How to Build a Dental Practice That Runs Without You

On this episode of The Dentist Money Show, Matt has a conversation with Dr. Michelle Jorgensen as she shares her journey from practicing dentistry to building a thriving, purpose-driven practice centered on whole health and intentional leadership. Dr. Michelle unpacks the mindset shifts that reshaped how she views ownership, growth, and success. She explains the critical role of leadership in dentistry, why traditional partnership models often fall short, and how redefining roles can create stronger and more sustainable practices. Tune in to hear a powerful perspective on designing a dental practice that truly works for you.

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Podcast Transcript

Matt Mulcock: Welcome to the Dentist Money Show. We have Dentist make smart financial decisions. I am Matt and I am here with entrepreneur, dentist, author, gardener, extraordinaire, Dr. Michelle Jorgensen. Michelle, how are you?

Michelle Jorgensen: Great, thank you. So excited to talk with you again.

Matt Mulcock: Yes, we love having you on. This is like third or fourth time you’re becoming a regular on the show. We love it. And this episode is special and it’s special because we need to highlight where are you joining us from right now, Michelle?

Michelle Jorgensen: the highlands of Scotland right now actually.

Matt Mulcock: So amazing. I when you said that before we got on, you’re like, I’m in Scotland and I’m like, what are we doing? You should be on vacation. You’re like, I want to do this. So we really appreciate you joining us from from overseas, the Highlands of Scotland. We’ll have to talk separately because Scotland’s like top of my list along with other areas over there. But I want to talk to you about it.

Michelle Jorgensen: It’s very cool, we’ve been having a great trip.

Matt Mulcock: Well, that’s great. ⁓ So much to talk about. ⁓ We’ve again, this is the third or fourth episode we’ve had you on. ⁓ I’ve shared the last episode we did, like think beginning of last year, I can’t even tell you how many times just the amount of knowledge and experience that you bring ⁓ today. We want to kind of continue that conversation. You were saying ⁓ even before we got on even just some change in perspectives you’ve had through kind of where you are in business and things that have happened. So I want to get to that. But before we do, maybe for people who have not heard you before, maybe we’ve got new listeners that haven’t heard your last episodes. If you haven’t, go back, please go research, go look on our website. Just search Dr. Michelle Jorgensen. You’ll find her last episode. But for those of the listeners who don’t know who you are, maybe let’s just start there. Kind of give a a summary of who you are, kind of where you are in business now and kind of how you got here.

Michelle Jorgensen: Yeah, so I’ll give the short version. So those who have heard it before don’t have to listen to the whole thing again. ⁓ So General Dentist, I practice in American Fork Utah, and I’ve been there and actually it will be 25 years in May and the program currently right now started in 01. So I’ve been there a long time.

Matt Mulcock: Gosh.

Michelle Jorgensen: And as many of you know who may be practicing in Utah, everyone says that it’s the most competitive, you know, market that there is. saw research recently that disputed that. It’s one of the most competitive, but for sure it is. So we started at an American Fork and started with a focus on really whole health or just taking care of the whole person. But at that point, 25 years ago, that was all about massage chair pads and cooking bread all day long in the office and those kinds of things and really doing kind of high-tech service. And about a decade into practice, I started getting really sick. Didn’t know what it was. Got to the point that I actually put the practice for sale because I had completely lost all feeling in my hands, just numbness, terrible. I couldn’t sleep. It was just really bad. No doctor could tell me what it was. Eventually found out it was mercury poisoning from drilling out amalgam fillings. I had been cosmetic-focused dentist and had been doing that for the last decade. Drilling out so many mercury fillings, breathing all of the vapors, didn’t know that this could even make me sick as I’m sure probably many of you listening had no idea that this could be a problem for a dentist. Well, it can. And it was, and that’s what it was. And so I had to start doing dentistry in a different way to be able to continue even practicing. And this was, I was in my mid thirties, four young kids. My husband worked for the practice. So this was everything. This was our entire livelihood that we were going to lose at this point and finally figured out what it was, had to find out where there are ways to remove, you know, amalgam fillings, had to keep doing that and do it in a different way. Found that there was a way to do that, certain protocols through an organization called the IAOMT. So I started doing things differently in that procedure and I thought all of the patients would run screaming away from the practice and say, who is this crazy lady? And a few left but the large majority actually said, we’re really interested in what you’re doing. know, first of all, we’re sorry you’re so sick and so glad you found some answers, but isn’t this maybe better for me too? And so we started really catering people who are looking for a different way of doing dentistry and looking for a dentist that could really put the pieces together for them from a health standpoint. So really from that day forward, this practice started to grow and that was unexpected. I didn’t grow it intentionally that way. It just grew unexpectedly that way. But the practice started to grow. And as I got better, the practice did too. And now we actually have six associates and I have a partner in the practice. So we’re multi-specialty practice. We have four facilities, four buildings that are kind of all side by side that we work out of. And we have a full-time pediatric office, pediatric and ortho office. have a full-time surgeon on staff, periodontist. We have restorative doctors. We do sleep and airway treatment. And we just work really hard to take care of people’s health. We’re fee for service, which is unusual. So that’s a very unusual model. Also, fee for service completely have been for probably 20 of those 25 years. So we have really, really hard to take really good care of people. Otherwise, they’re going to go somewhere else because they’re certainly not coming to us because their insurance pays for it. They’re coming for other reasons. So it’s a very different model. But along the road to this, I have had mini bumps and bruises and things along the way. And I’ve actually had the practice for sale twice, avoided two DSO sales. You know, one of them that I worked through kind of with you or shortly after I went to that DSO sale, near DSO sale, was literally like December 23rd, 2020. The entire thing fell apart as one of my associates told us he was breaking ground on his own office. And so that was a…

Matt Mulcock: Blessing in disguise.

