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
Beyond the Operatory: Why Some Dentists Make Millions
You can be a great dentist and still struggle to grow — and here's why: your mindset. It's what keeps some practice owners stuck and helps others build the type of practice they want.
In this episode, find out how to shift out of "survival mode" and run your business instead of just working in it. From perfectionism and fear to day-to-day fundamentals, we discuss common mindset traps and habits that stall growth and how you can move past them. Tune in for tips to build a strong team and become a better leader!
Topics discussed in this episode:
- The mindset of successful practice owners
- Fundamentals of an efficient dental practice
- Common mental roadblocks to growth
- Tips to accelerate growth and lead more effectively
- Why you should stress test your practice
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Take Control of Your Practice and Your Life
We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams.
Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.
One thing we don't learn in dental school is how to be a successful practice owner. You can be a great dentist, work hard and still struggle to grow your practice the way you want to. If this is you, keep listening, because today we're digging into what separates practice owners that reach their goals from the ones that stay stuck. You'll learn what you need to change in your mindset to reach the next level, the number one thing holding most owners back, and the fundamental practices you need to build a multi-million dollar business. Let's get to it. You are listening to the Dental Practice Heroes podcast, where we teach dentists how to step back from the chair, empower their team and build a practice that gives them their life back. I'm your host, dr Paul Etcheson, dental coach, author of two books on dental practice management and owner of a large four-doctor practice that runs with ease while I work just one clinical day a week. If you're ready for a practice that supports your life instead of consuming it, you're in the right place. My team of legendary dental coaches and I are here to guide you on your path from overwhelmed owner to dental practice hero. Let's get started.
Speaker 1:Welcome back to the Dental Practice Heroes podcast. I'm your host, dr Paul Edgerson. Today I am joined with my DPH coaches, dr Henry Ernst and Dr Stephen Markowitz. Dr Henry's got a large practice in North Carolina with 18 chairs and Steve's got a multi-location group outside of Boston, massachusetts. Today we're going to talk about why do some dentists make millions and others just struggle? Because, we see it, there's going to be a whole spectrum in anything. There's going to be the ones that guys, the outliers on this end, outliers on that end. I'll start with you, steve. Like what do you see? Like what is the difference?
Speaker 2:What's that X factor in people that are doing really well in dental practice ownership versus the people that just struggle and don't know why? I knew we were going to talk about this topic. I wrote down the word mindset 11 times. It is purely just how someone thinks of their world. It separates good people from great people. It separates people who are making millions from people who are unable to get a full schedule. And what I know about dentistry is yes, there are challenges. Yes, insurance has challenges. Yes, patients have challenges. Yes, team members have challenges, but dentistry is a license to print money.
Speaker 2:We have such a privilege to make as much as we want, work as hard as we want and take care of people in what I think is such a privilege to make as much as we want, work as hard as we want and take care of people in what I think is such a unique way. I share this with every single person that I talk to about. Why do I think that our group is growing? It's because we surround ourselves with people who say we're going to do great, we're going to take care of a patient a certain way. We want to surround ourselves with people who make us feel good about it and I don't even look.
Speaker 2:I've never looked at what insurance someone has who walks in my office. I know. When I'm sitting there and looking at the insurances that we take, I want to have an understanding of what makes the most sense for our business, but that doesn't even cross my mind when there's patients that walk into my operatory or walk into the practice. And if we're going to get so bogged down with the details that why patients suck, why team members suck, why insurances suck, we're missing out on all of the opportunities that Dentistry can provide us. And if we can put ourselves in that place every single day, we have the opportunity to print as much money as we want.
Speaker 1:I mean, I agree with you, Steve, it's totally. Mindset is a big part of it. I think there's a lot of crappy mindsets out there. What do you think, henry?
Speaker 3:I'm going to jump right on your back, steve Mindset. I wrote that down right over here as I was trying to make some notes to myself. It's all about the mindset and I think dentists have a specific mind that coming out of dental school, most people have zero business training and I was kind of like that. I didn't really know anything about business or running a business and I had to educate myself and I think there's a lot of fear. Also, you come out of school. I don't know what the going rate is of what people have in debt now. Is it 400, 500,000, something like that? That sounds about right.
