May 5, 2025 • 21 mins
How can you keep your team, grow your practice, AND reclaim your time? Discover how Dr. Ryan Bradley did all three without burnout, spending big on marketing, or micromanaging his team. We talk about what worked to reduce turnover through a merger, create work-life balance, and scale while cutting back clinical days. Tune in to learn how working less can actually help you grow your practice faster!
Topics discussed in this episode:
- How to successfully take over a practice
- Building a culture that reduces turnover
- Challenges expanding from 4 to 8 ops
- Maintaining low turnover through a merger
- Strategies to achieve work-life balance
- Avoid these common growth mistakes
- What it takes to be a good leader and practice owner
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Is low turnover, fast growth and work-life balance
really possible.
Today, dr Ryan Bradley is onthe show to share how he made it
happen as a new practice owner,even through stressful
transitions, mergers and cuttingclinical days.
This is a quick episode thatwill give you ideas on how to
have better relationships withyour team, get more patients
(00:36):
without relying too much onmarketing, and avoid making
common growth mistakes ofChicago.
I want to teach you how to growand systematize your dental
practice so you can spend lesstime practicing and more time
enjoying a life that you love.
Let's get started.
Hey, welcome back to the DentalPractice Heroes podcast.
(00:56):
Very excited for my guest today, I got a current DPH client and
somebody that I had just reallyenjoyed working with.
Really cool guy, 2019 graduateof OHSU.
He's the owner of PacificNorthwest Dental.
That's in Beaverton, oregon.
It's a big practice, gotassociates and he's just
somebody who I've got to watchgrow the practice and choose and
(01:19):
intentionally choose the lifethat he wants to live.
So please, welcome to thepodcast, dr Ryan Bradley.
What's happening, man?
Speaker 2 (01:25):
Hey, paul, thanks for having me Appreciate it.
Speaker 1 (01:27):
Tell the listeners about what led you to practice
ownership.
Because you ended up doing anacquisition and I want to get
into that.
Yeah, but why this practice?
Why any practice?
Why did you want to be an ownerand how did you find this
practice?
Speaker 2 (01:41):
At the very start, if you go way back.
I always wanted to be inhealthcare.
I thought I wanted to go intomedicine.
You know didn't love the waymedicine was going.
I liked the idea of four yearsand done with dental school.
Always loved practice ownership.
You know we have small businessowners in the family.
I just love the idea ofautonomy, you know, just being
(02:03):
able to run an practice forabout a year.
At that time owner wanted me topartner.
Covid hit.
It was a weird time in the world.
I didn't love the structure ofthe office.
I wanted to go off and do myown thing.
I realized that pretty quickinto associating at that other
office that I wanted to run theship and so I looked for offices
right in the peak of COVID,which was crazy.
There's a lot of people lookingto retire, which was nice, so I
(02:23):
had my pickup offices.
The place that I landed.
It's kind of near where I grewup.
I understand the demographicsin the area.
It's a really solid patientbase.
I can tell that they have thefinancial means to get the
dentistry done but also careabout their oral health.
And that wasn't really where Iwas at previous.
It was sort of anemergency-based dental office.
Not a lot of re-care going onand so landed on this office
4-op office.
(02:44):
They're doing around 800,000 ayear pretty solid patient base.
They've been there for a long,long time.
Speaker 1 (02:52):
What was the one thing about that office?
I mean, I imagine you werelooking at different places
where you're like this is theone.
I just know it, this is the one.
Speaker 2 (02:59):
Yeah, so I did a lot of research.
You don't learn anything aboutpractice management when you're
in dental school, so I read alot of books.
Read your book, read somepractice transition books, just
how to look at numbers.
I think the numbers were superimportant.
In hindsight, having a bigpatient base is super important.
Growing an office is probablythe most difficult thing in
practice ownership that I'velearned.
(03:20):
Outside of that, they had areally strong re-care percentage
, really good collection rate.
I could just tell that theoffice was really solid from
their overhead numbers and ithad all the infrastructure.
I didn't have to scan a millionpaper charts.
They had a CT.
They had digital records.
It was pretty up-to-date, so Ididn't have to do a lot on that
front, which was nice.
