Are You Tired of Insurance Companies Running the Show? – Episode 103

What’s the right mix of fee-for-service and PPOs? While the answer may vary by practice, most dentists would like to run a business that relies less on insurance income. In this episode of Dentist Money™, Reese welcomes Gary Takacs, who explains how practices can thrive in a world of heavy-handed insurance companies and the emergence of corporate dentistry. He also provides answers to questions like: When should I hire my next front office employee? Should I continue to use my lab or buy a CEREC? When is it time to part ways with an employee? When should I hire an associate? When is it time to sell my practice?

Show notes:
Takacslearningcenter.com
gary@takacslearningcenter.com
Text Gary 602-321-1778

Podcast Transcript:

Speaker: This is Dentist Money. Now, here’s your host, Reese Harper.

Reese Harper: Welcome to the Dentist Money show, where we help dentists make smart financial decisions. I’m your host, Reese Harper, here with a close friend that I’m glad has come up from the desert to join us in the mountains. Gary Takacs. How you doing, Gary?

Gary Takacs: Hey. I am doing great, Reese. It’s great here to be with you.

Reese Harper: Well, for those of you who don’t know Gary, that’d be probably one of you, maybe two, Gary is one of probably the most … He’s the godfather of podcasting in the dental industry. I think you’re the first of … There’s probably a good 40 to 50 now that have tried to follow in your stead, but …

Gary Takacs: 72.

Reese Harper: Yeah. No one quite matches the breath and depth of the content that you bring. I’m always impressed with the quality of your guests and the passion you bring to dentistry. And I’m a big fan, as you know, and think you do amazing work. And so thanks again for coming on.

Gary Takacs: Oh, my pleasure.

Reese Harper: For those of you who don’t know, he’s got a new project up his sleeve too that I’ve been excited about for some time. Gary’s talked to me a lot about the Thriving Practice Academy, which is going to be coming online next year. He’s put together some amazing coaches and great content. And it’s going to be a real valuable addition to Gary’s practice. In the past, he’s had a focus of a solo and ensemble practice consulting model, and he’s really been able to put a great team together to match the demand for all of the services that are being asked of him at this point. And so …

Gary Takacs: Thanks, Reese.

Reese Harper: Yeah. I’m excited for that to come online next year. I’m excited to, I guess, make sure that we end up seeing some of that content ourselves and sharing that with some of our listeners, because I know it’s … My favorite part about when I do interviews and I break from my conversations with Sir Ryan Isaac, who … You know Sir Ryan.

Gary Takacs: Oh.

Reese Harper: He’s a great guy.

Gary Takacs: Love Sir Ryan.

Reese Harper: Yeah, he’s a good dude.

Gary Takacs: Yeah.

Reese Harper: So ultimately, what happens on these guest interview shows is I like to focus on practice management topics, because we’re a finance podcast that’s focused on dentists exclusively. And so when we break outside of purely personal and practice finances, we break to practice management, but we stay away from a lot of other topics. And I like to try to … In this interview, the way I’d like to take it is to take some of the most common questions that I’ve got in the last six months around practice management, and let you bring your decades of experience to work here for the next while, and give us some feedback on some of these most common questions. These are probably dozens of emails per week come in around these subjects, and they’re just on constant repetition. And …

Gary Takacs: I can’t wait to hear these.

Reese Harper: And I haven’t told you any of these questions.

Gary Takacs: No, this is unscripted.

Reese Harper: That’s how I like it.

Gary Takacs: And that’s how I like it. Then this is going to be fun.

Reese Harper: Yeah. Yeah, it’s great.

Gary Takacs: Can I back up for just a minute and share my passion for this new project?

Reese Harper: Yeah, totally.

Gary Takacs: And I know you share it with me as well, I love our profession.

Reese Harper: Yeah.

Gary Takacs: I absolutely love it. And I get a little bit frustrated sometimes when I go out to meetings and I see some dentists feeling a little bit despondent about some of the challenges that they’re facing. And there’s even a question among some dentists, is private practice a viable model in the future?

Reese Harper: Yeah, totally.

Gary Takacs: Have you heard that?

Reese Harper: Yeah. I mean, and it’s a very common question.

Gary Takacs: I believe it’s a fair question, too.

Reese Harper: Yep.

Gary Takacs: And yet, I believe we’re both on the same page on this, that not only is private practice a viable option, but in fact, dentistry can produce personal, professional, and financial satisfaction for you. And I don’t think there’s ever been a better time in the history of our profession to be a dentist.

Reese Harper: No.

Gary Takacs: That’s my story, and I’m sticking to it.

Reese Harper: Yeah. You’re right.

Gary Takacs: But I wanted to really grow the work that we do, so that we could help more dentists, and help more dentists have an abundance … Not only mentality, but an abundance experience, and help them be able to help more of their patients. You know, what I love so much about our profession is the way that we have the ability, dentists have the ability to change lives every day. And the work that we do, we have the ability to help dentists provide the prospective that allows them to help more patients. And so really, my motivation for growing is to be able to help more dentists, and I couldn’t be more excited about it.

Reese Harper: Well, I think it’s a great time to be pursuing this new endeavor. I think there’s a lot of industries right now that are in a very similar position as dentistry. And my industry’s in a very similar situation. There’s a lot of parallels in … If you look right now in, I guess, in financial services, there’s a race to cut fees and consolidate the industry. And you see that in organized dentistry as well.

Gary Takacs: With perhaps a natural byproduct of lower service.

Reese Harper: Yes. And consumers are as intelligent as they’ve ever been, and they’re very discerning. And so even though there’s a race to cut fees, and a race to consolidate, a race to allow corporations, maybe, to improve profit margins and potentially … I mean, there’s a lot of different outcomes of any time you let a partner come into your business, okay, no matter who it is … And this is common across all industries. If you have five partners in one business, that business has to get a lot bigger, and it’s got to cut costs in a lot of different ways in order to provide profits for those partners. And sometimes that results in a lower service experience.

Gary Takacs: So it’s almost like a commoditization …

Reese Harper: Yeah.

Gary Takacs: Of your business.

Reese Harper: Yes.

Gary Takacs: And in dentistry, same thing.

Reese Harper: Yep.

Gary Takacs: I think with so much intrusion of third party reimbursement in insurance companies, I believe that many dentists are in a race to the bottom.

Reese Harper: Yeah, they are.

Gary Takacs: And that’s just not a race you want to win.

Reese Harper: No. And you don’t need to go there. I mean, you can go … Financial services is to the point where you can go online and you can get almost any piece of advice that a professional could deliver to you. There’s an article on it, there’s some way to self diagnose, and there’s technology for you to engage in.

Gary Takacs: Because we don’t really need you anymore. It’s on my phone, right?

Reese Harper: Yeah, it’s on my phone.

Gary Takacs: Right?