Speaker 3:So there's a lot of fear and there's also the mindset of dentists of they're such perfectionists because we want to perfect this margin. It has to be perfect and this is the way we're trained in millimeters in dental school and essentially you're letting you know perfection be the enemy of good as an owner sometimes, because you're letting perfection be the enemy of good as an owner sometimes because you never learn to pass things off to others and train them and grow and stuff like that. So I think it's a combination of lots of these things of fear, mindset being very scared and cautious for making business decisions. I mean, I trusted when I was growing the practice and every time we had a decision to make, okay, we're at capacity, what do we do now? I knew the numbers. I trusted when I was growing the practice and every time we had a decision to make, okay, we're at capacity, what do we do now? I knew the numbers, I knew the metrics, I knew that we had to expand and I knew it was going to work. And I was really confident every time.
Speaker 3:And I think sometimes you see, like on the dental forums, on the Facebooks and stuff, it's like doing that is like the enemy. It's like some people just have this mindset like, hey, I'm going to stay in the four operatory practice and I'm going to take care of a family-based lifestyle practice. There's nothing wrong with that. But that's going to be the person who's going to be limited. They're going to have a ceiling, right, I never want to have a ceiling. I want to always keep growing. But the thing I've learned over time is grow efficiently.
Speaker 1:So what comes to mind for me is just general fundamentals, like what is the management fundamentals? This is what I see in my coaching clients that do really well and the people that work with me and work with us in our coaching is that we're holding them accountable to do the things that you need to do to run your business effectively. It's like if you make sure I'm thinking about me two, three years ago, maybe four years ago, about four years ago, with our lead meetings. We did them once every other week and then we stopped. Sometimes I showed up, sometimes I didn't, and then when I did show up, it was kind of like we were just talking about problems and reacting to them and after a while they started getting real stale and I was just like man, do you remember when we used to come to this lead meeting and we would talk about what are our primary goals right now in this quarter and what are we trying to effectively create and move forward?
Speaker 1:And we stopped doing that. We just started showing up. We stopped like being so goal-oriented and just started going through the motions. Same thing with team owners, where they stopped meeting with their team, they stopped communicating with their team, they stopped creating policies, they stopped saying what is the best way to do these things. So when I say what is making an owner make millions versus someone who's struggling, it's that person that's taking the time to do. All those little things, by all means, are not difficult to do I mean, anyone can do them but they're hard to do when you get so sucked into the dentistry and the day-to-day that you don't set aside the time and you don't make it a priority. So prioritization, prioritization of the fundamentals that keep the needle moving forward.
Speaker 2:Why do you think you stopped doing those lead?
Speaker 1:meetings. What about it? You know I think a lot of it has to do with is your attitude changes slightly when you sell your practice. It's hard to have that same amount of like engagement, and I've just like I don't know if that's just the time kind of burnout thing or if that has to do with the less percentage of ownership, but I felt like I just didn't want to go to those meetings anymore. I wanted to go in and out and you know what, maybe it was because we just stopped getting structured with it. We were just in there shooting the shit and it seemed like kind of a waste of time. Like morning huddles, like when we used to do morning huddles and then they got boring as hell, we stopped doing them. So I bet it was a combination of all those things.
Speaker 2:Yeah, the consistency is so hard.
Speaker 2:What I find is, when it's new and exciting, it's easy, and then when you shift from this entrepreneurial, really fast-growing business to a more established, mature practice, it's no longer new.
Speaker 2:So it takes a different mindset as a leader and we need to be able to evolve and adapt and the things that got us to that point of being like manic about all the details and knowing all of everything about every single person that works for us and who's doing what, when, as we mature and our practice becomes larger in size, we no longer can do that, and that's where I find a lot of doctors hit walls, and that can be when you go from a startup where you're doing your hygiene to now you have a hygienist, and that's a change. So finding a way to understand and mature as a leader that will allow you you to give the business what it needs not the business, you what you need is really hard, and I think that is that mindset of always evolving does leave people behind, meaning that what we say some people struggle. I don't think they're struggling, they're just not. They're not fulfilling the capacity or the greatness that this practice can become, because they're happy enough with what they have now and they're unwilling to change, to grow yeah.