Speaker 1 (03:40):
Now, when you showed up at this acquisition, you're
like hey, I'm new boss, DrBradley, what was the vision for
the office going in?
Or did you even have a vision?
Speaker 2 (03:50):
I'm sure a lot of people can relate to this.
Ask the previous owner hey, canI meet the team?
I think that's super important.
You know, I've always kind ofhad, and this is why we ended up
working together because you'rebig into culture in the office
and that was kind of my visiontoo is have a really solid place
for the employees to work andthe patients to come, and I
think that all flows andaccelerates that growth.
And so the dentist let the teamknow on a Friday.
(04:11):
I met them Friday afternoon andthen I started working on
Monday and that was the moststressful situation I've ever
been through all week.
I didn't sleep at all.
The weekend before I was likeno patients are going to show up
, the team's not going to showup.
The team looked kind of pissed.
They were upset that I was.
He was a younger guy, he's likehis mid-40s.
So he just up and left, movedto California.
(04:32):
Here I'm this new grad, say heyguys, how's it going?
Brought some cookies like I'myour new boss, and they were
just shock.
Since then it's been a reallysolid transition.
I was talking to you before theprevious owner.
He was a real micromanager.
He would do everything.
The hygienists were notsupposed to talk to the patients
about treatment.
He was the dentist.
(04:54):
He did all his temps for crowns.
The assistants they were spitsuckers, that was about it.
Front office team they didn'treally know what their role was
because he dictated everythingin the office, and so when I
came in, I wanted that solidculture Let people be in the
role that they're supposed to bein, give them a framework to
work in and then let them off tothe races.
(05:14):
I don't want to be everything.
I want to be the dentist andthe owner and the visionary.
I don't want to have to bedoing treatment plans and making
temporaries and doing all thosethings that other people can do
.
Speaker 1 (05:26):
How did you win the team over?
Do you remember a time whereyou're going into a conversation
with a team member and you'reslightly worried that, oh, I'm
doing this wrong?
Speaker 2 (05:35):
Yeah, I think just from the start I've just been
super open and honest with theteam as far as like hey, here's
my vision for the office.
I want to grow in thisdirection.
I hope you guys are on boardwith me.
I think previous they didn'treally have a structure in the
office.
It was just kind of like we diddentistry and it was just chaos
every day and implementingsystems doing that kind of
structure.
They kind of eventually sort ofjust saw through example that I
(05:59):
showed up early, I left late.
I really met them where theywere at.
I didn't give them the hey, I'mdentist, you are below me sort
of feel.
It's like hey, we're allcolleagues together.
I just happened to be theleader of the team and I think,
just through example, I thinkthey bought into sort of what my
vision was Was there anyemployees that just weren't
(06:19):
having it like that were out ofhere?
Honestly.
No, I have had kind of similarto yourself, really low turnover
in the office.
I think everyone's been reallysolid.
The only turnover we had was acouple assistants that we tried
out, but I think very quicklythey realized that this was not
the office for them and I thinkthe team kind of weeded them out
.
What I did to empower the teamis if we brought someone else on
(06:42):
, I would send them out to lunchand I have my lead assistant
give me a text message, thumbsup or thumbs down, as far as can
we bring this person on, and Iwas just like, hey, you guys
tell me.
So that's kind of how Iempowered them as well.
Speaker 1 (06:55):
What do you think your secret is to low turnover?
Speaker 2 (06:57):
I think like I said, just having a good place to work
.
We've all been employees beforeat various offices through our
life or even before dentalschool, working at a job, and I
don't think the pay is superimportant.
Obviously you have to hitrelative where your area is at,
but I think just having a solidplace to work that has structure
, where there's not a lot ofteam drama, everyone's very
(07:18):
mature and is rowing in the samedirection, knows what the
office goals are, and a lot ofmy front office team has worked
as dental assistants before,which is really nice because
there's a lot of well, I don'twant their job, you don't want
my job and they understand thefrustrations of both, and so I
think that helps a lot.
Speaker 1 (07:36):
Yeah, it's so true.
It's like any front desk thathas assisted, or any.
Vice versa there is a differentlevel of compassion for the
other person.
