Could It Make Sense to Downsize Your Practice? – Episode #367

You’re a clinical virtuoso but really don’t enjoy the business side. Adding to your team or working at multiple locations adds revenue but also stress. Plus, it takes you away from what you really love about dentistry. On this episode of the Dentist Money™ Show, Ryan welcomes Kiera Dent of the Dental A Team to talk about how to rightsize your practice so it’s a good fit for you.

Show Notes
thedentalateam.com

 

 

 

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Podcast Transcript

Ryan Isaac:
Hello, welcome back to another episode of the Dentist Money Show brought to you by Dentist Advisors, a no commission, fiduciary, comprehensive financial advisor just for dentists all over the country. Check us out at dentistadvisors.com. Today on the show, long time friend Kiera Dent from the Dental A Team. I had a question from a client that is, as Kiera discussed, a common question but a kind of a difficult one. A client had asked me if I have a second location, kind of a satellite situation, and I’m not sure I really want to keep it going, how do I think about exiting that? What are the things I should do before I do it? How do I exit? What kind of things should I work on to bring it back? How should I frame this mentally and emotionally? Because it’s kind of a big deal. It was a really, really good question. And Kiera says this, that situation gets talked about a lot, but it’s kind of hard to actually execute on that. So many thanks to my anonymous friend and client who posed that question. And this was a really great discussion. So thanks to Kiera for spending the time to explain this.

Ryan Isaac:
She not only frames the situation in some context that kind of normalizes what that’s like and why people ask that, but she also gives some really practical solutions to set a deadline and a timeline for your practice and really get to work to see if you want to keep it going, want to save it, and how to do that. So that was awesome. Thanks Kiera for being here and thanks to all of you for listening and tuning in. If you have any questions for us, go to dentistadvisors.com. Thanks for being here and enjoy the show. The Dentist Money Show is brought to you by Dentist Advisors, where you can get a free financial assessment. Simply fill out a scorecard using the Elements app and then meet with a CFP advisor to see how you’re doing financially. To schedule your free financial assessment, visit dentistadvisors.com/scorecard.

Announcer:
Consult an advisor or conduct your own due diligence when making financial decisions. General principles discussed during this program do not constitute personal advice. This program is furnished by Dentist Advisors or registered investment advisor. This is Dentist Money. Now, here’s your host, Ryan Isaac.

Ryan Isaac:
Welcome to the Dentist Money Show where we help dentists make smart financial decisions. I’m your host Ryan and I’m here with longtime friend of the show, Kiera Dent, Dental A Team. What’s up Kiera?

Kiera Dent:
I’m coming in hot today. I’ve got your brand on, you’ve got my brand on. That’s really solid. I’m so excited to be here, Ryan.

Ryan Isaac:
Yes.

Kiera Dent:
I love what you guys do. I love your audience. I mean, I work with you guys. You’re literally my advisor.

Ryan Isaac:
It’s true.

Kiera Dent:
So it’s an honor to be here. I truly am excited. So let’s rock and roll.

Ryan Isaac:
These are true things. Thank you for doing this. You are a busy person and we really appreciate it. So you and I were chatting and I had a question from a client. I kind of just want to dive in, if that’s all right?

Kiera Dent:
Yeah, let’s do it.

Ryan Isaac:
I told you about this. A client asked me about downsizing practices, like from multiple locations down to a single location. And you always hear this on the reverse, you know, like I’ve got one location, I’m growing. When is it time to get a second? How do you put someone in there? What are the metrics? That’s really, really common, but I’m not sure it’s talked about enough where people do have two locations and it’s just like for one reason or another, it’s kind of grating on their life. You know? I mean, this is anonymous, but it’s pretty typical story. This person’s like, I don’t know if it’s making me that much money. Even if it is, it’s just stressful. It’s cramping my lifestyle. I don’t like managing that big of a team. I don’t like driving to two different places. I kind of just want to like bring it back into one good, solid location. So two questions. Number one would be, how common is this? How often do you have a conversation with people about downsizing locations? And then number two would be, how do you go about this? Like, what’s the process like?

Kiera Dent:
For sure.

Ryan Isaac:
What would you tell my client right now, Kiera, if they were here with us?

