Stop Drowning: The Weekly Habits That Turn Chaos into a Calm, Profitable Practice

Overwhelmed in ownership? You can’t fix everything at once, but today you'll learn where to start. Get back to the fundamentals — vision, numbers, and leadership — with simple steps that will help you get organized and out of survival mode.

The DPH Coaches share the seven metrics every owner should track, the checklists that keep you and your team accountable, and how to spend less time on tasks you don't enjoy. If you feel like you're drowning in problems or stuck in decision paralysis, this episode is for you!

Learn how to:

• Navigate the mental toll of ownership
• Define your “why”
• Align your culture with your vision
• Do a “stress autopsy”
• Track important data in your practice
• Keep your team accountable
• Make smarter decisions based on data

This episode was produced by Podcast Boutique https://www.podcastboutique.com

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Chapters

• 1:44 From Freedom To Overwhelm
• 3:19 Rethinking Ownership And Your Why
• 5:39 Culture Alignment And Team Buy-In
• 9:26 Data Over Drama: Clean P&L, Dashboards
• 14:26 Outsourcing, Checklists, And Verification
• 18:46 Weekly Metrics That Tell A Story
• 22:22 Coach, Plan, And CEO Time
• 25:17 Closing Thoughts And Next Steps

Transcript

Paul: 0:42

You got into ownership hoping for freedom, but now you just feel overwhelmed and stuck. Does that sound familiar? It's something we're seeing more and more, especially from dentists who've taken over a practice or jumped into ownership with no real guidance. If you've been asking yourself, where do I even start? Stick around to learn how to get organized, keep your workload at a manageable level, and how to stop feeling so alone in ownership. Today we're going to share the seven numbers that we track in our practice weekly, the checklists that help us manage our team better, plus more habits that make ownership less overwhelming. 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 Etchison, 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. Welcome back to the Dental Practice Heroes Podcast. Thank you so much for joining us today. I am Dr. Paul Edgerson and I'm joined by my other DPH coaches, Dr. Henry Ernst and Dr. Steve Markowitz. Dr. Henry has a large 18-op practice in the Carolinas and Dr. Steve Six practices on the East Coast. So these are people that know what they're talking about and have the experience to prove it. We were talking about what we were going to talk about today. Sometimes we get a little heavy for large practice, and we don't spend enough time with smaller practices, which most of the listeners probably likely have a smaller practice that's evolving or you're getting started. And when we look on the Facebook forums, we see a lot of people posting things anonymously like, I don't know what to do. I don't know why I got into this. I hate this. I acquired a practice and it's not going well. So we thought we'd do an episode on, you know, what are those foundational things? Where do we start? When there's so many things to do. And I think a great analogy is when you walk in a room that's really messy and you don't know what where to even start. Where do we even clean it up? So I'm gonna go to you first, Steve. When you see these people posting these things, what is the first thing that comes to mind for you?

Steve: 3:04

Yeah, I totally feel for them because dentistry can be a great profession, and and they most people got into practice ownership because they love the profession and they wanted to be their own bosses, and they may not have fully understood what that really meant. So I think even before we get into like the details of where to start cleaning up the room, it's understanding what you really want out of this journey. Like just because your friends are going into practice ownership, or you think that's what you wanted when you started dental school, doesn't mean that that's the best thing for you. You could have a wildly fulfilled life, you can make more money than you know what to do with, and you can never own a practice. All of those things are possible. So I I would encourage anyone who's going to take that leap because it is such a burden. And by burden I mean responsibility when you have people's livelihood that you're responsible for, not just your patients, but your team. I don't think that should and can be taken lightly. There was a Patrick Ed David, like a just a thing that came up on one of my reels. He was telling the story about he was the happiest professionally when he was the second person in command. He made more money than he ever wanted to, and he did not have the burden or the responsibility of being the number one person. And for when we take that leap into ownership, there's no one else to turn to. We are the tip of the mouth, and that that cannot be taken lightly.

Paul: 4:37

Yeah, I feel the same as like sometimes I feel for specialists. I'm like where they get things referred to them and they have to do it. Like there's nobody else.

Steve: 4:46

Yeah.

Paul: 4:46

Like I feel like I couldn't do that. I'd be like, I don't want to do this. I want to refer this out to somebody else. So what do you think, Henry?