Now, you mentioned when youcame into the practice you had
this vision of just making it agreat place for employees and a
great place for the patients tocome to.
Has that vision changed overthe years?
Speaker 2 (07:56):
Not necessarily.
I mean, I think the directionthat we're going right now is
kind of making it a one-stopshop for our patients to come in
, not have to be referred,because they really do love our
office.
I've provided a lot ofamenities to the office.
We've done remodel in theoffice.
So our office, as far astreatment goes, it's now a
two-doc office.
We've gone from four ops toeight ops and then now we have a
(08:16):
couple of surgical ops whichhas been awesome to have an
associate in there where they'redoing a lot of the bread and
butter.
I'm doing a lot more of thesurgical complex treatment and
just investing super heavilyinto continuing education.
I think that's huge.
I've really come to realize Ilike the complex dentistry.
I think if I do less days justdoing that, I'm going to be
really fulfilled in my career.
And I've talked with you beforethere are kind of two camps of
(08:38):
dentists.
It's like, hey, I just want tobe hands-off dentist and I want
to go in and just maybe open upmultiple offices and so on and
so forth.
Or like the hey, we just growone big office and you just get
to do the specialty procedures,and I think that is kind of
where I'm at right now.
Speaker 1 (08:54):
Yeah, are you only doing specialty procedures at
this point?
Speaker 2 (08:56):
No, and I need to slowly start to give the reins
off.
But I think there's just a lotof dentistry coming through
right now.
I really like where our officeis at.
Back to the cultural thing Icheck in with all my employees
individually all the time, seehow their lives are going, so on
and so forth.
I think that's really key.
I think eventually, as we domore specialty procedures and
just have a higher volume ofpatients, I'd like to bring on
(09:19):
maybe one more associate to takeon all the bread and butter
that's coming through and then Ijust focus on the complex
surgical stuff.
Yeah, totally.
Speaker 1 (09:26):
Now you had four ops and you went to eight ops when
you were just four ops.
Like at that part of yourpractice growth, what was the
biggest challenge?
I?
Speaker 2 (09:36):
think just continuing to grow, getting new patients,
and I think that was the biggestthing.
And then the hygiene part ofthings.
If we would template and blockoff new patient blocks, I didn't
realize coming into how hardpatient acquisition is.
We're in an urban area, there'sother dentists there and I
think just really hammeringonline reviews, being a player
(09:59):
in the space in the local areayour name out there helps a lot.
It has to be organic at somepoint.
You can't just spend a bunch ofmoney and expect a million new
patients to come through.
So growing on that end,everyone deals with the hygiene
thing.
We had two hygienists andfinding month over month over
month is like hey, we needanother hygienist, but I can't
find anyone.
I can't find a hygienists.
And finding month over monthover month is like hey, we need
another hygienist, but I can'tfind anyone.
(10:20):
I can't find a hygienist.
The dentistry I don't think thedentistry is too hard, it's the
people thing.
We have a really solid team.
So I just think the growth partis really difficult.
It's not as easy as everyonetries to make it to be.
Speaker 1 (10:33):
Yeah, I think a lot of people right now are really
hung up on growth because theirbottleneck is hygiene.
And it's unfortunate becauseit's like for me, when I was
growing, that was one of theeasiest pieces of the puzzle.
Like you know, I'm talking 10years ago.
There were so many hygienistsit was almost like they were
graduating too many and peoplewere saying that there's too
many hygienists, like it reallystinks for you hygienists, and
(10:56):
now it's just like what happened.
It really stinks for youhygienist, and now it's just
like what happened and it seemsto be like that bottleneck for
people and it's reallyunfortunate.
Let's talk about you going fromfour to eight ops.
Walk me through what happenedthere and what motivated you to
do that.
Speaker 2 (11:08):
Yeah, I think I just saw that hey, I'm young, I
wanted to continue to grow theoffice.
We kind of had two directionsto go, I guess three.
It was hey, open up, maybewe're at capacity here, maybe we
expand hours.
And I just like my team toomuch.
They all have young families.
It's like hey, do we doextended hours, do we do split
shifts?
I just knew that that wasn'twhat my team necessarily was
(11:31):
best for the team.