Kiera Dent:
Oh man. Well, number one, I would say kudos to this client for actually admitting that this is real, because I don’t think it’s talked about as much because I feel so many people don’t want to be judged or felt like they’re a failure or say, Oh my gosh, like… That takes a lot of humility to come to you and say, Ryan, I hate this, my life sucks, I don’t want to do this anymore. And then I’m going to have to write to my friends and tell all them like, I don’t have two practices anymore. And so, I’ve in the entire time I’ve consulted and my body has physically been in over 200 dental practices.

Ryan Isaac:
So hard to comprehend. Yeah.

[laughter]

Kiera Dent:
I have had one client that I know actually downsize.

Ryan Isaac:
One?

Kiera Dent:
One out of 200 different…

Ryan Isaac:
But you would say a lot of people would probably like to do it. It’s just taboo.

Kiera Dent:
It is taboo.

Ryan Isaac:
Especially in today’s day where DSOs are the whole thing and having as many locations with as much profit as you can is like the whole thing. There’s so much pressure to do that, that the reverse feels almost crazy.

Kiera Dent:
Right. And so, it’s not like I have only had one client that’s ever talked to me about it.

Ryan Isaac:
Totally.

Kiera Dent:
But one who actually executes through, because I think so often you’ll talk to your friends and it’s like, well, that was just a bad day. And why am I being such a baby? Like look at my whole life, and it’s awesome.

Ryan Isaac:
Well, we all have that. Yeah. That’s normal. Yeah.

Kiera Dent:
Ryan is my therapist, not just my advisor. He’ll text me, right? I’m like, how you doing Mike? Ready to sell this thing?

Ryan Isaac:
I’m burning it all down. I’m done. I’m getting a one way ticket to Thailand and I’m never coming back and you’re like, all right.

Kiera Dent:
And I think if we didn’t have that, we wouldn’t be business owners. So I feel like number one, realize that the ebbs and flows and the waxes and wanes of business is normal. But I feel like if it’s dragging on your life and it’s been six months or longer, it might be wise to take a look at it. And I would always ask the question of why? So this is usually how I can work my way through with offices is, What is causing the most amount of stress? Like if it’s driving back and forth between the practices, well, a solution could be that we hire somebody who’s over there and you don’t have to go there. If it’s you hate managing, well, why don’t we bring in a high powered office manager? Just for reference, I was offered to run a very large practice after I left my first practices that I’d grown. And this was five years ago. I was offered 150,000 to work two and a half days a week. And could I have done it? The answer is absolutely, I just didn’t want to drive there and back, and that was why I said no thanks. [laughter] And I’m going to do my own thing, but you can hire very experienced office managers. Yes, you’ll pay a high premium, but okay, we bring in an office manager for 150,000. You literally wash your hands clean of that and you don’t have to manage anymore.

Kiera Dent:
So I would say like, what are causing these stressors and is there a way that we can alleviate, if this thing’s bleeding money? That’s usually when I say it’s time to bail. We’re going to play this game for three months, six months, we’ve got to have a cut time of when this is going to be folded in and we’ll figure out what we’re going to do with those patients and where they’re going to go. But if it’s bleeding money and it’s costing you, and there’s no way that you can get out of that hole, those are the ones that I’m usually like, let’s cut bait. But if it is just causing personal stress and life, could we hire somebody? Could we do something differently that then alleviates the stress of the things you don’t want? That would be where I would often probably talk to this client and just find out what are the specifics because oftentimes there’s a solution and it’s not how do we do it, but who could do it for us?

Ryan Isaac:
Yeah, who. Dang, which in this economy hiring the who is like really tough.

Kiera Dent:
That’s like a whole other envelope.

Ryan Isaac:
That’s a whole other episode. Maybe we’ll get to that actually.

Kiera Dent:
We probably will.

Ryan Isaac:
Okay. So a few things that come up in that conversation would be like if someone else… You do find the who and the people to go kind of take care of things for you, what’s a minimum profit level? You know, the person’s not doing clinical there, they’re not the dentist there. It’s an associate. It’s a good office manager. What’s a minimum profit level where it’s like, that’s worth it or below this you’re just wasting time and resources?