Henry: 4:52

Yeah, this is a topic that we're seeing more and more. And I've been in practice for 20 years now. I feel like I'm seeing this so much now. And I think number one is breathe, right? Take a step back, breathe. With great power comes great responsibility. The moment you step into ownership, just understand you're gonna be responsible for other people's livelihoods, like Steve said. There's gonna be times where you're sitting there on a Sunday, especially when you know how systems in the beginning and you're doing work. And maybe you want to sit up by the pool and have a beer, but you have to do this, right? So I would also say just understand it. There should be no ego, right? You can make fine money doing there's so many things you can do in dentistry that are a lot less stressful than ownership, right? Find a confidant, find somebody you can talk to. So much of this mental illness that's happening in dentistry right now that people don't want to talk about. They feel embarrassed, they feel like they're a weak person. Dude, we need to talk about this and reach out to somebody, right? There's somebody that's going through something that you are also. So don't have an ego, find somebody to talk to. I mean, we can talk about the business end of it, but a lot of this is just about the mental aspect. Like, how much money do I need to live a fulfilled life and reverse engineer it? Like, can I be an associate and do that? Right? Can I, who knows, do prison dentistry or whatever? There's so many things you can do that can make you happy. It doesn't have to be pigeoned into you have to be an owner, you have to do this. And I see everybody on Facebook is doing this. That's what because I have to do it. So I would say this number one, just realize what's my why. Don't let this get to the point where you're so overwhelmed that it just takes over your life and you're a bad, you're a bad husband or a bad son or daughter, and it just ruins your personal life.

Paul: 6:36

Yeah, it's true. And I think it always comes down to why when we jump in it for different reasons. I think for me it was it was money and I think it was autonomy. I think I just was a shitty associate. I just wanted to do things my way. Like I was just, I would hate having me as a social. I was a great producer, but I was just always like rocking the boat because I wanted to do things my way. But you know, it's like if I look at an owner and I look at, you know, overwhelm people, they don't know where to go, they don't know where to start. I think it always starts with the the feelings, the why, and what do you really want from this practice? And then communicating that to the team. And then when we communicate that to the team, then it's just like playing whack-a-mole. It's just asking them, what do you guys think are the issues here? What can we address and figuring out who's with you? I think I see a lot of owners that are really struggling against a culture that's moving in a different direction than what they want to take the practice in. And I think there needs to be some cleanup, but at the same side that there's cleanup, there also needs to be some declaration of like, this is how we're doing things, this is what I want of this practice. And not only this is how I want to treat the patients, this is how I want to treat each other as team members in finding out who is with you. And that's that's stuff that it's so easy to skip because we get bogged into like, well, how should we answer the phones? How should we be collecting dollars? How should we do this? So that's the foundational stuff that I think this is where I think you start.

Steve: 7:59

Yeah, I I do we can get into the details and the grenade, like what checklists to start with. And I think there are there are definitely ways that it can make it easier. But whenever I'm working with a coaching, with a coaching client, or when I'm talking to friends of like, how do I navigate these types of things that you just said, Paul? There's a book called The Advantage by Pat Lancioni. And the reason why I quote him every single episode that we do is because I think I just think everything he says makes so much sense. And in The Advantage, they have six critical questions, they call it. And those questions are what do we do? How do we behave? What is our purpose? What is our strategy? What is most important now? And who's doing what? Wow. And if you can answer those six questions, you will have a path to be able to not only understand what your vision is, but to be able to communicate that with your team. And that is what is going to make them stay. I guarantee from the from your team members' household to your office, they pass at least 10 dental offices. Why the hell are they going to choose you? Why are your patients choosing you? You need to be able to start and communicate that to your team so that they can be the extension of you. And I think that's always the fluff and why more people want to start with what's our cancellation policy. Yeah, it feels fluffy. It is that stuff that will actually create the stickiness of your patients, of your team, that they feel connected to not just what you're doing, but why you're doing it.

