What You Need to Know Before You Expand Your Practice – Episode 127

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How did this dentist go from associate to a 28-operatory multi-speciality practice? In this episode of Dentist Money™, Reese interviews Dr. David Bender who shares how he expanded his services and built such a large scale operation. Dr. Bender talks about the financing decisions he faced, DSO versus private practice considerations, partnership agreements, and how personality plays into business decisions.

Podcast Transcript

Reese Harper: Welcome to the Dentist Money™ Show, where we help dentists make smart financial decisions. I’m your host, Reese Harper, on sight at the Dental Success Summit here with Dr. David Bender, he’s the owner of Village Dental, a really large practice in Indiana, and soon to be a larger practice in Indiana. He’s also a faculty director with me at the Dental Success Network. David, welcome to the show.

Dr. David Bender: Thanks for having me, Reese. I appreciate it.
Reese Harper: Yeah, it’s been an exciting morning for me looking through all of the topics that we are going to be able to cover today. Let’s start just by having you give everybody a little bit of your background, and about how you got to where you’re at today.

Dr. David Bender: Sure, yeah. So, I’m a 2002 graduate from Indiana University Dental School–

Reese Harper: So, Indiana Dental, they call those guys the Hoosiers Toosiers.

Dr. Bender. Well, I like to say so (laughs). I have a partner that graduated from Perdue undergrad, and IU and Perdue are major rivals, right? But the degree that counts is from Indiana University; I like to tell him that. So, I graduated in 2002, I joined Heartland Dental Care for five years. Probably two years longer than I anticipated, but it was a good experience. I happened to be in some good offices, I was in three, actually, but in essentially January 2008, I started up a scratch start practice in Fishers, Indiana, just outside Indianapolis. I went ahead and collected $144,000 for the first year–

Reese Harper: Yes! Good!

Dr. David Bender: So it was a major struggle, you know? It was a tough time.

Reese Harper: I’m just curious what your staff composition looked like at the time. If you did $144,000, did you have a hygienist yet, or are you doing your own hygiene?

Dr. David Bender: No, I did my own hygiene for a few years.

Reese Harper: Did you have an office manager?

Dr. David Bender: (laughs) no, I sure didn’t.

Reese Harper: Okay, so… you had an assistant?

Dr. David Bender: I had one assistant, and one front office team member, and then a lease…

Reese Harper: You definitely lost some money that first year.

Dr. David Bender: I was about a 200% overhead.

Reese Harper: (laughs) good! So how did you fund that loss? Did you have a little bit of cash? Did you go into some debt? Did you just, like, borrow some money throughout the year?

Dr. David Bender: All of that. So, I went through the working capital that I had, I went through my savings, I did everything I had to do in order to keep that office floating. Yeah, so I had $75,000 in credit card debt… I even borrowed money from my parents who took out a loan, I guess a second loan on their home just to get us through that time frame.

Reese Harper: Sounds like fantastic parents. Well, I think those are the best stories of the startups. So, people out there complaining about their student loan payment right now, just know that it can get a lot worse.

Dr. David Bender: It can get worse! Yeah.

Reese Harper: The Amex payment on interest was higher than the student loan payment, and it had a balance only one-third of the size, probably.

Dr. David Bender: (laughs) exactly. So I ended up growing the practice; I had nowhere to go but up. In 2011, I was able to bring on an associate, and then it 2012, I brought on a second associate. In 2013, I decided that I didn’t struggle quite enough, so I started a scratch start, associate-driven practice, which is extremely expensive. We’re still kind of working through that one, but we managed to grow that as well.

Reese Harper: Scratch start, and you never really practiced there, or did you go a day a week or anything?

Dr. David Bender: No, I was just management; associate-driven all the way.

Reese Harper: So, why do you think that’s the hardest one? I mean, there are obvious reasons that a lot of people are thinking about, but why don’t you highlight why that’s the hardest version that you kind of clarified.