Kiera Dent:
Sure. I truly think it’s the individual. And I mean, if I were to tell you that it’s 10% profit, well, that’s better than most investments that you can make to do nothing on and you’re getting a 10% year over year return.

Ryan Isaac:
Totally.

Kiera Dent:
That to me might be worth it. Especially if I’m truly hands off, some people might be like, absolutely not, not worth the stress and the risk. I’m at 20% margin or no go. So I feel like it really is up to the individual. And I know, again, it can feel very hands off, but it’s like maybe that looming stress of, yeah, it’s hands off today, but if that associate walks, then it’s going to be full hands on deck. To that I would say, but are they bought in? Do we have a partner? Could we make them a partner? So that way it truly can be, can you get your office manager to be a partner? I was a partner, guys, as an office manager, you better believe I was bought into those practices, slaying all day long because I was invested into those practices. So for me, I feel like if I can get a 10%, 20%, 30% return, rock on, that’s an awesome practice. But again, you have to be comfortable with that. And if it’s taking 10% of your profit from your main practice and you’re always having to pump money in there and you’re only getting 1% or 2%, it might not be worth it. But I mean, Ryan, you’re the investment people. It’s like right now it’s been a great year to invest with you, Ryan. I’ve lost all the money. It just keeps going down. [laughter]

Ryan Isaac:
It is my fault. It is all my fault, you’re right.

Kiera Dent:
You keep telling me, Kiera, it’s a great time to buy, ’cause it’ll be back off. Like it will be off sell in a while and you’ll be real happy you were buying. So it’s one of those things though, like investments. I think a second practice is an investment. Like why did you do it? Yes, you want to serve more people. We’re on the Dentist Money show. It is about investments and how can you build your portfolio and how can you make yourself that way? But I think like to even go back earlier in the conversation, one of the biggest pieces that I feel dentists and business owners and people in general should be looking at is, why do we grind and slay all day long and not enjoy life hoping for this awesome payout to then enjoy life?

Ryan Isaac:
Later.

Kiera Dent:
So that’s kind of where I’m definitely changing my tune and just asking people of like, what are your ultimate goals? ‘Cause it doesn’t matter if you’re getting a 10% profit, if you hate your life and you don’t want to do this.

Ryan Isaac:
Yeah, not worth it.

Kiera Dent:
Not worth it.

Ryan Isaac:
20 is not worth it, 25 is not worth it. If you hate it, 30 is not worth it. The money is not worth it. Yeah.

Kiera Dent:
No. Never. So I think that those are some of my thoughts on what is that appropriate profit? I would say, what are you good with an investment? And can you use that money if you were to sell and get rid of it, could you use that money to go and have something else that would generate just as much if not more, or is this a pretty good investment if you can truly be hands off?

Ryan Isaac:
Yeah. You said something earlier too about if it’s affecting the other practice. So like if it’s a satellite struggling, but it’s taking the other one down or it’s taking resources and you away from making the other one go well, that’s a red flag, right? Like that would be a very clear problem to you?

Kiera Dent:
I would say absolutely yes, because for me as a business owner and as a CEO, my job is to ensure that the business survives. So if I’ve got this needy child, AKA my satellite practice, who’s sucking me dry to make my main business suffer, I’m not doing my job as a CEO. So either I’ve got to fix that or I need to dump that to protect what’s building the business and what’s going to feed my team, my people and myself. That’s my job, in my opinion. Now, you get to decide, I mean, some people have millions of dollars and they don’t care if it’s a loss, like a loss leader and you’re losing money on it all the time. So that might not be a red flag for everybody. But to me, I’m like, I don’t like investments. I don’t like businesses that don’t make money. That’s always been my standard. That’s always been Kiera Dent’s philosophy. I don’t go into practices like we’re going to make you more profitable with ease. So why would we continue this satellite? It’s kind of like gambling and thank goodness I have never gambled ’cause honestly, you guys, I would be the person who lives there and never sees my family. And I’m like…

Ryan Isaac:
You’d be like got shades on it.

Kiera Dent:
A hundred percent.

