Mastering the Growth Game with Dr. Richard Low – Episode #471

Your heart and soul go into starting up a practice, but as success comes and your energy wanes, do you really need to keep pursuing more growth? On this Dentist Money Show, Ryan talks with Dr. Richard Low, of Shared Practices, about his entrepreneurial journey and why he believes one large practice provides most dentists with more fulfillment, problems, and money than they know what to do with.

 

Show Notes
Shared Practices
Dental Moneyball

DentistMoneySummit
Richard will be a featured speaker at the upcoming Dentist Money Summit, June 20-22, 2024.

 

 

 

 

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Podcast Transcript

[music]

Ryan Isaac:
Hey, everybody. Welcome back to another glorious episode of the Dentist Money Show, brought to you by Dentist Advisors, a no commission fiduciary, comprehensive financial advisor only for dentists all over the country. Check this out, dentistadvisors.com. Today on the show, old friend of the show, Richard Low from Shared Practices, we are discussing a topic that is very interesting to me, and a lot of our audience and clients, which is growth and scale, the pros and cons, the good, bad, the ugly. We ask a lot of questions about how his Shared Practices journey went, things he loved in the early days, things he hated about the early days, things he loves and hates about the growth and the scale days, how he would do things differently, and advice he would give to young dentists thinking about growing or scaling your business. He gives some very specific advice that I thought was spot on. Thanks Richard, for doing this. It was very, very helpful to our audience. And if you have any questions for us, you can go to dentistadvisors.com and book a three consultation anytime. We’d love to chat with you and answer your money questions and point you in the right direction. Thanks for being here. Enjoy the show.

Announcer:
Consultant advisor, conduct your own due diligence when making financial decisions. General principles discussed during this program do not constitute personal advice. This program is furnished by dentist advisors or registered investment advisor. This is Dentist Money.

[music]

Ryan Isaac:
You are a serial entrepreneur. That’s kind of the topic for today, though, that I kind of want to get into. You are kind of a serial entrepreneur for anyone. Okay, I think this might go out on both of our shows, but just in case someone doesn’t know Richard Low Shared Practices, give us a fast intro.

Dr. Richard Low:
Sure.

Ryan Isaac:
s if you haven’t been on the podcast like five times this year, which I’m happy for. Thanks for being here, by the way.

Dr. Richard Low:
Of course. Thanks for having me. I started a podcast back in 2016 around when you guys started yours, more or less, and about practice ownership, about how to buy and grow the right practice or start the right practice that turned into number one rated dental podcast in the industry. No disrespect to anyone who has less ratings. I’m sorry. [laughter]

Ryan Isaac:
It’s Alright. I’m proud of you. I’m excited for you, and it’s cool.

Dr. Richard Low:
And that turned into a consulting company. And then we also have a book that just came out, Dental Moneyball, which is about how to buy and/or how to grow dental practice. It’s not about buying or acquisitions, it’s about how to grow using analytics. And then we also have a group, Shared Practices group, chain of denture and implant practices. We opened 20 offices this year, which it’s like having 20 kids in a year.

Ryan Isaac:
Oh my gosh.

Dr. Richard Low:
It’s easy. You just do it.

Ryan Isaac:
That’s so much, man. Okay. And I texted you a few weeks ago, and which by the way, we have shared anniversaries today. We’re both like podcasting on our anniversary. Are you okay with that? Like, is the wife okay with you doing that today?

Dr. Richard Low:
We went to Cabo earlier this month. It’s our 15 year wedding anniversary today.

Ryan Isaac:
Exactly. Cool.

Dr. Richard Low:
But we kind of already celebrated it because right the week before Christmas is kind of a crappy anniversary date.

Ryan Isaac:
It’s insane. It’s insane.

Dr. Richard Low:
It sucks.

Ryan Isaac:
I don’t like it, man.

Dr. Richard Low:
At all.

Ryan Isaac:
My wife’s birthday is also a week before Valentine’s Day or a week after, and so it’s just, I don’t like… I wish they were more spread out. This is tough. I’m also not a fan of… Okay. This is like probably annoying to hear for some people. I’m not a fan of celebrating things just because it’s the day on the calendar that says you have to celebrate. I like to do things when they feel celebratory.

Dr. Richard Low:
Yeah.

Ryan Isaac:
Like maybe two weeks ago in Cabo felt way more celebratory than some random cold day in the middle of December, a week before Christmas. And you’re like, I guess we have to go out tonight. Like, no, let’s go when we feel like it, and call it the anniversary celebration.

Dr. Richard Low:
The nice part, if you do it ahead of time, then when it gets to the actual day, you’re like, no, we crushed it. We did it. But if you…

Ryan Isaac:
We crushed.

Dr. Richard Low:
Pushed it back, then you’re like, Oh crap, we should probably go out today. But despite all that, I still have the calendar reminder. It’s like, Okay, flowers, chocolates, card, and a present. And like, if I just do that, then, I’m never wrong…

Ryan Isaac:
It’s most of it. Okay.

Dr. Richard Low:
On birthday anniversary, Valentine’s Day, that’s just the formula. That’s what we do.

Ryan Isaac:
I was just thinking if you push it back and celebrate, like we’ll do it later, you’re in like a little bit of celebration debt.

Dr. Richard Low:
Yes.

Ryan Isaac:
And you owe yourself and you’re significantly…

Dr. Richard Low:
You’re behind the curve.