Dr. David Bender: Yeah, so I mean, with an associate, I wanted to provide a guaranteed minimum salary, so in order to pay that minimum salary, we had to produce, but we didn’t produce enough, and so it directly came out of savings. Around that same time, the first two associates that I had at Village Dental, the first practice, they bought into the practice, and I guess that was 2015. So I ended up using that money to help subsidize the other operation.

Reese Harper: Yeah, I know how that goes. Borrowing from Peter to give to Paul. I like to say rob, okay? Because it’s not that severe; you’re just shifting it around a little. So, the 2002 was the first start–

Dr. David Bender: 2008.

Reese Harper: Oh, I’m sorry. 2008 was the first start; 2002 was the graduation. 2002-2008, you were working at Heartland, and then in ‘08, we had the great opportunity to do the first startup, produce $144,000… but then year two is probably pretty decent?

Dr. David Bender: Year two was better, yeah. During that year, I was able to take a paycheck.

Reese Harper: Okay, so when did you do the second practice again?

Dr. David Bender: The second practice was five years after the first.

Reese Harper: Okay. And so, what made you say, “it’s time for practice number two?” What emotional moment did you hit where you were like, “I’m going to do a second practice?”

Dr. David Bender: I think it was just the growth mindset that I had to develop in 2008 during that first practice. When you’re producing $12,000 a month, and your overhead is $24,000 a month, all you can do is think about growth, you know? And I look back at that time, even though it was a major struggle– my wife was pregnant with our first child, we had no maternity coverage– there were a lot of expenses, and there was a lot of struggle, but I look back fondly, because I think it was one of the greatest impacts I’ve had. It was one of the most impactful events of my life that helped me to constantly have the mindset of growth. I’m very goal oriented: in 2008, I wrote out a five year goal where we, Village Dental, the first office, would produce $2,000,000, we’d have two associates, I had it all written out– again, this is when I was producing $12,000 a month– and we hit it! In 2013, we actually hit it.

Reese Harper: So you’re saying really early on, you kind of had this idea of a growth mindset, and that helped you push through. My assumption would be, based on my experience working with dentists– it would have been from 2008 – 2013 from practice one to practice two? You probably didn’t start harvesting practice one in a major way. You’re not a million bucks liquid yet right out of practice one; you’re not sitting on a ton of cash. So you’re kind of, like, taking that step into the dark in operation two before you have had a chance to feel like you’ve got a lot of financial relief. There’s some, you felt stable probably, but not, like, flush, right? Is that a good description?

Dr. David Bender: That’s an excellent description.

Reese Harper: Okay, so you go to practice two… you’re stepping into the dark in terms of growth; you don’t get to feel 100% confident that everything’s fine before you take that next step, right?

Dr. David Bender: Right! Yeah, sometimes, you have to jump.

Reese Harper: I think that’s sometimes a misnomer of growth and business: sometimes, if you wait too long to feel 100% stable and fine, and the opportunities just slowly kind of slip away. You can wait for a long time to take that risk, and it never will really actually materialize the same way. Once it’s safe and stable, it’s no longer a risk, so the return for you in your own personal life, your own personal wealth… on the back end when you’re 55 or 60, if you waited too long to take those risks, they don’t really materialize in the same way. I just don’t think people really think about that as often, and I just think it’s cool to see that you– before everything was hunky dory, you still had to take that step to open that second location, and it’s panned out for you, obviously, in a great way, but that’s a step into the dark a little bit that most people don’t take.

Dr. David Bender: Yeah, I mean, it was something I’ve always wanted to do, though. I’ve wanted to be a multi-practice owner, you know? Even in dental school, it was a dream of mine. So again, sometimes you have to take a leap.