Ryan Isaac:
5:00 am just pulling machines, slots, like a little cup of coins and like a hundred burnt cigarettes. And you’re just like, I don’t know what’s going on. [laughter]

Kiera Dent:
That would be me through and through and through because I’d be like, Oh, the next one, Ryan, the next one, the next one.

Ryan Isaac:
Yeah. Yeah. You’re thoughts. Yeah.

Kiera Dent:
I wouldn’t stop. And so some people might feel the satellite practice, just give it another time. But you’ve got to have a deadline. If it’s not profitable by X date, here is our exit plan. So at least you have a plan, at least, you know what you’re going to do. And we have a true deadline because you can sit there and keep shelling money into it. But I’m like, I can pour water on this dirt in my backyard and it’s not going to grow flowers. No matter how much I put water on it, it’s not going to produce what I want it to do. And I think truthfully, the hardest thing as business owners, I remember I heard a podcast, it was on entrepreneurs on fire and whomever was speaking. And it struck me so hard as they said, one of the hardest things as business owners is to actually realize when it’s time to close a business.

Ryan Isaac:
Ooh. Yeah. That’s what this is about. Totally.

Kiera Dent:
And I shut a business down three months after hearing that podcast that I had, dental placement pros. I realized that was sucking the life out of Dental A Team and taking my time, effort and resources and not generating. And it was really hard for me to shut down a business. I felt like a failure. I felt like, if I would have just worked hard enough, this could have been better. And the answer is that is true. It could have been, but that’s not today.

Ryan Isaac:
It wasn’t.

Kiera Dent:
That’s not the season. And so I need to be able to make that hard decision as well, realizing what I ultimately want. And that was to make this business profitable.

Ryan Isaac:
Yes, man. That is so true. Okay. Another question, which would probably be a whole other segment, hours long segment would be, I love the idea of a deadline because you’re right. You don’t want to end up being the old wrinkly casino playing person. No offense to any wrinkly casino playing people listening. [laughter]

Kiera Dent:
None. I just know, Ryan, we would have no money to invest. I would have like pennies and my investment would be that slot machine. And I just know I’ve got that addictive personality. [laughter]

Ryan Isaac:
I can see you. Yeah, that’s fair. I’m not a gambler either. I’d rather just buy food with my money than waste it. But okay. But I like the idea of a deadline. What’s a realistic debt? Let’s say it’s a practice, it’s okay, it’s not on fire, but it’s not like going anywhere. It’s kind of limping along. It’s enough to open doors and pay people and whatever. Is that a three month thing? Can you turn something around intentionally enough in three months? Does it need to be six? Like What’s too short, What’s too long to set this deadline? That’s one question.

Kiera Dent:
Okay. So again, I’m going to pull back to people because for some people, three months is plenty of time to go turn around. Like if you are saying I’m 100% committed, I’m going to give this everything I’ve got. I’m going to put my A Team players in there.

Ryan Isaac:
Ooh, little plug there. Little plug there for the Dental A team.

Kiera Dent:
It wasn’t intentional but go for it.

Ryan Isaac:
Yeah. I like it, dentalateam.com. Yep.

Kiera Dent:
Thanks. But if you guys, like you’re going to go put this massive awesomeness into this practice, then for sure, I would say three, six, 12 months is totally realistic, but also I’d like to have a budget of how much money I’m willing to put into this investment before I need to see an ROI. So it’s like, how much money am I going to lose before we call cutting it, including the deadline? So that would be number one. But if it’s limping along and you’re just like, you know what? I look at it more as, Is this a liability or an asset and how much effort is it going to take for me to get it into an asset rather than a liability? Limping along, one bad patient review, one bad team, like you lose it.

Ryan Isaac:
True. It’s over.

Kiera Dent:
You then start to go into the negative. And so on that one, if it’s limping along and you have zero desire to go invest in it and you don’t want to grow this and you have no passion, just get rid of it.

Ryan Isaac:
No deadlines, just go. Yeah.

Kiera Dent:
Let’s do an exit plan now. But if you have that dryer and you have that fire and you not just for yourself, but you can see actual potential in it, then I’d say, give yourself three to six months. I feel dentistry is a good six month window because we see patients in a six month cycle. And so give yourself six months. You should have filtered through all the patients. And that’s probably going to be a pretty good prediction of what the next six months will be like. So if at that point we’re not there, but again, I don’t like to lose money. The only rule my husband gave me, which guys, he doesn’t really give me any rules at all in life.

