Bulletproof Dental Practice

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 71 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Brian Colao, Dykema   Key Takeaways: Dentistry is undergoing a great evolution and a great consolidation. There’s also massive disruption within the workspace of dentistry. There’s a lot of fear out there, and it doesn’t have to be that way. A big part of the fear is lack of information. If you can understand what the changes are, why they’re happening, and what the legal options are, there is no reason to fear change. DSO’s allow dentist owners to sell their practice to the whole world, not just to another dentist in your state. If you’re a solo office, you don’t necessarily need to be a DSO. If you plan to grow and are looking for the largest buyout possible then a DSO setup will be a great benefit. After 3 offices you’ll generally see more favorable tax treatment under the new code. Check with your CPA for specifics on your practice. A lot of specialists are forming DSO’s as well. GP DSO’s are buying specialists as well. As the whole market starts to consolidate to DSO’s, strictly referral-based services will start to lose market share. Technology is making specialty procedures a lot more doable for general dentists. The next 3-4 years will include a lot of consolidation, but right now there’s room for everyone at the table. After 5-10 years the marketplace may change, and some opportunities won’t be there anymore. Seeing 14-15x offers will most likely become less common over the next couple years. Brian predicts 6-7x offers will be the norm. There is tremendous demand from private equity to buy dental practices. There is a bit of a gold rush in the dental industry; there’s high demand and low supply. Don’t give in to FOMO; sell when it’s the right time for you. For organizations under 5 offices, it costs around $20,000-$25,000 to set up a DSO. For restructuring DSO’s, 8 out of 10 times Dykema can rework the original DSO into a better structure. Dykema’s 5th Annual Definitive Conference for Dental Service Organizations is coming up July 18th-20th. Register NOW with and use code “BulletProof” to receive discounted registration for $350!   References: Private Equity is Pouring Money Into a Dental Empire

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 70 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Dr. Drew Byrnes, The FFS Dentist Podcast   Key Takeaways: FFS Practices take courage and planning. The first one is the hardest. You’ve already got your proof of concept. It’s super important if you’re a FFS practice to really make sure you’re creating an experience. Your online reviews are the truest barometer of who you really are. Marketing should be fun, especially on social media. Recessions are hard to weather but also offer great opportunities for growth. Always be auditing for the patient experience. Create your culture and make sure you hire the right people for the right job. Your team has to come first. Treat them like your family. Support them and they will support you. Don’t let anyone who is toxic come into your business; patients or team. Marketing is a big factor of growing your practice. Effective marketing amplifies your office culture and experience. Don’t spend a lot of money on fancy print ads. The bang for the buck isn’t there. Have a bulletproof patient experience process in place BEFORE you spend money on marketing. Reach out to any influencers you can find and offer them free services in exchange for them posting about you on social media. Have them publicize their experience about your practice. Master attention-based marketing. Find out how to get in front of people on their phones. The more you capture someone’s eyeballs the more you’ll capture their conversion. There’s no such thing as coasting. You’re either getting better or you’re getting worse.   References: Voices of Dentistry Under Armour Protect This House Bulletproof Summit 2018   Tweetables: The difference between success and failure is typically one more day. – Dr. Peter Boulden

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 69 Hosts: Dr. Peter Boulden & Dr. Craig Spodak   Watch full video of the interview by clicking here!   Key Takeaways: A lot of general dentistry practices see a slump in the summertime. Kids are off school so parents focus more on their dental care. Boulden predicts what is done in March will predict business for April, May, and June. Cycles happen and they are normal. Oral surgeons tend to have busy months, so take advantage of those procedures. During downturns pay attention to pre-appointment rates. What % of your patients are leaving with another appointment scheduled? If you’re in the 90% range you have an iconic practice. Pre-appointment rates have the highest correlated number for profitability and overall practice size. Have your providers with high pre-appointment rates train those who are lower on how they do it. Also look at your revenue per patient and work on growing that number. Focus on the # of visits, avg production per patient per visit, and profit rate. Only 11% of what can be maximized on dental insurance is being used. Marketing isn’t print ads anymore; it’s influencer marketing, spending on patients, social media, etc. Focus your dollars on where people’s attention is. Today it takes about 20 impressions of an ad before people choose to act. Influencer marketing is currently very low-priced attention. Authentic testimonial videos are GOLD. Videos don’t have to be super-well produced. People respect unpolished testimonials and often weight them as more authentic. Find a dental advocate who wants success for you. Bounce your ideas off them and share tips and tricks.   References: Dental Intel Tribute Spodak Jeff’s Reaction   Tweetables: Use pain as a motivator. – Dr. Craig Spodak You get what you focus on. – Dr. Peter Boulden Influence is the difference. – Dr. Craig Spodak