Reese Harper: What do you think it is about that? Because yesterday in a presentation I gave, it was about Genghis Khan conquering the world… and there’s been, like, this obsession sometimes historically that people have had of conquering land and taking territory, and sometimes I wonder for some entrepreneurs if there is not a little bit of an element of, “I just want to see that I’ve conquered some territory, and I’ve built up kind of this little empire,” and we don’t really– it sounds dumb to say it that way. No one’s going to be like, “yeah, I’m a total conquistador.” Like, since the beginning of time, it seems like people have been conquering land and putting up stakes in the ground. But I think there are obviously more reasons to be a multi-practice owner, but I’m wondering if you had to list what some of those are… what comes to mind when you say, “I was in dental and I wanted to be a multi-practice owner.” Why did you want to do that? What was it about that that felt better than one location?

Dr. David Bender: You know, really it’s like a series of challenges, right? And once you achieve a certain level, a certain goal… what’s the next goal that you have? And so you continue on and continue on, and before you know it, you end up with two or three practices. I think what drove me was just experiences that I’ve had with close friends and family members where they had an entrepreneur type attitude.

Reese Harper: Okay, so you had some examples that you saw, “that was success.” You related that to success.

Dr. David Bender: Yeah, sure. In dental school, I had an opportunity to invest in a close friend of mine: he was opening up a financial company, I suppose, and I borrowed extra student loan money just to invest in his company, really just to invest in him, and now I own 1% of an investment capital company. Also, I invested in another friend of mine who was involved in certain bar and grills, and that has panned out for me. So, these experiences kind of shaped my perception on entrepreneurship and why I wanted to grow to multiple practices.

Reese Harper: This is interesting. So, in my world, we would call those private equity investments, or private investments, right? Private equity is like a fancy word that people use to describe something different too, but investing in a private business is a pretty unusual– I don’t want to say unusual, but the minority of dentists would choose to do something like that. Give a friend 25 grand, give them 100 grand, give them 10 grand… whatever the number is, it’s not usually a common thing to find. In this group here at the Dental Success Network, it is a little bit more than nationally; this group tends to be a little bit more entrepreneurial. The personality type that does that tends to also almost be a little bit more risk-tolerant; they’re looking for opportunities that are a little bit riskier. I’m just curious: did you ever do anything that was really conservative along the way with your money as well, or did you feel like that just wasn’t really on your mind for the first ten years of your life? Or maybe it hasn’t been up until now?

Dr. David Bender: Sure, I guess the most conservative is that I invested money within Heartland in a 401k (laughs).

Reese Harper: Alright, and did you feel like you needed to because you were giving away free match money?

Dr. David Bender: Yeah! Absolutely.

Reese Harper: You just didn’t want to give away the free match money.

Dr. David Bender: I didn’t want to give it up! Yeah.

Reese Harper: If they wouldn’t have given you the free match money, do you think you would have done it?

Dr. David Bender: I don’t know, I feel like I want to invest my money in products or businesses that I have some kind of control in, you know?

Reese Harper: Yeah! That’s interesting. I think that’s an interesting attribute that I would have said seems like a common theme, here. You seem much more comfortable being able to be in control of your destiny, which is an attribute that actually fosters a lot of success in successful multi-practice owners. People who like control tend to seek for that control and try to make sure that their money is in a place where they can actually influence the outcome, right? That’s cool. So, did you ever do anything conservative to this point, besides expanding practices? Did you ever put money into a CD, or a bond, or some kind of a safe mutual fund?

Dr. David Bender: (laughs) no, not really.

Reese Harper: Interesting! I’m not saying that’s weird, it’s just kind of insightful to see what’s driven you.

Dr. David Bender: I have a 529 for the kids, is that considered–

Reese Harper: Okay, so that’s conservative. Why not invest their money in one of your friend’s bar and grill? It would have grown a lot more! (laughs) you probably lost money in the 529! Just kidding. 2013… where did we go from there?

Dr. David Bender: So we started the second practice, we also– I guess 2015 was when we added two more associates for that first practice, and that’s also when the first two associates bought in to the practice, so now I have two partners. We expanded that first facility from six ops to eleven ops, and immediately we actually filled it. I didn’t think it was going to be as quick as when we first started talking about an expansion, you know? It’s 2018 now, that’s only three years ago, and we went from six to eleven ops, and we’re completely maxed out. We ran out of space. So, that’s when the dream for this multi-specialty type practice came about: about two years ago.