Henry: 10:32

Yeah, the it comes down to fundamentals. I know it sounds really stupid, but I can't tell you whenever I run into people with problems, most of the time they have no idea any of their numbers. Yeah. How much does it cost to run your business? No idea, not a clue. Right. And do an autopsy. Like, what are the things that are causing me stress? Is it clinical side? Oh, yeah, every time I do an extraction, my heart goes through my chest. Okay, let's stop doing extractions, right? There's no rule that says you have to do everything. Do the autopsy. What are the things that are causing me stress? Have a pad of paper at your desk and over the course of a two-week period, write down everything that sucks that you hate doing, that you never want to do again, whether it's clinical, whether it's business-wise, or whatever that looks like, and you'll have a good sheet of this is what I need to clean up right here, right? Business-wise, if you're just drowning and you feel like you love dentistry, you just feel like you're doing a good job, but you just you look at that statement every month, and it's there's nothing left on the bone, right? Then fundamentals. What is our overhead? What can we make better? Are there low, you know, low-hanging fruit, dental supplies, this, that. I mean, this is all stuff that a confident a coach can help you with, right? But there's some people, and I give them so much credit for coming out there on a limb, is they say, Listen, I've tried it, I just can't do it. It's not for me. And it really, really sucks because you've invested so much education. But at some point, life is more important, right? You have to just figure it out what to do. There's been people that we've helped before that just had to sell it and walk away from it. Yeah. And maybe they look at themselves as a failure. I don't look at you as a failure. I look at you as somebody who had the big, bold action to say, I'm not happy with this. I'm making the change.

Steve: 12:14

Yeah. Congratulations on having the courage. Like that's really Yeah.

Henry: 12:18

Because most people just put their head in the sand like an ostrich and just keep going down that miserable path and they're miserable SOBs.

Paul: 12:24

You know what I see a lot, and I'm going through this with recently with a newer client, is that we get did that diagnosis, or you call it that autopsy, and we're looking at numbers. We're trying to see like what's going on. We're trying to get an accurate representation of what's going on in this practice. And when we take somebody on as a client, you know, we always do the anonymous survey with the team. We get a lot of information from that. But I had a client and she sends me her profit and loss, and she says, I don't even know how to read this. And I get her profit and loss, and I say, I don't know how to read your profit and loss either. This is so common. Is like I'm using this mom and pop accountant. It's not a dental person. They give me my categorization and everything, but it's it's laid out in a way that's like completely useless. Like, what is your payroll percentage? What is your supply percentage? What are you paying your hygiene team versus your assistant team? What's the back versus front? Like, there's so many different things we can look at and make a profit and loss useful so that we can use it to make decisions in our practice. But the fact in there is it's just a complete mess. And we got to get it cleaned up. Same thing with like, I mean, I don't know what the stat is, but I think three out of four, maybe half. I'd say half people, half of the people we work with have no sort of checking on metrics. There is no metric reporting, they're not paying for an outside service that can put it into a dashboard. They just flying blind. And it's like you've got to start looking at things. Now, I am not one to say, hey, we are gonna get buried in the numbers. Steve, Steve freaking loves numbers. Steve like loves the metrics, like you wouldn't believe, but he's running six practices, and you know, that's the level of leadership he's at. For me, I will base everything are the metrics at a good level and does everything feel good? Now, I'm only on one practice. I don't know if Henry, your experience is like that as well, but I'm just not super big on getting granular with the numbers. But you've got to start somewhere. You can't just be completely blind on the numbers. So I would say that's another thing, too, is getting your fundamental dashboards so you can make decisions that are routed in data versus I don't know where to go. I'm feeling, I mean, it's this ambiguity that makes us feel so uneasy. I think as humans, we want to have certainty. And there's a lot of uncertainty when we just don't know our head from our ass because of how our data is.

Steve: 14:39

I think the data is so important because when we we're talking about people who are in such a rut that they're going on Facebook anonymously or calling us and just, I don't know what to do, I don't know where to turn, I feel hopeless. It is hard to see anything because you see everything through the lens of everything's happening to you, and you've just are stuck in the mud. So creating an understanding of your data and making decisions that have no feelings attached to them is actually so freeing because many times in these types of situations, you can't see it. So you're basing everything off emotion, and you're not in a place to even be able to see things clearly. And I think that's a really challenging thing for any entrepreneurial dentist um when they're starting in practice ownership, is they're just getting it just feels like they're drinking through a fire hose and they don't know where to turn, and they're trying to do everything, they're doing their own bookkeeping, they're making their own phone calls, they're doing their own payroll, they're checking the credit cards and deck, and they're like, I just want to prep this tooth. And they don't really understand how to do everything. So I kind of made a list of where I start. I'm happy to go through it all if you think that'd be helpful. Let's do it.