Ryan Isaac:
I think it might be reverse. Yeah.

Kiera Dent:
You don’t say, the slot play.

Ryan Isaac:
I feel like you might have a few more, yeah, you might have more rules than he might have rules, but go ahead. I digress.

Kiera Dent:
I think you would be accurate. The only thing he told me when I started the business is, Kiera, don’t lose money; otherwise you don’t have a business, you have a hobby. And that has really stuck with me. And of course, there’s different things like you’ve got to invest and you’ve got to go in debt and there’s different pieces. But when I’ve got a business that should be making money for me and dentistry is a pretty good investment of a business. If it’s not profitable and I don’t enjoy doing it.

Ryan Isaac:
Yeah. Why?

Kiera Dent:
Other than ego. Why are you really holding onto it? Yes, of course, you can be serving more people, but I really feel like that’s where you’ve got to know yourself and you’ve got to know why you’re doing this. If it’s truly for ego and you’re embarrassed, call me up and I will tell you how embarrassed I was to have to close down a business. And I felt like the most failed business owner. But when I did it, guys, freedom was freaking lurking right on the other side of it. I had so much more energy, so much more life in me. It was about, 30 seconds, like not really, it probably was more like 30 days of just like, gosh, that really was a jump.

Ryan Isaac:
Yeah, took a hit.

Kiera Dent:
Before I saw how happy I was and how much more energy I had to put where I really wanted to put it. Maybe two, three months. That’s been a while since I closed it down, but I can talk about it now and there is, I have zero regrets of closing that business. Absolutely zero. I wish I would have done it sooner. It gave me a great platform. It gave me great experience, but I would never in a million years go back and open it up. So I feel like realizing it’s just like when you got to fire somebody and we stress about it and we have those like two, three, four, five, six weeks of pain. And then it’s about 48 hours and that pain’s gone. It’s almost instantaneous. So realizing you have more stress and struggle before you close it down. If you know you’re going to do it than what it will actually feel like when you do it.

Ryan Isaac:
Yeah, that’s good advice.

Kiera Dent:
So I think I’ve kind of spun in a few different directions, but I hope that there were answers for the all different types.

Ryan Isaac:
No, that’s really good. So much of life, so much of making hard decisions in life is just normalizing the hard decisions that you’re not the only one. You’re not crazy. You’re not failed. Like it’s just a thing that’s happening. And I think that’s a really good first step.

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Ryan Isaac:
High level, really, really high level. What are the things… If you give yourself three to six months and you’re like, I would like this thing to work out. It’s not just limping. I would like it to work out. It’d be great to turn a corner. What do you tackle? I mean, there’s no way to like diagnose everything, but high level, what are the areas in the practice that like you focus? I got three to six months, What am I focusing on?

Kiera Dent:
Amen. So literally I go right to the numbers, your PNL, if it’s clean, which hopefully it is clean, that is going to be your guiding star to know exactly where to hit first. So I always, whenever I go into a practice, it does not matter who they are, I am looking at that PNL to say our supply is high, is our payroll high? And can I reduce any of those? Or do I need to just increase production? Like which one of these levers do I need to pull first?

Ryan Isaac:
Can I ask you a question on that?

Kiera Dent:
Yeah, of course.

Ryan Isaac:
What’s the average, like just for a GP office, single doc, I mean, there’s a break-even to just the cost of doing dentistry and paying people and supplies and keeping lights on, right? Is it 500 a year? Is it 600 a year in collections? Like what’s the break-even of just paying for a dental office, paying your loans?