Michelle Jorgensen: Such a blessing in disguise because the practice has grown one and a half times completely since that day. And I’ve since brought on a partner who is now 50 % owner in the practice. And we have learned a lot about what it takes to actually, first of all, have an associate that is long-term and very, very happy. In fact, we don’t even call them associates. That’s part of trick here, to have a partnership that’s actually a partnership partnerships in dentistry make zero sense to have a business model that operates perhaps like a DSO but completely different than a DSO and it’s completely you know independent and privately funded by us instead of corporate funded there are ways to do this and I myself am able to take trips to Scotland and I actually stopped seeing patients clinically last May so it’s been almost a year ago that I stopped seeing patients clinically

Matt Mulcock: Wow.

Michelle Jorgensen: I’m completely in the managerial oversight, you know, CEO role of the practice. But even that I am turning over to my partner in June. So she is going to become CEO of practice. And I have figured a way out a way to stay owner to stay an owner in the practice, but yet back myself out of the large majority of even the managerial duties of the practice. So lots that I can talk about from from from

Matt Mulcock: so much.

Michelle Jorgensen: nearly selling to where we are now.

Matt Mulcock: Yeah, so much. there’s I mean, anyone who hears that if there’s the first time hearing from you, just here’s that summary. And like you said, there’s so many different places we could take this. We want to focus today around partnerships. What how do you structure them? How do dentists think about them incorrectly and associates bringing on an associate? I also think there’s an overall theme here to talk about around leadership. And I think there’s a real void of leadership. And a huge opportunity for dentists to to learn more leadership skills and ⁓ changing their minds about how to approach leadership. I want to I want to I’m curious as you were going through that, Michelle, when you said we didn’t necessarily start with the intention of this growth of this rapid growth. So for you. Because it sounds for you, mean, I know, and knowing your story and in that summary for you, it was, I just needed to do something different for my health and to like, keep my business going. But where kind of take us through that journey of where did it go from kind of reactionary, like, my gosh, this is actually having an effect and we’re growing. But what point did that transition into like, okay, now here’s I’m implementing a vision to grow this thing. to this level or did that ever happen? Has it all just been a kind of natural growth?

Michelle Jorgensen: Well, the practice had already grown pretty substantially to the point when I was looking at the DSO sale. And that was a bit of a breaking point for me because I was sole owner. had four associates at the time. And so, and I was working clinically full-time. was full-time clinical sole owner, four associates, busy practice, so much going on. And at that point,

Matt Mulcock: Yeah.

Michelle Jorgensen: it looked like the practice was going to continue growing. Like sometimes I say it grew despite of all the things we did, you know, that’s we found, we’ve found a niche that, you know, is really a wide open niche. So if anybody wants to talk to me about that, I’m also very happy to talk about that one. But, I had to decide at that point what I was going to do. Because I couldn’t keep doing what I was doing, but I saw the growth was still on the horizon and I wanted it to happen. I wanted the practice to grow. I knew that that was a good thing because the more the practice grows, the more people were able to help. And that’s my mission in life to help more people live well. So the more people I’m able to help, that’s why I looked at a DSO sale and said, okay. This is apparently the only way this is going to work. Actually, to back up just a slight bit, I actually offered a partnership to all four of my associates and they all turned me down. So that was a blow, which I thought was very fascinating actually, but so instructive for anyone listening to this. Why did they turn me down? What did they not want? Well, they all looked at what I was doing and killing myself basically. And they said, why would we exchange what we’re doing? You’re taking really great care of us right now. Why would we exchange that for what you’re doing? That makes no sense to us. They also didn’t believe the numbers that we were doing. They had never really seen the inside of the, of the practice. And they didn’t believe that I was actually able to run it as profitably as we were. So it was a very odd time. The DSO sale happened or didn’t happen thankfully and the practice continued growing. So I knew that I wanted to grow. I knew that that was something that I wanted to allow, which I think that’s actually another thought process that you have to change in your head a little bit. You know, am I okay to allow growth to happen or am I so burdened with all of the all of the work I’m doing that actually growth is a bad thing? You know, we joke sometimes that we have ⁓ like treatment presentation fatigue. If you’re doing a treatment treatment presentation at about 4.30 p.m. You just kind of pray that they say no. Because they say yes, you have to do the work. I mean not right then, but you’re tired. You know, you’re tired. So sometimes I think we look at our practice and we think, well everyone says we’re supposed to grow, but I’m so tired. How could I even do more than I’m doing now? So it was a real mindset shift for me to say, I want to grow. We have the potential to do that what do I need to do for my own sanity, for my own health, for everything, for my own self to allow the practice to do what it needs to do. Because at that moment, I was the thing that was stopping it.

Matt Mulcock: Yeah, that’s so interesting. I love the phrasing too of allow it to grow, like almost get out of its way and see and you’re also highlighting the mindset shift of what trade-offs am I making by having this continue to grow? I want to come back to the offer of the partnership to the associates for a moment. Can you get more specific around the two highlights you said? It sounds like you almost like internally golden handcuffed them. They were kind of like, why would we do anything different when we’re killing it here? And then the other piece being they didn’t really believe necessarily the numbers going back to that moment. ⁓ What do you think you would have done differently or if there’s a dentist right now in a similar situation? How do you think they would approach that discussion differently?

