Brews and Tiny Teeth, The Unfiltered Pediatric Dentistry Podcast

As the two year anniversary of opening my practice approaches, I thought it would be a fun exercise to go over my profit-and-loss statement from the last 12 months and breakdown my expenses. The average overhead in pediatric dentistry is around 50%, but I think we can do better.  I've been able to run a very low overhead, lean office by keeping my expenses in check and doing many services myself. In this episode, I review some of the following that allow me to keep a sub-30% overhead: - How to calculate a true overhead (what do I include and what do I take out). - How being rural keeps my rent, staff salaries, and advertising budgets low - Bringing in more revenue is an easy way to lower overhead that doesn't involve cutting costs - Save money by doing your own bookkeeping, website, marketing, payroll, etc. - Where to shop for dental supplies, and why the big suppliers can eat into your profits. I hope you enjoy this deep dive into practice numbers. Cheers!

Dr. Tim Richardson is guest who has been on the podcast in the past, and it was a pleasure to host him again. He is the founder of Acorn Kids Pediatric Dentistry in the Salem, Oregon area. He currently has six offices, eleven dentists, and a wealth of knowledge on growing and operating new pediatric dental practices.  Today we talk about bringing on an associate. When is the right time? How do you know it's a good fit? Where do you find good associates? Should you offer them equity? What's a competitive compensation package? How do you make the administrative process go smoothly? All details that we discuss in today's episode.  Dr. Richardson and I also discuss listening to Ben Nemtin as the keynote speaker at AAPD San Diego. Dr. Richardson was inspired by his message to live without regrets and to create a bucket list, and he was actually able to convince Ben to give a virtual presentation to his practice. Dr. Richardson is hosting the event through his foundation, Acorn Kids International. Listeners of the podcast are able to join Ben's presentation for free, but donations to the foundation are welcomed, and proceeds go to support children in poverty in Kenya. I'm excited for both myself and my team to tune into this event so that I can help them grow both professionally and personally, inside and outside of the office.  If you are interested in tuning in to this presentation, email Dr. Richardson at timrichardsondds@gmail.com. The event is October 25th and 2:30 PST. 

With oral boards coming up next week, I thought it would be a good idea for an episode to go through my notes and pull out 50 random fun facts that could potentially be helpful on the exam. Some of them may be relevant, and some may not. I also included some tips and things to keep in mind during the actual exam itself that could be good to know to help us better prepare. Good luck to my colleagues taking the test, and here's to having a cold adult beverage next week when everything is over. Happy studying!

Dr. Mikaela Hazard is an Iowa-trained endodontist. She practices in Fargo, North Dakota and frequently treats pediatric patients. She joins us today to give an update (and a bit of an oral boards review) on permanent vital and non-vital pulpal therapies. Some of the things we discuss: - When do you stay out of the pulp vs completing a coronal pulpotomy? - What is the consensus on using sodium hypochlorite to clean pulp chambers in permanent teeth? - What bioceramics are endodontists using right now? - How do you complete an apical barrier/plug in a necrotic, immature tooth? - What are the key steps to success in regendo procedures?

In response to the recent popular episode with Dr. Roy Shelburne, I decided to reach out directly to my local state Medicaid office to talk to somebody about how criminal medicaid cases are handled. Although I wasn't able to convince any members of the department to join me on the podcast directly, I was able to take and share notes from the conversation. There was a lot of listener feedback with confusion about how a dentist could end up in prison over simple billing and coding errors. I was able to shed a lot of light on that in my conversation with the Medicaid auditor.  I also give my thoughts on a recent Medicaid fraud/kickback scheme involving the indictment of two individuals at a Texas pediatric dental office involving 6 million dollars worth of fraudulent and criminal dental billing to Medicaid (allegedly). 

Shawn Johnson is the vice president of business development at Treloar and Heisel, a premier provider of financial and insurance services to dental and medical professionals. He joins us to discuss topics relating to protecting both your practice and yourself. We walk through different stages in the career path of a typical pediatric dentist and review what systems and insurances should be in place to protect yourself from all of the curveballs life throws at us. Some of the topics include: - What to look for in a disability policy, and how much coverage should you have? - When is a term life policy appropriate compared to a whole life? - Why pediatric dentists need a higher level of coverage with the trend for in-office general anesthesia. - What are the components of a business owner's protection policy? - Finding a balance between keeping an emergency fund vs having business interruption and overhead coverage.

Dr. David Knight is a pediatric dentist and the owner of Knight Pediatric Dentistry in Woodbury, Minnesota. He opened his practice almost three years ago, shortly before the COVID shutdown caused him to close his doors for a period of time. David and his wife also had their first baby during this time period. Now three years later, his practice is thriving and booking out for months.  When Dr. Knight opened his office, he initially did not see Medicaid, given that Minnesota had some of the lowest reimbursements in the country. With Minnesota recently overhauling their Medicaid program and increasing rates, Dr. Knight discusses why he added Medicaid to his practice and how it has added tremendous growth in terms of new patient numbers and collections.

Dr. Roy Shelburne joins us on this episode to tell his incredible story about being arrested for Medicaid fraud. After years of running a busy and successful practice in Virginia, Dr. Shelburne received a phone call that the FBI had raided his office. All of his personal assets were seized, and he was tried and found guilty of medicaid fraud. He served 19 months in prison, and now spends his time consulting dentists on how to prevent this from happening to them. This was an eye-opening conversation. As pediatric dentists, many of us see medicaid. You may think that if there were an error or mistake with an office's Medicaid billing, penalties and fines could occur and simply be paid as long as the mistake was innocent. Dr. Shelburne's story demonstrates that this isn't always true.  For anybody looking for more information on Dr. Shelburne, his website is: http://royshelburne.com/ Link to registration for Dr. Shelburne's Dental Billing Bootcamp: https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fform.123formbuilder.com%2F6180041%2Fform&data=05%7C01%7C%7Ce22febb87d32459cfd8708da54595fb1%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637915040111326747%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=CBiK8%2FzfZ8Dp0LZGJpdrBQ3Nlsi2URYTti%2BOh60O%2BVI%3D&reserved=0

On this solo episode, I review 5 new tools/materials/pieces of equipment that I've purchased in my practice over the last year. I break down the good and the bad of these products, and how listeners can consider using them in their practice. We should always be trying new products and technologies to constantly try to deliver dentistry better, faster, and cheaper. The products I review are:  1. Dukal throat packs 2. Optrasculpt composite sponge 3. Mosquito diamond bur 4. Zyris anterior isolite system 5. Denovo extraction forceps

Lilly Cortes-Pona is a dental practice consultant and coach who specializes in pediatric practices. Her company writes the practice management newsletter for the AAPD, and she works with practice owners all over the country to help them lead, connect, and profit. In our discussion, we go through common barriers and issues that pediatric dentists face at each stepping stone in their career, from early practice owner all the way to multi-doc, multi-office practices.  In this podcast we discuss: - Challenges that early career dentists and startups face - The importance of considering utilizing a therapist for your mental well-being - When to bring on an associate and why associates are in such demand - How to get multiple doctors to agree on what direction to take the practice. - How a dental coach works and how they can work with a practice to improve outcomes LCP coaching website: www.lcpcoaching.com Lilly has also provided our listeners with a free link to her "checklist for success": https://lcpcoaching.formstack.com/forms/checklist_for_success