Dental Practice Heroes
Where dentists learn how to cut clinical days while increasing profits - without sacrificing patient care, cutting corners, or cranking volume. We teach you how to grow a scalable practice through communication, leadership, and effective management.
Hosted by Dr. Paul Etchison, author of two books on dental practice management, dental coach, and owner of a $6M collections group practice in the south suburbs of Chicago, we provide actionable advice for practice owners who want to intentionally create more time to enjoy their families, wealth, and deep personal fulfillment.
If you want to build a scalable practice framework that no longer stresses, drains, or relies on you for every little thing, we will teach you how and share stories of other dentists who have done it!
Dental Practice Heroes
How to Utilize an Associate to Bring you Balance with Paul Goodman
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Ever wondered how hiring an associate dentist can revolutionize your practice? Join us on this compelling episode of Dental Practice Heroes as we sit down with Dr. Paul Goodman, a multi-practice owner and the visionary behind Dental Nachos. From his seven-year journey in dental school to his transformative experience at Albert Einstein, Dr. Goodman opens up about the milestones that shaped his career. Alongside our co-host Steve Markowitz, we dive into the personal and professional benefits of bringing an associate on board, and the profound impact it can have on both patient care and your bottom line.
Unlock the secrets to achieving rapid growth and financial success through strategic investments in modern dental technology and human resources. Dr. Goodman shares real-life examples, like how the right mindset and preparedness can turn initial hesitations into lucrative, long-term advantages. Hear stories of patients and dentists who have reaped the benefits of these investments, and learn why resisting change could be costing you more than you think. This episode is packed with practical advice on alleviating burnout, improving business processes, and unlocking your practice's full potential.
Balancing the demands of running a dental practice with personal well-being is an ongoing challenge. This episode explores how fostering a healthy work-life balance is crucial for preventing burnout and maintaining professional growth. We also delve into the challenges of dental team turnover and the evolving job market, offering insights on how Dentist Job Connect can simplify your hiring process. Dr. Goodman’s invaluable advice and personal anecdotes serve as powerful reminders for all dental professionals to prioritize self-care while striving for excellence in their careers. Tune in for an episode that promises to enrich both your professional and personal life.
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Benefits of Hiring an Associate Dentist
Speaker 1Hello everybody , welcome back to the Dental Practice Heroes podcast . I am your host . Dr Paul Etchison Got a really good one today . I got Dr Paul Goodman on and we're talking about associates and this is a great one if you are looking to become an associate or if you're looking to hire an associate and we're just discussing , like what is that secret thing ? Like why could every practice benefit from an associate ? So if you are maybe on that fence where , like , you had an associate and you're like , yeah , it didn't work out , this is a good episode for you . And if you're on that fence where you're like I'd like to have an associate and I'd like to know more about how this works , this is a great episode for you . So this is a great episode for every single dentist there is . I think we just really delved into the topic and took it apart really well and there's just so many gems in it , so this will be one that you don't want to miss . Let's get to the interview .
Speaker 2The Dental Practice Heroes podcast , where successful dentists share their best systems , methods and lessons learned to help you achieve early financial freedom through profitable practice ownership . We're here to talk about operating a successful dental business through communication , strong leadership and by being the hero for your patients and your team .
Speaker 1Hello everybody . Welcome back to the Dental Practice Heroes Podcast , where we believe that our knowledge and intentionality anyone can become the hero that their practice needs and deserves . I'd like to welcome my guest , a graduate 2002 University of Pennsylvania , multi-practice owner two locations in the Philadelphia area and owner of Dental Nachos . Please welcome back to the podcast , dr Paul Goodman . What's up , paul ?
Speaker 3Awesome to be here with you , paul , great name . Excited to chat with you .
Speaker 1Awesome . So we got Steve Marco with us . He's co-hosting with me today .
Speaker 4What's going on ?
Speaker 1Steve Doing awesome man Just happy to be part of this and got a lot to learn from Paul here too , nice , nice . So before we get into our topic , paul , I always like to ask every guest give a little , just a short , description of what your journey was from graduation to practice ownership . What did that look like for you ?
Speaker 3Sure . Well , when my original dream failed of playing in professional basketball , in the NBA , I had to get a new dream , a backup dream , if you will . I had amazing parents and they said you could be anything you wanted to be , but they lied to me because I could not play for the Philadelphia 76ers . So instead I said you know , I wanted to be a dentist , doctor or a lawyer right , george Clooney from ER , I like Tom Cruise from A Few Good Men , or a dentist , like my dad , and I'm so honored and lucky to have practiced with my dad for 11 years . Sadly , he passed away in 2016 . But I went to Villanova and it was interesting . I mean , this is back in the olden days , right , Like I graduated high school in 1995 . You go in on those college trips . My dad and I were sitting in an auditorium in Villanova . They said , hey , they have this thing called the seven-year dental program and I am someone who , like I , love systems , I love learning about things and this thing , if anyone knows about it , has no risk . Hallmark , because you apply to Villanova and Penn at the same time . You skip your senior year of college and you start freshman year at Penn . They take your credits from your freshman year of dental school and put it on your transcript . You graduate with a biology degree . If after your freshman year of dental school you said I want to be a dentist , you can just get a biology degree . If midway through the program you say you don't want to do it , you just stay as a biology major . So I thought this was great , could accelerate my learning . I saved a whole year of tuition . My awesome parents really supported 95% of my education , which I was grateful for . During dental school I wanted to quit and I had the best dad . He was like hey , if you don't think dentistry is for you , you don't have to do it . I'm here to support you . I'd taken a lot of courses in sociology . I like writing , I like ideas . So I said maybe I'm not using my best skills in dentistry and I also really hated preclinical lab . I hated the waxing up of teeth and the making of the mediocre bite rims . But I decided to stick with dentistry . I'm really glad that I did .