Paul: 15:45

Yeah, let's do it.

Steve: 15:47

So the things that I never like doing bookkeeping, payroll, I don't do those things. I've never done those things. I'm not detailed enough. I want to get reports on what they look like. I want it to be off my to-do list. Bookkeeping was outsourced maybe on day two of my practice ownership journey. A lot of what else I hear is I don't know how to manage things that I don't know how to do. I'm really good at managing the hygienist or managing the assistant or managing the dentist because I know how to do those things. I have no clue how to manage what's happening at the front. Perfect. You don't need to know how to do those things, but you do need to know if they're being done. You need to have a checklist. I'm not asking. You need to have one. You need to start with an end-of-day checklist. That what you think was what you thought was collected was collected. You need to know if there was any cash that was brought in, you need to know the checks, you need to know the credit cards, and it needs to match up with your practice management software every day. You need to know that again, I would start with having those that person at the front, if they're responsible for 10 things, they need to write down those 10 things, and at the end of every day, they send a checklist and it sits on your desk and you get to look at it every morning. If you are just guessing if things are being done and then upset amount of money in your checking account at the end of the month, it's you. You need to fix it. And it doesn't mean you need to know how to do everything, and I don't want you to do everything, but you need to verify and make sure that that stuff's happened.

Paul: 17:17

I love that, man. And it's one of those things about having a path. Like I mentioned that uncertainty. Like when we don't know where we're going or where we're supposed to be, it just doesn't feel good. I remember when I had my practice, my practice was maybe like two or three years open. And I started like, man, I'm kind of making a lot of money here. This feels really good. And you know, I grew up like a single parent. My dad raised me, he was a carpenter, and then he just I was making like 50k a year, you know, it wasn't anything extravagant, like we were really like middle class. And I said, Man, I am getting money. I don't want to screw this up. So I reached out to a planner, and what was interesting is I thought I should be saving way more. And then what I've learned from this planner was, hey, like what are your goals? When do you want to retire? When do you want to do this? Now, at this time, I was like, I want to be done at 45. You know, I wanted to be done earlier. But what was cool is when you look at you what your goals are and you get a plan, it feels really good when you can hit that savings goal because then you know everything after that. It's just free money. Spend it, do something cool with it. But you have a plan. And I can tell you personally, from the the position of not knowing if I'm saving enough, if I'm doing the right things with my money, to actually working with a professional and saying, wow, I am doing the right things. I know that I'm gonna be okay. That is the difference. And that's what I think is working with a coach is having somebody hold you accountable and actually create this stuff with you because there's like we said, there's so many different ways we can go about it, but there is a basic kind of like template that we should do. But that was just my experience, is I felt like it just felt really crappy as a person to not know where the hell I was supposed to be going. And I think that's what people are feeling when they're on the internet. And I don't think asking Facebook is the best solution.

Steve: 19:00

I really don't. Paul, that's awesome. Yeah, thank you for sharing that. Do you think that it's always financially driven?

Henry: 19:06

I don't think it is. I think some people go into dentistry and they just realize this is very stressful. I'm in charge. I've heard this exact statement from dentists before. I'm in charge of somebody's mouth. If I screw this up, then they're gonna be in pain. They're gonna call me. I don't know what to do to fix it. It's oh my god, well, like what the heck did I get myself into? You know, so some of it comes from that aspect. But I'd say most of it comes from the financial aspect. And I mean, the first thing that I would say, just from this podcast to you guys is out there, is I mean, consider us an olive branch. Like, we're happy to have a conversation with anybody, even if you don't underpractice and you're going through this here. I mean, there's too much of this going on in dentistry that's not really talked about. Like, please reach out to us. We're those guys that work two days a week. So I guess we have some time here and there. But a couple of the points that I would make, right, is the fact Especially Steve. Especially Steve.

Steve: 19:59

I have no freaking time. I'm crying myself this weapon. Leave me alone.