Ryan Isaac:
You’re behind. And that doesn’t feel good. Okay. So anyway, a few weeks ago I texted you and I said, Hey I’ve been thinking a lot about this. Maybe just the trade-offs that happen along the many, many grinding years of scaling and growing a business. Dentist Advisors started by Reese Harper. I joined him like right after that in 2007, and we’re like 16 years into this thing. And just like you who started something from the scratch a long time ago, and has grown it like huge and still growing like really fast, there’s so many things you witness along the way that you get to see along the way. There’s so many things in the early years that you have no resources in the early years. Like, you have, like I think back to what we were doing for clients, and the most we could offer them was, we will spend more time with you than anyone else in our industry is gonna spend with you. Any financial. We’ll sit down for hours and hours and hours and talk to you. That’s like a Reese Harper trademark.

Dr. Richard Low:
Which if in case people don’t know, the way to make money as a financial advisor is have…

Ryan Isaac:
Is not do that.

Dr. Richard Low:
It’s the same as a marketing company. You want as many clients as possible, and you wanna spend the least amount of time with them possible.

Ryan Isaac:
Yeah, we did it opposite. Yeah.

Dr. Richard Low:
And then also make recommendations that happen to benefit you as a byproduct.

Ryan Isaac:
They’ll pay you.

Dr. Richard Low:
So that’s the way to do it, if you want to crush it. And so you guys were like, no, we’re not gonna do that. We’re not gonna make…

Ryan Isaac:
We’re like, we don’t wanna make money.

Dr. Richard Low:
More money.

Ryan Isaac:
Per se. We just want to like be really helpful. Honestly, though, I was just talking to Reese this morning, and that’s one of his superpowers is being able to spend time with people, educating them in ways that I’m not even sure they probably wanted to be when it started, but really ends up being really important.

Dr. Richard Low:
Yeah.

Ryan Isaac:
So the early years, I just think about that. That’s all we had. It was a willingness to sit and educate and talk and spend time and be proactive where a lot of our industry doesn’t, because that’s not how you make money in our industry. But we had no technology and no marketing and no podcast and no Instagram. And like, we had nothing. I don’t even think our, I don’t even think we are called dentist advisors officially yet at that point.

Dr. Richard Low:
Right.

Ryan Isaac:
But there’s so many… So there’s like the… But I have a lot of fond memories for that.

Dr. Richard Low:
Yeah, I love that phase.

Ryan Isaac:
There’s simplicity. You’re like four people. Scrappy.

Dr. Richard Low:
You have like Scrappiness. Excitement, the potential…

Ryan Isaac:
Yes. Okay. So I wanna pause there before we like go all the way to the end. Can you reminisce a little bit on what that early year was like? And just for everyone listening the whole point of this, I wanna do this with several people that have scaled larger businesses over the years. I’m just really curious on how that’s been for people. The dream is to grow, to grow something, to scale something, but there’s a lot of trade-offs along the way, and I just wanna have a conversation about it. So your early years look like what?

Dr. Richard Low:
I was in the Army. I had done the Army HPSP scholarship. I was a year out from dental school, and had had a lot of conversations with like Alan Mead, I talked with Mark Costas, who was a friend, and then I had actually produced Howard Fran’s podcast. And they encouraged me to start a podcast. And I’m like, I’m a year out from dental school, who wants to hear a new grad who’s still stuck in the Army for five years podcast about practice management? But I was listening to a podcast at the time that was all about building an online business, and being a leading learner. So it’s like, how can you learn things and then turn around and help someone who’s just like a few steps behind you, but because the problems and the challenges are still fresh and present for you, you really care a lot. So and for me, the problems and challenges were I don’t want to get out of the army and buy a bad practice and not scale and not know how to be a business entrepreneur. I had a business entrepreneur. It’s the best kind of entrepreneur.

Ryan Isaac:
It’s like the business kind, as opposed to the other kind, which we won’t name right now, but…

Dr. Richard Low:
Yeah, we won’t, yeah.

Ryan Isaac:
Yeah, yeah, yeah. We won’t talk about it.

[overlapping conversation]

Dr. Richard Low:
I had five years until I was gonna get out of the army, and all I had was a bunch of angst and time, and I was like, maybe if I interview people who know what they’re talking about and know what they’re doing, all learn, and then anyone else who happens to be listening will learn as well. But like, it was very much of a commitment to be vulnerable and open and real, but also, like you talked about you and Reese, how can we make this the best possible resource for someone in this exact position who wants to buy and grow and scale a practice despite industry pressures, student loan debt in current times for free. Like how can we give away the absolute most? And I was in residency in the Army two year AEGD residency. We had two small kids. I would come home from like long hours in residency and then I’d disappear in my closet to like podcast, and I’d have to wake up at 4:00 AM to edit because like, that was the only like slot of time that I could carve out.

Ryan Isaac:
Yeah, you were the in-house editor. Yeah.

Dr. Richard Low:
I was the editor. Like Adobe Audition and I are good friends, and it scrubbed all of the ums out of my first episodes and stuff like that. So I loved those years, and the early years of like partnering up, like the first year was me by myself, and then bringing on George as a partner, because realizing I couldn’t take this where it needed to go. I was tapped out. I was getting some ultimatums from my wife at home about like, Hey, your priorities are not straight. You gotta figure this out, otherwise there’s gonna be a problem. And then bringing on another visionary that had more vision than even I did, and that’s what’s amazing. It’s like you and Reese and it’s like this partnership where you both can see what’s possible. You’re both very committed to giving and serving and building the best solution, and you believe so much in that mission.