Reese Harper: When did you start seeing that as the goal as opposed to a really large general practice? When did you say, “multi-specialty is where I want to be?”

Dr. David Bender: Like most dental offices, we referred out– I mean, too many procedures. It felt like we referred a lot to oral surgery, we referred a lot to ortho, and we had some capacity in our eleven opp practice, and I wanted to maximize that.

Reese Harper: Were you guys doing most of your own endo, or were you outsourcing the endo as well?

Dr. David Bender: No… and we still do. Endo is something that our office typically doesn’t like to do.

Reese Harper: Okay. So at the time, you were outsourcing all your endo, all your OS–

Dr. David Bender: Most of it. Yeah, I’d say most of it. OS, it depends on the doctor, but some of them like to do their own now, and they like to place their own implants, you know, packed at their molars we refer out, IV sedation, things like that.

Reese Harper: Okay. And then, this started to shift when? When did you start seeing– did you have an example, or some kind of practice you admired where you were like, “I want to be more like that one?”

Dr. David Bender: You know, not necessarily, but I think one of the issues that we had in our Village Dental practice as it was growing… there are a lot of problems that can develop in a large practice, and one of them is that you get a big practice feel, and we’ve had patients complain about that. They would ultimately see a number of different providers, and whether they complained to us about it or not, I think it was an issue. And so, we wanted to created some sort of practice that had a component of a smaller practice within a larger practice, and that’s the idea behind the 28 op practice.

Reese Harper: So if we can get into that a little bit, how do you compensate all of the producers? How do you run your P&L in an operation like that? How do you envision doing it, since it’s kind of materialize I guess now?

Dr. David Bender: Yeah, so if you think of it, we’ve got 18 operatories that are going to be for the general dentist and hygiene, right? So there’s going to be three pods of six, and each pod is going to be for one general dentist. They’ll have their own assistants, and hygienists, and front office team members, so we’re kind of creating their own specific office. We pay our associates and partners based on a just of production: 30% typically. We have a sliding scale–

Reese Harper: Based on their volume?

Dr. David Bender: Based on the monthly production, yeah.

Reese Harper: Okay. So, if they hit some goals and increase, it might increase a bit?

Dr. David Bender: For sure.

Reese Harper: And then, how are you going to pay the specialist?

Dr. David Bender: The specialists… so far, we have two: an orthodontist, and an oral surgeon. It ranges from 40-50%, and then you negotiate out the lab fees, the supplies, the staffing, you know, those things.

Reese Harper: How many days do you schedule those specialty procedures? Let’s say OS, do you bring– in your practice, what’s your vision for that?

Dr. David Bender: So right now, our oral surgeon comes in a half a day a week, and he’s kind of scheduled out, so we would like for him to come in one day a week, but we just don’t have space. Same with the orthodontist–

Reese Harper: Don’t you have 28– oh right, you have 11 right now. When you have 28 operatories, you’ll be fine.

Dr. David Bender: (laughs) yeah.

Reese Harper: Do you envision a point where the surgeons are going to be in two locations? In terms of, he has his own location and he’s basically working part time for you, or do you want him to be full time there? What’s your vision for those, and the ortho?

Dr. David Bender: Yeah, both OS and ortho, even endo and pedo… I envision all of them being part time; it would be two to three days a week. Generally, they have their own practice. Many specialists in our area operate out of two practices, you know, either a satellite for themselves, or two different–

Reese Harper: Yeah, I think that’s pretty common in a lot of places. It seems like that’s where the market is moving to some degree; it seems like a healthy way for them. That way they don’t have to pick up– I mean, we have a lot of specialists who have two locations, and sometimes that second location, they struggle to get it up to its optimal capacity, and those who can kind of get involved in piggyback, essentially, on the overhead of another practice… sometimes it can be more profitable.

Dr. David Bender: Absolutely. I mean, you don’t have to do a second set of marketing, you don’t have to find team members for that second office… there’s a lot involved in that.