Speaker 3My dad was always the dad who said you know , it wasn't like he jumped up and down because he had a root canal every day . He wasn't that type of dentist , but he said he liked being his own boss . He liked helping people . So after dental school I did a multiple year general practice residency at Albert Einstein one of the greatest decisions I ever made in my life . My dad said you got your whole life to be in private practice with me . Go learn from somebody else . He did the Air Force for two years . Have you guys heard like it's kind of popular for some dentists of that generation to have done the military ? Yeah , my dad did the same thing . But my dad said your GPR is so much better because he went to this Air Force base in California and the other Air Force colonels who were dentists . They were seeing their own patients so if he needed help he had to go ask them for help and he said often they didn't want to help him . So he sort of just had this like hey , I figure out dentistry on my own . He learned a lot about extraction . He said this general practice residency such an amazing idea where you get to learn from these attendings that come in just to teach you .
Speaker 3One of the things about me is I like predictability , I like systems . So I really did not like class twos crown prep stuff that didn't have predictability and I got turned on to placing implants , which I loved and I love to this day . I still call implants nachos and teeth tacos , because all teeth break and become implants and all tacos break and become nachos . That's my metaphor for that . So at multi-year general practice residency I started teaching for this implant company , hyacinth how to place your first implant . Joined my dad and his partner , I had this entrepreneurial spirit so I started bringing specialists into the practice . We purchased the second location . My brother , jeff , came into the practice in 2008 . So , to use a Seinfeld term , yada , yada . I am in my practice today , 2024 . I only come one day a week and I say I just contribute joy to everyone around me , help solve problems , help manage . I don't do a tremendous amount of clinical dentistry anymore , so that's where I am now .
Speaker 1Nice man . So like I want to talk about associates like what kind of doctor could benefit from an associate ?
Speaker 3Because I know how I feel about this and I kind of feel like there's a lot more people that could have associates that don't . But I'm just curious , you've got associates at your practice . I mean , what wording there ? So I don't tell patients they need a crown . Even my wife comes to me and say you need to clean up this drawer that you throw your junk in . She's 100% right and I'm pretty irritated when she says need . But she said you know we benefit from this drawer .
Speaker 3So who would benefit from an associate dentist ? And that's every single dental practice owner in the United States who would benefit from an associate dentist . And the why behind this guys is because you're tremendously vulnerable when you are the only person licensed to do the thing in your practice that provides food for your family , your team's family , helps patients chew and smile with confidence and helps your entire organization run . So I would not be a dentist if my dad did not have a partner . I would not have considered it . My , you know , covered on vacations . So my dad was a partnership where they would be able to cover for each other of more than one dentist in the practice . So someone gets injured , someone gets sick . So I think every dentist in the US would benefit from an associate dentist .
Speaker 3The and part to this not but is it has to make some kind of economic sense to bring in a whole nother dentist into your practice . Maybe a better way to put it is it has to not not make sense , which I know sounds like a Seinfeld joke . But you know , dentists will tell me guys , I can't afford an associate dentist . Right , I can't afford one . And I go .
Speaker 3Is that your K-1 ? That says $857,000 ? Because I don't think you understand how words work . Right , you can afford an associate dentist . And here's why Investing in an associate dentist 100 days a year at some type of guarantee of like $600 to $700 a day , that's a $70,000 expense . Then we throw in $30,000 materials , that's $100,000 . I have seen dentists I don't know about you guys go to exhibits and trade shows , come back with a CEREC machine , haven't done an onlay in their entire career , they've purchased . So my joke is that everyone could benefit from an associate dentist to protect your practice , unlock freedom , unlock free time , unlock fewer hygiene checks Very important , I think and then also figure out when it makes economic sense to do so . That's awesome .
Speaker 4Paul , how do you get these docs to see ? Because when I talk to doctors , it's just how do I take that first leap ? It's a big jump . Like you said , it's one of the biggest four decisions in your life . How do you get these doctors to say like , all right , I'm ready . Or how do you know when it's time to bring ?
Speaker 3on an associate . You can motivate people with pain and positivity , right , and people like combinations of both . You can make people responsibly concerned or you can show them the benefit of what they're going to do , and I kind of use a combination of both , usually through questions . One of my great friends , dr Todd Fleischman , in 2017 , when Nato's was first starting . He's an amazing guy . He said hey , you're in Philadelphia , let's meet for beers . It's like the guy version of getting ice cream . As kids we talked he's one of the best dentists that I know . We've become such close friends . This is our first meeting , right ? First time we ever met , having beers . Talking . He has an amazing fee-for-service practice in Philadelphia Spear coys , all of those things and I was like , why don't you have an associate dentist ? And he goes oh , you know , my patients just want me . Same thing , right . My patients just want me . My team won't get it . But I didn't let up're so successful . But you're also crazy stressed , right . So I basically kindly annoyed him into saying like hey , would you like more free time for your family ? Would you like to not feel like you're the only person doing this ? And he started with a part-time associate and to kind of bring this story full circle . We were texting this morning and he's on vacation because it's spring break for a lot of people , but his office is open . Hygiene's there , his associate's there this week , so I kind of show them that fun benefit . Then I also scare them and be like , hey , what if something happens to you and you get injured ? Who's going to support your practice ?
Speaker 3One of the things that I think is key is your team and the dentist . You're in it together , but most of us have very different financial situations than our team . So most dentists this is not a judgment , it's an observation , one of my lines . Not a judgment , it's an observation . Most dentists , if they didn't get a paycheck for the next 30 days , wouldn't have a problem paying their rent or mortgage , wouldn't have a problem eating food or providing for their family . But wouldn't be the same case for my team , wouldn't be the same case for me , guys , when I was 26 sometimes , or 27 or 28 . So what if something happens to you ? Who takes care of your team ? Who takes care of your patients ? So those combinations are usually ones for them to what I call JFO . Just find out and I'm proud to have helped solo dentists hire their first associate dentist group owners hire their 15th , and then we work with large groups too , so I really really enjoy it .
Speaker 1Yeah , you know it's interesting because I have a lot of coaching clients that will reach out to me specifically .
Speaker 1They want to work less clinical days and they want to bring on an associate .