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 68 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Dr. Kyle Stanley, DSD, Speaker, Lecturer, Dental Expert   Watch full video of the interview by clicking here!   Key Takeaways: The Lip Factor – Dr. Stanley’s concepts regarding moving lips if needed. The lower third of the face has to be involved with smile designing. Dentists have a great opportunity to partner with plastic surgeons to create exceptional results for patients looking for facial changes. Oral surgery programs should include two roads; hospital and private practice. Bone sets the tone, but tissue is the issue. DSO mania is helping super high-end practices by differentiating them from “normal” dental offices. Rogue dentists can get away with terrible treatment in a way that medical doctors cannot. Dentists have to get away from what was being taught in the 70’s. Always over-communicate with your patients so they can’t ever feel you haven’t shared all education with them. If you give your patient a proper education, you’ll never regret it. Dentist are 500x more likely to commit suicide than the general public. Stress is a real killer. A lot of dentist’s stress is related to dental school costs, practice acquisition, and the enormous pressure of debt. Dentistry doesn’t do enough to change patient behavior and manage expectations. If we can put less pressure on ourselves we can be more open with our patients, it creates less stress and is a better patient experience.

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 67 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Dr. Gregg May, 10X Dental   Watch full video of the interview by clicking here!   Key Takeaways: The obstacles we overcome make us who we are. When times are tough it’s really easy to isolate. Seek out another dentist who you can talk with and commiserate with. The 10X Dental group is designed to fuse experience from old-school dentist with passion and new technology from younger, up-and-coming dentists. When dentists get challenged they tend to revert back to dental terminology. You’ve got to talk in plain English. Always use patient-friendly language. 10X Dental Group is also about sharing leadership skills. Accountability is key. You need people to hold you to the fire. Mastermind Groups are great for finding like-minded people to relate to and share best practices. Sometimes “more” can make you really unhappy. There’s more to running a dental office than ever before, not least of which is creating office culture. The bigger you get the larger the expectations of you are.   References: The Power of NOW by Eckhart Tolle   Tweetables: We all crave context. – Dr. Craig Spodak Don’t resent the process. – Dr. Craig Spodak Real happiness is in the solving of problems. – Dr. Craig Spodak We must all suffer from one of two pains: the pain of discipline or the pain of regret. - Jim Rohn It’s not the “what’s next,” it’s the “what’s now.” – Dr. Gregg May

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 65 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Dr. Scott Leune, Founder & CEO of Breakaway Practice & Dental Whale   Watch full video of the interview by clicking here!   Key Takeaways: Most DSO’s don’t allow for the dentist to work with them to continue growing their business. Breakaway Practice provides DSO infrastructure to provide partnership and value for practice owners. Breakaway Practice wants to take the best from corporate infrastructure has today and make it available to a private dentist through a partnership. Traditional DSO’s are a great benefit for new grads who want guaranteed salary with a lot of CE and ability to move around the country. Practice sale strategy all depends on the specific wants and needs of the selling dentist. Most Breakaway dentists are entrepreneurs who want multiple locations. 7 out of 8 practices should not be purchased by someone who wants to own multiple locations. Invest in training, coaching, and learning if you’re interested in owning multiple locations. It’s a lot of hard work and isn’t for most people. To get a really high EBITDA multiple you must own lots of locations with a ton of infrastructure and a solid path to continue rapid growth. Leune has found there’s a tipping point at 11 days being booked out, profits start going down and no-shows start going up. Once you’re at that tipping point you have a problem and must fix whatever is holding back the schedule. January-March are the best months of the year for acquiring new patients, cost-wise. August is also good. Worst times for marketing are December, April-May, and September. Dentists need to strive for both clinical AND business excellency. Specialists are in the hardest position right now, as GP’s are taking over more and more of their business. If you’re doing what you love and making a good amount of money, perhaps there’s no reason to change or do anything different. Not everyone has to be the CEO. If you do what’s right for the patient, create a really good value-based practice, and have a good following there’s plenty of room for you to be successful in the future. Figure out the “why” first so you don’t end up going down the wrong path. Once you’re clear in your decision making, decisions aren’t that hard.   Tweetables: Innovation comes from pain, and not giving up. – Dr. Scott Leune It’s so much easier to make a decision when there’s purpose behind it. – Dr. Scott Leune