Speaker 3:I think complacency is very easy for it to set in. I mean, I was just doing some math in my head the three people on this group right here we have about $38 million in collections between the three of us. We did it already, you know. We know that we can do it and it's easy for complacency Like hey, we're not doing the team meetings every week Like we used to, or every other week that we used to, and it's so easy for that to happen.
Speaker 3:And another point that I wanted to make is like the premise of the whole podcast today is like how do people like sit in that wall of like gosh, I make this much money. But how do people like sit in that wall of like gosh, I make this much money? But these people over here like way up here and I'm not saying that one's better than another you have to do what makes you happy. You could have that lifestyle practice that makes you completely happy and you have a great family life and that's perfect. But if you want to ascend right, don't listen to the naysayers. This goes for anything in society nowadays. Don't listen to the naysayers. This goes for anything in society nowadays. Don't listen to the naysayers. You put something up on Facebook, there's 50 naysayers that say don't do this.
Speaker 3:If these three guys are doing $38 million, they probably crown every single thing. They probably never put a filling in there. They probably overcharge. You know they do all these. Don't listen to that. Charged anesthetic Never turn down an opportunity to have a conversation with people. That's probably where I've made the most progress in my career is just being at certain events or this or that and just having lunch with somebody and just shooting the breeze of how they do things and picking everybody's brains and then eventually seeing what works for me. I didn't want the four operatory lifestyle practice. I wanted the practice that was truly a business that didn't depend on my hands to sink or swim all the time.
Speaker 2:Henry, that's awesome because it makes me think of just. We all have people that we can aspire to grow from, and I think when the people that are, at least in my experience, that struggle the most to get to their goals think that they have all the answers and they are the least humble, anytime that I wanted to grow, the first thing I did I was like, all right, let me look around and see who's doing that, because I want to talk to them, I want to learn from them. So I think part of that mindset is knowing that, yeah, you may be considered successful, but I guarantee there are people way more successful. Go get into another room, start talking to those types of people and you'll learn so much, and then that itself can be motivating.
Speaker 1:Yeah, I've noticed, like getting going to events, and depending on who you hang with at an event, or if you go into a masterminding event or if you're just going to like a CE, you will find people more successful than you and they will light a fire under your butt.
Speaker 1:Like I've come back from so many events where I'm just like man, I thought I was good, I thought I was like happy, and now I want to do all this shit.
Speaker 1:I want to do what that guy is doing. You know, what comes to mind when I'm thinking about some clients that I've worked with is that I see some because occasionally I'll see clients that will just struggle with the people stuff. It's not a comfortable area for them and it's something they don't really like to get too involved in and it really hurts their growth because they can't keep a solid, cohesive team in order to grow. So they might get to the point where maybe 1.5, 1.8 million, but they can't bring on an associate because they can't keep team members or they don't have a good culture and it stems from them not being able to have those conversations. And I think if somebody, if that's not your strong suit, it's something you have to work on. You either have to get good at it or you have to find somebody that really loves to do it and you need to delegate that to them. Have you guys seen that with some of your clients Just the people avoiding the difficult conversations?
Speaker 2:I think there are two aspects of it that I see. One is avoidance of difficult conversations, which I think we could do every podcast for eternity on.
Speaker 1:I'm guilty of it too. Yeah, I'm not going to say yeah.
Speaker 2:Yeah, no, because it's. It's really hard, but I think even more so than that, it's forming true relationships at work. When people love who they work for, like truly love who they work for, they will go through a wall, They'll do some crazy stuff and they will be so connected, not to dentistry, not to the purpose of or the vision, but they're connected to you as their owner. So if I were to tell anyone where to start, it's like you got to surround yourself. If you're going to be the owner and the leader of your practice, people have to love, love, love you, and that in itself can get you really far. Where I would start is make sure you're setting up time for that.
Speaker 2:So if your patient day ends at five and at 5.05, you're running out the door for four or five days a week and you have lunch by yourself, you're not doing the right thing and you're complaining about you're not growing to where you want to be, I would first say I'm going to have lunch, I'm going to sit at that table and we're going to have lunch together and I'm just going to start talking to my team and have them understand what I'm doing or get to know them better.