Michelle Jorgensen: First of all, we have to discuss the fact that every dentist doesn’t want the same thing. So a lot of dentists get into dentistry because they love the technical part of the dent, the dentistry. like the doing it’s artistic, it’s creative, it’s fulfilling. That’s where they get the rush from, you know, is doing a great, whatever it might be that, you know, you really love. And so the clinical dentistry is the part that you love. There’s that component of it. Well, there’s a whole entirely other component of dentistry that’s the business aspect. And I think leaving school, we just all assume that everybody’s going to like all of it. That that’s just what we’re supposed to do as a dentist. We’re just supposed to own a business, right? Well, it’s okay if you don’t. And interestingly enough, I’m thinking back, three of the four of those associates had all owned practices in the past and were working for me now. That was a choice because many different reasons. They were all in a different situation, but they had all owned practices previously. And the large majority of my associates have over the years, they’ve owned practices previously. They’ve tried it and they’ve realized that they love the clinical aspect of the dentistry. So if I could talk to myself back then, I would say, what did these dentists love? Go and have a real honest conversation with them and say, what do you love about this practice? Do you love doing the surgery? know, two of them were periodontists. Do you love doing the surgery? Do you actually love managing a team? Do you love running a team meeting? Do you love taking care of the finances and the books? Do you love watching the IT and the facilities? Do you love worrying about marketing? Like, which, which portions do you love? And I know now that all three are all four of them would have said, I love the dentistry. So I was offering them the wrong thing. I said that we actually don’t even call our associates associates. I mean, we do because everybody understands that that term, but I actually call them clinical partners because inside of it, inside of a dental practice, you have the clinical act of dentistry that we do the clinical performance of the, these procedures. And then you have all of the supporting business and add administrative pieces that support the business that provides the dentistry. So when we’re going to dentistry, we think that a dental partnership is something that we offer a dentist that’s been there for a while. So it’s based on tenure, right? It’s based on tenure. Well, we know how well that works inside of the education system. Very poorly. ⁓ Not very well because professors are tenured, but that doesn’t mean that they’re quality.

Matt Mulcock: Yeah. Yep, not very good.

Michelle Jorgensen: or that they actually should be there still, or that they should be given those responsibilities, it just means that they’ve been there a long time. Well, I want you to think, everybody that’s listening to this, I want you to think to a dentist. Being there a long time, does that actually qualify them? No, oftentimes it may be the opposite. Correct, so tenure is the wrong thing to base a partnership on. So what we did and what I did at this, what I wish I would have done then, but honestly,

Matt Mulcock: Now, oftentimes it could be the opposite.

Michelle Jorgensen: The outcome wouldn’t have been different because now I know why they said no. So what I instead did is I said, okay, clinical portion of the dental practice is one side. Let’s just call that half. The other side of the dental practice is all the admin pieces. And I figured out that there’s 12 different things that need to happen inside of a dental practice from an admin managerial side. So now if I were to go to those same doctors and say, Would you like to be a partner? I would say you are already doing the clinical portion of dentistry. You’re already a clinical partner in the practice. So compensation or what you pay someone equals contribution, what they contribute. So if a person is contributing clinical dentistry, they’re compensated by the dentistry they do. So typically that’s a percentage, right? A percentage of production or collections, whichever way you run it in your practice. They’re already a partner. They’re a clinical partner in the practice. So I would then go and say, okay, you’re a clinical partner. You’re already being compensated with your percent that you’re making. Do you have any desire or do you have any, actually that’s the wrong word. Do you have any abilities that you could bring that you could contribute in these other 12 areas? And they might’ve said, yes. You know, they might’ve said, well, yes, I actually think I would be great at facilities management, you know, whatever it might be. And then they would be very simple to structure that partnership. So, okay, great. You get one 12th then of the business portion of the practice. You’re going to be compensated one 12th of what we make in profit. It’s so simple, but then I would also spell out what does it mean to be a one 12th owner? What are you gonna do from a facility’s management standpoint? What things are you gonna contribute? And it would be very clear what that expectation would be because this is where I see dental partnerships fail so often. You have a great associate. They’ve been there four years. You you get along great. They do good dentistry and they say, okay, I wanna be a partner. say, great, let’s buy in 50%. That sounds great. 40%, 30%, whatever it is. but you don’t ask them to do anything different than what they’re already doing. But you’re already paying them for what they’re doing. You’re paying them to do the dentistry. They need to be, if they’re going to be compensated on the other side of the practice with the profits of the business, which is the owner compensation, they need to be doing some of those 12 administrative managerial owner duties. Otherwise you can’t pay them any more than you already do. You’re already paying them for the work they’re doing.

Matt Mulcock: Yeah.

Michelle Jorgensen: So I would have a very different conversation today than I had then, because it would all be about what can you contribute.

Matt Mulcock: Totally makes sense, Michelle. And I love this concept of referring to them internally as clinical partners. I think that is such an easy way to shift the mindset of an associate and almost empowering them to be like, we’re already partners because we’ve seen this a lot from the associate side of feeling somewhat maybe entitled to partnership because of the tenure. I’ve been here for so many years. Like I should be a partner. I love that you’re setting an expectation from the beginning of like, you are my partner clinically. That’s what, and you’re getting paid for that. I think that’s so great. ⁓ what do you, what do you say or how do you approach, like there’s the two parts of it. You were saying the desire, but then there’s also needs to be a skillset. What, how do you approach if this has ever happened, a clinical partner associate who says, I have a desire to do this, that or the other one of these 12, but you foresee maybe or maybe you’ve witnessed like they’re lacking some skill set in that area. How do you match that up and what’s what’s your approach like, okay, they want to do this. I’m seeing a gap. Is that just like a no, this isn’t for you or how do you approach that?