Reese Harper: And at least dentistry has a physical venue that you have to go to to get a service. And my point is our business has never grown …

Gary Takacs: Wait a minute though, but there’s YouTube videos about how you can do your own braces now, right?

Reese Harper: You’re right. There is. There is, and you know it’s coming, where you can ship overnight … You can be able to ship a portable chair.

Gary Takacs: [inaudible] Smile Direct Club …

Reese Harper: Yeah. Yep.

Gary Takacs: … Is do it yourself Orthodontics.

Reese Harper: Yeah, and it …

Gary Takacs: That’ll be another show.

Reese Harper: Another show.

Gary Takacs: We’ll come on and talk on that one another time.

Reese Harper: Yeah. My point is that I’ve never been happier about the prospect of dentistry in this world, where service is … These consumers are very discerning and they want their dental experience to be much more like a very high end professional experience. They want a high touch, they want to know the doctor, they want to know the staff and team. I don’t like the word staff. They want to know team.

Gary Takacs: Staph’s an infection. [crosstalk]

Reese Harper: Yeah, it’s a stick.

Gary Takacs: Or a stick.

Reese Harper: Yeah, it’s a long stick. Anyway, and I feel like it’s been interesting to see the parallels among many industry … Legal services, tax planning, financial services, dentistry, medicine. I mean, medicine is being completely consolidated through an iPhone application to diagnose and prescribe, even, And so there’s an opportunity though with a really discerning customer base that’s out there … Everyone has information. If you can show them what a real service experience looks like, they’re … As a portion of the market, they will always want to pay for that, and they’ll prefer quality over cost reduction.

Gary Takacs: See, I knew that we are simply brothers from a different mother.

Reese Harper: [inaudible].

Gary Takacs: Can we get a fist bump on camera?

Reese Harper: Yeah. Yeah, on camera. Okay, everyone saw that. Okay, go to the YouTube channel and you can see that. We just did a fist bump to celebrate this moment.

Gary Takacs: That’s right.

Reese Harper: Anyway, I’ll stop going off on that tangent, but I just feel really strongly about that.

Gary Takacs: It was a good … And I echo your sentiments.

Reese Harper: Anyway.

Gary Takacs: And I hope as you’re watching this and listening to this that you see the hope, and you see the opportunity, because there are certain patients or customers, clients, that want to go and receive services from people who they know, like, and trust.

Reese Harper: Yeah.

Gary Takacs: And there’s enough of them out there for you to make a wonderful business on that, and that’s my story and I’m sticking to it.

Reese Harper: I like it. Well, let’s jump in to some of these top questions.

Gary Takacs: Please.

Reese Harper: Okay, and start with one that’s the most common that comes to me, one of the most common. And that would be … I don’t really … Gary, I get the question and I don’t really understand exactly who should be at my front desk working up there, what they should be doing, if I have too many people, too few … My front desk just doesn’t seem like I’m staffed … I’ve got my team, it’s not staffed correctly. I could say staffed, but I can’t call them staff, okay?

Gary Takacs: Yes.

Reese Harper: Okay? It’s this idea of I don’t think I’m doing it right up front.

Gary Takacs: Yeah.

Reese Harper: And it’s a generic question, because it’s not like they’re saying, “I don’t like my office manager. I do. Or I don’t …” It’s just I don’t think it’s right up there.

Gary Takacs: Well, and that area is harder to figure out, because if we look at the other departments in a practice, we’ve got our hygienists.

Reese Harper: Yep.

Gary Takacs: And we can make those decisions based on our demand, our supply and demand. Our assisting team, we can also make that decision. Do I need two assistants, do I need a third assistant? How does that work? But it’s often confusing about how to staff the front desk. And there used to be … Back in the day, there used to be some formulas that you could use. I heard Linda Miles way back when, that said, “For every X dollars of production, you needed a team member.” Unfortunately, those formulas have evaporated, because today, it depends how we’re embracing technology.

Reese Harper: Yeah. Technology affects it a lot, doesn’t it?

Gary Takacs: And how we’re using it. Our dental practice management software. And I’ll … Whatever brand it is, whatever software that we have, very rarely is a practice using the software to its full capability. In fact, I often think of that monitor at the front desk as a paperweight. It’s holding some things down. But if we can start to embrace technology in your practice, whether it be through your practice management software or through, for example, patient communication software that allows you to reach out and confirm appointments. You can get a great deal of efficiency.
And it also depends on the caliber of our front desk team members.

Reese Harper: I think that’s really crucial, Gary. If I could interject one thought there. When you say embracing technology, what I find a lot of times is that it’s difficult for … It really isn’t the doctor’s responsibility … I mean, he doesn’t have the time, it seems like, to embrace that. So if he doesn’t have someone up there who is excited to embrace technology and dive into it and develop some competencies, the practice does run inefficiently.

Gary Takacs: And it hits a glass ceiling of how much someone can do.

Reese Harper: Yeah.

Gary Takacs: Now I will tell you that a related question I get a lot is when do I go to a second front desk team member?

Reese Harper: Yeah.

Gary Takacs: I’ve got one up there, but it seems like she’s like that schizophrenic octopus with eight arms trying to keep everything going. And there is a very real practical side of when do I need an additional person up there to allow us to grow? I’m going to frame it this way and say don’t let a headcount at the front desk be your bottleneck. Don’t let that be your bottleneck, because oftentimes, a practice will be unable to grow, because …

Reese Harper: That’s how I feel. Yeah.

Gary Takacs: How many times have you gone to a really nice hotel? When you go to a conference or something.

Reese Harper: Every time I go.

Gary Takacs: There you go.

Reese Harper: Just kidding. Yeah.

Gary Takacs: But our conferences are usually at fairly nice places.

Reese Harper: Yeah. Yeah.

Gary Takacs: And the hotel is fabulous. It’s got the pillows soft, the pillow topper mattress, the 150 count Egyptian cotton sheets, and it’s just wonderful. But every time you interact with the front desk, there’s a queue of 10 people standing, visitors waiting because they’re understaffed at the front desk. And so your whole experience can go from a favorable experience to a negative experience, because of being understaffed at the front desk.
Now, if I can help … Be specific about that. I have, in our client base … And we have a wide variety of clients, from small practices that are just poised to grow, to practices that are achieving a real, solid level of growth, to mature practices that are just doing fantastic. And there are some numbers I can help you with, but we have clients in our client base that have a really strong front desk team member, very, very strong, a practice that’s producing and collecting 900 to … 900 thousand to a million dollars a year with one front desk …

Reese Harper: With a solo front desk person, yeah.

Gary Takacs: But now, typically she … And I want to be gender neutral, because it could be a male today, that person is very strong. Now, yes, who should that be? I want to introduce a job title that I think needs to be at that person … Whether we have one, two, or three people at the front desk, Director of First Impressions. That person, the ideal front desk team member is … It’s a bit of a unicorn to find that person.