Speaker 2:And then I would go and I would purposely find two or three people a day doing something that is pretty awesome, that's making my job easier, and I would go up to them and I'd say thank you for doing easier. And I would go up to them and I'd say thank you for doing this, or I would send them a text at the end of the day. It used to be my checklist, my personal checklist. I would have to write a text message to two people every day, just thanking them for something specific that I thought was awesome or that helped me, and just continue to form that bond. And next thing, you know, you have eight, 10 people that just love what you do and speak so highly of you. It's contagious. And then you can bring in that associate because they're coming into a place that's already full of that type of energy.
Speaker 3:So I'm going to disagree with you. One point is we haven't fought Henry yet Sitting down and eating lunch with the team. And the only reason I bring this is fresh in my mind, because I was coaching a dentist practice and there was an older dentist who just came into the practice and he was trying to like be everybody's buddy and stuff like that, and he sat down with them and had lunch like for two or three days and the staff hated it because the lunchtime was like their sweet time to just like shoot the breeze about their boyfriends or this or that and talk shit about or do whatever they do, right. And then you come in there and now you're messing up their whole like it's like the teacher sitting with them. So I love everything you said, but I'm just gonna punch holes here and I would say I don't love the lunch thing because I think that you're coming into their space and I'd say stay away. While I had it in my mind.
Speaker 3:As far as the growth aspect and getting the mindset, it's not natural for most dentists to have these personal skills. It just doesn't. Most of those things don't come together and if you're not comfortable I love science If you're not comfortable in that space, find a mentor, find somebody who can give you those skills, or even a coach that can do this for you. And I will tell you this because it always stuck with me, is, whenever you're in a room of, let's say, dentists and maybe there's some successful ones and non successful ones what I found over the years the ones that are the nervous ones or don't have all the answers or not so successful those are going to be the loudest voices in the room.
Speaker 3:The people who are the most successful and quote unquote have all the most of the answers and are very knowledgeable. They're usually the quietest ones in the room. So always take note of that. And I always wanna see if I've got somebody talking to me and coaching me. I wanna know the worst stuff that's ever happened to them, because I want them to be honest, I want them to be open, because we could all again, we could do a podcast for a year and talk about all the bad shit that has happened to each one of us, and we'll be open to do that, because that's who we are and you learn from the mistakes that you make. So I just want to get those points in, yeah.
Speaker 1:I'm with you, henry. I don't like eating lunch with the staff. I feel like they would just be like get out of here. Old man, maybe when I was like in my early 30s.
Speaker 2:I'm not saying every day, bring your roast beef sandwich, paul, and sit down with them and watch them eat. But what I'm saying is I'm using that as an opportunity, because if someone's not willing to at least sit with you for 10, 20 minutes, you don't have a real connection with that person. And what?
Speaker 2:I would say to that old guy is he's making my point? Those people, they're not even going to sit with you for 10 minutes because they don't respect you enough to want to spend 10 minutes of their break with you. They sure as hell aren't going to help you. Bring on an associate, yeah.
Speaker 3:Steve, I was just picking on you. You can bring your old school roast beef sandwich in your little brown bag and sit with the staff. We're Boston pastramis.
Speaker 2:It's a turkey and cheese header. You know I get the same thing for lunch every day. How dare you.
Speaker 3:You're just that guy, I just pegged it. You're so that guy that has the same turkey sandwich every day. Dude, I used to eat so like.
Speaker 1:I never take a lunch and I never did and we're like when we open our practice, everyone used to give me shit because like I'm like what can I eat really fast? And I could throw down four uncooked hot dogs in like literally a minute and everyone be like you are disgusting.
Speaker 3:Is there not some disease you get with that when uncooked hot dog?
Speaker 1:Dude, I don't know, they're already cooked. You don't have to cook them, they're just ready to go. And then people give me because I would eat spaghetti. I was right out of the can, cold and I would eat pork and beans out of the can cold. They're like you're sick, but I'm like I was looking up like what is the absolute worst thing you can eat for your body. It is a hot dog. Congratulations, that's for a day. It was like a staple of my diet.