Dr. Richard Low:
Literally, the thought was if I’m podcasting in five years and no one’s listening, then I’ll just like shut it down, but I’m committed to making the best possible resource for free for dentists around these topics of entrepreneurialism. We’re committed to sharing our journey, being vulnerable and like the warts and all approach of pure content, pure quality. Here’s the reality of it. And that was like an amazing drive and fire in my belly that allowed me to be full-time in the army and like keep the army overlords happy, while at the same time, pursuing this passion on the side. And I loved it. I loved that period of time, and it wasn’t a burden to be like all consumed by the business, because it’s like what I wanted, my heart and soul was in it at all times. And there was a point where that shifted, where that like was no longer the feeling, because of just it’s like only for so long can you be super excited about something new and then it’s no longer new at some point.

Ryan Isaac:
Yeah, the 12 hour days. The midnight end times, the early mornings. It is when you… Maybe it’s an age thing. Maybe it’s like a phase of life like you do, there’s just a different energy for it, but you can handle it. I couldn’t do that now.

Dr. Richard Low:
Yeah. No, and like, nor would you want to. And people talk about balance and I remember we were sitting with a therapist and him talking about like finding balance. I was like, I’ve never had any balance. Like, this was a thing I pursued in my 20s. This was like, I just need to find the right solution for my life, and then I’m gonna have balance. And then I’ve just realized like, no, I’m just extremely unbalanced in particular directions for periods of time. And somehow it works out because I don’t completely drop the things that really matter, but I’ve never been balanced. So this form of like your heart and soul is in a business, is in an idea that you know has potential, creates this like, unbalanced energy that you get high off of. It is a driver of performance and success and ambition because you really, in your heart and soul believe in it, and it’s intoxicating. I loved it.

Dr. Richard Low:
Yeah. It’s the fuel that keeps you going. I’m curious, can you remember what you… Do you remember like what you thought you wanted when you were young in the business and growing it? And like, do you remember what you thought the hopes and dreams were, like, where it was headed?

Dr. Richard Low:
Yeah. I mean, there’s actually a board in my basement right now. It’s a… If you go to Home Depot or Lowe’s, you can buy a shower board that is, it looks like a whiteboard, and it functions like a whiteboard, but it’s just a whole lot cheaper, because I was cheap at the time.

Ryan Isaac:
Oh I did that in a garage once for when I started doing like garage workouts. I bought… Like, they filled up my whole garage wall and I’d like write my workouts like it was in the gym or something.

Dr. Richard Low:
Exactly.

Ryan Isaac:
Yeah, I know what you’re talking about. I bought that. I paid $20 a sheet, and screw them on there. Yeah.

Dr. Richard Low:
Yeah, I was in a manic goal setting phase at the time and I went and bought this whiteboard and I wrote down a bunch of goals and personal goals and professional goals. And then I wrote down this like ladder, this value ladder of like, okay, the podcast free, and then we’ll have these eBooks and then we’ll have like an actual book and then we’ll have online courses, and we’ll have in-person courses, and then we’ll have coaching and like mastermind. And here’s like the vision of what we’re gonna build. And like that was it, but it was also just this underlying sense of like, I want to unlock the potential for me to earn more and have more freedom, and be able to help and serve people and have these amazing conversations. But I wasn’t that good at like, knowing what I really wanted. I think it was like a vague sense of like, I want this to work and reach people and be successful. And if it weren’t for George, I’d just have like five podcasts and no revenue and like…

Ryan Isaac:
Yeah. I’d still be working a lot. That’s fine.

Dr. Richard Low:
Yeah. I’m so grateful for George and then Matt Guarino and then all of our other partners that we’ve added since then who’ve actually like, been good at building a business and not just good at aggregating an audience via a podcast. ‘Cause that was the thing that I was really good at, which was like very top of the funnel. How can we serve an audience and gain trust in the industry and never betray that trust? And it was really easy for us, because we had seasons and we could tell people, No, don’t come on the podcast, ’cause this isn’t a relevant season. So we could turn away like, people who were trying to peddle their own stuff or like have their own agenda. And we realized real quickly that as we gain that trust, people would take our recommendations and buy stuff. And so if we sold out to a sponsor who then…

Ryan Isaac:
Totally.

Dr. Richard Low:
Will kind of end up being crappy for people, that would burn us real quick. And the dental industry is so small, you lose that kind of trust or reputation, it’s so hard to get it back. And so that was… I think the thing that we figured out very quickly was how to provide this journey in this education and build that trust for people.

Ryan Isaac:
Do you remember milestones along the way? Was there anything that hit you that was like, made you realize you were growing, that you were hitting some of these things maybe very tangible, or do you just remember any moments along the way that made you realize that you were actually growing, it was working?

Dr. Richard Low:
Yeah. The first time that my wife met someone who had listened to the podcast when I wasn’t around, and they were like, it was a New Dallas student…

Ryan Isaac:
We know Richard.

Dr. Richard Low:
Who had just graduated and they’d driven to Fort Hood, Texas from Arizona. And they’re like, Oh my goodness, your husband is Richard Low. Like, we listened to Shared Practices the whole way here. And she was kind of like, Oh, I really haven’t listened to it. And they were like…

Ryan Isaac:
Like, that’s weird.

Dr. Richard Low:
Like they were confused. But I also think back to when Dr. Matt Guarino joined us. We set goals, and we did the EOS like one year, three year, and five or 10 year goal. And I think our… I can’t remember if our one year or our three year goal was a million in revenue, and then our 10 year goal was 10 million in revenue. And that just felt so ridiculous to me.

Ryan Isaac:
Yeah. Insane, right?

Dr. Richard Low:
Yes, just bumpers.

Ryan Isaac:
Why are we even putting this? Yeah, so dumb.