Reese Harper: Yeah, it’s tough.

Gary Takacs: Because they are a strong people person, but also a task person as well. They can … They have great interaction skills with your patients, but they have the ability to put their head down and do tasks as well.

Reese Harper: Yeah.

Gary Takacs: And it is an unusual team member that has the balance of those people skills and task skills, but I can point to practices all over the country that have a strong team member like that, that the practice is producing collectively between 900 and a million dollars. I would say at about a million dollars a year, we absolutely need to look at additional help, because of just the magnitude of checking people in, checking them out, the phones, all of that. But I’ve seen two team member, two front desk team members handling a million five, a million six. And I’ve seen three team members, front desk team members handling up to three million dollars.
So I don’t know if that helps answer the question.

Reese Harper: Yeah. It does. How would you say if I get to the point where I either want to invest a little early in that second full time team member or maybe I’m at that larger practice that justifies it … I’m always the kind of person that likes to invest in team early, so I believe that if you can … If you look at the … As a financial advisor, I think if you can manage your debt wisely, structure it properly and get your cashflow just right, to where you can reinvest in just a little bit more than the average practice in the front, I think it can just really change the dynamics.

Gary Takacs: Can I share a formula?

Reese Harper: Yes.

Gary Takacs: So how do you determine whether you can afford to hire someone? Because if you ask the team, guess what they’re going to say? Hey, I’m thinking about hiring someone. What do you … Yes. They want more help, right?

Reese Harper: Yeah.

Gary Takacs: And it’s a rare team that doesn’t feel like they’re overworked, right? So how do you make that decision? I simply make it analytically, and say the time at which you can afford to hire a team member is when your staff costs, all in … And when I say all in, I mean not only wages, but FICA, FUTA, payroll taxes, payroll service, all the related expenses, matching 401K contributions, all of that … When you’re at 28 percent or less, you can afford to hire someone. So for example, if you’re at 26 percent, and you can help your clients with this … When you’re at 26 percent, you have a budget that you can afford to hire someone, and then you’re making the decision on hard science instead of emotions of well, today everyone was overworked and they felt like we needed more help.
So you make that decision analytically when you’re below that. That doesn’t mean you have to use all of that budget for that, and this will certainly vary. If you’re in a smaller town, maybe a more rural area where wages are lower, you might have more of a budget. If you’re in an urban area, you might have a harder time meeting that.

Reese Harper: Harder time.

Gary Takacs: But when you’re under that …

Reese Harper: You know what? I think that’s great. And I like that … I tend to think of it from a slightly different angle, but the way you brought it up actually, I think is a really … It’s really easy to think about it in that term. What’s my current staff cost? And I’m probably running it a little high, so that means I’m probably asking them to do maybe a little too much if it’s too low. And if it’s too high, maybe I’m not doing quite enough.

Gary Takacs: Right. I mean, here’s an example. A million dollar practice, and let’s say they’re at 26 percent. We’ve got a two percent budget. Well, last time I checked, that’s 20 thousand dollars, to bring it up to that 28 percent. Did I do the math right?

Reese Harper: Yep, you did. Genius. I like it.

Gary Takacs: So we’ve got a 20 thousand dollar budget. That doesn’t mean we have to spend that.

Reese Harper: No.

Gary Takacs: And one of the things we might consider doing at that point is hiring a dental, an additional dental assistant to help us with production that would be cross trained up front to be able to be that maybe half time person up front as you grow.

Reese Harper: Yeah. Could also be potentially some technology that might help leverage that front desk person’s time a little bit better.

Gary Takacs: Can I give an example of that?

Reese Harper: Yeah.

Gary Takacs: So one of the things I really love tracking in the practice is what … Of the available hygiene appointments, what percent went unfilled at the end of the month? Of the whole available … And my goal is to have that filled in a positive way instead of a negative way, at 92 percent or above. 92 percent above. So we have a hygiene schedule at Cornell. I want to actually call her out by name, because she’s amazing.

Reese Harper: Amazing.

Gary Takacs: Her name’s Carly. And if I could grab a lock of her hair and clone her, I’d put her in every dental practice in the country. But prior to having patient communication software, she was responsible for keeping hygiene fill. And the benchmark is at 92 percent or above, meaning eight percent … I’m an accepting an eight percent unfilled rate. At 92 percent or above, that’s an A on the report card. So she was able to do this, and consistently, at 92 percent, but she was spending three hours a day to keep the hygiene … To put butts on the seats in hygiene. We added patient communication software … May I share the name?

Reese Harper: Yep. Yeah.

Gary Takacs: We added Solution Reach to that. We did a deep dive in training of Solution Reach, and now, for the last year … We’ve actually had Solution Reach for a number of years, but for the last year, we’ve been at 97 percent filled, and she’s spending an hour a day doing it instead of three hours a day. Now, don’t worry about Carly’s hours. I’m not cutting her out. We have plenty of other things that she can spend her time on. But as an employer, how do you like the idea of her spending an hour to a better degree of performance than spending three hours with a lower degree?

Reese Harper: Yeah. That’s the point of good technology, when you implement it properly, I mean, it really just gives your team the ability to accomplish more with less.

Gary Takacs: Now, as we did that, they had wonderful training materials online. She spent … I asked her to spend an hour a week in self training, in the training materials. So over a period of time, we were really using every ounce of capability out of Solution Reach, which has added to our performance.

Reese Harper: Yeah, it’s great.

Gary Takacs: So oftentimes, you have this tool, but it’s almost like I can’t slow down long enough to learn how to use it.

Reese Harper: Yeah, and some of the tools are just so dang clunky and bad that you can’t figure them out anyway.

Gary Takacs: Right. Well, I’ll [crosstalk].

Reese Harper: Another story.

Gary Takacs: Another story.

Reese Harper: So one suggestion that I might just offer, if I can, is sometimes as a financial advisor, when people ask these questions to me, my first gut reaction is to look at the practice globally and look at the profit that’s either there or not there. And break down the practice and just say, “Okay, how much true profit is there in this practice?” For lack … Let’s just use the million dollar example again. And let’s say that half of the practice is going towards overhead, between staff costs and rent and supplies and lab. So we got 50 percent of that million bucks is getting eaten up into overhead, and we got 50 percent that the doctor is somehow keeping. But 30 percent of it, as I think a metric that you taught me, Gary, that you felt like was a reasonable number for producers to get paid … At 30 percent, you felt like that’s a reasonable place where most dentists … It’s generic across the whole country, but that’d be a reasonable producer’s take home that you could apply to any associate, right?

Gary Takacs: Well, that’s what it would cost you to replace yourself if you hired an associate to come in and do your work.