Speaker 2:As we were going through this, one thing that I kept thinking about was overcoming fears. I really think that is the biggest obstacle in what makes dentists unable to be as successful as they want. And what I found is, even at this point in my career, I still have these giant fears of like is this a deck of cards and it's all going to crumble? Or is this doctor so important to the organization that, if something, if I don't give them everything they want, then this thing's got to collapse. And what I think has been helpful for me is just experience and that's really hard to tell someone as they're starting out is that I've seen enough bad times. I've seen us get through it enough times to know like I can't care that much about this small thing.
Speaker 2:I've really been able to take myself and look at like, all right, what are the eight to 10 things that I really can influence that are going to impact the business? And how do I make sure we're upholding ourselves to that and not get stuck in the minutia of all the stuff? And I think, as business owners, there's so much that can happen in a dental office in a day and if we, if we try and fix and control every single thing, we lose sight of what we're really trying to do, which is grow a healthy business and take care of people in a dental office. And that always starts with my fear fear of losing control, fear of it not working, fear that I suck all that stuff. I'd love to hear you guys' thoughts on how do you overcome these fears.
Speaker 3:I think, education. Looking back on how I always made these like snap decisions when the business needed to grow and grow. I made those decisions because I had the fundamentals of understanding the dental business and it didn't come from dental school. I remember I had somebody asking me oh, do you think they should teach the business part in dental school? And I said hell, no. And the reason why is because the people who are going to teach that are people who don't even do it. They're going to set you back further. Yeah, so I think the main thing that comes from this is education and understanding the education of your dental, because you're trained on all the dentistry stuff. That's great, but now we need to get educated in business, dental business and what this looks like and what you mentioned there.
Speaker 3:I love to stress test the practice even to this day, like you know. Stress test. Hey, what would it look like if in the next year, our business expenses went up 10% and our revenues went down 10? How long would the business like be okay? What happens if their shit really hit the fan in this world? And 20% expenses and 20% less revenue? What would that look like and what decisions would we have to make. Those are the kinds of things that when you get knowledge you're not just flying by the seat of your pants, you feel comfortable because you know, like you've kind of done this in your head, and we never have all the answers, but being educated gives us like the path better.
Speaker 1:Yeah, I think the period that I want to put on the end of this episode is that if you're paying attention and you're engaging with your team, you can't go wrong because you will always know what the next thing to do is. And to your point, Steve, I remember when we were coming out of COVID we were just kind of kissing everyone's ass and didn't want to ruffle too many feathers or upset people, and I got to the point where I said you know what? Things are not going the way I want them to and I'm kind of tired of it. And I said things are going to change here and the people that didn't change. We got rid of them. We lost a lot of people in a short period of time.
Speaker 1:But damn, going through that process, let me realize that nothing can kill the culture of this practice. Our practice is too strong. We have reached a level where, no matter what happens and I'm going to go to that bad spot and say, holy cow, this whole house of cards is about to tip over, it's about to fall, it's not going to happen that's where I think this resilience and mental toughness came in my career. Was me just realizing every single thing that happened over my career. It didn't kill the practice and nothing is going to kill this practice. We might have a bad month, we might have a time where we're covering for each other and we're a short staff, but shit, it is not all falling down. And I think we're all guilty of having that thought at some point in our career, because it's just fear.
Speaker 2:So when you realize that the threshold that made you feel comfortable with it it was just you, yeah, absolutely Nothing changed.
Speaker 1:Nothing changed. I thought my practice was two months away from tanking for 12 years. You know like when you're taking a tooth out, you're like two seconds away for like two hours. That one tooth, that like you're in there for two hours You're like I've got two seconds, I get this thing out in two seconds, but you think that for two hours straight. That's what I've thought for my whole practice career. It's all about, yeah, maybe 10 years in. Yeah, okay, where to go now?
Speaker 2:Just let the silence sink in. It's all about mindset. You said so. Just let that sink in Nice and we're overcoming our fears.
Speaker 1:And we're going to take you out of this episode. Steve's going to take us in a guided meditation. Go ahead, Steve.
Speaker 3:With his turkey sandwich.
Speaker 2:Oh dude, it's so good.
Speaker 1:Thank you so much for listening everybody. If you're looking to take your practice to the next level because you want to take more time off, have more consistency, make more profit and just have a better practice life, please check us out at dentalpracticeheroescom. Try working with a coach. You know we didn't even talk about that. You know, one of the things that I see in a lot of successful dentists is they work with coaches.