Kiera Dent:
I wish I had a better answer for you because I’ve seen as low as literally $25,000 a month, which is so minimal, all the way up to like 500,000 a month. So depending upon the size of your practice, but I’m guessing these limping along ones, we’re talking like I’ve seen 25,000 in collections a month, can’t pay the bills and their expenses were 13,000 a month. So, I mean, they were only open two days a week. So that’s a very low threshold. And that’s another thing you guys can do. If this practice is limping along, so many people, when they’ve got limping along practices, don’t realize that if you consolidate your days, you could actually be more profitable. So I’m going to start looking at what are some outside the box pieces I can do on this practice? Can I shrink down my days to reduce my payroll and have more full days? So almost treat it like a startup and just have full days, maybe have a receptionist there that can answer phones. Maybe I can send the phones to someone else, especially if I’ve got a first practice, can I transfer phones over and we could schedule? But we just get one or two days really solid or three days because that’s going to reduce my supplies, my overhead, my payroll, staffing, and I could do a rotating schedule so I could be open more days.

Kiera Dent:
But getting really creative in these three to six months of what can I do to reduce cost and maximize production? If this practice, I go back to my startup mode and startup mode in any practice is always when patients are there, if we can, let’s try and do same-day dentistry. Same-day dentistry has saved hundreds of practices that I have watched because this is where you’re able to convert. Same day, they’re there, we’re able to generate a profit. We’re able to do more than we thought we’d be able to do because the patients are already in our chair. So I’m going to go after same-day treatment. I’m going to look to see where I can consolidate and reduce. I’m going to watch to see, are we collecting money? Because oftentimes practices are limping around and really struggling, not because the practice is truly struggling, but because we have a problem with our collections.

Ryan Isaac:
Now it’s producing, but the money’s not coming in.

Kiera Dent:
Correct. Exactly. Because so many offices like here, we don’t have any money. And I go look in their AR and I’m like, you’ve got 450,000 just sitting here. If I could even collect 50,000, you’re going to feel like you’ve got breathing room again. And it’s just sitting there. We haven’t ever collected it. So I would be looking at your billing and your collections as well to see, are we actually getting the money? Are we doing the correct write-offs? Are we presenting treatment plans? So that would be my next spot. ‘Cause that’s low-hanging, easy money sitting there. And then after that, I’m going to move into our diagnosis and our treatment acceptance to see where we’re at with that. And then my next move would be looking at your schedule. Are we letting patients break up with us all the time? Are we trying to get our schedule to be tight and full or are we just like very lackadaisical with it? And those might feel exhausting to someone who’s on burnout mode. But the bottomline is, I just showed you how you can actually get two to three more days of your life back by just consolidating your schedule down and reducing your payroll.

Kiera Dent:
Looking to see, could we, is it just in our collections? If we just called these people and collected money, you would have breathing room and then looking at your, guys, diagnosis and your scheduling. That’s going to be my quick hit list. And then the last piece would be, make sure you collect money before they leave. Like that sounds so simple, but so many people don’t collect over-the-counter. And that’s how I was actually able to take a practice and add 50,000 in revenue and collections in one month, was simply by having them stop at checkout before they left. So I feel like those are usually… When I come in, like practices that are limping along, unless it’s a new patient issue, most of the time it’s this low-hanging fruit that if you just even exerted like 10% of effort, you’re going to see a pretty good return on that effort.

Ryan Isaac:
Yeah. And then if you can make your deadline and you can make these improvements and these things actually change the course of everything, then you can start working on like deeper, longer term things, marketing, branding, new patients. Can you talk about that really fast? You said, unless it’s a new patient issue, that’s a whole different story, I’m assuming?

Kiera Dent:
Yeah. ‘Cause new patients, if we don’t have enough, sounds gross, if we don’t have enough lifeblood coming into the practice, you can’t survive. And so we need enough…

Ryan Isaac:
Blood is totally gross actually. I agree. I don’t like blood.

Kiera Dent:
Enough blood into the practice. I mean, we’re all in dentistry and we call it red stuff, whatever. But if you don’t have enough patients to feed this practice, it’s like blood is the lifeblood truly of our bodies. I feel like patients are the lifeblood of a practice. If you don’t have enough of those, we got to then go into reactivation and like how many patients could we access in this practice? So that would be number one before I’m going after marketing, which is going to probably cost me money, let me look at my internal practice and see how many patients are not even scheduled for recare. Let’s hit that list. Let’s make those phone calls. Guys, there’s companies that do that for you. You don’t have to do that. You could literally call up CallForce, but I think they changed to Reach, they’ll call all these unscheduled patients and get them scheduled for you. So there’s a lot of ways that you could actually do that. But if you have all your patients there and you’re just like, gosh, we’re struggling because we don’t have enough new patients, our patients are pretty healthy. One, I would challenge that and say, yes, they’re healthy, but guys, I’ve got a healthy mouth. Why don’t you offer me Botox? Why don’t you offer me whitening? Why don’t you offer to fix my lateral? That would be really great. And I would say yes to you.