Michelle Jorgensen: So this is exactly what happened with my partner when we started. So she came to the practice. It’s actually funny. She, she came and asked me for a job. ⁓ maybe four years earlier. And I turned her down. said, no, said you’re going to drown, drown in your mind practice. You are not ready. So she went and she did some learning on her own. She went and worked in some other practices. She was traveling to Alaska to a practice. mean, she was, she was working hard.

Matt Mulcock: You’re not ready.

Michelle Jorgensen: And she was seeing what it looks like on the inside of the business besides just a, you know, just a clinical practitioner. But when she came, I said, okay, these are the 12 that need to be taken care of. Which three do you feel like you have skillset for? Because actually which four? Cause she wanted to buy in 30%. So we decided which four she was going to take, but we didn’t partner right then. What we did is we spelled out what did it look like when she had the ability to take care of those. So she started working toward that and some of it was mentoring from me. Some of it was mentoring from other people. So I have a business coach that I’ve worked with forever that has taught us the management side of the practice, the business side of the practice. I mentored her in some of those areas as well. And when we met those, really those milestones of what it looked like, then we said, okay, now it’s time to partner. So she learned how to do the job before she got the job, which, doesn’t that make sense? We had another associate that came to us and he said, well, I really want to be a partner. And we said, that is so great. The two areas of oversight that we need help with right now are facilities management and marketing. Which one are you competent and capable of doing? And he said, well, neither. Well, then there’s no contribution you’re going to be able to make right now. You already contribute clinically. And well, he said, well, I’m

Matt Mulcock: Yeah, yeah.

Michelle Jorgensen: I’m going to manage my team. said, Oh, that’s what you already do as a clinical partner. Thank you for doing that. That’s your job. And we already pay you a lot of money to do exactly that. So thank you so much for that contribution. You’re already paid. You’re already compensated for that contribution. But you know, if he were to come to us now and say, I’ve been actually studying marketing and this is something that I really want to learn and I have a lot of desire to do this. This is what I’ve done. We would.

Matt Mulcock: Yeah.

Michelle Jorgensen: Absolutely say that’s a great thing. We love that you want to contribute. Great. How can we do this? What do milestones look like? Let’s bring you up to where that needs to be. And interestingly enough, there are not a lot of business resources and training inside of dentistry itself. That’s actually what we do. My, have a training program that does that because where do you learn it? You know, how do you run a business? So we’ve actually learned outside of dentistry. Oftentimes our coach is not a dental coach. She is one that trains a lot of times manufacturing businesses, but you’d be surprised at the crossover between a manufacturing business and a dental practice. There’s actually a of similarity. So we’ve often found that sort of training, know, marketing training. Well, dental marketing training is lousy. they’re teaching you to basically repurpose the exact same thing that every single person, every other dentist in your town is doing. No, that’s not the way you do marketing. So you go outside of dentistry and learn these business practices. So

Matt Mulcock: Yeah.

Michelle Jorgensen: That’s what we do, is we coach them up, we encourage them, we help them get training, and when they’re able to contribute, then they’re able to move into that role.

Matt Mulcock: Yeah, that’s awesome. The themes I hear from you every time we talk and it’s coming out to, know, and this conversation is just clear communication, being really upfront, being really, really clear with people like here’s the expectations. Here’s, you know, the for your contribution, here’s the compensation. And I love this story of, yeah, you, this is what you do. You get paid to manage your team and to, to be a clinical partner. It’s just such a good mindset shift. ⁓ I’m curious from your experience, Michelle, through this whole process, would you like when you hire an associate in the past or, moving forward, is your mindset always hiring an associate to eventually be a partner? Or do you not have that expectation or thought like you’re fine as long as this person is really competent and a quality clinical partner, if that’s all they ever want to be, that’s great. Or is it like, no, I kind of want that person. I see them as a partner in the future. How do you handle that?

Michelle Jorgensen: Great question. And it’s really based on your need. Currently, I don’t have a need for another business partner because I have one. So when we hire, in fact, I remember we were hiring for pediatric dentists and I had some decent applicants that were coming through, four or five different dentists that came and talked with me. And one guy I remember, he was very like,

Matt Mulcock: Yeah.

Michelle Jorgensen: Physically large, so I’ll always remember he was about probably good six inches at least well, probably almost a foot taller than me. So he was just like looming over me and I I always remember him but he was very just gregarious and so excited about owning a practice and growing and you know doing all these things and as soon as he walked out the room I crossed his name off the list. Why? Not because he wouldn’t have been a phenomenal dentist most likely and probably helped to grow the practice and everything else, but it’s not what I needed then I needed a clinician. I needed a clinician to take our pediatric practice and grow it clinically. That makes sense. Like we are doing the part of the business. We already were doing the marketing and the managerial and the HR and like we were taking care of all of that. I didn’t need an entrepreneurial dentist. I’m a clinician. So that’s what we hired and she is phenomenal as a clinician. She has zero desire to be a partner in that way. She’s already my clinical partner.

Matt Mulcock: Yeah. Yeah.

Michelle Jorgensen: Partner but she has no desire to be a business partner with us. But now I’d said at the beginning that I’m starting to want to even back further out of my role. So right now we’re 50-50 owners which means I have six of those you know what we call them seasons in our practice six of those business oversight areas and my partner has the other six seasonal oversights. I don’t want to do six anymore. I want to do two and I told her I want to be down to two by December. So this is where March, we’re almost April. So at first we started discussing, who could be a partner? And we did exactly this conversation and we started talking through our associates. Man, they are just killing it clinically. They wanna go and take this other clinical course. They wanna do this, they wanna do this. And it was all clinical growth that they were looking at and that we were so happy to help them do. And we knew that if we were to then say, okay, now you’re over all team training or you’re over, you know, all HR, whatever it might be, it was going to, first of all, not be their love, but also distract them from the clinical dentistry that we need them to do. So we looked at that and said, we don’t know that any of them actually is a fit for this partner, business partner right now.