Dr. Richard Low:
Like really guys, are we really gonna… And we just went through the process this Tuesday of like, Okay, what is our collections goal, and our overall goal for next year? And it’s like, Oh, we’ve… As a group of 35 dental practices, like we’ve far exceeded that 10 year goal. It’s definitely not been 10 years. And we hit that 1 million goal, and I can’t remember if it was a year or three years how close we were. But hitting that million dollar mark of the first time, it was like, holy cow. Like at this current rate of our coaching clients and what we’re offering and our courses, like, we’re a million dollar a year company. Like that was a huge deal.

Ryan Isaac:
Crazy. Yeah, that’s insane. That reminds me of one of our first goals when it was just Reese and I. I think in the early days we would bring on like one dentist a month, new client, ’cause him and I would like drive to their office and like sit in their office all day long and do free work all the time. I don’t know what we were doing. But then I remember we hired who’s still with us, Justin Copier. And he was just a really smart numbers person, and can project numbers and performance and business goals and metrics out. And I remember him saying, I think we’ll get to a point we’ll hit 10 new clients a month onboarding. I just remember thinking there’s no possible way…

Dr. Richard Low:
World where that exists.

Ryan Isaac:
Yeah. And at the time, our company was still mostly, we started in Utah, so at the time, and this is pre-podcast and pre-Zoom and people just… You just work with a financial advisor in your city. That’s it. So I was just like, there, where are we gonna find 10 people to join us every month in Utah?

Ryan Isaac:
Except there’s a lot of dentists here, but I don’t think 10 people are saying yes. And it’s so funny when you set those goals and then one day you look back, you’re like, oh, we’re doing that. And that couldn’t have seemed like a more impossible goal. Couldn’t have seemed more impossible. Insane. Stupid, a little annoying that someone would even throw that out as a thing to think about.

Dr. Richard Low:
That’s what the 10 million in 10 years felt like. Like, really guys?

Ryan Isaac:
Who said this? Get him out of here.

Dr. Richard Low:
Yeah. Matt and George. Okay. I’ll play along. Let’s write this number down, but I don’t believe it.

Ryan Isaac:
Yeah. And, okay. So these are just things that are on my mind. So another question I’m curious about is, do you remember some of the first times as the growth was happening that you realized that maybe something had been left behind or lacking or you weren’t doing as well, or maybe just not even enjoying the same as you achieved the growth? Can you think about some of those things?

Dr. Richard Low:
It’s funny, I have a lot more recent DSO fresh experiences of where we’ve dropped the ball. The thing, I feel like as we scaled the podcast, our online education, our in-person education, I think maybe our mastermind was the first area where we built something amazing, but as we tried to scale it, it wasn’t scaling. It was like we were adding more dentists, and the original dentist who had been part of the mastermind were part of these really engaged pods. And it was like, they were meeting, they were all in. And then as we were adding more people, we were adding them to both the coaching and the mastermind. And some of ’em were just like, I’m really here for the coaching, and they weren’t participating in the mastermind. And stuff was breaking down. And it was like, crap, what do we do? The way we’ve structured this doesn’t really scale the same way that we had hoped it would. And then you’ve got mismatched expectations and people not getting out of the social mastermind side as much as they were hoping they would because the other people in their little pod aren’t participating.

Ryan Isaac:
Yeah. Yeah.

Dr. Richard Low:
And that was like a, oh crap. Not only are we struggling to deliver here, but we’ve also built the structure of this in a way that doesn’t scale well and what do we do about it? And it took a long time to even answer that question. And then there was people that were frustrated in the mastermind in the meantime as we were trying to explore that answer, there’s people who were frustrated within our company that were helping us administer all of that. So that’s one of the early examples, I think, where our scale started to feel like, ugh, like… Running across from something.

Ryan Isaac:
You’re sacrificing something.

Dr. Richard Low:
Yeah. We’re not overdelivering, we felt very strongly about overdelivering like you guys did of spending excess time with clients. It’s like we were trying to make sure that no one ever felt like they weren’t receiving the best experience and the most education possible.

Ryan Isaac:
That’s an interesting point, over delivering. That’s probably just something we’re all guilty of when we start businesses, because we don’t have anything else to do. Really. Do you think, I mean, do you believe that, is that a common thing you think a lot of young people do, young dentists do that too?

Dr. Richard Low:
I think so. I think young dentists probably, like when they’re a practice owner for the first time, they really want to overdeliver for their team and their patients. But I think there’s something healthy that comes out of that. There’s an unhealthiness of lack of scale that comes out of overdelivering, but I would rather come from the side of overdelivering and scale that back to barely overdelivering versus massively overdelivering, rather than start with underdelivering from day one, and then your reputation is shot. People don’t trust you. You don’t have momentum. So that overdelivering, the thing that it does is it builds the flywheel of people who will say really good things about you. So I think it’s a great place to start from. And usually you have more time than resources. So that’s one way that you can use that time. And then as you have more patients, more clients, more responsibilities, you have less time and more resources, and you can figure out, Okay, what is the 80 to 90% version of this that we can scale? And that’s hard for me. I’m a perfectionist. I have a really hard time letting go of the overdelivering.

Ryan Isaac:
What’s something you miss from the early days?

Dr. Richard Low:
I think I miss… One of the hardest things for me to give up was interviewing other people who have stuff that’s competing with what we do. So we do a lot of coaching and practice management consulting. And at first we were not the experts, and after five years of podcasting about this, coaching clients like data, we all of a sudden were the experts. And it felt weird and trite to be asking people the same kind of questions we were asking early on of, they have their own coaching platform and they do practice management, but maybe their philosophy is different than ours. But I really like the contrasting philosophies. I like when…

Ryan Isaac:
I like it too.

