things or not? If your debt load's already 1.3, adding another ... So, the idea is having sound advice, a comprehensive plan, eliminate mistakes, that's where people have to be in life. But ultimately, for our listeners, as a practice owner and, unfortunately, sometimes it's the cost of, well, I have to pay $50 to go to an event or I have to spend two hours of my evening or I have to spend time gathering data for Four Quadrant's advisory to analyze to see if they can help me. Yes, there is a cost to that, there's a cost for our services. What you get is made up many times over and, if anybody listens to our client testimonials, for our listeners, your peers say this word for word they do for you many times over what it costs, again, if it makes sense.
And that's why we love our vetting process. We learn about people, we learn about practices and numbers and, a lot of times, it doesn't make sense, people are shocked when we tell them that but other times they need it more than they need air and they just ... Change is hard, writing a check is hard, it's just easier to stay where they're at and just bitch about it. And of people like that, a lot of people just like the bitch-

Jarrod Bridgeman:
I do, I love it. I also still fix stuff and I still bitch about it so that's my jam. I got it naturally for my grandfather, he did the same thing. But I thought of a funny thought in my head when you were talking about all that and I was like, At some point, is this almost going to be like a counselling group? Hi, my name is Jarrod and I own Premier Dental and, yes, I have high overhead. Is this an AA kind of a thing?" At some point, they have to admit they have a problem or an issue in their practice to even address it.

Casey Hiers:
Well, you hit on something important and that was a funny way to get there but it's very true. A big part of our process, people will feel vulnerable and exposed and that can be hard for some people, for some personalities, that's the worst thing. But ultimately, people have to be willing to admit what's wrong, what could be improved on and be open to that. That's hard, that's challenging, we understand that but, again, what's the cost of not having courage and just keeping on doing what you're doing. Well, most dentists will be okay but has okay ever been good enough.
And I say most because we see a lot where, my God, overhead's 85, 90% and we're talking about an associate and it's you'd be better off just to sell your practice and go be an associate. It gets to that point sometimes and people still don't even realize it. It's like the fog of war, the fog of ownership and they're just pulled in so many directions they don't know whether to zig or zag and so they just do nothing.

Jarrod Bridgeman:
And they've been doing the same thing for so many years that they can't imagine that there's another way out there.

Casey Hiers:
Well, yeah, good point there. They've been trying this for decades in some cases and it's just impossible, it can't be done. And then people's minds go to, oh, you're just going to make me fire somebody, raise my fees and use crappy supplies. That's where people's minds go because they don't know how to become more profitable. Well, again, that's why we exist, that's why we educate the dental community and that's what we've mastered for over 21 years and we'll continue to do so. Again, for those who are ready, have a practice that we can help, who want the help, who have the courage to take action and to understand there's a cost to everything, there's a cost to doing something and there's a cost to not doing something.
But ultimately, that's what each person I speak with, they have to be there in their own minds, I'm trying to find that out real quick. If somebody's not ready for it, that's okay. We talk to an incredible amount of dentists and many of them are ready and they're just like, "Wow, I wish I'd have found you sooner," but there are some that they have not experienced enough.

Jarrod Bridgeman:
Right. And if they had found us sooner, they may not have been ready. They haven't felt that pain, they weren't ready to help themselves.

Casey Hiers:
It's an interesting topic because I think, when we're all younger, we just have that what's the instant gratification. I want the sugar, I want the toy. I want the stuffed animal.

Jarrod Bridgeman:
And the fact that we think we're invincible.

Casey Hiers:
Yeah, we're not thinking ahead. And then everybody in their life has reflection points where they get into something and start to think about the future and plan. Well, with dentists, it's the life cycle of ownership and, ultimately, typically by year three, year five, year six, most practice owners know they're blessed and doing better than most but they also have that feeling in the pit of their stomach that, ugh, but they don't know where to start. And unfortunately, many people that we work with, they have trusted people or worked with people who just under-delivered and so they get used to that and they have a hard time with the leap but, again, it just comes back to what's the cost, there's a cost to everything and, for practice owners, it is incredible.
Some of the people that have taken that leap of faith and work with us, ultimately, come to an event, we talk. Unfortunately, some people it's just like, "Hey, this isn't the right time, we can't help you and your practice," we're upfront with that. But the ones we can, my goodness, it is just incredible what is at stake.