Matt Mulcock: Yeah.

Michelle Jorgensen: So we started looking outside of the practice and saying, who else do we know? And we’re still, you know, testing the waters saying, is there someone else outside of the, outside of the current practice that may be interested in taking on some of these managerial roles? We just hired actually literally while I’m in Scotland, this is how you get things done, even on your vacation, hired a finance.

Matt Mulcock: You’re busy. You’re busy working in Scotland. You should just be enjoying the Highlands.

Michelle Jorgensen: know, whatever. But yeah, hired a financial controller while we were here because my husband whom you know very well has been doing basically our financial control role for a long time and he’s ready to retire. He told me he’s like, am out. So instead of having a dentist that doesn’t really know accounting and bookkeeping and financial management, mean, what dentist knows how to be a financial controller?

Matt Mulcock: Yeah. Yeah.

Michelle Jorgensen: Not one of us, okay? So, I mean, maybe one, certainly not very helpful, right? So why would that be the role that we would give to a dentist? Like that makes no sense. So we hired a financial controller and what did I do? I actually took a pay cut. I took a pay cut out of my salary, my guaranteed salary per month, and it is going to help pay for the financial controller. That might seem a little insane, but it’s not.

Matt Mulcock: There’s maybe a handful, yeah. Yeah.

Michelle Jorgensen: Because we’re paid by the number of seasons that we have oversight with. So we take the amount of profit that we get per month, we divvy that out, we divide it in 12 and we divvy it out to the two of us. So what I finally figured out is we actually don’t need another partner. We need, and this is one of my mentors that is big kind of in finance and investing. These are where my mentors typically are, but he always asks me, he says, should you pay for this? with the harvest or with the seeds. So I want you to think about that because if you are selling a portion of your business, you are selling the seeds. You no longer have the potential to harvest anything from those seeds. If you are selling, if you are paying for it with the harvest, you have retained the seeds and you’re capable of continuing to harvest. So what I’m choosing to do is I’m retaining the seeds. I’m retaining 50 % ownership in the practice, but I’m not retaining 50 % of oversight. I’m using some of my harvest to pay someone else to do the job. Does that make sense?

Matt Mulcock: Yeah, yeah, definitely. such a brilliant way to look at it. And this is inherent in the capital markets as a whole. Any business that’s raising capital doesn’t through debt or through equity. And that’s the harvest versus the seeds. And that’s that’s the trade off you’re making. I think it’s brilliant. And I think it’s such an insightful take for Dentist to think about is that you have to make a trade off in some way when you’re giving up. responsibility and, and you’re, you’re, and these seasons, you’re having someone else do that. You, the compensation has to change, but it doesn’t mean that you have to give up the equity in your business and, and, and the asset itself. I think that is something that not a lot of dentists think about. They, they, they think about the default of like, I got to sell this or I got to give a portion to this associate. But you’re highlighting perfectly. That’s not the case. You don’t have to do that.

Michelle Jorgensen: I think it’s really important to talk about this from a DSO standpoint, because really the DSO model is a fallacy. When I was at the point of ready to sell to a DSO and we were days away from this sale, I thought I’d be just raking in the money, right? I’m gonna bring in all these dollars and… Now the practice is worth, like I said, one and a half times what it was. Well, two, no, it’d be two and a half times what it was at that point. ⁓ So I certainly wasn’t going to be raking in the dollars. But the problem is, is that I also wasn’t going to be giving up any of those seasons. I want dentists to really think about this. If they sell equity in their practice or sell their practice outright even, know, some DSOs, you’re selling 100 % of the seeds. You don’t have any of the seeds left at all. So you’re selling the seeds and the hope is that they’re going to take all the things off your plate that you don’t like to do, right? That was my hope. that it’s going to give me a life again, that I’m going to be able to actually, you know, see my kids and, know, whatever it might be, you know, all the things that we all feel burdened by and weighted down by all of those managerial pieces. Man, why can’t my team members just get along? Why can’t I find a hygienist? Is the marketing, does the marketing always have to be this hard? You know, I’m always worried every single day or every single month about bringing in enough patients. I mean, these are the worries that we all have, right? Every single day, these are the worries that we have in practice. And we think that that DSO sale is going to solve it. And I’m telling you, it doesn’t because you still carry a large portion of those 12 seasons or there’s 12 areas of oversight. You are the one day to day managing your team, not getting along. So guess what? You’re still over HR. You’re still talking. You’re still the one who has to set systems and has to talk to your front desk team member about How do I schedule for, how do I block schedules so that I can actually meet production because I’m not making as much as I used to be anymore. So now like my schedule is even more important than it was before. You’re still the one that has to worry about if something starts to leak in the lab and you’ve got a leak on Seek, you’re still the facilities director. You’re still all of these things. If your computer software goes out today, guess who’s still worrying about that? You. So you have not given up.

Matt Mulcock: Yep.