Reese Harper: Yeah. So in that case, we got 20 percent left. Well, that’s a pretty healthy … Probably above average profit margin.

Gary Takacs: Very much so, especially in a practice that size.

Reese Harper: That size.

Gary Takacs: The smaller practices will have a harder time reaching that, because … And you know this so well, so much of the initial dollars go to fixed overhead.

Reese Harper: You’re right. And so I guess in that case, if I see a practice that’s quite profitable and there’s a single front desk member, and that person’s feeling a little bit spread thin, you can look at that profit and just think about it in these terms. We measure profitability as a risk indicator. So in our financial planning, we look at profits and we say too much profits actually presents a risk, and too low of profits present a risk. The risk of too low of profit means you’re probably over-investing in something that’s not really paying off. And too much profit means you might be stretching yourself thin to the point of where at some point, it’s unsustainable, and something might break.

Gary Takacs: You know, I was in a practice the other day as a coach, and this was a practice where the doctor absolutely embraces technology.

Reese Harper: Okay.

Gary Takacs: Now, full disclosure, I am a geek. I’m a nerd, and I love technology. I don’t mind saying that. By the way, he is too.

Reese Harper: Yeah, I’m a geek.

Gary Takacs: He is too.

Reese Harper: Yeah. 10-4. We’re sitting in a room with 10 cameras and 30 lights, and …

Gary Takacs: I believe it’s a giveaway.

Reese Harper: The Heil PR-40 is our favorite microphones, because we …

Gary Takacs: Oh my gosh.

Reese Harper: We can’t do it without them. We … Anyway.

Gary Takacs: No. So we’re geeks. And I love technology, but this is a doctor that truly is an early mover.

Reese Harper: Early adopter.

Gary Takacs: An early adopter, and embraces everything. And this is a practice, truly, where he had 90 percent overhead. 90 percent overhead. And he was very frustrated. He enjoyed the environment with which he practiced in with the gadgetry and the … But I said, “You deserve … Let’s spend some time. Let’s get the numbers in line, because this isn’t fair to you.”

Reese Harper: Yeah. Great insight. I think it’s a great place to start, and then figure out where … I think that you’d probably agree with this, but it seems to me that front desk philosophy, the front desk efficiency, it really does contribute to whether … I mean, if you’re just looking at it objectively and saying, “Should I sell my practice and work for Heartland, or should I keep running my own independent practice?” It’s really going to depend on how effectively you can manage this front office. I mean, a lot of it deals with that. It’s not … I don’t want say exclusively, but man, it really … Sometimes … You can’t expect to open your doors, under-invest in the front, and then somehow your profit margins are just going to be there and everything’s going to be fine.

Gary Takacs: Right.

Reese Harper: And sometimes I feel like we … That some doctors even … They tend to maybe not value compensating that role quite enough for that person to be capable, to handle the breadth of skills. I mean, you just said earlier, it’s got to be someone who’s great with people and good with data and technology and numbers.

Gary Takacs: It does, yeah.

Reese Harper: And if … That’s a hard combination to find. And I …

Gary Takacs: And that person’s worth more.

Reese Harper: And that … I promise you that that person’s not an inexpensive … It’s not the least expensive hire. You can’t find that kind of talent, and you can’t compensate that person below market and expect them to be in a good position.

Gary Takacs: Yeah. Totally agree. Invest, invest. I would summarize that discussion by saying be willing to invest in quality administrative team members, quality front desk team members.

Reese Harper: I love it. Talk to me a little bit about the second question that I get really commonly, which is should I keep doing this fee for service model that I’ve tried or should I go back to PPOs or I’m on PPOs and I want to go fee for service, and should I? There’s always … I think there’s a love hate relationship here with insurance that everyone has, and you see people on both sides of the spectrum, and sometimes confused at whether they should have made a choice that they made, or … And I just want to get your overall philosophy on this issue.

Gary Takacs: There’s … It’s dangerous here to make broad generalities about how to handle insurance.

Reese Harper: Great advice.

Gary Takacs: Let me give an example. Certainly … Pick a … I’m going to pick a state capital. Olympia, Washington. Good size city. It’s the state capital. Nearly everybody in Olympia, Washington is somehow tied to state government for their employment. They either work directly for the state or Washington or for a subcontractor who works for the state of Washington, who by the way, the dental insurance is Delta, is Washington Dental Service. For me to just blanket-ly say regardless of where you are, you should be a fee for service practice, and that’s the path to success, would be dangerous advice.

Reese Harper: Totally.

Gary Takacs: For a doctor in Olympia, Washington, where 98 percent of the patients …

Reese Harper: Good. That’s great advice.

Gary Takacs: [crosstalk] tied to that. However, I will tell you the single best strategic decision that Dr. Nielson and I made with our practice LifeSmiles was to radically reduce our insurance dependency. Radically. The single best strategic decision. And we did that. We started on that path three months after we bought it in May of ’07. So in August of ’07. By the way, I’ll be very candid with the numbers. Is it okay if I talk numbers?

Reese Harper: Yeah, that’s great. I am, always.

Gary Takacs: So this was a practice when we bought it that was a 500 thousand dollar practice.

Reese Harper: Okay.

Gary Takacs: And if you do the math on that, that’s a practice that produces and collects 41,666 a month. And change. You can check the math.

Reese Harper: Exactly that.

Gary Takacs: Just saying.

Reese Harper: Details guy.

Gary Takacs: And so … And it was a practice that … And it was stuck there. It was stuck there for the last 10 years, wasn’t moving. And the previous dentist was asleep at the wheel. So we bought the practice, felt like there was a lot of potential.

Reese Harper: Lot of opportunity.

Gary Takacs: By August of that … And by the way, Paul, amazing young dentist, hard worker. The practice was like a rescue puppy. And the imagery I’m using is maybe some of your viewers and listeners can have experienced a rescue. You bring the rescue puppy home. You lather some love and attention on it, and it blossoms into this wonderful four-legged family member. That’s what our practice did, okay? And by August, we produced 70 thousand dollars. That’s pretty good growth for …

Reese Harper: Good ROI.

Gary Takacs: 41666 to 70, right?

Reese Harper: Yep.

Gary Takacs: But we collected, in August, 45 thousand dollars. So Paul said to me, “Here, I think we have a collections problem.” He said, “We produced 70 thousand this month, but we only collected 45.” And I said, “You know, I don’t think we have a collections problem.” Our team, we’re now filing claims electronically. I’ve taught them how to properly submit claims and properly attach everything, and we’re collecting the copayment time of … I don’t think we have a … He said, “Well, here’s the data. We produced 70, and collected 45.” So let me do a deeper dive and see what’s going on.
I did a deep dive into that and discovered that that month, our gross production was 70 thousand dollars, but the adjusted production after insurance adjustment was 40 thousand dollars, because we had 30 thousand dollars worth of adjustments. We did … And you can … If you’re following along here, you can see that we didn’t have a collections problem, because they collected 45. The front desk team, at that point, pulled a five thousand dollar rabbit out of their hat. They collected five thousand dollars more than their adjusted production. We had an adjustment problem.
And over time, we didn’t do it over night, but over time, we simply couldn’t get most of the PPO plans to work for us. I discovered when we were looking at a MetLife patient. Every time we did a crown … I’m pretty good at cost accounting. Every time we did a crown on a MetLife patient, it cost us 138 dollars. Cost us, out of pocket.