Jarrod Bridgeman:
But see, even the people that we don't end up working with, they at least walked out of there with the knowledge of now I know what to look into and look for at least, a starting spot.

Casey Hiers:
Well, it's interesting, we covered DSOs really just at a high level, we render a little bit of an opinion but, for the most part, it's just a high level, here's deal structure, here's some things to be aware of. I've had people, we'll call them mini-DSOs, a dental kingpin that owns 45 practices has come to our events and he's been like, "Man, you guys are dead right. I learned this the hard way. I'm okay now, I own 45 practices, I know many people who try to do the same thing and failed miserably." But they have literally said, "Hey, for all you solo owner, two-practice, three-practice owners, they are right, you need this." When we hear that from people who don't exactly fall into our business model but respect expertise, that's very, very compelling.
And then, ultimately, at our events, sometimes we have our clients, if they're in the area, they want to come and then they want to talk and they want to share their experience, that's very powerful. If I forget to mention it to a client and I'm in their geography, they get pissed at me and I'm like, "Oh, my gosh." They want to come and hang out with us because we've changed their damn life, we've doubled their income and life's good.
So, what's the theme of today? There's a cost to everything, there's a cost to status quo, no change, being content, being mediocre, there's a cost to that. And unfortunately, in dentistry as a business owner, it's going to affect you, your patients, your family, your staff, your team. The ripple effects of indecision or decision, they're going to be there, choose your hard, we've talked about that before. What are you comfortable missing out on? For us, it's a small amount to hold a seat, a couple hours, potentially engage in a conversation.

Jarrod Bridgeman:
And enjoy some food and some bourbon and have some drinks on top of that.

Casey Hiers:
Yup, we have people that enjoy. We have people that enjoy Arnold Palmers and Shirley Temples and we have others that enjoy great bourbon. That's just a little something we like to do but, again, I just like to encourage practice owners, don't be content, be an achiever when it comes to your business and your profitability.

Jarrod Bridgeman:
It'll take a little hard work upfront but, once things are in place or at least on the right path to being in place, it gets a little smoother from there.

Casey Hiers:
Mm-hmm.

Jarrod Bridgeman:
Casey, thank you so much for calling me, I know you're on the road. Folks, if you want to come see us or just want to have a conversation, go on our course on our website and fill out a form and one of our amazing people here will reach out to you. But if you're not coming to one of our Kansas events, we are going to be in Virginia Beach in Richmond, we're coming to Grand Rapids, Michigan, we're going to be in the Wisconsin area, we're coming to Texas.
We've got so many great cities and places and restaurants we're going to, I know we're all so excited to meet all these docs that we've not had to be able to touch yet and speak with and engage with. And so, Casey, I'm just so excited for you and your team that gets to go out there and just get that real life. I sit here in my room and talk theoreticals, you get to come in and bring in the actual experience of these are what people are telling me.

Casey Hiers:
Hey, Jarrod, one more thing. This is the season now that school's going to start in the fall when dental societies and study clubs get back going, it's been incredible how many have reached out to us and asked us to come in and present to their members. And again, if you're a listener and you have a dental society or a study club and you have minimum 20 people that come in person, you can reach out to us that way. We sprinkle in dental societies and study clubs every year, we enjoy doing that and that's something that people have been reaching out a lot to try to get us booked. And as you know, we do 50 events a year, many ours but many state, national, regional meetings. So, if you have a dental society or a study club, reach out, we'll consider it.

Jarrod Bridgeman:
Yup. Go to fourquadrantsadvisory.com and there's forums all over the place and there's also a phone number you can always give a call and we can get you all squared away. Casey, thanks again for calling me, man, I appreciate you.

Casey Hiers:
Thank you.

Announcer:
That's all the time we have today. Thank you to our guest 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.