Dr. Richard Low:
We can talk about something, and maybe I’ll learn something from their perspective even if I don’t completely agree with it. And there came a point where it was like, this is confusing to our message and to the growth of our business by having competing services and people on that directly compete with our business. So that was a hard moment for me was to say, No, we’re going to be the Shared Practices show, not the everybody else show.

Ryan Isaac:
Yeah. That’s tough. And some of that is friendships and networking partners and then…

Dr. Richard Low:
Relationships.

Ryan Isaac:
Yeah. Relationships. People that you go see at a dental event and you’re like, maybe it’s weird at first or something.

Dr. Richard Low:
Yeah. Totally. And some of… Someone in particular, and I don’t think she would mind if I said this, Kira Dent and I were friends from when we were… I was in middle school…

Ryan Isaac:
Oh, yeah. Midwestern.

Dr. Richard Low:
At Midwestern. She was…

Ryan Isaac:
Yeah, yeah. Arizona.

Dr. Richard Low:
In the dispensary handing us out our teeth to cut teeth on.

Ryan Isaac:
Oh yeah.

Dr. Richard Low:
And I got to see…

Ryan Isaac:
I was like, wait, Kira worked in a dispensary in 2009? Not that kind of dispensary though.

Dr. Richard Low:
No.

Ryan Isaac:
Your dental dispensary is different.

Dr. Richard Low:
Pre CBD world.

Ryan Isaac:
Pre CBD. Okay.

Dr. Richard Low:
Yeah.

Ryan Isaac:
That’s cool.

Dr. Richard Low:
I just remember the first time I interviewed her on the podcast and I was like, Holy cow. I’ve never heard someone be able to hold someone accountable with compassion and directness in this way.

Ryan Isaac:
Yeah. She’s good.

Dr. Richard Low:
And I loved her verbiage, her case presentation. I just felt a lot of power out of what she brought to the table. And for a long time, we were coaching dentists, but we weren’t coaching like their team members.

Ryan Isaac:
Oh, yeah. Yeah.

Dr. Richard Low:
So there was this synergy of, Okay, we’ll coach the dentists on the vision and we’ll refer over to Kira for their team. And when we brought on Suzanne Rasi, our director of coaching, and, she’s the genius behind the administration of all of the growth of these practices in our coaching department. We all of a sudden we’re like, Well, no, actually we’re coaching teams now. And so we couldn’t have that same relationship of her coming on the podcast and us referring clients. It just all of a sudden became like, Oh, okay, now we’re doing the same thing.

Ryan Isaac:
Yeah. We’re doing the same thing. It’s weird. We’ve done the same thing. The supplies in our industry, we’ve had close relationships with CPAs that we’ve been mutually referring to for a long time. And then, the CPAs will bring on financial planning and investment management. Even more recently, which is weird that our elements technology that we originally just built as a analytics system for dentists only got spun off into a separate app and tech company. Now some of our competitors buy it. It’s like, I mean, I know how that goes. We’re still friends with them. They still do a great job, but then it’s weird because you’re like, yeah, we didn’t used to play in the same area. Yeah. Now we do. So it’s weird to have them on your content promoting your competitor even though you’re friends now, that is, I feel that actually pretty deeply. How about something you don’t miss from the early days? Probably a long list.

Dr. Richard Low:
Not being able to delegate. I mean, from both as a leader not being good at it, number one. But then number two, not having people with talent that can do stuff better than me. And that was where I had a really hard time for a while as we started to delegate things, like you can DIY pretty well a lot of things, especially if you’re an obsessive ADHD person, you can just dive in and learn it yourself and grassroots it.

Ryan Isaac:
Ask me if I learned how to code one, back in the day. Yeah. Just dive in and learn stuff that you have no business doing or learning or even get really good at, but…

Dr. Richard Low:
Totally. And because you care deeply about the results of it, that leads to a certain level of quality and attention to detail that for a long time I had mental barriers around handing these things off to other people, because I didn’t feel like they either cared as much or that they were better than what we were doing. So I don’t miss being in a space where you can’t afford to hire the talent that can do it better than you and that you’re just too tightly clinging to that overdelivering and how you feel about it to be able to hand stuff off.

Ryan Isaac:
Very true. Yeah. That was tough. I mean, you probably remember the days where you wore like 17 hats in the business. And you shouldn’t have been wearing like 16 of them. I feel that. I feel that. How about nowadays, what do you like more about now? Maybe it’s just the reverse of what you didn’t like before, but what’s something you really love now with a bigger team and more resources and more growth and scale?

Dr. Richard Low:
I love… And I think this has been the thing that’s been the most surprising the whole time. I love the quality of people that keep showing up. So it’s… Of our central team, our Shared Practices coaches, our doctors, our team leads, our team members, the partners that we have, all of these things that have come from the podcast being our DNA and what we’re all about of like, Okay, we’re going to give back, we’re going to serve, we’re going to educate. We care a lot. And we have these core values that we’re trying to actually live and not just be cat posters on the wall. And the who keeps showing up has been the most delightful part of it is it’s like, wow. We have really good, every new hire. It’s like, that’s the other thing with being a fully remote company that I’m really grateful for, is that we get to hire from a nationwide pool. We have a headquarters technically in Scottsdale, and I think mail goes there and we don’t check it.

Ryan Isaac:
Yeah.