Speaker 1But what I see is that common fear is that , oh , I just don't want to take a cut and pay , I don't want to make less money , and I think there's a lot of almost like and I don't agree with it is that a lot of people feel like if I bring another dentist in here , there's less dentistry for me , and that's the one thing . And then the other thing is , like you mentioned , my patients want to see me . In my experience with every single coaching client I've worked with is the dentist will make more money with an associate , depending they have enough new patient flow and they can drive that keep that associate busy . But two is that your patients don't love you as much as you think . They don't love you so much that if you bring somebody else in there that they're just like no , no deal . Instead of staying here where I know everybody else and I have a new dentist , I'm going to go start over completely at a new practice where I don't know anybody .
Speaker 3It's a hundred percent fear-based . You're totally right . And what is funny about dentists is you have to develop this ego and I don't mean ego in a bad way . You're the king or queen of this castle . You're running the whole place . It depends on you .
Speaker 3But I was actually at a great place in Philly Hope you get to go , paul named Kafar , for this great coffee . And a guy was in front of me and I was telling people , like , move up in line . I'm that type of person likes me , right . And I used to make a joke he goes , I'm going to the dentist soon and I was like , oh , who's your dentist ? He's like I don't know their name . I was like , so like , I bet you , if they got an associate , they wouldn't even know . So I think you're so
Impact of Hiring Associate Dentists
Speaker 3right . And the other and part you know if we get a chance to talk about I sent you my viral video with my 70-year-old patient on YouTube to thinking about getting implants Each recall exam .
Speaker 3Oh , janice , don't you want to chew when you go to those family functions ? Oh , janice , you're struggling with this denture . Right , there's ways that we can fix this right . You know what she said . I wish I did it sooner . You were right , dr Paul , and Dr Todd Fleischman . He doesn't like when I say this , but he should have done it sooner , right ? So when you're coaching clients , all you have to show them as a coaching client . I say the magic word for communication is just like you Like . Hey , there was someone just like you , worried about the expensive implants . Her name was Janice . Here's a video .
Speaker 3And I'm sure you have a coaching client who was resistant to hiring an associate . And now what Dr Todd Fleishman says to me now he will never practice alone again . If his associate moves across the country , he's got another associate . If his associate buys a practice , another associate , he will never practice alone again . So those are the things . And people have to be ready to move forward when they're ready . But I mean , I don't know what you guys can think . It's kind of wild . The dentist is the only one licensed to do the work that makes the whole practice run and they don't have any bench there . And whether you do $3 million a year and you make a million dollars a year or you bring in 600,000 , no judgment your whole business operation is vulnerable when you're the only person that can do that .
Speaker 4Are there times where you're like this person isn't ready and this office isn't ready , or do you think that it's just everyone ?
Speaker 3can benefit from it . Paul , you do coaching right , so everyone can benefit from coaching . But I have been on both sides of this . You have to be able to do the work with the coach to get the results out of it . So in the Job Connect world we are working with the job seekers who have moved across the country for a job where they weren't ready for an associate and now they're stuck there . So we have like checklists to help them get ready . Is the team ready for somebody new to be a dentist there ? How are they going to communicate this to the patient ? It's an opportunity . You know , I just did a great thing with the Productive Dentist Academy . It was actually my awesome wife , mary , who went out there and I was preparing her . You know what are the community benefits ? Right , like you have more hours . Like you know it's crazy Like our patients , it's kind of like us at restaurants .
Speaker 3You ever get mad at a restaurant where it's taken a long time , but you clearly see they don't have enough help , right , but you're so like emotionally unstable . You're like , well , I need my nachos now . You know , like you say to a patient like , hey , you know your tooth will benefit from a crown , it's broken and then the front desk is like we can schedule in six weeks , like why can't I come in tomorrow ? Right , and you have to balance that . But I do believe that booked out too far problem on everybody because you tell someone they have a problem in their mouth , then you tell them to come in two and a half months later . How big of a problem . It's like my dermatologist joke . I'm like , hey , I got to come in for this rash . They can come three weeks from now . The rash is going to be gone by then . Right , but the readiness factor is is the team mentally prepared ? But by and large in this experience , whether it's solo GP , group practice owner , they wish they did it sooner . They're sometimes making less money temporarily is a great thing .
Speaker 3I'll use this example . We have a CBCT downstairs and I regret not getting a CBCT sooner . I freaking did the mobile imaging thing , me and my periodontist . We were from the generation where we didn't use it . I don't need it . I regret it . Right , I wish I got one sooner . But when we got one , I don't know , it was like 75 grand . We did some financing thing . The scan started to pay for it . Now it's paid off and we're helping patients and making more money . Think your associate dentist . The same way . You're going to have a cost initially , and then eventually you're going to be able to get more financial success . So I think you're totally on point with that .
Speaker 1Yeah , I think the big thing that we overlook is the freedom that comes from it . I noticed this when I brought on an associate , and I brought on an associate just out of burnout . Way too many patients Should have did it way sooner , like everybody says , should have did it way sooner . And then I noticed that , wow , I actually have time and energy to actually sit down in my office . Look at what we're screwing up , what we could do better , working with my team , discussing with my team . And we grew so fast when I got myself out of the chair and gave myself an ample amount of time to work on the business and everybody wants that they're like well , I'll work on the business on Friday . I'll go Monday through Thursday and I'll work on the business on Friday . You just don't . You do it when it's like there's so many things building up that you're like damn it , I got to go on on Friday .
Speaker 3But like hell , no dude , life is nine to five , whether it's 2024 or whether it's 1984 . This concept that you're going to do things Sunday at 10 pm or Wednesday at 6 am yes , you can do things that I don't know whether it's listen to podcasts , but in general there's this nine to five time where most of the things happen in life and you can't be in two places at once . So if you're checking three hygiene patients and you have to work on your vision for next year , it sounds great in theory to do it at 8 pm on Thursday night , but everyone gets tired . So I think your point is so key . And you know , here's a good regret my friend Dr Todd Fleischman . When I sat with him I said get your associate for two days a week . Okay , he goes . I only need one , paul . I hope he listens to this . I really hope he listens . I'm going to make him listen to it . Get your associate for two days a week . And I hand-delivered him . An amazing associate , right GPR experience , amazing person , like one of my best , of my best . I'm still friends with her . She's an awesome person . They're both lucky to have . I only need one . Get them two days a week . Nobody tell you that today I should have got her two days a week .