Reese Harper: Yeah. Just fun to give it away though, wasn’t it?

Gary Takacs: I told the team, “You know what we should do? You know that front desk drawer that has the sticky notes and the pens in it? We should dump that out. We should put 100 dollar bills in there, and every time a MetLife patient comes in, we just hand them a 100 dollar bill and say, “Go somewhere else.” It would have cost us less money.” Seriously, and we only had one standard of care, we wanted to take care of patients the way we wanted to take care of them, so we weren’t about to use a different lab for those patients or have any different clinical protocols for those. We’re not going to use different materials. We’re going to take care of them like we would take care of anybody.
Well, over time, we resigned from those plans. And by the way, this is in Phoenix, Arizona.

Reese Harper: That’s what I was going to say. How much is this … Do you think is … Was driven by your market versus not? I mean, a lot of it has to do with the market, right?

Gary Takacs: And one of the most competitive markets in the country.

Reese Harper: Yeah. No question.

Gary Takacs: I made a mistake one time when I was giving a course. I said, “You could swing a cat and hit 10 practices.” And all the cat lovers sent me hate mail. So when I say swing a cat, that’s not … It’s a figure of speech.

Reese Harper: That’s the way they say it in Arizona.

Gary Takacs: We don’t really swing a cat, okay? But anyway, highly competitive. And by the way, follow the timeline. We started this process in August of ’07. What happened in September of ’08?

Reese Harper: That was not a good time for our friends in the financial industry.

Gary Takacs: The economy just literally …

Reese Harper: Lehman brothers, Bear Stearns.

Gary Takacs: Took a dive.

Reese Harper: Wachovia.

Gary Takacs: The way I tell the story is it felt like I was on an elevator, and someone just had a big set of bolt cutters and clipped the cables, and the elevator just dropped. And at that point, and I don’t mind sharing this, we were now about a year into the process, about halfway through eliminating these PPO plans. And Paul and I sat down terrified. I don’t mind saying that. What are we going to do? Because literally his schedule went from being booked out a couple weeks solid to Swiss cheese tomorrow. And hygiene was even worse.

Reese Harper: It’s good cheese, but I mean …

Gary Takacs: Yeah, but not on your schedule. And we literally said, “What should we do?” And I … We’re in uncharted territory. And I said, “Paul, it’s worked for us so far. I think we should just full throttle ahead, and if it doesn’t work, we can always go back to what we did, and sign up for the plans.” And yet I didn’t know exactly every single tactic we would do to make it work. I knew it was the right decision.

Reese Harper: Man, that’s just … Those are the moments where they’re make or break. The five year plan would have been drastically different had you made a different choice in that moment. Not a lot of pressure.

Gary Takacs: And we kept pushing. And by the way, this was in an era, in ’08 and ’09, in Maricopa County, which is the county where Phoenix is located, it’s one of the largest counties in the country geographically and also population.

Reese Harper: Yeah, it’s big.

Gary Takacs: We had 1800 dentists before the downturn in ’08. After the downturn, it shrunk to 1400. 400 practices either failed, went bankrupt, or foreclosed. This is going on around us. And yet, we grew every single year. And we doubled down on what we needed to do. And really, what it came down to is better marketing to attract quality patients that, by the way, didn’t have insurance because then we weren’t asking the question, “Are you in network or out of network?” It took a better level of customer service, so the patients did … We wanted to treat our patients so well, that there was no way they would ever want to leave us.
While I’m not going to suggest that every one of your listeners or viewers should go fee for service. That doesn’t make sense. I will say this, and this is with full conviction. Every one of your listeners, every one of your viewers, could reduce their insurance dependency. And that might mean getting rid of two or three of the most offensive PPO plans. Every one of your listeners can reduce their insurance dependency. And the reason I can say that so confidently, we’ve done that with dentists. It’s not just isolated in our practice. In my consulting firm, we’ve done that with dentists all over the country. I give a course called, “Breaking Free From The Shackles of Insurance.” And every one of you can reduce your insurance dependency.
And if there’s one message that I’d like to get out is I get frustrated when I meet young dentists that think that the only option they have is to sign up for insurance. The only option they have. And while I will say that it does depend on where you are, it does depend on dynamics in your community, you have other choices. Half of the adults in the United States don’t have dental insurance at all. Let’s go find some of them. You could add services to your practice that aren’t covered by insurance. Things like adult orthodontics, things like treating sleep apnea, things like cosmetic dentistry. Now, people are going to ask, “Are my Veneers covered by insurance?” They’re going to ask that question, but when you tell them, “No, because it’s a more progressive type of service, and your dentistry only covers the most basic things,” they’re not happy about that answer, but they understand. Are my dental implants going to be covered by my dental insurance? No. And they still want to do those things.
So that’s another thing you can do, is you could add services to your practice that aren’t covered by insurance to further insulate you from the intrusion of insurance.

Reese Harper: Yeah. Well, I’m sure that people learn a lot about this from some of the work that you guys are going to be doing at Thriving Practice Academy, and some of the content you’re going to be releasing too. So, excited about that.

Gary Takacs: But I would … Absolutely. And I would say that strategically, it’s the single best decision that we’ve made, because it’s put us in control of our fees.

Reese Harper: Okay. So, let’s go on to the next question. We’ve had you going here for a while, so we only got a few left. First, or the next question is if you had to respond generically to the … If a general dentist asks, “Should I continue to use my lab or should I do this stuff internally? Should I buy a [CEREC] or should I continue to expand the use of my CEREC?” Talk to me about this a little bit.

Gary Takacs: You bet. And I have a deep background in this. In 1986 … That’s before some of your listeners were born, my goodness.

Reese Harper: Yeah, it’s true.

Gary Takacs: I was privileged to be involved in the introduction of the predecessor to CEREC at the Chicago Midwinter Meeting with Dr. [inaudible]. And this was … The computer that ran that was as big as a refrigerator, if you can imagine that. But anyway, I would absolutely say, from my vantage point, remember I’m not a clinician, but I have a lot of experience in this, that the technology is now there. In terms of being able to restore a tooth, that looks like a tooth … The material. The materials that we use for the blocks were really the part of the technology that was lagging behind …

Reese Harper: Was lagging.

