Very Dental: Building a Practice That Runs Without You with Dr. Paul Etchison

Jul 4, 2025

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Alan welcomes back friend, dentist, and coach Dr. Paul Etchison to talk about his unique career journey. Paul shares how he went from working in a high-volume clinic to building a startup practice that grew so quickly he was forced to bring on associates.

He details the specific strategies he used, like prioritizing new patients and intentionally creating capacity, to scale his single office into a five-doctor, 9,000-patient practice. Paul also opens up about his battle with burnout, the decision to sell to a DSO with the intent to exit, and the surprising realization that led him to stay. This conversation is packed with actionable insights on creating systems, delegating, and building a practice that grants you the freedom to work less and live more.

Key insights:

From High-Volume to High-Value: Paul’s journey began in a busy HMO/Medicaid clinic, which taught him speed and what he didn't want in a practice.
Forced Growth: His startup became so busy through organic referrals that he was "forced" to hire an associate to handle the capacity.
The New Patient Engine: Intentionally holding schedule blocks for new patients is a key strategy to drive growth and justify adding hygienists and doctors.
The Magic of Two (Plus) Associates: While one associate adds profitability, Dr. Etchison believes the second associate is when the magic happens, making the owner's personal production less critical.
The Path to Less Clinical: Paul now works only a few half-days per month by successfully transitioning his practice to be associate-driven.
Burnout and the DSO Sale: Feeling overwhelmed, he sold his practice to a DSO at age 39, planning to exit dentistry.
Why He Stayed: After the sale, he successfully delegated leadership duties, which rekindled his passion and led him to stay on after his contract ended.
Delegate What You Dread: Tasks you hate are often tasks another team member will enjoy; learn to delegate effectively.
Design Your Ideal Work Week: Consciously identify what brings you joy versus what drains you, and restructure your role accordingly.
Build a Practice That Runs Without You: The ultimate goal is to create systems and a leadership team that allow the practice to thrive, whether you are there or not.

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