Michelle Jorgensen: Those areas of oversight, but you’ve given up the seeds that pay for the person to do those areas of oversight. So can you see how you’re being robbed blind? You’re still doing the work, but you’re no longer getting paid for it. So this is why it’s so crucial that we actually start to understand how we should be paid. And when an associate comes and says, want to be a 50 % partner, you say, great. Let’s look at the 12 things that we have to do inside of a dental practice and let’s decide which of those, which six of those you’re going to do and take off of my plate because you’re going to take money out of my pocket. So you have to be doing a lot of my work in order to do that. Same thing with any buyer, any investor in your practice. They have to be doing a commensurate amount of work to be taking that amount of money from you. So I’m making this choice now. I’m making this choice to give some of my money to a person to do some of the work. That’s a choice that I’m making. But when you’re doing it through a DSO, you’re actually not making that choice. You’re giving that up without realizing what you’re really sacrificing. And this is where I feel so bad for dentists. I actually have family members who’ve done this and are now starting over. And they thought that this was gonna be generational wealth for them to be able to sell to a DSO. And they’re literally starting from scratch now. Brand new practice have gone through almost all the money they were given, not because they were overspending, but because it just didn’t really pan out to be what they were told. That’s not how it really goes. And I think that this DSO model is starting to crumble because it’s not really supported by truth and by reality. And it’s possible to create a situation in your own practice that is.

Matt Mulcock: Yep.

Michelle Jorgensen: And when I talk about, know, so somebody may say, well, why do you even want to keep the seeds if you’re giving them away, if you’re giving away the harvest? Well, what we do is we have set aside a, it’s called a guaranteed, basically a guaranteed salary for my partner and I, we’ve decided amongst the two of us what that amount is. And that guaranteed amount is divided in 12. Well, the hope is, and we often do make more money than that. So our guarantee is covered and I make like one fourth of that now if I only do four of the things, but I still make 50 % of anything above and beyond that guarantee. Does that make sense?

Matt Mulcock: Yep, yep, definitely. Yeah, I love this. And again, to that question of anyone said, why would you give up the harvest and not the seeds? You just highlighted it perfectly because you can multiply the seeds. And when you’re paying, let’s say in your example, a controller to offload that with some harvest, generally, if you keep growing that harvest becomes the percentage of harvest you’re giving is smaller and smaller and smaller compared to the seeds you retain. I love. Yeah, which, yeah.

Michelle Jorgensen: And if he does his job, which he should, the reason I’m asking him, if he does his job, that’s what’s gonna happen is what’s left over after we pay that guarantee is gonna be more.

Matt Mulcock: Yeah. Yeah, exactly. Well, and I think the other part of this, too, Michelle, to highlight is when we talk about capital and we talk about this trade off you’re making, money is only one piece of capital. It’s also your time. It’s your energy. It’s your attention. Your sanity. Yeah, there’s a lot of things you’re gaining with this trade off as well. So I think that’s really really critical piece. I love the way you’re framing this. I’m curious from your perspective, ⁓ when I hear you go through this, what’s going off in my head is, wow, the ability to delegate has like you’ve cultivated this skill of delegation. How have you cultivated that? What mistakes that maybe you come across or that you’ve made and how would you recommend or how would you? Advise a dentist to cultivate a skill of delegation. Because I’d imagine that’s a big challenge here when you’re doing this.

Michelle Jorgensen: You have to learn how to do it right, first of all. So usually we think of delegation as telling somebody else to do something. But that’s just, that’s not even truth. Like that’s not even what you do. You first of all have to decide what it is and you have to decide the target for that thing. So let’s say, well, let’s use an example that was reality today. I got an email and my partner was talking about another situation, but she said, I am putting out the fire of the surgery schedule. Right now, that’s the fire. So in past Michelle life, I would have instantly gotten on and started emailing everybody I could think of, well, we need to do this and we need to do this and how about this team member and how about this and how about all, you know, all of these kinds of things. But I didn’t do that today. And the reason I didn’t do that is because we have set a target for what our surgery schedule should look like. Surgery manager knows this surgery front team member knows this. We also have done training. We just literally did a full two day training for our team, which we are doing this for other teams. If other teams want to come do this, we did a full two day training for our team and helping them to be able to help people say yes to care, be able to say yes to treatment. So they have the tools now to do it. They have the targets. So if they’re not meeting it, we do something called going to see. So first of all, usually often when we delegate, we don’t give anybody a target. We just say, hey, we just need you to take care of the schedule now. What’s the target? You need to tell them what the target is. How do they know if they’re winning? How know if they’re actually doing the job? that’s problem number one. Step number one is you have to give a target for whatever you’re delegating for. Step number two is you have to go see. What does go see mean? Literally, go see. So now if the surgery schedule, if we have holes in the surgery schedule, what does my partner do?

Matt Mulcock: Yeah.

Michelle Jorgensen: She goes to see, she goes and she sits down right next to the surgery schedule and says, can you show me what’s happening? Like, what are you finding? What are patients saying? What are, know, she listens, she listens to the phone calls and she says, are you saying that word? Like, one of my favorites is, ⁓ I’m just calling to confirm your appointment. my gosh, it’s the worst line you could ever say on the phone call. I’m just calling to confirm your appointment. First of all, just. You’ve just made it sound so not important, right? And then call and confirm. No, no, no. Their appointment’s already confirmed. They’re on our books. I am calling because we are so excited to see you tomorrow for your appointment. Can you hear the difference? So we go see, we go sit next to them and we listen and we say, whoa, whoa, whoa, what did you just do on that phone call? We don’t say it meanly. You know, we don’t say it mean. Sometimes I say it a little more mean than other people, but cause that’s just, that’s just the way I am. But, um,

Matt Mulcock: Yeah.

Michelle Jorgensen: Like, ooh, let’s reverse just a little bit. Remember what we talked about at that training, you know, last month. Just is not a word we ever use because you’ve minimized, you’ve minimized everything that comes out of your mouth after that word is used. And their appointment’s already confirmed. They already made it. You’re just excited to see them. If they say, I’m not going to be able to make it, you say, my gosh, are you okay? Like, is your family sick? Like what is going on? You act like you are shocked.

Matt Mulcock: Yeah.