Speaker 3Once you're associated with a schedule somewhere else , it's hard to extract them dental pun intended from that . So get them for even an extra day , have them train with you , have a mentor with you . I mean , I watch all these shows your time . The Bear has anyone seen the Bear with their chef ? Yeah , chicago , I worked in restaurants my whole life . The top chef trains the assistant chef and they're like just watch me do this . Right , why don't we do this more in dentistry ? Why does the associate have to come and just get thrown into some schedule of class twos and hygiene checks , missing out on your mission , core , vision and values ? So that's my rant on pay attention to it . But , like you had said really good point you want to make sure your readiness factor's there so you don't like you're asking a whole person to come and join your team , get licensed in your area , maybe sign up with dental insurances . So make sure that it's not something that you're not doing with intention .
Speaker 4Love that , Paul . A lot of the focus so far in the conversation has been on the benefit to the owner . I have a bunch of associates . I hope they're with me forever . I try to treat them great . What do you see as the benefit for the associate doc who's going to be there as well ?
Speaker 3I'm going to give you guys a trick . I try to be a nice person . Gary Vee talks about altruism and selfishness . Most people are like 90% selfish , 10% altruistic . Best you could be is 51% selfish , 49% altruistic . So I try to be altruistic as
Balancing Altruism in Dental Practice
Speaker 3the nacho guy . But I'll give you some behind the scenes tricks .
Speaker 3When you have associates and you don't want them to leave the by a practice every time they're in the doctor room with you , just complain as much as possible about how hard it is to run a practice Right , and I use this joke with aunts and uncles because the associate is the aunt or uncle .
Speaker 3And that's the benefit . I had my amazing niece over for the past two nights and they get to be with your practice , protect your practice , grow with your practice , but not have the ultimate responsibilities , stress and anxiety of being the parent of that practice . And then they can learn via taste test another Gary V term what they want out of their own practice , what they don't want out of their own practice , or an amazing path that we can talk about , maybe never being a practice owner . I sat with one of my original coaching clients yesterday and she said the best advice you gave me in 2018 was not to buy this terrible practice . She's now an associate earning $360,000 a year great work-life balance , and that fits her life . So I think the benefit is that they get to be the aunt or uncle in the best way . You're taking care of each other , they're helping you with the practice , but they get this . Look at what it means to be a practice parent without having to go through the financial risk , the anxiety , and then they can do it when they're ready .
Speaker 1Yeah , it's funny , I do the same thing is I'm always just like oh , just running this practice , you don't want to do this . But you know what ? There's a great opportunity Like I have a partner in my practice and she was an associate for a very long time and she bought in with the condition that she would not have to do any management . All she had to do was just keep doing what she was doing and I would continue to run the practice . I didn't want another like partner owner in there that was making decisions and stuff . I said just be a good leader , when you're here , I'll take care of everything else you have to do . And she's like that's perfect .
Speaker 1I think she would have been completely comfortable being an associate for the rest of her life , but she was there long term . I wanted to keep her long term and I liked that and I think she earned it and I sold her a small piece of the practice and it worked out for everybody . We're always just so scared that we don't have a practice that can support it . We hear these nasty stories of oh , it didn't work out . I don't know , and I think there's some truth to that . There are some associates that just don't fit in with a practice , but I think an associate would fit in at some practice . Maybe it's not my practice , but at some practice you're really in touch with dental graduates . What do you see as for their job market , their opportunities coming out of school right now ?
Speaker 3Dental nachos has this JBN mentality , which is just be nice . I will explain . If you see someone post a tooth and they do a crown and you would have done a filling , don't call them the worst dentist you've ever seen on the internet . Okay , that's the just be nice mentality . Try to be curious like Ted Lasso , not judgmental about dental care . But we also have a JBR mentality just be real , like what's really happening .
Speaker 3I know it's part of your podcast and what's really happening is the job market for the 2024 grads is brutally difficult . In areas that are saturated with dentists , there's amazing opportunities where the dentist to population ratio is favorable . But I will share with you in the most authentic way . I don't think many of these 2024 grads thought they went to dental school and that they'd only be successful if they moved to a far off land with no friends or family . So one of the things is when you ask somebody to do something you haven't done , you got to be really empathetic about it Because I had a coaching client .
Speaker 3He was a great guy . I always like to not violate HIPAA , even with this , so I'll just make up his name . It was like 2019 , maybe before the pandemic . I think he's like Paul . He's a young dentist . I'll call him Dr Ron . He's like these young dentists , they're so entitled . He's like I got this great practice in West Virginia . You can make so much money . I make a million bucks a year , so she can make 250 grand a year . Why don't these dentists want to come down and work with me in right ? And I go Dr Ron , you like the money ? I have a practice for sale in Philadelphia . You can make $2 million a year . Why don't you sell yours and move to Philadelphia ? He goes I don't want to do that . I'm from West Virginia and I go . Yep , that's the problem . You can't call it going rural . If you're going home , you can't .
Speaker 3I have all these awesome clients on Job Connect , these interviews . One is Dr Michael McKay in Seattle , a great guy . You got to craft a story as to why someone would move to your area who doesn't know anyone and do one of the most stressful jobs ever in a dentist , and we've done it . Dr Jordan Souders in early Job Connect time . He goes I want to go to the place where has the best economic opportunity and the best mentorship , and he went to the middle of Illinois . Okay , maybe you know this practice , paul . He's a great guy and he's doing digital dentistry , placing implants , making over $250,000 a year . He moved his wife and baby , didn't know anybody and I think he's going to live there the rest of his life .