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 63 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Dr. Mark Costes, Founder of Dental Success Institute   Key Takeaways: There’s no one right model for setting up a dental practice, it must be tailored to the owner’s goals and the specific geographic area. Boulden predicts the rise of the “Super GP,” a dentist who has skills and training to do more services than they have traditionally. Less will be referred out. Technology is allowing a wider range of dentists to practice a wider range of skills. “The grass is greener” is always psychology. Most dentists don’t have a business. If you’re not making more than 30% as dentist owner then it’s a glorified job.

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 62 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Uche Odiatu, keynote speaker, author, wellness expert   Watch full video of the interview by clicking here!   Key Takeaways: Uche integrates total health wellness within his busy dental practice. Probiotics are now acknowledged by mainstream medicine. Probiotics are live organisms that supplement your diet. If you’re eating the right food you don’t need probiotics, but up to 90% of people are not eating the right food. Probiotics have been proven to prevent sickness in trails with extreme athletes, so their benefits for anyone with a stressed immune system can benefit. 85% of CEO’s of Fortune 500 companies exercise 3-4 times per week. 15% of the average North American population exercises. Fit people have an attenuated response to stress. Keeping up with regular exercise helps your body and mind slow down. The goal of exercise isn’t to get in shape, it’s to change your life and stay there. Find successful people to model yourself after. The lack of serotonin causes depression. 90% of serotonin is made in your gut, from food. The fundamental, #1 food for your body is fiber. Exercise is an independent factor that affects your gut flora. It balances and brings homeostasis to every one of your neurotransmitters. To get smarter, exercise and eat fiber. If you want to lead you need to do things to increase energy, have abundant thinking, and have good reaction to stress. You can’t buy great physical condition. Its an expression to the world of your standard for your body. Morning routines are key for setting a great tone for your day. Comparing yourself with others is not good, being grateful for what you have is important. One thing you can do to start improving your life is to act on one thing you heard that resonated with you. Celebrate, don’t analyze.   References: Align Probiotic Supplement The Mind-Gut Connection by Emeran Mayer The Microbiome Solution by Robynne Chutkan MD The Subtle Art of Not Giving A F*ck by Mark Manson Exercise – When Less is More with HIIT!!! By Dr. Uche Odiatu   Tweetables: Time flies for people who aren’t paying attention. – Dr. Uche Odiatu The quality of your life depends on the quality of your communication. – Tony Robbins No one is an overnight success. – Dr. Craig Spodak Gratitude is the master emotion. – Dr. Craig Spodak Comparison is the thief of joy. – Theodore Roosevelt