Reese Harper: Yeah, the front office team can be expensive. And the facility, although it’s not your biggest expensive, it’s meaningful. Yeah, that’s a really great model. So, you just got to a point where you were like– this is mostly driven by patient care, though. It doesn’t necessarily sound like, “this is how I’m going to make more money.” It was like, “I think this is a patient care issue, and I’m sure it will make more money too.” It sounds like money was maybe secondary to the fact that you just felt like the patient feedback and your own intuition was just driving you this way.

Dr. David Bender: Yeah, the patient feedback, and I guess our passion to continue to grow. It’s a heavy volume, high PPO practice. Certainly, there are two ways to increase revenue: either bring in more patients, or decrease your PPO involvement. I think maybe some of my upbringing in the middle class where money was tight helped to influence my drive and my desire to keep dentistry affordable for most people.

Reese Harper: You wanted to make it accessible. So, what’s the time frame on this construction project for you, and was it just breaking in to another space that was adjacent? Was it ground up construction?

Dr. David Bender: No, it’s ground up construction. It’s across the block from where our current location is. We’re in a retail building right now, a commercial retail building, but we bought a plot of land that was vacant– it’s still in a growing area, again, 100 yards from our current location, so it’s not going to be an issue for our patients.

Reese Harper: And from a finance perspective, were you able to structure it where it didn’t require another big cash committment, or is it still going to create another one of those “taking all your liquidity, and now we’re going to sink it into a building…” I mean, how was the financing able to work out for you where you live?

Dr. David Bender: Yeah, so the financing was actually easier than I thought for a project like this. I don’t know if you want me to name–

Reese Harper: Are you going to end up shelling out 10%, or is it going to be 100% financed?

Dr. David Bender: It’s almost 100% financed. It’s with Live Oak Bank. I don’t know if that’s–

Reese Harper: Yeah, Live Oak does a great job. I always name names where I can (laughs), as long as I like the names I’m naming. If not, I edit them out, okay? So ultimately, the transition is going to be fairly smooth for you, because you’re just moving from one location across the street, to some level. I mean, it’s never easy. What’s your plan? Are you going to have it perfectly ready to go? Are you going to lose two weeks of production? Are you going to lose four weeks? I mean, what’s your goal?

Dr. David Bender: Yeah, I expect Patterson to move everything over in the weekend and just be done.

Reese Harper: Wow, you just expect that. I like that! I hope they’re listening.

Dr. David Bender: (laughs) we’ll send this to Bob Keating; I’ll give a shoutout to him.

Reese Harper: What’s you estimated lost time do you think?

Dr. David Bender: I think maybe a week, honestly. So, obviously, we have to buy a lot of new equipment, and that can go in without affecting our current practice.

Reese Harper: And would you be able to potentially schedule some treatment in some of the operatories before you move everything over?

Dr. David Bender: Without a doubt. I mean, we’re not going to be at capacity in a 28 operatory practice, so we can utilize the new equipment and the new chairs immediately as we’re moving more of the other equipment over.

Reese Harper: Well, it seems like you’ve thought through this quite a bit. Tell me some of the major differences in choosing to grow multiple practices with associate-driven practices versus partnership-driven practices. Let’s talk about that a little bit.

Dr. David Bender: For sure. So, I’ve done both, and you know, I feel like the associate-driven practice, although it can be very profitable, there is a lot of struggle with it. Any time an associate leaves a practice, you end up losing some of the team members; they’re afraid of change, even if the new doctor is going to be fantastic, or better than the other one. Many team members might leave just because of the change. You also lose patients, because they get attached to that doctor, or they don’t change either. People don’t like change. So I think that is a major drawback. Once the initial two associates bought in to Village Dental, the first practice, there was a mindset change you know? It was like an overnight, they’re skin in the game, they all of the sudden care deeply about the practice, and that’s exciting! It’s fun to share an office with people who are compassionate and passionate about the practice.

Reese Harper: How did you decide on what percentage you were going to let your associates buy in at?