Ryan Isaac:
These are not things I’m noticing. I don’t know what you’re talking about.

Kiera Dent:
But those are just things that I would say. So I would challenge the belief that your patients are all healthy and I would look to see what other services could you offer. Older patient-based, sleep apnea, younger patient-based Botox, whitening, ortho, all day long. So those are two really easy things that you can add that don’t have a lot of cost for you. But if we really, truly are like, no, we diagnose, we offer all the services here, and we truly just don’t have enough new patients. I have an office who called me and said, “Kiera, we need help with our treatment planning.” We got in there. They have five doctors running and they have 15 new patients a month. And I was like, it’s not a treatment plan problem. We don’t have enough patients, there is no lifeblood to this practice. You guys are crumbling as a practice, we’ve either got to get rid of doctors, you’ve got to get rid of something because we don’t have enough patients to feed this many doctors. And so that’s where I would say, if it’s a new patient problem and you can’t get it, some people are in remote areas, it’s very hard to bring in new patients, but I would look at different things.

Kiera Dent:
Could you go fee for a service? Could you reduce the days that you’re working? Like there’s still options out there, but I think the bottomline is, I can give you all these tips, but if you’re freaking burnt out toast and you don’t want to do this, don’t do it.

Ryan Isaac:
Don’t do it.

Kiera Dent:
Sell it. Someone will be happy or bring in a partner who’s eager and excited to do it and like have them own it. You have minimal risk on it and free yourself from that. And that’s not bad.

Ryan Isaac:
No, it’s not bad. And then I’m just thinking like, if this is a situation where somebody has like a main location and then a satellite and they end up folding the satellite because that’s the best decision. All of the things you mentioned are probably still worth looking at in the main location. I mean, there’s no way that all of those things are running perfectly at all times, there’s always something you can go and check on. So if that list doesn’t apply to the satellite, you’re going to shut down, then shut it down and take that list and go apply it long term to the practice you know is staying open and really get to work on it. ‘Cause that’s a lot. That’s awesome. Thanks for going through that. I didn’t know if it was possible to even name things. Like if you have a three to six month window, like what do you do? I don’t know, [chuckle] just panic and hope?

Kiera Dent:
And I do think most people do panic, which is why… I have saved so many practices. I remember I had an office, they were actually in Utah and they were legit. I would get calls at 9, 10, 11 o’clock at night where this doctor was on bankrupt row and just stressed out. They didn’t have a second location. It was main location. And we got them off of bankrupt row and they sold their practice and they went off to do whatever they want to do. And they just didn’t enjoy practice ownership. And what I love about that story is like, guys, I didn’t know if I can turn this thing around. I was like, oh gosh, why do I get these ones? But what I found is no matter what practice, it can always be turned around if you want to. Like I have yet to see one. The only one that folded, it was because they had two other practices. And I’m like, guys, we’re wasting so much time. We could split this patient base into the two offices that are doing really, really well. And then we don’t have to pay the overhead. We don’t have to pay a payroll. Like it makes no sense to keep this office open. There’s, we were cannibalizing ourselves by having these practices too close to each other. So let’s close it down and make these other two amazing. They’re now rocking and rolling producing way more than they were doing with three because we were smarter with our decisions and our resources.

Kiera Dent:
So I feel like no matter where you’re at, one practice, two practices, like don’t have shame, it’s okay, reach out and get help if you need to. ‘Cause sometimes when you’re deep in that hole, which that’s honestly why I love Ryan so much, is because when I’m deep in my hole of just, I hate all of this and I can’t see any light there. Somebody outside of that can show you how to get out and show you little things that you can do. And small changes result in big, big gains in dentistry. And it’s really not hard to shift it if you want to.