Dr. Richard Low:
But we work remotely. And it’s been really cool to just be able to look for the best people anywhere, and it doesn’t matter where they live. And then when we get in person, we got all in person, our central team like a month ago, month and a half…

Ryan Isaac:
Was I there?

Dr. Richard Low:
And… What’s that?

Ryan Isaac:
Was I there, was that the weekend?

Dr. Richard Low:
Yeah, yeah, yeah. I think so.

Ryan Isaac:
I showed up for that. We had tacos in your office.

Dr. Richard Low:
It was awesome.

Ryan Isaac:
Okay. Alright. I did like that.

Dr. Richard Low:
No, actually that wasn’t one of our dentist facing events. This was our group event.

Ryan Isaac:
Just team only. Okay.

Dr. Richard Low:
Yeah. It was just amazing to hear everyone how much what we were doing meant to them. Also how much the flexibility of working from home and the culture that we’ve built in this company and people who are… They’re putting their hearts and souls into this. They’re working long, hard hours, but they also have flexibility to take care of their family or be there for things that they wouldn’t be able to otherwise. It’s just really cool to see that we can build. I’ve been the most skeptical on the two sides of our company. We’ve got the consulting and education side Shared Practices. We’ve got Shared Practices group. On the Shared Practices group side, the thing I’ve said all along is, culture doesn’t scale. And that’s my whole… I was the most skeptical builder of a DSO because I’m like, guys, it’s a silo of the dentist and the office manager and how good of leaders are they?

Dr. Richard Low:
And you really don’t know a lot of times what’s going on behind the doors of that office. And I was very skeptical that we could scale culture. And it’s been amazing to me how much our team leads in particular, our office managers have come back to us and said, This is the best company I’ve ever worked for. I’ve never felt so supported. We’ve had doctors telling us the same thing. I’ve never felt so encouraged, supported, educated. And it’s not perfect. And we dropped the ball, and we’ve scaled a little quickly, it’s fair to say, and we’ve learned some lessons from that this year. But we’ve been able to do that. And I really attribute that a lot to Alex Sharp, he’s… I just stepped down as CEO, he’s our new CEO.

Ryan Isaac:
Oh, I didn’t know that. Shout out to Alex. I got to email him now, he’s my client.

Dr. Richard Low:
Yeah. He’s your client, right?

Ryan Isaac:
Yeah. Yeah, yeah. I’ve known him for a long time. That’s cool.

Dr. Richard Low:
Yeah. So Alex is now the CEO of Shared Practices.

Ryan Isaac:
Did know. Wow. Okay. Alright.

Dr. Richard Low:
Yeah.

Ryan Isaac:
Sir Alex.

Dr. Richard Low:
Yeah, he’s awesome. So, and he really drove the culture. I mean, we saw it at his Sharp Family Dentistry, which is now Cabot Family Dentistry in Arkansas. He built this amazing culture, he put his heart and soul into it for years, and all of a sudden it was this amazing organization and we were like, Okay, that’s the culture that we want for our company as a whole as we scale. And he’s done it. And then, it’s taken a lot of intentionality. A lot of this soft stuff that some people are like, Well, it’s not about numbers, that’s not about these other things, but it’s these core values that we live by, they really matter. And it’s how we run our company. And Alex was the driver behind all of that. So, yeah.

Ryan Isaac:
Cool. I like that, man. I got three more questions for you. Thanks for sharing all that. Thanks for being vulnerable too. I mean, it’s weird asking an entrepreneur who’s very visible and public and very successful, Hey, what sucks in your company right now now? Will you be honest about that?

Dr. Richard Low:
Oh, yeah, yeah, yeah.

Ryan Isaac:
Of course you will.

Dr. Richard Low:
I remember, okay, this is another moment of…

Ryan Isaac:
Okay, Alright.

Dr. Richard Low:
I remember being at one of Mark Costa’s events, and talking with one of the doctors in one of his offices who wasn’t very happy. And there was this dichotomy between, Oh, what this doctor is saying about his current office in this office that Mark owned. And then what was being taught from the event. And I remember thinking when, if I’m ever in a group in scaling, I’m going to be transparent and share my failures and all that. And Mark does that. He owns up to it. They’re like…

Ryan Isaac:
Yeah, sure. Yeah.

Dr. Richard Low:
I’ve screwed up. I’ve learned these things the hard way. And the moment that I owned three practices with some partners, I was too vulnerable on the podcast and it interfered with operations, with team members and my relationship with them. And it got weird real quick and I was like, Oh, you can’t be fully, fully transparent.

Ryan Isaac:
You can’t say everything. You can’t say everything all the time.

Dr. Richard Low:
You cannot. And so, there is a balance to it all. And if you talked with all of our doctors, you would find some that had some things that they could definitely complain about with Shared Practices group at this point, and a lot of doctors who would have a lot of amazing things to complain about or to talk about.

Ryan Isaac:
Yeah. That’s like anything though. You get to a certain size and you’re going to have some fans and some haters and some things you legitimately did wrong and learn from and messed up, and then a lot of amazing things you did along the way. Okay. A few more questions here. Number one would be, it does seem like nowadays, and especially over the, let’s say last five to seven years as private equity and venture capital has been so much more prevalent in the dental industry, not just with DSOs, but you just… We hear this on the side of investments, that growth and scale can sometimes be put on a pedestal. And the thing that you have to do, you should do that is the right way to do a career or a business. You shouldn’t have one location with four or five six chairs and just you and lifestyle practice. You have to get big, you have to scale, you have to grow. Do you have any opinion on that? On people who struggle with that, do you have to, should I…

Dr. Richard Low:
I feel like this is the question that you should have started the episode off with, ’cause this…

Ryan Isaac:
Okay. Alright. Well, the next interview I do on this topic, I’ll start with that one. Alright. Good, good.