Dr. David Bender: So, they each bought in at 24%.

Reese Harper: Okay, so… is that your favorite basketball jersey number? (laughs)

Dr. David Bender: It wasn’t. So, I thought I had to maintain 52% ownership, right, just to have some kind of control, and I realize that that’s not necessarily true. Ultimately, I’m looking for that first practice to have five total owners. So, four GPs, plus myself, all at 20%.

Reese Harper: Okay, and so maybe, some of the two associates will be diluting a little bit of their equity and selling it off to make that all happen. Cool! So I guess, you’d say ultimately… you’d never want to go back to an associate-run practice again, that you owned, at least.

Dr. David Bender: Yeah I’d rather go into a practice, either a scratch start or an acquisition, with a partner. It just feels– it’s just easier. There’s just a lot more dedication, maybe, that you get from the doctor.

Reese Harper: How do you feel about a larger DSO with an associate-run practice, or let’s say a partnership model? A larger DSO with a partnership model that’s a little… maybe not the same kind of partnership model that you’re talking about where you’ve got a partnership at that single location. What are the challenges that you see from that, and why not just continue to– if you’re the growth mindset person, a lot of people would just say, “you’d be a lot smarter if you just scaled up really quickly, and sell out to a DSO, and I give you a 12 EPITDA, maybe an 18, you’ll have some numbers thrown around, there was probably some of that psychology that kind of was passing through your mind as you’re consciously deciding how to grow… kind of talk to me about that choice, because it kind of seems like you made a different choice than the maximum growth possible model that you could have pursued, I don’t know. That’s kind of how it sounds.

Dr. David Bender: Yeah, I ultimately– I guess my end game is to sell to my individual partners. You know, I’m not into the idea of rolling up a group of practices to a private equity company and sailing off into the sunset, you know? I feel like–

Reese Harper: Yeah, what’s driving that psychology, or what’s driving that choice for you?

Dr. David Bender: You know, I think– number one, I gained a lot of pleasure and personal gain just from ownership of a practice, and I think keeping private practice private is important, you know? I know how much it meant to me, and I’d like for other dentists to know what practice ownership feels like and not be working for a larger corporation, or a private equity company.

Reese Harper: I think that’s really interesting, and I think there’s a lot of people who can probably resonate with that in how they’d like to build too. There’s a lot of paths to go down in growth, right?

Dr. David Bender: Yeah, for sure. That’s what’s so exciting about dentistry. I mean, I’m not even practicing clinical dentistry anymore, and this is a path that I’ve taken, but it’s not the only path. I mean, there are so many different ways to work through dentistry.

Reese Harper: Well we talked a little bit about PPO versus fee-for-service as you talk about your personal choice to kind of keep dentistry affordable. Anything else you’d really like to talk about there in that area?

Dr. David Bender: Yeah, so one of my practices is actually a fee-for-service only practice. It’s the third practice, the acquisition that a partner and I bought into. You know, the saying is, “work smarter, not harder,” and you hear that a lot between a fee-for-service practice and a PPO practice. I feel like, with a fee-for-service practice, you’re still working hard. Maybe your clinical days are less hectic, perhaps, but you’re still working hard in trying to attract patients in your marketing, or in your creation of a better customer service to provide an experience that patients aren’t seeing in other practices. You know, I think a fee-for-service practice in a highly competitive area with a lot of PPO offices around, it’s going to take a dynamic dentist, you know? And it’s maybe a dynamic personality, I should say. That model is harder to grow for me, because I’m counting on individual doctors and individual leaders that, you know, maybe that dynamic personality is one out of ten, and so it might be harder for me to find those types of dentists that can really take off with a practice like a fee-for-service practice. First is a PPO practice that is probably more dependent on systems, and efficiencies, and things that you, management wise, have more control over.

Reese Harper: I think that’s a really good insight. Tell me a little bit about purchasing technology. This is a question that comes up a lot. How do you make technology decisions from a financial perspective? How do you do that for yourself?