Speaker 3I don't want to say it's impossible , but I just had a coaching call with a D4 on Friday and she has applied to like 20 private practice jobs , one interview and three giant DSOs want to hire her tomorrow . So I just think that to give people the context is that it is a difficult time if you're not geographically flexible . When we have a job in Austin , texas , which I just promoted one , we sometimes get 12 applicants in like 12 days and what that means , guys , is 11 people aren't going to get that job . Then we have one in Kansas no disrespect to Kansas , but we'll get four or five 600 views on that job with zero applicants . So I just think that's a from me , the job-connected nacho guy , the context of what people can kind of see . So hopefully we're all more empathetic .
Speaker 3But then also , I actually believe , guys , that pre-dental students should be told if you want to be successful in this career , you must be willing to move to where jobs are . If that is not your personality type dentistry should not be for you . Right now I'm in where I grew up . Most dentists who graduated 2000 or after you just went back to where you grew up . The geographic opportunities and saturated areas for me for associates have declined .
Speaker 1Yeah . So I was just going to say follow up on that . Just one last question before we move into our question segments . If somebody's saying I think I'm ready for an associate , do you have any benchmarks that you think someone should hit ? Oh for sure Before , as far as maybe collections or new patients . So someone might be like , oh , maybe I am ready for a associate , maybe I didn't think I was . I actually am hitting these benchmarks .
Speaker 3I couldn't love this question more . Okay , because dentists , we think we're scientists and we're into data . But you know this space well . A dental practice called Dr Nacho's House of Dentistry can have two drastically different EBITDAs
Dental Practice Efficiency Systems
Speaker 3evaluated by DSOs . One DSO can say we only go by the numbers and we are going to give you $3 million . And then another DSO can say we only go by the numbers and we're going to give you $4 million . And I want to be like aren't you guys looking at the same numbers ? So my answer to this is the benchmarks are part facts and part feelings . So the facts are if people are listening , I think you should go to your practice management software and just be like hey , do I have more than 1,500 active patients ? Right ? Do I have more than 1,500 active patients ?
Speaker 3Some of these dentists are wild out there . A guy called me from South Carolina . He's like Paul , I think I need an associate . I was like oh , how many active patients do you have ? Like I just checked 3,300 . I'm like well , so over 1500 active patients .
Speaker 3How far are you booked out for something like a single crown somewhere ? So if someone was in hygiene the broken tooth , is that more than six weeks , right ? Can you not get in people for more than six weeks ? I would love to be on this podcast multiple times . I don't want to be too verbose , but if you're booked out more than six weeks , you might not be able to get new patients in . You not be able to get new patients in , you might not be able to do big cases . Sometimes you're just spinning your wheel on like wheels and taking care of smaller things in the practice . So you have more than 1500 active patients .
Speaker 3Are you booked out more than six weeks ? This is just to start thinking about this process , and then I also just think you know a capacity , right ? New Jersey is the place of small offices where I am so like we have a three op office and like it would be nearly impossible to have two dentists work in that space at once . So do you have more ? Five to eight operatories , six plus operatories ? So those would be the three things I tell people to think about . Yeah , Awesome .
Speaker 1All right , man . Let's move on to the segment where we share little systems that add up to big results . Dr Goodman , what is your little system ?
Speaker 3Well , I hope this one really helps people , because I love my team , I think they're great , I like to empower them and they are forbidden forbidden to schedule an emergency the same day without checking with the doctor . I'm the doctor , by the way , my brother's the doctor . I tell my patients to call me Paul . My team can call me Paul . We do this because we want to preserve our sanity and we don't want emergencies to cause total chaos . Because when I joined my dad's practice , emergency caused total chaos . They would cram people in . People had been told that their wisdom tooth needed to be extracted 10 times . They'd be brought in for a limited oral exam . So we have this form . You call for an emergency . We take all the information on this orange form . I'm into colored forms . How bad does it hurt on a scale of one to 10 ? When will you last in for hygiene ? When can you come in ? We put this information together .
Speaker 3There's no more paper charts , which it does bother me . Okay , I don't know if you guys , you guys are paper charts to the digital world . Back in the day of paper charts , if someone had an implant placed and I need to find out which implant it was , I'd be able to find it in under four seconds . Now with digital charts , I'm 17 clicks into the software and I'm further away than when I started . Okay , but they used to put the charts on our desk , but now we review it . I mean , have you ever had this experience where you go down to work on a patient and you have an opening at three o'clock and you go I hope my front desk team doesn't fill it and you come up from your filling and not only did they fill it , they filled it with one of the most annoying patients in the practice and you go . I just don't have the brain space for that , okay . Also , patients do this other thing like lie . So I'll put it in a implant overdenture and I'll be like , hey , you got to test it out for a week . I don't want to see you in under a week . Eat nachos , eat pizza . Write down your problem . I tell people , write down your problems . It's going to be sore . Next day they call Dr Paul told me to come in right away . I don't do that orange sheet . They're sneaking in the office . So this orange sheet we manage all same day emergency for our sanity . I think it's been so successful in helping the whole team stay on time , and it's all because I believe that I'm responsible , just like the Jocko Will thing , for everything that happens right . Not once has a patient snuck in and put themselves into Dentrix . So that's one of my systems .
Speaker 3The other one is our yellow form for financial agreements . I like the F words , like associates , unlock , more freedom , flexibility and fewer hygiene checks . The yellow financial form we're able to have costs about care with clarity and less confusion . So I have an entire yellow form . That's just about the money . We print out two . My office manager holds one , gives one to the patients . They say , hey , the cost for your care is $8,000 . You'd like to take care of that at the time of treatment ? Pay in full . We're going to give you a 5% courtesy . That's $400 savings . And then they stop talking . Believe it or not , I don't know if you guys do . You guys offer any payment in full courtesies in your practices . Yeah , just like you .
Speaker 1We do not at ours right now . No .