Dr. Richard Low:
No, no, it is a completely different conversation, but I think, I actively convince dentists and when I lecture at dental schools, I tell them we’re doing this thing with Shared Practices group. But I think one large practice can provide you with more fulfillment problems and money than you know what to do with.

Ryan Isaac:
Problems and money and fulfillment. Yeah. Yeah. That’s true.

Dr. Richard Low:
Yeah. One large…

Ryan Isaac:
Enough problems in one practice. Yeah. One large practice.

Dr. Richard Low:
In one large practice with two to three doctors.

Ryan Isaac:
What’s large? What would you, okay. What’s large? How would you define…

Dr. Richard Low:
Two to three doctors minimum.

Ryan Isaac:
Okay.

Dr. Richard Low:
So, not a one doctor practice, but you’re at multiple doctors. You’re four to six hygienists. Man, that practice can provide an amazing lifestyle. It can provide your business. I got to meet Tito. You’re not a vodka drinker. Neither am I, so I really hadn’t had…

[overlapping conversation]

Ryan Isaac:
Well, I am actually, I do, but I’m not very well versed on what that even means or who Tito might or might not be.

Dr. Richard Low:
Tito, I didn’t know this either. Tito is the number one, the top sales vodka in the United States.

Ryan Isaac:
Okay that’s the brand or it’s like a dude named Tito that started the vodka?

Dr. Richard Low:
It is both.

Ryan Isaac:
Oh, it’s both.

Dr. Richard Low:
It is the brand and it’s a dude that started it all in Austin Texas. And I got to meet him a few months ago and I had no clue who he was. And I shook his hand and he kicked over a water under the chair and I was sitting right behind him and I was like hey man you kicked your water over.

Ryan Isaac:
Hey dude what are you doing?

Dr. Richard Low:
But so it turns out he’s worth like $7 billion and he’s the sole owner of Tito’s Vodka, and it’s a company that he started from scratch and retained ownership of himself the whole time and now dedicates a large portion of his wealth and revenue to causes that he cares about and also that his employees in his company care about. And I think that control of building an organization you’re passionate about and being able to do things that you feel like matter in the world beyond just your practice or your company is a really cool powerful combo. And unfortunately in dentistry the way to scale by adding multiple locations, you end up losing control of the company at some point. Yeah. It’s sold to private equity it’s sold off in different ways.

Ryan Isaac:
It’s not yours anymore.

Dr. Richard Low:
It’s not yours anymore. And you can’t support different causes and you can’t do all these other things. And all of a sudden someone else is making the decisions that’s not you. And if you’re looking for the way to earn 20 $30 million in dentistry that might be the way you do it. But man dentistry doesn’t scale that well. I don’t know if anyone knows this but it doesn’t really this is not an e-book it’s not… There’s a video game…

Ryan Isaac:
It’s not an app.

Dr. Richard Low:
Stardew Valley that this guy made by himself every aspect of this game and now it’s in my Tesla and it’s like he’s made millions and millions and millions of dollars with this game. It’s like that’s the kind of thing that once you make it it actually scales well. Dentistry is the opposite it’s very technical, it’s very human capital.

Ryan Isaac:
It’s human driven yeah it’s human driven.

Dr. Richard Low:
Human driven and so I think the challenges of scale are often underestimated and the intentions of the people who are doing the scaling I sometimes worry about it. I hear about a lot of the crap that’s going on in the DSO industry. I just I think my challenge to any dentist who wants to scale into a multi-practice organization, I tell them build one large practice first. If you can get to two to three doctors and you still are crazy enough that you want to go do more, make your second practice larger than your first practice.

Ryan Isaac:
Okay.

Dr. Richard Low:
And if you do that the challenge of scaling from like one to nine is that you’re spread thin you don’t have the resources to have the proper infrastructure, you’re in this ugly growth phase. But if you just scale like each one is kind of a silo of like profitability and leadership and culture that is self-sustaining and then you’re crazy enough to go do a second large one, you can then stop and decide hey I’ve got these two beautiful practices that are providing like I said way more problems money and fulfillment than I thought possible. I don’t have to keep going. I think you’ll reach that point. And there’s oftentimes this point of like oh crap we have to keep going because this is way less profitable than running a single practice. And I remember my original partners on my first three practices they’re like, Man running your own practice if you’re trying to make money quickly as a dentist that’s probably the best way to do it. You have to run five to seven to 10 practices to make the same amount of money that you would have made at one if you were the owner operator. And that’s per partner. So then if you’ve got a bunch of partners you need a bunch of locations otherwise why wouldn’t you just go be dentists on your own?

Ryan Isaac:
Yeah that’s such good advice. As the financial advisor in the room I will say that one good practice can retire you with enough wealth just fine. Just fine it’s gonna be okay. Yeah that’s such good advice. And thanks for being so specific because I don’t think people know where to stop and how hard to push. And a lot of that I think has to do with maybe not having the right mentors or examples or having seen it enough or maybe just not having the data about their own lives. They don’t know why they’re pushing. It could be for money or wealth or security or fulfillment and maybe just not understanding themselves very well kind of contributes to that. Two more questions.

Dr. Richard Low:
I have one more point. I know we’re going long. I’m sorry.

Ryan Isaac:
No I don’t care. Let’s go for three hours. I mean it’s just our anniversary.

Dr. Richard Low:
It’s just our anniversary.

Ryan Isaac:
We have nothing else to do.