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 61 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Garrett Gunderson, author & founder of Wealth Factory   Watch full video of the interview by clicking here!   Key Takeaways: Wealth Factory is a personal wealth management company with a specialized focus for entrepreneurs in dentistry. Garrett co-authored a new book, called “5 Day Weekend.” Look for it on shelves everywhere! “The 4 Hour Workweek” is more about outsourcing and frugality. “5 Day Weekend” focuses more on keeping more of the money you make, learning to make more money as an individual, growing your money, and investing back in yourself. Dentists got screwed with the new tax change because they’re service-based professionals. Dentists won’t get the pass-through deduction. Two major things when it comes to taxes: You should have an accountant to get tax deductions. The biggest way to save tax is to reclassify your income which comes from attorneys. If your attorney isn’t a tax attorney, you will be spending too much money. Every three years you should get a different set of eyes on your taxes. You have three years to amend. If you’ve done any R&D or domestic production. This includes CEREC manufacturing, training, software research, etc. These deductions are additional money you could be leaving on the table. Do a cost segregation on any property you own. Saving tens of thousands of dollars on taxes is like ten years of investing. The two main factors of income reclassification are: How can you take your active income and classify it as passive income? You’ve created unique processes and intellectual property. Set up a separate company as an intellectual property company. Then pay that company 15% to use that proprietary intellectual property. How do you take ordinary income and classify it as capital gains income? Create captive insurance agencies. If you do it right, you can put money in pre-tax and create various insurance protections to sell back to your practice. The money taken out is considered capital gains and has better tax benefits. You can ensure actual business risks. If you can’t sock away $300,000 it’s not worth doing. You can drop your tax rate to 4% if you choose to live in Puerto Rico for at least 4 months of the year and be outside the US for at least 6 months. If you have a company event at your home or personal property you can pay yourself rent without claiming it as income. LLC’s that hold real estate that is rented out to your practice count as reclassification of income and have valuable tax incentives. There’s no reason to be overpaying on taxes when it’s legal and ethical to avoid paying certain things. Wealth Factory acts as your personal financial quarterback, and 93% of their clients save significant amounts of money by working with them. Two ideas about 401k’s: Everyone should look at a charitable remainder trust. You can create tax deductions when you sell assets. Even better, look at converting 401k’s to a Roth plan. You have to pay tax when you convert, but if you use a structured annuity where it’s valued at half of the actual 401k. You’ll get a guaranteed future income stream. Make sure you build up enough liquidity. People overemphasize investing and underemphasize saving. You’ll be ahead of 90% of other dentists by learning how to hire bad-ass people, building liquidity, and owning a building.   References: 5 Day Weekend by By Nik Halik & Garrett Gunderson Killing Sacred Cows by Garrett Gunderson Bard Press The 4-Hour Workweek by Tim Ferriss America’s Best 401k   Tweetables: Automatically save and deliberately invest. – Garrett Gunderson

Text ‘bulletproof’ to 345345 to stay in the know about our upcoming book release and the Bulletproof Summit on October 12-13th 2018 in Atlanta!   Bulletproof Dental Practice Podcast Episode 60 Hosts: Dr. Peter Boulden & Dr. Craig Spodak Guest: Debra Englehardt-Nash   Watch full video of the interview by clicking here!   Key Takeaways: Private practice dentistry is NOT going to go away. We must learn how to stop commoditizing our patients. Instead we should learn to value appreciation of our patients. Passionate dentists make great leaders. They create the vision and enlist the help of a supportive team to put that vision in action. When a new patient calls start out asking “inspirational” questions, instead of asking about insurance first. Listen to what the patient wants. Help your team and patients understand how fees are based: Skill required to do it right Time it takes to do it well Materials used so treatment endures Dentistry used to be all about efficiency, now it’s all about experience. Thoughtful approaches take longer, but you end up with a better result. Pre-collect for appointments. It takes the stress off collecting at the end of the appointment and eliminates no-shows. There’s room for all kinds of dentistry, you just have to decide where you want to be. Success is a meandering stream, it’s not a direct line. The business of dentistry is hard work. Consultants are facilitators to help the leader be the difference in the practice. Listening to webinars and podcasts is important, but they can’t replace in-person trainings and meetings. Toil is good for you. Successful people don’t act as victims, they address their own actions that led to where they are. Catastrophes give perspective and help you redirect. You don’t have a lot of time to establish trust, so you better do it quickly. Ask for your patient’s permission before you start offering treatment options. 70% of the reason why patients don’t follow through with treatment is because the treatment wasn’t explained well enough and they were released too soon to talk about money and they weren’t ready to commit. Dentists often settle for way too little when choosing members of their team. Olympics are won by 1/10th of a second. That extra 10th of a second could be that one thing that moves you forward faster.   References: American Academy of Dental Practice Extreme Ownership by Jocko Willink   Tweetables: It’s the head of the fish that always smells first. – Benjamin Franklin People who get frozen in fear will never get a win. – Debra Englehardt-Nash You have to believe to be believed. – Debra Englehardt-Nash Whether you’ve spent $400 or $4000, if you’re not happy you’ve spent too much. – Debra Englehardt-Nash Change your modalities and you might get a different result. – Debra Englehardt-Nash The dentist’s fear is holding back dentistry. – Debra Englehardt-Nash Life’s too short to be unhappy. – Debra Englehardt-Nash Happiness is in the solving of problems, not in the absence of them. – Dr. Craig Spodak If you’re going to ask your team to be a cheerleader, you better give them something to cheer about. – Debra Englehardt-Nash The chokehold on any business is always the psychology and skill set of the owner. – Dr. Craig Spodak The culmination of many small successes is a massive win. – Dr. Craig Spodak