Speaker 3Do you ever notice that the people who say they have hey , not everybody can do that at once ? We totally get it . We can break it up into three equal payments over the course of treatment . We strive hard to make those two the ones . And then we also have outside financing options . So those are two . I have many systems , but the orange form and the yellow form are game changers . I believe if dental students learned how to use the yellow form , they would graduate faster . Because we have to do everything in dental school . That was crazy . You had to set up your operatory . You had no assistant . I had to take the patient to pay at the end , sometimes , right ? What kind of system was that ? We got the people who don't know anything struggling to learn being like did you bring your 20 bucks for your copay ? Right ? That was a wild time . So I think that if dental students could talk about care with more concern , cost , with more concern , clarity , less confusion , they'd graduate faster .
Speaker 1I used to hate when you set up for endo and then they don't show up , because that was like the biggest procedure you had to set up , for You're setting up all these files . You're like damn dude , I got a lot to do , Like what . It's just overwhelming , and then they just don't show . Then you gotta put it all away , break it down and it's a cost .
Speaker 3They have to re-sterilize it , do everything . I'm with you , totally with you .
Speaker 4And the appointment only . The root canal only took like six visits , so it's perfectly fine .
Speaker 3Yeah , yeah , exactly . Seeing how long your file is I gotta go stand in line with the patient . You bring back just these memories , remember , like the rubber dam you would never want to take it off or anything . You got to go to the bathroom with that thing on , so you had these like zombie , rubber dam , people walking around .
Speaker 4It took me so long to put that on .
Speaker 2Yeah .
Speaker 4At Tufts , radiology was on another floor , so you literally would take the person down another floor to do an x-ray for a check of a crown . That's the first time I thought about that in over a decade .
Speaker 3Thanks , paul , I appreciate it . Yeah , sorry , sorry , sorry , memory burned . So those are two systems . I got plenty , but those are two of my favorites .
Speaker 1Awesome . All right , let's move on to the segment where we celebrate that all of us are human and none of us is perfect . Dr Goodman , let's get real . Everybody get down . It's about to get real in here . What is the biggest struggle at your practice right now and what are you doing about it ?
Speaker 3This is really an on-brand one that from driving with my brother this morning
Struggles With Dental Team Turnover
Speaker 3. The biggest struggle is putting a full team . I think of dentistry like basketball , so you got to play a game every day and to put that full team together with people's availability , their ability , how , where they are in our office has become incredibly difficult . I believe that I've had more team change another word for turnover after the pandemic than I had in the previous 12 years prior .
Speaker 1Yeah , I agree .
Speaker 3So I think my biggest struggle , like two team members called out today with very reasonable reasons , right , traditional ones illness . I don't want people to come in when they're sick but I don't think people realize . Unlike fantasy football , you got no bench and I just think that it creates so much stress . I was posting on the DSN this morning . They're one of my favorite groups , they're sponsors . Mark's my great friend .
Speaker 3So I have two companies I thought up in my head Dental Notches and Dentist Job Connect . There's no playbook for those companies , they're from the thoughts in my head . And then I got two dental practices . The stress of running dental practices , with putting your team together , is like 20 times harder than those other two companies . The financial risk of those other two made up companies is like 200 times harder than dentistry . So dentistry is like a very stable financial business model . But to me over the past 20 years , putting that team on the field to play your game has just been incredibly difficult and I'll just be honest with you guys it's demoralizing . Demoralizing People leave for good reasons , bad reasons , challenging reasons , and it's demoralizing .
Speaker 4Paul , do you have any ideas of why you think that's happening ? Because every single doctor that I speak with that's their number . One thing is their team turnover . I like how you phrased it employment change or whatever I'm going to use that . I haven't heard a good reason of why .
Speaker 3I'll give you my reason , because I'm 46 years old , thanks for asking this and I've spent time in this building since I've been born . This building that I'm in was a house office where , before the 1950s , it was here when I was a kid . In fourth grade and my parents were building a home a few miles away , I came and spent time with the widow of the original dentist upstairs , okay , and I got to see my dad and his partner . So what I believe is the job choices for people who worked in the dental field assistant , front desk and hygienist were more limited in the 1980s and 90s . So when someone's a dental assistant like this is my career and we had literally career long dental assistants it was quite awesome , okay , and I also think working in a dental office is , like I always say , running a dental practice is like running a circus , where the animals don't try to eat you , just slowly annoy you to death . Okay , I mean , when , honestly , I have this woman who makes cupcakes right , it's like people walk into her place and like , please give me a $10 cupcake . I think it's awesome . Our team absorbs the energy that people not want to be there . So if we use dental assistant , you're sitting side by side in a very stressful job and making let's just say for the purpose of this podcast , making between $20 to $30 an hour , which could be a $50,000 to $60,000 a year job , and I just think there's more opportunities , whether it's remote jobs , whether it's other things , and I think dentistry has got to try to solve it .
Speaker 3I mean I said that , my brother , before the pandemic , the biggest crisis not enough dental assistants . We have a surgical process . The guy's like a superhero , okay , comes in , extracts teeth all on four . Rob , rob Slough , he's a great friend . I mean , the guy is literally like a superhero . Dentist . Okay .
Speaker 3If his assistant can't come in , the whole day collapses . People took off work , people scheduled three hours and then , if you're naive enough and I don't want to sound mean some dentists go oh , we'll just get him another assistant that day . No one knows . Like you talk about endo , the assistant who works with the all-in-four dentist . They're not just we don't have five of those in the office . So I think dentistry has got to solve it . It's like we need to do that thing . You know , in the Superbowl where , like the pistachio , people like all get a Superbowl ad . I always wonder about that , right , like how do they all get together and be like we're going to promote pistachios . Dentists have got to create some promotional stuff for how good it is to work in a dental office , because we are suffering .
Speaker 1Yeah , it's funny you say that . I've said that in the past before . I'm like we got to go , just do some PSAs . We'll get like the association of dentists or one association . Probably it's not going to help with that , but it'd be nice to get a association where all it is is we're like man hygiene's awesome , dental assisting's awesome . What a profession , wowee . It's like when they tried to sell all the milk . They got milk and then the pushing , the cheese and the eggs .