Dr. Richard Low:
[0:41:31.4] ____ murder us in the room.

Ryan Isaac:
Oh, please go ahead.

Dr. Richard Low:
George’s one of his favorite phrases and this is like the end of Dental Moneyball is anything you want in life nothing off the table. And knowing what you want and being willing to go for that is a challenge, that I think a lot of people get it wrong. And I think it’s okay to get it wrong. It’s okay to think that you want something and go for it and then realize like, Oh okay I guess I didn’t really want that. Or I got there and it didn’t provide the fulfillment that I wanted. I also think that like figuring out what is enough for you is really important. And not overshooting that because the amount of time and energy and stress and stomach lining and like late nights and time away from family that it takes to scale past what your, this is enough for me really is is a lot. That’s your life you can’t get that back. And so if you’ve like overestimated your vision for what you want and it just feels cool or you’re like I just wanna win, I just wanna be the dentist who made more money than the other dentist. There’s a major cost to that and we convince ourselves that it’s like in pursuit of quality of life or so that we can have freedom and so that we can have these things. Like dentistry if you just do one practice well can offer that and you can scale back you can be non-clinical with one large practice. Anyways I can beat this drum all day long.

Ryan Isaac:
We’ll do part two on that exact subject. Well maybe that part of this feeds into my second and last question…

Dr. Richard Low:
The next two questions yeah…

Ryan Isaac:
Which was what would you tell young Richard? What advice would you give young Richard along these lines of scale and growth in building a business?

Dr. Richard Low:
It’s funny because I did the army and in retrospect by the time I got out of the army people had listened to our podcast bought practices made more money paid off debt. You know so there’s like part of me that was like don’t do the army.

Ryan Isaac:
Okay Alright.

Dr. Richard Low:
And I would tell people that when I was recruiting if the reason you’re joining the military is only financial you shouldn’t do the military. You should do it for other reasons. And there’s some financial benefits. But at the same time I wouldn’t have created Shared Practices if it wasn’t for the angst. And I did a two year AG residency and I’m done practicing clinical dentistry as of like the next few months. I’m not seeing patients anymore. And so it’s like that’s two years of my life in this residency but at the same time it opened these doors. I think the biggest thing that I would tell myself is something that I’m currently working on which was the allure of building a business is that it’s this promise of future rewards and you can build habits of self-discipline and pushing yourself to get into dental school to get out of dental school to buy the practice to grow the practice. But there’s this self-discipline in order to be lazy later that was secretly underlying it. And then all of a sudden once I hit the point where it’s like, Oh crap more money isn’t really gonna change my life that much because I’m a cheap date in the Midwest and it’s easy to hit that number in the Midwest.

Dr. Richard Low:
Then my purpose and my discipline and all these things like started to flounder. And I’ve been through kind of a multi-year funk around all of this. And so figuring out like, Okay can I work on being the kind of person, the kind of father, the kind of husband that I want to be for other people and for the discipline in and of itself is providing way more fulfillment now than pursuing a future goal that would allow me to be lazy later. And that’s in the last two months so I don’t know. Ask me in a year from now and I’d tell my past self something different.

Ryan Isaac:
Yeah it’ll be different. Yeah we learned something different. Thanks for sharing that. Yeah it gives me a lot to think about actually. Last question any resources that were really helpful to you along the way in all of this books, podcasts, seminars things that you’ve picked up workshops anything that sticks out?

Dr. Richard Low:
I mean the podcast I listen to that inspired me to start it all their art is on the wall back here you can’t see it because of my camera blurs it out. It’s called The Fizzle Show and one of the things.

Ryan Isaac:
Fizzle Show? I’ve never heard of that.

Dr. Richard Low:
The Fizzle Show.

Ryan Isaac:
Okay cool.

Dr. Richard Low:
Most small businesses fizzle out most online businesses whether it’s a blog or podcast or any of these things they fizzle out. But the thing that I got the most from them was figuring out, Okay the people I’m trying to serve so whether that’s my patients, whether that’s client, whether it’s a listener of a podcast what is their problem and how can I understand that problem and fix that problem better than anyone else? And if you can do that then it solves a lot of the problems of like, I have an idea of a business that I’m gonna go run and start. So they’re framing around the customer journey and who you’re serving and how to build content that really actually solves people’s problems was the core of what allowed things to gain momentum in the first place. So that’s a super random, the show’s not running anymore but you can still go back and listen to the original episodes and I consumed every one of those. So that’s something I loved.

Ryan Isaac:
Cool. Thanks for sharing man. Thanks for spending 47 minutes and three seconds with me today on your anniversary talking about growth and scale. And maybe this is a dumb question. It just came to my mind but would you do it again? Would you do it all over again?

Dr. Richard Low:
In a heartbeat no absolutely. Yeah.

Ryan Isaac:
Okay good. I think I would too.

Dr. Richard Low:
Yeah I was gonna say how about you man?

Ryan Isaac:
Yeah I would do it again too. I would do it. Well thanks. I appreciate it, man. For those who might not know where to find you where can people find Shared Practices?

Dr. Richard Low:
Yeah, sharedpractices.com. Download the podcast on any podcast player, [0:47:33.4] ____ Podcast is another one if you’re interested in [0:47:34.8] ____ dentistry. Lots of good stuff on there.

Ryan Isaac:
Happy anniversary. Thanks, Richard, my good friend. [0:47:44.8] ____ a long time. Have a good day and thanks everyone for tuning in. Catch you next time. Bye-bye.

Dr. Richard Low:
See you.

Early Career, Work Life Balance