Michelle Jorgensen: That they would ever not come to their appointment. That’s what we go see. They go see what is missing about that because they know their target. We’ve given them training. Now we go see why things and we’re supporting them. gosh, now I see what the problem is. Absolutely. You need another computer or whatever it might be so that we’re actually supporting. So delegation is all about you deciding what it is that you want, communicating that to somebody and then making sure they know that they have the support, whether it be the training or you’re just there with them to help them with that thing. Because if you just tell somebody to go do something and you never ask them about it again, you’ve just told them it’s not actually important.

Matt Mulcock: Yeah.

Michelle Jorgensen: That’s what most people do. That’s most of us how we delegate. And this is how, this is what I learned from my business coach, not my dentist coach, my business coach, because this is business. This isn’t dentistry, this is business. It’s separate, it’s different.

Matt Mulcock: Yeah. And we’ve seen this so many times. like you said, this different mindset of even even the dentist owner who doesn’t have associates putting in their mind, I am a clinician. I’m also a business owner and everything you’re highlighting. That’s why I think it’s a really good point to say getting mentorship even outside of dentistry a lot of times can give you a different perspective because even I’m imagining, you know, we see consultants talking about within dentistry, they’re going to kind of come through that lens of maybe helping you clinically, but not with the things that you’re highlighting on the business side, communication, delegation, all this.

Michelle Jorgensen: Teach you how to like file insurance claims and how to you know ask for fluoride treatments that’s not what you do and I will tell any dentist that’s listening to this if you own a practice and you despise the ownership duties you shouldn’t own a practice anymore you should sell your practice and go and be a clinical partner for somebody else like literally why do we think that that’s the only way that that’s like the pinnacle of achievement that that’s the only real way to be a real dentist is do you own a practice really

Matt Mulcock: Yeah. Yeah.

Michelle Jorgensen: Dentistry is about doing your P and L and about marketing. No, it’s not. Dentistry is about crown margins. It’s about, know, like that’s what dentistry is about. So if you just want to be a dentist, go be a dentist. Like I said, that’s why lot of my associates are previous owners. They want to be a dentist. They don’t want to deal with the HR junk and the marketing and the facilities and whatever. They don’t want to do it. There is no, that is not a lesser role. In fact, I love my clinical partners and I could not do what I do.

Matt Mulcock: Yeah. Yeah.

Michelle Jorgensen: Unless they do what they do. So that is not a lesser role. If you just love clinical dentistry, then go just be a clinical partner for somebody.

Matt Mulcock: Yeah. Yeah, that’s a great point. And I think that’s maybe where coming back to what you said earlier, where a lot of DSOs are push on for a while is like, well, hey, we’ll offload this for you and you can just be an associate and, you know, do the clinical work. But to your point, that’s very rarely how it goes in a lot of these situations. But I’m with you. There’s nothing wrong with saying I want to be a dentist and I don’t want to be a business owner. There’s nothing wrong with that at all. And speaking of that, so we’ve got our summit coming up. You’re going to be a part of it again. We’re so excited to have you again speaking on our panel. ⁓ The theme this year being practice on your terms. I know very few people in my life in dentistry that have embodied that more than you of just doing it on your terms, obviously hard earned through stakes and, you know, suffering and pain and struggle. ⁓ but when you talk about there’s nothing wrong with being a dentist and not being a practice owner, I think of that, like do it on your terms. What does that mean to you? This idea of practicing on your terms and things, the lessons that you’ve learned with that.

Michelle Jorgensen: You know, I think it’s being okay with… with not being happy and figuring out why. So there’s nothing that you have to do. There’s nowhere you are stuck. And today I was a little frustrated honestly by the email that said, the surgery and instinctively, I just went into fix it mode and I backed myself out and I said, no, you have created a system that will care for that without you. Leave it alone because that… It ruined like a half an hour today. And I was like, really? Did I want to lose? Did I want to ruin that half an hour? Was it worth it? No, because I have created a system that that allowed that takes care of that without me having to do it now. So the hardest part of all of this. Is deciding. That’s it. The hardest part is decide if you’re not happy.

Matt Mulcock: Yeah.

Michelle Jorgensen: Then you need to decide what will make you happy. And I do not believe that there is ever a I can’t. Just on this trip, I told my husband, said, you know what? I want to take a train all the way through Europe for like three or four weeks. And then the next day I looked at him again and I said, so we’re going to next June, we’re going to take a trip for three or four weeks on a train through Europe.

Matt Mulcock: It’s amazing.

Michelle Jorgensen: Because I decided that is the hardest part. And I don’t ever want anybody to say I can’t because I’m a dentist. That’s incorrect. There is always a way once you decide. So if you’re unhappy doing what you’re doing now, then you need to decide what it is that you want to do and find a way to get that. It’s the decision. I’ve done this over and over and over again. I wrote a book last year. I decided the day that the book released with It was the last day I was going to do clinical dentistry. I actually beat it by four days. The last day I did it was four days before the book released. I then said December, 2025 is the last day I’m going to be doing. And I listed out these managerial duties. It was the last day I did it. You have to decide. And that’s the hardest part. So allow yourself to decide. What does it mean to practice your own terms?

Matt Mulcock: It’s amazing. I love that. I love that decide. then the other thing that you that you embody is deciding and then putting action behind it and not looking back and being OK with it. I wouldn’t even say wrong, but it not working out being OK with that and learning from it and then making another decision on top of that. I love that. I love that perspective. ⁓ Michelle, how so? people out there listening. You’ve mentioned a couple of times. So you’ve talked about your book, which I told you right before. It’s right right next to me. Living Well with Michelle. Dr. Michelle, check it out. ⁓ But you’ve you’ve mentioned earlier in this discussion ways that you’re helping dentists out there who are struggling with partnerships or bringing on an associate or leadership. What are ways that people can get involved with you, get help on these on these fronts? All the things you’re highlighting.