Henry: 20:02

He's looking at numbers too much. Yeah. In all seriousness, like you were talking about, Steve loves the numbers, and Paul's maybe like a little on the other side. I feel like the numbers tell a story. So we have certain metrics that we look at every week, and I look at them every week during our L10 meetings. And if I see that certain things like our ortho starts are down, okay. If everything's fine and dandy, we're on cruise control. That's all good. If something is lower, that's telling me a story. If our treatment plan acceptance is lower for the of three or four weeks, let me look into this a little bit more. Is there one doctor that's lower than others? Maybe he or she's having a bad month and we're talking to them, and this has happened. All of a sudden, hey, I'm having troubles at home. I'm sorry. But it's kind of cool to realize, hey, the numbers led me here and they told me this, right? And on the other end, you mentioned this, Paul, is a coach, right? In my practice growth ascension, we went from opening the doors with two staff members and four chairs to less than four years later being at 18 chairs and five and a half million dollars of collections, right? I'm not God's gift to dentistry, right? There were paths along the way where I had to make certain decisions that maybe I wouldn't have made unless somebody that had more experience told me five months into it, like, hey, listen, you're growing so fast. What's your why? I want to grow as biggest practice as possible. Okay, need to call the construction guys tomorrow and tell them you need an expansion.

Paul: 21:26

Yeah.

Henry: 21:27

Right. I wouldn't have the balls to do that. But when somebody looks at my numbers that are telling a story that has had experience and they told me that, that's why I did that. So Olive Branch, if you're having issues, whether it's whatever it is, feel free to call us. We're happy to help in whatever way we can. If you're business-wise, you're having troubles, have some sort of CEO time that you designate. This is my time. It doesn't have to be at the end of the day, like Steve mentions. I'm a beginning of the day guy. I look at beginning of the day stuff, what's happened the day before, but definitely make it consistent. This is my time that I look at this. Because if you don't look in a single practice, nobody will.

Steve: 22:06

Um, as far as the checklists, end-of-day checklists, beginning of the day checklists, downtime checklists are the three. If you're gonna start with if going down that checklist route, those are the three that I would start with. But numbers that I would want an office of any size to be looking at every week should be production, collections, new patients, visits, reappointment percentage, amount treatment plan, and treatment accepted. You don't need every single number or every single data point, but if you're looking at at those six or seven numbers weekly, you will have enough information about your practice to make the changes that you want to.

Paul: 22:43

You say something like that, Steve. It makes me think I'm more buried in the numbers than I give myself credit for.

Steve: 22:48

You are more buried in the numbers than 99% of dentists. I show you my spreadsheets, and you're like, You know so much more. I'm like, Paul, shut up. You know everything about the same crap. I look at the same numbers.

Paul: 23:00

I know, but I'm like, oh, I'm not into the numbers. And then you're like, what about these numbers? I'm like, oh yeah, those numbers. Just those ones. Yeah. And you're like, what just those ones?

Steve: 23:06

Those ones are really important. Let me tell you all about those.

Paul: 23:08

Yeah. You know what I think is good to recognize is that life is about relationships. And, you know, relationships with our spouse. And we've got to have quality time with our spouse. We got to have quality time with our friends, quality time with our kids. You need some quality time with your practice where you just need to sit there and say, Hey, practice, how's it going? What's going well in your life? And you got to say, okay, your practice is going to tell you some things. You know what? I've kind of been unhappy with you as a leader of my practice because all this crap's going on. And you need to actually address those things. So, what I'm saying is, like, I know this is where I'm fictitiously giving or personifying a practice, but you need to spend time with your practice and ask your practice, what do you need from me? What do you need, baby? Come on, you more chatta.

Steve: 23:48

Paul talks some really those that those late night conversations. Henry, we should go listen to the late night conversations between Paul and his practice.

Henry: 23:55

Those would be great.

Steve: 23:56

Those will be some some sexy conversations.

Paul: 23:59

Show me those numbers, baby. Baby, come on, baby. Talking dirty to the practice. Oh, God. So anyway, hey, you know, we're gonna wrap it up. If anyone's, you know, you're thinking, listen to this, and you're like, dude, I need some direction. I need a coach. What the heck? I mean, I have yet to find somebody that has not benefited from coaching. We have all had coaches in our career, and like Henry said, like, I have had coaches in my career. I was not born with the knowledge of it. You got to talk to somebody that's further along ahead of you. And that's how you skip the line. That's how you get in front and you get the gains. And it's not only that, getting the help, it's putting that focus where it deserves that's really going to get you results. So that's just something that comes with experience. So if you're thinking about working with a coach, please check us out at dentalpracticeheroes.com. And we thank you so much for spending your afternoon or night or your drive with us today. We really appreciate it. And we will talk to you next time.