I thought that was superimportant, or it's hey, do we go
build another location?
Well then we're kind of back tomy original comment about
culture and maintaining thatculture.
And your overhead doubles.
It doesn't get smaller when youbuy another office.
You're just doing the samething twice over.
So we're in a medical complex.
The guy next door, he waslooking to retire, really small
(11:53):
office, needed a lot of remodelwork.
But they had the infrastructure, they had a couple hygienists.
So we ended up doing a merger,which is super non-traditional
but we just had the ability todo that.
We actually got a city grant,which is really amazing, yeah,
and so we ended up doing amerger and so we ended up
outfitting three ops.
We ended up outfitting anotherone, remodeled the whole thing.
(12:13):
So I think that was definitelya way to get to growth a lot
quicker.
It was just patient acquisitionthrough a merger.
Speaker 1 (12:19):
So let's talk about work-life balance.
I mean, because you're not atthe practice five days a week,
how often are you working?
How often are you seeingpatients?
Speaker 2 (12:25):
Yeah.
So originally doing thetraditional four days a week at
the initial office when Istarted working with you, you
were really pushing hey, go downto three days.
Whatever.
Your scheduling is making itsuper efficient.
I think that's helped a lot,giving the autonomy to the
assistants making temps, doingnight guard deliveries, doing
all those things that they cando.
All of a sudden we'reconsolidating.
(12:47):
I went from one assistant totwo and, yes, my overhead went
up, but the second assistantpays for themselves so fast.
And then my four days gotshrunk down to three.
But looking at the numbers,everything was still where it
needs to be.
And just having thoseefficiencies in the office and
trusting the team that they canNot micromanaging freed me up to
do a lot more dentistry, andthen that extra day I could
(13:09):
spend working on the office andgrowing it that way.
So I think honestly, if you cando three days a week, you're
going to grow an office a lotfaster, even though it sounds
counterintuitive.
Speaker 1 (13:19):
Talk about what did you do on your non-clinical day.
Yeah, because I think a lot ofowners they say like I get it, I
should be working on thebusiness, but what does that
really mean?
Speaker 2 (13:28):
Some weeks would be nothing.
It's like I just go golf withfriends or just hang out with my
family and just coming backinto the office and just being
fresh and just being like, hey,let's hit the ground running,
we're here to work, so justhaving that just fuel behind you
when you come in with a shorterwork week instead of coming in
dragging your feet Mondaymorning, the team kind of feels
it too and they're like, well,we're going to drag our feet too
(13:49):
.
I think that's huge.
Yes, we work on the business onthe off days and maybe doing
marketing calls or looking atnumbers or so on and so forth,
but trying to slam that in onyour lunch hour, trying to talk
to your accountant noon and thenpopping back to a patient 1230,
it's just chaos, yeah.
Speaker 1 (14:06):
How have you changed as a leader, I mean from going
into this to where you're at now?
Speaker 2 (14:11):
Yeah, I think just confidence.
Initially you came in, you kindof fake it till you make it.
Same thing with taking on newtreatment you're learning.
I in, you kind of fake it tillyou make it, and that's the same
thing with like taking on newtreatment you're learning, you
know.
I think just having theconfidence you know and really
meeting my team where they're at, like taking more of an
interest in them as people, Ithink that's kind of helped a
lot and grown in my confidenceleading I used to be very big on
, like everybody on my team.
Speaker 1 (14:31):
Now, eventually my team got to a size where that
just wasn't feasible.
I couldn't know all of them ona deep personal level.
I just didn't have the time.
But I still have my leadershipteam, which is my four people on
my leads man.
I can't remember the last timeI asked them about what's going
on in their lives, because we'vebeen so business and that's one
of the things is like we canget so set on the business that
(14:54):
we lose that relationalcomponent of knowing that these
are people and these are ourfriends.
And part of what makes thatgood culture is that, even
though that doesn't seem likeproductive work, I mean, would
you agree?
Speaker 2 (15:07):
Yeah, totally.
I mean, I got to put myself intheir shoes a lot of the time.
It's like okay, they havefamilies, they're trying to make
an income.