Speaker 3There's wildly awesome growth opportunities in dentistry . My office manager starts a dental assistant when she's 16 . There's hygienists who go from hygiene to high six-figure jobs outside of the dental field . So I mean , dentistry is a launching pad for awesomeness . You get to know how to deal with people , you get systems , you can grow inside your own organization . So those things I think are great . It's just that there's a lack of team members from hygiene assistants front desk . That just causes us to struggle .
Speaker 4Yeah , true , we need a colored form for that .
Speaker 3Paul yeah , I need that . I do need the color form .
Speaker 1Yes , If you could go back in time to the beginning of your career , what do you wish ? You could tell yourself .
Speaker 3I had this amazing coach , carol Kivler , and she did . Every team meeting is about keep doing , start doing , stop doing right . So when you say go back in time to tell yourself something , us negative dentists say just tell yourself what you did wrong and make yourself feel worse about it right . So I wanted to come up with three things . One was keep doing . I would go back and say , keep coaching your team . I hired a coach for practice management in 2010 , which is a fairly early adopter to the whole team unity . I knew the team had to get along . I knew we had to do with EQ , emotional intelligence and systems . So I'd say , keep doing that .
Speaker 3I invested a lot of money in that . I would start doing , or I regret not investing as much in my practice numbers . My dad went at it based on feel . They took these insurances that were terrible , but they said it was the teacher plan . I kind of like you know when you go to those restaurants and they put the calories on the menu and you're like well , now you've ruined it , right , I'm not getting the potato skins . So I wish I had looked at my practice numbers earlier in my career because this might be coming up , but I can ask like Spoiled Glock .
Speaker 3Ppo , which I say is a dental insurance that's popular in my area , wrote my brother and I a letter in 2017 saying , hey , we're reducing what we pay you next year and it was a big part of our practice and we were going to have our . The money we'd be reduced was over $100,000 and I kept taking it and I shouldn't have . In that moment , I should have had the emotional security . I was fearful . I was worried . I was way too into my team . Oh my gosh , if I drop insurance , someone might work a less day . I can't do that . I made so many excuses , so I would keep investing in the culture and the team , but I would start paying attention to my numbers a lot sooner .
Speaker 1I really regret that . Yeah , if you could share a story where you learned a valuable business lesson from an experience or the hard way .
Speaker 3I mean , it's a continuation of that letter , right ? I was sitting in this room , we had a table here , and my office manager was like I don't think this is a good letter . So for me to deepen this story , I looked at this letter from Spoligwak PPO and saying they were going to reduce what we were being paid . I was like , how are we going to figure this out ? How are we going to make it work ? Sometimes you try to make something work too long and you learn it the hard way . So I said , oh , let's just see what happens . We don't want to lose all these patients .
Speaker 3It's okay if my brother and I don't make as much money , but one of the things I'll share and it goes back to the calorie things you make $100,000 less one year than two years , than three years , than four years , and it took me till 2022 to separate myself from that plan . And that was really learning something the hard way , because what I found out was I should have taken the pain of that change earlier , and maybe it goes back to the associate thing and maybe the pain of change is not the right way to put it . I should have taken that uncomfortable feeling of the change earlier so that I would have had a longer runway to solve it . There are dentists probably listening to this podcast saying I got a letter like this and I'm not telling people to drop their plans , I'm not telling them to sign up for plans , but I wish I made a plan about my plans . I actually wish I hired someone to help me with the decision . I try to make it all myself .
Speaker 1What was the factor that five years later , you're like that's it , we're done ?
Speaker 3It was a combination of the capacity problem caused by the pandemic and actually sometimes I make decisions more for my morale than money . It's funny how these wind up working . I was just like I can't see these EOBs where we are getting paid 50% of our listed fee and I was just like I'm prepared to deal with what happens . I wasn't like just ran into this and said , hey , I'm just going to drop this . We started marketing more . We started trying to figure out how we get . We upped our membership club . I regret that too . I wish I'd started my membership club sooner . You know , I had a patient guys who one time he came to me after 30 years of not seeing the dentist and we did this giant full arch implant case and I was like , why did you come ? He's like the pain got bad enough . But that's not how we should make decisions . Right , like so learn from me . The pain got bad enough . Fall for me in 2022 to be like , hey , I just can't do it . I wish I had done it more in my own terms .
Speaker 1We dropped Delta back in August and I would say , looking back , I wish we would have done it sooner . We could have done it sooner . I wanted to do it sooner , but it was the same thing . The pain got bad enough and then we had a capacity issue where we really had to look at it . But it was also like just this monumental thing of we got to do this training . We got to learn how we talk to people differently . We got to do this training . We got to learn how we talk to people differently . We got to change how we approach a lot of things , and it was just this big thing that I didn't want to get involved in until , finally , I was just like I can't do this . I can't pay my team to retain them with the fees that we're getting . We have to do something . As much as I want to be this trailblazer and say , hey , yeah , we just did it because we wanted to be different , it wasn't the case for me either . It took a very long time for us to make that decision .
Speaker 4Was that pain related to the employee turnover thing too ? Is that being able to retain and attract the talent ?
Speaker 3Well , I think it was . It's a good point . I have a really funny comedian named Sebastian Maniscalco and I'll make this joke a little more PG . But he said you know , growing up girls would give me any excuse not to date me . They'd be like date you , I can't date you in this economy , right . So it was a very funny . So I do believe I leveraged the pandemic challenges to my advantage . They were true in what was happening . We actually just really didn't have enough people to manage everything . I started outsourcing insurance billing during the pandemic . My office manager got mad at me . When I asked her I was like , hey , we got to outsource insurance billing . We don't have anybody , we just got to do it . She's like we don't need to do it . I'm like let's try it for six months and see what happens . That's my trick with people . I say , oh , if you don't like it , come back to . But I didn't have the self-esteem to do it . I mean , I don't know , but people should say that I believe it was a self-esteem problem for me .
Speaker 1Yeah , yeah , I could see that . So talk about Dentist Job Connect how can people learn more about that ?