Gary Takacs: The other aspects. And the material … We can now use beautiful monolithic eMax restorations, same type of restoration that the labs are going to use. So the quality is absolutely there. However, you have to take a close look at some things that have been happening. Basically, I’ll run … Can I run through some very specific math for you?

Reese Harper: Yeah, let’s do it.

Gary Takacs: So if you were to buy a CEREC with an oven, you’re going to spend about 150 thousand dollars.

Reese Harper: 150. Okay.

Gary Takacs: Your lease payment on that’s going to be about 25 hundred dollars a month. So you have to look at am I doing enough units to justify that lease payment? And of course the Dentsply salesman is going to tell you that you’ll never have a lab bill again. And that’s not true. I don’t know any CEREC users that have completely given up their lab bill. Multiple units for example, some anterior aesthetics. Now granted, again, depending on your skillset, you can do some beautiful anterior aesthetics with CEREC, but you’re still going to have a little bit of lab bill. So you have to look at it and say, “How much do I pay for a unit?” And that’s come down radically with the competition of lab business.
When Paul and I bought LifeSmiles, we were paying 250 to 275 a unit. And if I needed to pay a … Say, how many units do I need to do to justify a 2500 dollar a month lease payment on the CEREC, if you’re paying 250 a unit, I’ve got to do 10 or more units. You might look at that and say, “Hey. Are there 10 posterior units in my practice we can do a month to pay for that?” Then it’d make more sense to have the CEREC, because now you’re making a capital improvement in your practice instead of paying the lab bill.
But now, that lab bill, what do you see as lab fees today for your clients, given the competition of the lab industry?

Reese Harper: Well, it’s shrinking for sure. And it depends on the size of the practice, right?

Gary Takacs: It does.

Reese Harper: But you’re definitely seeing that compress.

Gary Takacs: And I’m seeing …

Reese Harper: And you’re seeing the labs end up feeling like … I mean, they definitely feel competition.

Gary Takacs: They feel squeezed.

Reese Harper: Yeah.

Gary Takacs: And I’m seeing lab fees in the 120 dollar range, 130 dollars. So, now do the math. If I’m paying 120 dollars a unit, how many units a month do I have to do to justify that 2500 dollar a month lab bill? And the other way to look at it is … I will … I’m an absolute advocate on the idea of one visit restorations for patients.

Reese Harper: And you think that patients definitely value that, and will they pay for that?

Gary Takacs: No doubt. Absolutely no doubt about that. And by the way, it’s not just executives that are thinking, “Well, I bill out at 500 dollars an hour or so.” No. It’s mom who has a crazy busy schedule …

Reese Harper: It’s like I got one day to do this, and I can’t come back.

Gary Takacs: Time pressure. So in no doubt, the patients will appreciate the one visit restoration. And I believe you can market that. I believe you can successfully market that very, very well. But you also have to look at your personality. Are you the type that are going to embrace this technology and go through all the required training, every practice that I’ve ever worked with that’s implemented a CEREC goes backwards before they go forward, because of the fact that they’ve got to slow down to use this new technology. And then do you have the team, the assisting team, because as you get more skilled with it, you want to bring your assisting team on so that they do everything they’re allowed to do under your practice act. You don’t want to reduce the doctor to become a ceramist.

Reese Harper: Yep, which doesn’t pay as well.

Gary Takacs: Which doesn’t pay … You take a doctor and you convert them to doing the work of a ceramist, you’d be better off paying a ceramist to … So there’s no easy answer to that.

Reese Harper: Yeah. It probably depends on the size of your space too, right? If you really can comfortably accommodate that workflow, and it doesn’t cost you space and chair space too.

Gary Takacs: Can I answer it emotionally instead of analytically?

Reese Harper: Yeah, yeah. Do that.

Gary Takacs: We’ve talked about it analytically.

Reese Harper: Yeah.

Gary Takacs: Is it something that’s going to make your life more enjoyable?

Reese Harper: Yeah.

Gary Takacs: You know? Dive in … Or is it going to be something that adds more frustration to you? And it depends on your mindset relative to technology. If you’re a gadgeteer and you love it, go for it, man.

Reese Harper: Well, so one more way to … And this is just me listening to you and thinking about this more. You say that … I know you’re just using this as an example, but you say a 150 thousand dollar unit, your lease payment’s 2500 a month. I’m assuming that’s a five year lease. Maybe they give it to you at zero interest, and you got to pay 2500 for five years. That’d be a total of 150. Is there … Generally speaking, do you find that there are no repairs and cost in the first five years? Because I’m trying to just say is it really a 2500 dollar a month cost? Or is it less …

Gary Takacs: Great question.

Reese Harper: Because it could spread out further, and then …

Gary Takacs: It’s not the repairs and maintenance that’s going to bite you. It’s the upgrades.

Reese Harper: Yeah.

Gary Takacs: And especially if you’re in a closed system. If you’re in a closed system where … We’re talking about CEREC. It’s a Dentsply product. You’re in a closed system, and the latest upgrade comes, and what is the pace of upgrade? About every two years, maybe 30 months, two and a half. And now all of a sudden … And by the way, the upgrades aren’t inexpensive. It’s a 70 thousand dollar upgrade. It’s an 80 thousand dollar upgrade. So you do have to look at that as well.

Reese Harper: Where do you see the industry going? And what is the penetration right now?

Gary Takacs: Well, we’ve got six units about to come on the market that … Right now, we’ve got two on the market. We have six units about to come on the market. By the way, I believe that at least two of those are going to find some value pricing. And I believe it’s going to … It’s just what happens when Southwest Airlines comes into any market?

Reese Harper: Yeah. Yeah. They …

Gary Takacs: Well, what happens?

Reese Harper: Pricing comes down.

Gary Takacs: You saw it happen here in Salt Lake.

Reese Harper: Yep. Delta starts charging less.

Gary Takacs: Delta had to charge less, because there’s a new kid on the block.

Reese Harper: Yeah.

Gary Takacs: I think you’re going to see that. I do believe that we’re going to see …

Reese Harper: I’m stuck with my dang Sky Miles. Okay? So I didn’t start with Southwest. I have too many miles now. All right? They got me.

Gary Takacs: They saw you coming.

Reese Harper: They suckered me into Diamond.

Gary Takacs: They saw you coming.

Reese Harper: Okay.

Gary Takacs: Yeah.

Reese Harper: Well, the problem is …

Gary Takacs: You like the first class seat. You’re that guy that likes that first class seat, aren’t you?

Reese Harper: I … No. I wish I didn’t like it. The problem is if you start sitting there, it becomes a problem. You never go back. So I like when I see you posting on your social, you got three seats, you’re taking a nice nap there in your first class. I mean, it’s first class with three seats, and you only paid for one. I’m …

Gary Takacs: I’m telling you. I’m telling you.