Ryan Isaac:
Love that. So I love all the practical, pragmatic things that you can actually go do. That’s advice you can actually go implement, but I love the key that, do it if you want to do it. And if you don’t want to do it, just don’t do it then, let it go. Like Queen Elsa said so perfectly, just let it go. And that’s okay. Like that’s totally okay. I think there is a lot of stigma around that because growth is, more locations and more growth, it’s just such a thing. And it is kind of a badge of honor in dentistry. Especially in this day and age where DSOs are giving huge multiples based on the amount of locations and free cashflow and everything. So I love that. Can you tell us really quick? What’s The Dental A Team up to right now? What do you have planned for 2023? Are you working on your annual summit yet? What are you doing with people? How do they reach out and get in touch? Are you taking new clients? You guys are always so busy and doing such a good job. Tell us about the A Team.

Kiera Dent:
Yeah, no, thank you. I appreciate that. A Team is growing. Ryan’s right, we only can take on so many people. And so we do have a consultant. So we’re taking on about 10 more in-person practices as of right now. So absolutely yes. If you’re wanting this, we also do virtual coaching, which we have a lot more spaces for virtual, but yes, still accepting new clients. It might shift. I might put a cap on that next year. So we’ll see. So if you wanted to be part of our family, please join us. And then also, yes, we are doing our… Uh Ryan, I’m stressed to do an in-person summit.

Ryan Isaac:
Oh, it’s going to go from virtual to in-person in 2023.

Kiera Dent:
This year I’m sticking with virtual.

Ryan Isaac:
Okay. Okay.

Kiera Dent:
2023 is going to stay virtual. I think 2024 is going to move. But as a business owner it’s so expensive to take your whole team and to get great CE. So I think I’ll forever have virtual. So yeah, it’s April…

Ryan Isaac:
You guys rock those. Okay. Sorry. I’ll cut you off. April 28th?

Kiera Dent:
April 28th and 29th. And it will be virtual and your whole team can come and it’s CE for you guys. And it’s just a blast. We have had so many people. Last year, we had over a thousand team members hang with us the entire time. So we do team on Friday, doctor and leadership on Saturday, just half day. We try to make it real fun but this year is building. We’re trying to figure out the exact name, go onto our Instagram and vote for it, but it’s going to be all around, really how to build a successful dental practice from people to community to systems. And we have a lot of fun things in there this year that are practical. So yeah.

Ryan Isaac:
You guys knock it out of the park. I mean, honestly, so many people do virtual things nowadays ’cause it’s convenient and it works, but there’s a magical touch of like it’s production quality. You get the right partners on board. It’s production quality. It’s like activities, it’s engagement, it’s like just the whole environment. You guys really do a good job with virtual events. So yeah, attend April 28th and 29th, 2023. And the website to register to find this?

Kiera Dent:
Yeah. Head on over to thedentalateam.com or you guys can email us hello at thedentalateam.com or listen to our podcast. We’d love to have you guys there, but truly reach out. We can serve you in any way but go do these things or do your best life. Be like Ryan, where he says, eat, drink, surf, and be merry. You don’t have to like wait for happiness, like get happiness today in whatever way that looks like.

Ryan Isaac:
That’s true. And real fast, The Dental A Team Podcast just hit, how many downloads?

Kiera Dent:
Oh, Ryan, thanks. We just broke our million and it’s just three-years-old.

Ryan Isaac:
That’s crazy.

Kiera Dent:
So I feel really proud of our listeners and grateful, and just I can’t do it. I just produce the content and I’m super thankful for people sharing and coming on that journey with us.

Ryan Isaac:
Our audience is mostly docs, but get your team hooked on The Dental A Team Podcast and you’re cranking out content. It’s so valuable. Congrats on the million. That’s really awesome.

Kiera Dent:
Thank you. I appreciate that. Thanks Ryan.

Ryan Isaac:
Hey, yeah. Thanks Kiera for being here as always. Thanks for everyone for listening. We’ll catch you next time. Another episode of The Dentist Money Show. Take care now. Bye-bye.

Kiera Dent:
Bye guys.

Practice Management, Work Life Balance