Michelle Jorgensen: Yep. It’s so funny because you know, I’ve had this conversation. remember last year I said, I just don’t like coaching. And you said, it’s really too bad because I think you’d be pretty good at it.

Matt Mulcock: You are. Yes. Here we are.

Michelle Jorgensen: So I’ve given in and we’re doing coaching, but no, actually it’s quite delightful and I’m loving it. And we are mentoring offices and mentoring doctors and being business owners, taking all the things that we’ve learned with all the bumps and bruises along the way and short-cutting the way to it. So it’s called living well professionals. If you want to learn how to live well in your practice, how to actually decide what it is that you want to do, and then a path to get there, livingwellprofessionals.com. Go check that out. We actually have a course coming up in April. If you check that out, if you’re interested in coming to Utah in April, it is all about new patient acquisition. So how do you find new patients in a different way than other people are telling you on the dental marketing things and partnerships and associates? How do you structure these agreements so that their clinical partners, business partners, all of that, we are gonna walk you through it, handhold you through the entire process. And if you just want to know more about the dentistry that we do and even just have us, know, mentor you through that business and dental aspect as well, it’s all there. Living Well Professionals, the book LivingWellWithDrMichelle.com as well as dental products. That’s a whole nother life I live. So check both of those out. But we would love to help anybody. I’m always I’m always up for giving you a piece of advice and telling you, you know, resource and a place to find some help. And I’m happy to help.

Matt Mulcock: Yeah. Every time we talk, you know, you and I and Steve talk multiple times a year. And every time I talk, we talk. There’s something else that you’re working on. think it’s amazing. But you said something so interesting to start ⁓ to answer this question. And you’re totally right. In our last conversation, you mentioned and you were pretty like adamant about it, like I don’t want to be coaching or mentoring. And I told you after and in subsequent conversations, I’m like, I think you’d be really good at this. But I think there’s a lesson there too, that you’re highlighting of you. There are certain situations that they’re probably Dentist out there thinking, ⁓ I don’t want to do that. Or I don’t want to grow my business or I don’t want a lifestyle practice. want to grow whatever, whatever that thing is that you think a lot of times you’re again, an example of this that you may not know until you go try it. And now I’m seeing you thrive and build out this whole other side of your business and mentor and coaching. And I think you’re really enjoying it, but you, you wouldn’t, you didn’t think that a year ago.

Michelle Jorgensen: Yep, yep, we kind of tiptoed in and said, right, but you know what? I did it on my own terms though, too. I’m doing coaching, mentoring on my own terms. It’s not taking over my life. There are ways that I knew it was gonna work and ways that I knew it wasn’t. And so I was very selective. I am very selective about those that I help and the way that I help them because I only want it to be effective.

Matt Mulcock: Yeah.

Michelle Jorgensen: And I want them to actually see results because like I said, my mission is to help more people live well. So I just want those results to be there for the people that I help. And I see that there’s to do that. And there’s ways that just waste a lot of money. And I’m not about that. So.

Matt Mulcock: Yeah. Yeah, well, so great, Michelle. I want to give you final word here on everything we’ve talked about, whether it be partnerships, associate leadership, practicing on your terms, this whole discussion, any other kind of like final summary words of wisdom you would add to the to the dentist out there listening.

Michelle Jorgensen: I’ve been in dentistry now 28 years, believe this year. 29 years. Wow, I am getting old. ⁓ There have been a lot of changes in those years and I certainly have not done everything right as I’ve gone along. But the thing that I’ve always stayed true to is that it’s worth changing to get something better. If there’s a need for change in your life, it’s worth it. And is it going to be hard? Sure. It used to feel like a year was like an eternity to me, but now to say, I’m going to do this, you know, month long train trip next June. I’m like, man, I got a lot of work to do before June, but it’s okay because I’ve decided and it’s something that I want to do. So if you want something different, you’re worth it. It’s possible. There’s ways to do it. You absolutely can have what you want inside of dentistry and there’s all sorts of different ways it can look. Do not believe these people that say it’s only this way and only this way and only if you have this kind of practice and practice this way and own this much that that’s the right way to do it because that is not true. There are so many different ways to do dentistry the right way and really only you know what that way is.

Matt Mulcock: So great, Michelle. ⁓ Every time we speak, think, man, we could go for another hour. And so I want to bring you back. But so appreciative of your knowledge, your wisdom. So you’re so open about sharing the mistakes you’ve made and the journey you’ve been on. And it’s just so valuable for the dentist out there listening. ⁓ Like I said in our last conversation, I shared that I’ve shared that podcast so many times.

Michelle Jorgensen: Yep.

Matt Mulcock: And I know this is going to be the same way. And we’re so excited to have you at the summit. So one final time, living, livingwellprofessionals.com.

Michelle Jorgensen: Yep, Living Well Professionals, come check it out.

Matt Mulcock: Yeah, check it out. again, you’ll be at the summit in June, the Dentist Money Summit speaking on the panel. If you’re out there listening and want to get face to face with Dr. Michelle, highly recommend it. If you think she’s great on a podcast, you may need to meet her in person and come to the summit and listen to her words of wisdom. So, ⁓ Michelle, again, thank you so much for being here. Go enjoy with Steve the Scottish Highlands now and stop working. Really appreciate you being here.

Michelle Jorgensen: Yes.

Matt Mulcock: Everyone, thank you so much for listening. Till next time. Bye bye.

Keywords: dentistry, leadership, partnerships, delegation, holistic health, practice growth, dental business, associate management, practice on your terms

Practice Management