Reese Harper: Ryan always tells me all the time. He’s like, “Dude, you got to be a Southwest guy.” I’m like, “They got me. I got too many miles now.” So …

Gary Takacs: We’re going to see at least two of those six systems come in at value price. The technology really shouldn’t cost 150 grand.

Reese Harper: Yeah.

Gary Takacs: It costs 150 grand because that’s what they could charge for it.

Reese Harper: Because there are some patents that are still … They’ve been on the market for a while, and now all those things are changing. And so …

Gary Takacs: [crosstalk].

Reese Harper: I think it’s … So do you see that this is just going to be a longterm, it’s going to be a function that either you’re going to have to provide this or you’re going to be out-competed?

Gary Takacs: Well, there actually is a mid … You talked about labs and CEREC. There’s a middle choice as well. And that would be to invest in a digital scanner today. Work with a lab that accepts your …

Reese Harper: Yeah. Good point.

Gary Takacs: Accepts your digital scan. And by the way, the turnaround time on that is about five days now. It’s not same day, but a couple things happen. You improve the experience with the patient. Have you ever met a patient that appreciates getting an impression?

Reese Harper: Yeah.

Gary Takacs: Under the [crosstalk].

Reese Harper: Of course. Yeah, they love it.

Gary Takacs: Even if it’s Pina Colada flavored impressions, they don’t like …

Reese Harper: Yeah, dude. I’m like … They don’t care what it tastes like.

Gary Takacs: No.

Reese Harper: It’s not fun.

Gary Takacs: Yeah, they hate it. So now we’re doing a digital scan, we’re sending it to a lab. The lab’s getting a higher level of accuracy because of the digital scan. They can lower their costs because of the technology. You’re providing it to them, so you get a lower lab cost. Higher result. You’re getting a turnaround time at four or five days. And that’s technology that really everyone ought to be involved in too.

Reese Harper: Yeah. So there’s no right or wrong answer, but it sounds like your preference would be … Look, it’s going that direction.

Gary Takacs: Get on board.

Reese Harper: So get on board.

Gary Takacs: Get on board. Even … If maybe just scanning at this point is your comfort level of getting on board, get on board.

Reese Harper: So let’s jump into another subject. We only got time for two more questions.

Gary Takacs: Sure.

Reese Harper: One is when do you know if you should … The question that I get often is I don’t really know if I should part ways with this employee. I don’t really know if I’m just being frustrated by something or if … Should I … How do you know if I should fire somebody? How do I know, because …

Gary Takacs: I will say a disclaimer first.

Reese Harper: Yeah.

Gary Takacs: I’m a humanist.

Reese Harper: Yeah.

Gary Takacs: And I always try to be mindful of the fact that these decisions have impact. And there’s families involved, there’s emotions involved, there’s very real financial survival.

Reese Harper: Consequences.

Gary Takacs: [crosstalk] some of these consequences. So I don’t say any of this in a cavalier manner. I think the hardest thing for any dentist to deal with, and myself as an owner included, is dealing with these tough personnel issues. But I’m going to share with you that … Something that I’ve shared with my clients, that you need … I think about my team. We have 15 team members. And then there’s Paul, Tim, and I. There’s 18 of us all together. And I did the math the other day to figure out that when you look at our dependence among the 18 of us, there’s over 65 people that depend on the decisions that we make. 65 people. And one of those is my five year old grandson, who at this point, is completely dependent on others for his living. And so don’t make those decisions lightly.
But with that said, I … You think about that, and you think, “Can I possibly let down 65 people, because I don’t have the courage to address this in my practice?” And I have an axiom that I believe in. It sounds harsh, but I believe in. You hire slowly and you fire quickly. And almost every time that I can think of, when we part ways with a team member, if you do it right … Now, I want to emphasize this. It should never be a left field discussion. You should never … The team member should never have the deer in the headlights, like, “Oh my gosh. I never saw this coming.”

Reese Harper: Never saw this coming.

Gary Takacs: If that happens, then you’ve done a poor job as a leader and a manager.

Reese Harper: How many discussions do you think you should have with someone about an issue before you make the decision?

Gary Takacs: Depends on your state. There’s actually state regulations on this. If I practice in a state like California, where it’s very employer friendly … Excuse me. Employee friendly.

Reese Harper: Employee friendly. Yeah.

Gary Takacs: Then you better follow your state HR. If you practice in a state that is at will, where literally you could come in and say, “I just don’t want to work with you anymore,” that’s never a good approach.

Reese Harper: Let’s say aside from the legalities, we know that’s important … Let’s say what’s best practice?

Gary Takacs: Three.

Reese Harper: Okay.

Gary Takacs: So the first time, you want to say, “There’s …” May I role play? This wouldn’t be you, of course.

Reese Harper: Yeah. Well, it might be me.

Gary Takacs: Reese, we need to have a very serious discussion. There’s some performance issues. Let me outline these. And there needs to be some radical changes in order for you to remain a team member here with us. And we outline that. The second warning, the second is a written notice. So the first one’s a verbal. The second one goes into a written format, where we document it, and we have them sign that. And we close that discussion by saying, “Reese, I want to be perfectly clear. If changes aren’t made …” Let’s say it’s a tardiness issue, and you’re having trouble with getting there on time … That I want to be perfectly clear with this, that if you are late for work another time, it will result in your termination of employment.
I mean, when you’ve been that clear about it, and then I don’t believe we fired that person. I believe they made a decision not to be there, because they knew the consequences of it. Now, is there ever gray area around that? I mean, heaven forbid there was some kind of emergency at home that happened that day that caused you to be late. Is there … There can be gray area in there.

Reese Harper: So verbal discussion, then written, and then the third time, it’s maybe time.

Gary Takacs: It’s time.

Reese Harper: Maybe a fourth if you’re being really nice, okay? If you’re a real humanist like me. Okay, last question. How do I know when it’s time for me to sell my practice?

Gary Takacs: That one is such an important question, and I don’t know that there’s any more on the business side. I don’t know that there’s any more emotional decision for a dentist to make, because for most dentists, the practice is not a commodity. It’s not a material possession. There’s a lot of emotion involved in it. And literally blood, sweat, and tears, and heart muscle. Heart muscle and stomach lining in their practice. And you know, it’s interesting. I’ve advised three clients in the last year who I’ve advised to pre-sell their practice a little bit early. These were in their mid to late 50s, and in their situations, it made perfect sense. They loved to practice. They wanted to continue to practice, but they really didn’t want to continue with the management responsibility and all of that. And they were able to sell to corporate entities in a positive way, where they could continue to work for the next two to four years, and step away from the management of the practice.
In all three cases, we got a premium for them. Not a huge premium, but a five, eight, 10 percent premium over what it was worth in fair market value. And in following them, tracking them, it was a good decision. But it really is individually made. There are dentists that aren’t cut out to own a practice, and they might discover that. For example, a client of mine bought a practice from a dentist that owned it … A young dentist that bought it right out of dental school, owned it for two years. And he discovered in that two year period that he was not cut out to own a practice. He worked four days a week in his own practice, and worked a day a week over in a clinic, a corporate clinic. He actually enjoyed the day in the corporate clinic better than the four days he owned his own practice.