Dentist Job Connect and Career Advice
Speaker 3How can they get on there if they're looking for a job ? Or how can somebody get on there if , oh , awesome . Well , dennisjobconnectcom , I've made it friendly , try to make it friction-free . I do not use the example of a dating website . That's more like for buying practices , because most people don't have eight or nine boyfriends at the same time , or girlfriends , but people have eight or nine of this . I don't know if this is your life . I'll take eight or nine of these . In my life , I'll take 11 or 12 of them . I'll take 20 of these in my phone , and that is babysitters , right ? So when you have a nine and a five-year-old , no such thing as too many babysitters to take care of the most important thing in your life . So I've modeled it after carecom Super affordable for practice owners , no charges this time for job seekers .
Speaker 3It's community-based from nachos . So if we have a couple minutes , you always get good ideas from young people , right ? Whether it's your kids . Someone came to me and said hey , paul , do you have any dentists looking for associates on Dental Nachos ? Because I figure if they join Dental Nachos , they must be really nice people . I'm like , well , not everyone's super nice , but it made this aha moment that they were actually trying to find a job through someone who was connected to Dental Nachos . So we have this community feel it's not all from Dental nachos but so far the candidates that people are getting they've been really happy with and I've just really enjoyed growing it . So you go to dentistjobconnectcom . We'd be glad to help them .
Speaker 1Awesome . All right , let's move on to the Dental Practice Heroes , sexy Six .
Speaker 2Six sexy questions .
Speaker 1What is your favorite quote and what does it mean to you ?
Speaker 3My favorite quote is everything that matters needs a system and everything matters . It's a quote that I've either made into my own , but it comes from Dr Mark Setter , who sadly passed away recently , but he was a periodontist . I heard him speak on customer service and he said the most important place to have clean in your office is the patient bathroom . So it comes to me where everything that matters needs a system and everything matters in what you do , and we strive to make that part of what we live in our dental practice and other companies .
Speaker 1So he was out in Michigan , wasn't he ?
Speaker 3Yeah , yeah . Mark Port here in Michigan . I know his daughter is great . Jill Fairley passed away a few years ago , but he was an amazing speaker and I really like learning from him .
Speaker 1Yeah , he's a good dude .
Speaker 3Okay , what are you reading right now ? I'm going to take a small audible and someone who loves books . I mainly listen to podcasts . Now I always say listening is unlimited learning . You can listen anytime . Reading I got to stop and look at my phone or a book . So Entrepreneurs on Fire by John Lee Dumas is one of my favorite things to listen to . They're 20 to 25 minute podcast . Recently listed one on sales . I'm showcasing your success story . It inspired me to show more of those Janice videos that I share with you . But the best book that every dentist should read to me that I've I've read multiple times is the Cell is Human by Daniel Pink . So that is one of my absolute favorite books .
Speaker 1I recommend a single book all dentists should read . Are we just going ? Yeah , that was it . Sorry , I'm going to do .
Speaker 3The Cell is Human by Daniel Pink Perfect . It really gets you to reframe how you think about selling things .
Speaker 1Awesome . I recommend a seminar event or continuing education .
Speaker 3I'm really partnered with Ripe Global , with Dr Lincoln Harris . They are a sponsor of my group , but he has created the basketball gym . Dentists need to practice their skills outside of the patient game , until what they've done by doing this through WebEx and lifelike models . To me , it's a total game changer , whether you're an associate or practice owner , so I would highly recommend checking out what Ripe Global does .
Speaker 1Awesome . Please share an analogy that you use to communicate an idea to a patient .
Speaker 3So one of the things I'm known for is dentists are dramatically negative about stuff that lasts a long time . So if you brought a car in that had lasted 17 years , you wouldn't call it a failure , You'd call it a success . So I often relate hey , you would benefit from a crown Crown's like a hard hat for your tooth . Crowns work a lot like cars . They last five to 10 years . They get a lot of wear and tear and my signature is we eat a thousand meals a year . So five to 10 years is like five to 10,000 meals . So be proud . It lasted that long . Dentist , instead of negative with the patient and we do not say fail , in my office we say time to be replaced . My message to dentists less negative terms . Yeah , Need a little maintenance just like everything else .
Speaker 1Yes , exactly , it's weird . It's so unusual why the patients expect everything to last forever , and we do too , as dentists .
Speaker 3It's a hundred percent our fault . I mean it's . I've started using my sponsor , john Warranty . It's a great conversation with people . It's because we don't have the conversation up front . They're used to replacing shoes and cars and we just here's our crown . Go on your way . You've got to stop and have that maintenance conversation .
Speaker 1Yeah for sure . All right , if you had three pieces of advice for a dentist or soon-to-be dentist , what would they be ?
Speaker 3I say work on your dental core . Back in the 1980s and 90s , when I worked out , all we did was bicep curls , bench presses and left the gym . So you had guys with big chest and biceps and tiny , and now people do core Pilates squats . So your dental core to me is your mind , your business skills , your words , your patient communication skills , your hands , your clinical skills and your heart skills . So work on your dental core daily . Don't just work on getting better at crown preps . Work on getting better at everything that affects the patient experience . I said , become very comfortable making training videos , sharing videos and success videos . My brother , who's about as not like me as they get he makes loom videos for our team on how to do things systems . So I would make more videos , and I met with a 2018 grad yesterday and I just think it's so important .
Speaker 3Done work with Dr Kyle Stanley from the Light Side Academy . Remember you're more than a dentist . Your happiness , your growth , your sanity as both a person and a professional
Importance of Work-Life Balance for Dentists
Speaker 3matters . Easy to go from passionate to obsessed with dentistry . So remember work-life balance . Remember taking care of yourself both as a dentist and a human being , because it's easy to forget that ?
Speaker 1Yeah , so true . All right , paul , thank you so much for taking time out of your day to get on the podcast . Thank you for all you do for the industry . You are a fantastic advocate for new dentists and dentists all around . But just really appreciate all you do for the industry , man , and appreciate you coming on .
Speaker 3Awesome . I love chatting with you guys . Thanks for doing this . It's really awesome . Yeah , paul , that was awesome . I appreciate it . Thanks guys .