Dr. David Bender: Yeah, so I’m definitely not early doctor, right? I’m a fact-finder as far as–

Reese Harper: A researcher?

Dr. David Bender: Yeah, so we have a CEREC, we have a cone beam… I feel like the cone beam is by far the best technology that we have in the practice. You know, it’s great for not only just helping to place implants, or to diagnose why you have a failed root canal, but it helps in just general diagnosis overall, plus if you’re able to manipulate a 3D image in front of a patient, the perception for the patient is that, “this doctor knows what he’s doing.” It’s a great marketing tool. You know, the CEREC, I feel like is beneficial for offices that have capacity, you know, they have open chair time. When ends up happening now when, let’s say for example, we want to do a posterior CEREC same-day crown, E-MAX crown, we schedule out two and a half hours. It may not always take two and a half hours, but with our schedule, we don’t want to run behind, so we schedule two and a half hours. Normally, if it’s a two-appointment visit, it would be seventy minutes for the first appointment and maybe thirty minutes for the crown seat, and so already, we’re losing some time with that, but it’s a benefit for the patient, right? You know one visit for the patient versus two like that. Financially, I think it’s going to be a harder sell for these in-house milling companies, you know? You can buy an E-MAX crown from a lab anywhere from $50- $100, so to make that $3,000 payment, you have to run through a ton of crowns. A lot of onlays.
Reese Harper: Yeah, and it’s not a payment that really ever goes away once you start down that road, right?

Dr. David Bender: Yeah, there’s always an update. Yep.

Reese Harper: Well, tell me a little bit about this last question that I really wanted to chat about. I wanted to talk about if you have any tips that can help people increase profitability. If there’s anything that comes to mind to help people reduce where they spend, or increase production, I guess, where do you put your focus?

Dr. David Bender: Yeah, so really there are two ways to increase profitability, right? You reduce spending, or you increase revenue. Honestly, I’ve always been in the growth mindset, so my path has always been in to increase revenue. There’s a dramatic–

Reese Harper: You’re like a Silicon Valley tech entrepreneur. “Grow that revenue! We’ll figure out how to make money one day.” (laughs) so your mindset has been, “look. Revenue solves a lot of problems.” And eventually, you can clean up your profitability.

Dr. David Bender: Yeah, you know, reducing expenses I feel like is something you have to look at, but I also feel like it’s one of those things where you almost set it and forget it, you know? You spend time to get the best deal you can for supplies, labs, right? These overhead items. Staffing obviously is a big overhead item. However, if you’re understaffed, then you’re not able to maybe see the same-day patient, right? And that’s going to be what causes you to increase revenue. I liken a dental office to how a restaurant likes to staff their team: they staff it for the peak periods, right, so they can handle when they’re extremely busy. There is going to be some down time, certainly, but if you don’t have enough team members, then again, you’re not able to maximize the capacity of your office, or do same-day dentistry, or whatever it might be.

Reese Harper: Yeah. Well David, it’s been a great set of questions that we’ve been able to go through today, and a lot of insight that you’ve been able to provide. I really appreciate it, and is there anything you’d like to leave with the listeners this last minute here before we let you go?

Dr. David Bender: Yeah, so I think dentists in general, we all have the same problems, right? We think we’re unique and special, or maybe we’re told that growing up, but we all have the same problems, and I feel like if you are able to find a group of people, a group of dentists, where you can collaborate, and work through some of the same issues– I know the problems I have right now, a thousand other dentists have gone through that same issue, but if we can come together and talk this out… there are lots of areas that you can go to, DSN is one, and I feel strongly about that one, because it’s a fantastic, collaborative platform.

Reese Harper: Well we are excited about this interview, and we’re really grateful for the time you have taken today. We’ll have to do it again, man. I’m excited to hear about your operation post 28 ops installed, and we’ll talk when your margins are back up to 30% again.

Dr. David Bender: Sounds good to me.

Reese Harper: Okay, we’ll talk to you soon. Thanks, David.

Dr. David Bender: Thanks. I appreciate it.

Practice Management

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