Reese Harper: Just relieving himself of that management responsibility just was … It was a big deal.

Gary Takacs: It was liberating, and it really fit his desire to really just come in, put my head down and do dentistry, and not have to deal with the other things. Now, with that said, there’s nothing like owning your own practice. I’m an advocate for entrepreneurship in dentistry. I don’t think there’s a better business environment to be in than owning your own practice.

Reese Harper: Yeah. Okay. I’m going to ask you one more, because on [inaudible] said no more. My last one is when do I know if I should hire an associate or another associate? Or how do I know it’s time to add? Versus the …

Gary Takacs: So if you’re … For example. When Paul and I built the new building, we built in … New practice, we built in 2011. We built it for two doctors, even though he was only solo at that point. And we planned on having a second … So part of that is … That part of your planning all along. I do think the idea of a solo practice has questionable model moving forward in the future.

Reese Harper: Yeah. Sustainability of a solo practice with no … Yeah.

Gary Takacs: Yeah. I think that might going the way of the dinosaur, and I think that’s okay.

Reese Harper: Yeah.

Gary Takacs: But when you look at a couple things rising overhead, quality of work, the balance of work home life. Work, family life. The fear of taking time off, because you’re overhead keeps going up and you can’t take enough time off. So I do like the idea of having an associate or partner in the practice. I think it helps in so many ways. I told Paul that … He said, “When do we know we’re going to hire an associate?” And I said, “When you’re booked out solid for four weeks, and we literally can’t get a patient in, that’s when we need to look at that.” And I remember it. I remember it in detail. It was November 12th, 2012 when I looked at the schedule and he did not have another appointment open before the end of the year. It was November 12th. So we were beyond that four week … [inaudible] We’re always going to work people in. We’ll work emergency. And we’ll stay in. At lunch, he’ll stay over and we help people.
But we literally couldn’t get a patient in. That’s when I said, “Paul, it’s time to hire an associate.” And we did at that point. So when you’re booked out three to four weeks solid, that’s when it’s a good time to really look at bringing in a new associate. The number one reason why associateships fail is the practice isn’t busy enough to support the owner, doctor, and the associate. So make sure that you address that proactively by dialing up your marketing, by investing in that, and making sure that you create an environment where the associate is going to be busy enough.
Now, if you’re at the point where you want to start taking a little bit more time off, that can be another way to feed the associate, but make sure you address it proactively, and you don’t get into a situation two months later where the associate’s saying, “Well, I can’t make a living here.”

Reese Harper: Yep. Well, that’s great advice. Man, Gary, we’ve covered every topic under the sun today, which I really appreciate. It’s been such a great interview. You always have great perspective and optimism for the industry.

Gary Takacs: Thank you.

Reese Harper: But it’s … You’re cautious, but you’re an optimist. I just think you’ve been a great help to so many people, and I appreciate that you’ve dedicated a lot of your career to making the industry better for a lot of our friends.

Gary Takacs: Reese, thanks. That means a lot to me coming from you, and guilty as charged. I love our profession. I am an optimist.

Reese Harper: Yeah.

Gary Takacs: You might be able to pick that up, but I am an optimist. But there’s also a strong pragmatic streak in my personality. One of the things … Owning a practice, it’s the best test kitchen in the world, man. I thought I knew a little bit about HR before I owned a practice. Guess what? I’ve got a PhD in HR.

Reese Harper: PhD in HR now.

Gary Takacs: I thought I knew a little bit about cancellation no-shows, until I owned a practice. And I’ve had the school of hard knocks on that one. And I spend time every week in the practice. And when I’m lecturing on a Friday, it’s a pretty rare Friday that I haven’t added new slides based on what happened that week in our practice. But it’s probably the most fertile test kitchen or learning and teaching laboratory that one could have.

Reese Harper: Well, tell everyone how they can get in touch with you, if they’d like to learn more about the Thriving Practice Academy that’s coming up.

Gary Takacs: You bet. You bet.

Reese Harper: Takacs Learning Center, if they don’t know much about it.

Gary Takacs: You bet. The website today is Takacs, my last name, T-A-K-A-C-S LearningCenter.com, and love receiving emails. So if you’re an email person, shoot me an email. Gary@takacslearningcenter.com. And having raised four kids, I learned how to text. So if you’re a texter, that’s actually my preferred method of communication, reach me on my cell. 602-321-1778. Don’t bother leaving a message.

Reese Harper: Yeah, just text.

Gary Takacs: Just text. Text me.

Reese Harper: What about the Thriving Dentist Show? How do people … It’s one of the most successful podcasts in the industry. How do they get subscribed to it?

Gary Takacs: It’s on iTunes. It’s on Google Play. Just type in Thriving Dentist Show. By the way, we have listeners in 158 countries. I count myself very blessed to have that wonderful audience around the world. We’d love you to listen to the show. All 303 episodes, as of today, all of them are available in the archive. You can download all of those, and would love to have you join the ranks of listener on the Thriving Dentist Show. You can do iTunes, Google Play. Hit subscribe. That means every Wednesday when we upload a new show, it will automatically be uploaded to your listening device.

Reese Harper: Well Gary, thanks again. We really appreciate you coming on. It’s been great to get this on film, and on the airwaves. And for those of you who would like to reach out to Gary, we’ll put all his information in the show notes and links and everything will be there as well. I’d just like to thank everyone for listening to the Dentist Money show. We’re really grateful to have each of you each week, and grateful for the continued comments and suggestions and questions that keep coming in. We really appreciate it, and really enjoying it.

Gary Takacs: Hey, let me take a minute and thank you, man.

Reese Harper: Yeah.

Gary Takacs: I appreciate all that you do. We share a number of clients, and I love to see firsthand the peace of mind that our clients have that you work with on the financial side. And we talk about this when we have dinner, and how they just feel so good about knowing the direction that they’re going. And it allows them to be better practitioners, clinically and behaviorally. So thank you.

Reese Harper: Well, I think that’s true. Thanks a lot. Really appreciate that. If anyone … If you’d like to leave us a comment on iTunes, you know how to do that. We appreciate the comments on our website at dentistadvisors.com. And if you’d like to book a free consultation, you can hit that green button on our website, pick a time that works for you, and schedule an appointment with one of our advisors to ask more questions, and I will be happy to point you in the right direction at any time. Thank you so much for listening. And thanks again for tuning in to the Dentist Money Show.

Practice Management