You know they're here more thanyou know they're at home, and
so to provide a good place forthem to work is super important.
Speaker 1 (15:20):
What is one of the biggest mistakes you've made in
practice ownership that you lookback on now and laugh?
Speaker 2 (15:24):
I would say bringing on new employees and thinking I
can change people.
I've always had that mindset oflike hey, I'm the leader, if
someone's not doing their jobit's because of me, and a lot of
times sometimes people justaren't in the right role.
I tried to force somebody intoa role that they just weren't
great at.
She was a dental assistant butalso worked at the front.
(15:44):
With the initial transition shewas a floater back and forth.
Really great person, terribledental assistant, really solid
front office team member.
And I think just finding theright role for people is really
important and trying to bring onassistants that, just like we
had one assistant that I broughton, she'd been a temp for the
last 15 years.
I think that should have been alittle bit of a red flag
(16:07):
because I don't think she eversaw in hindsight like the
terrible work she was doing andshe just things at the end of
the day just could not do herjob and I just I kept her on too
long.
Speaker 1 (16:15):
Yeah, it's funny when we look back in retrospect and
we're like the red flags, theywere so obvious.
Yeah.
Speaker 2 (16:20):
I know they should have been so obvious.
Speaker 1 (16:22):
So as far as like work-life balance goes, man, do
you feel like you've got enoughat your three days or is there
something?
Are you pushing for lessclinical dentistry?
What?
Speaker 2 (16:30):
are you?
Speaker 1 (16:30):
doing, going forward.
Speaker 2 (16:32):
I think you know me buying an office you know, only
a year out of school, was great.
We didn't have kids yet.
I was recently married, I had alot of free time and so just
really pushing to grow theoffice to where I felt
comfortable three days a weekcould step back, really just
enjoy life.
Since then we've had I gotmarried, had a son he's six
months right now.
(16:52):
So now just being able to spendtime with family and just enjoy
was really great.
I think the next step for me isbringing on one more associate
to take on the bread and butterwork and then just continue to
grow our full arch side of theoffice.
I really like surgery, implants, things like that, and so if I
can do that a couple days a weekfor a very long time, I'll be
(17:12):
very happy.
And, like I said, I don't seeour office growing exponentially
bigger because I think thecultural piece kind of you know
it's hard when, like you said,just to talk to everybody in the
office and so you know thatmight change, but we have space
in our office to grow.
I just don't see us doing multioffice.
Speaker 1 (17:29):
So you bought a practice pretty early out of
school, and that's somethingthat some people have some
opinions about.
What are your thoughts?
Speaker 2 (17:36):
I think straight out of school is really tough.
I think my strong suit's alwaysbeen able to relate to patients
and talk to people.
I've worked a lot of sales jobsin the past and so I think
having that under my belt hasbeen really nice.
Not being that dentisttechnician that talks very
analytical to patients to kindof meet them where they're at
the dentistry side.
I think finding anassociateship on my front end
that was very busy was nice.
(17:58):
So I got to kind of practicewithin their practice.
So I thought a year out I wasvery comfortable with the
dentistry side of things.
I think once you feelcomfortable with the dentistry
by an office, I think it's toughto learn both at the same time
right out of school.
So I thought a year was apretty sweet spot.
Speaker 1 (18:14):
What's one thing that you wish more practice owners
understood about practiceownership.
Speaker 2 (18:19):
I think, kind of like what I said before, the
dentistry is not hard, it's thepeople thing.
So if you get a really solidteam behind you, turnover is the
hardest thing to do.
It looks bad for the office.
It's hard to retrain people.
The patients don't love it.
So if you can have a reallysolid culture and I know you've
talked about this over and overand over and people don't want
to hear it I think just havingthat really solid team behind
(18:40):
you is key and it's taken somuch stress off my plate.
I don't have to worry aboutteam drama.
It's hey, how can we grow theoffice?
I think that part is superimportant Knowing your numbers,
just self-educating on thosethings.
Looking at the back end, youmay have 100 new patients in,
but if you have 150 out the backend every month, that's what
everyone wants to brag about istheir production and their new
(19:02):
patient numbers.
But if you do all thatdentistry and you have a super
high overhead and a lot ofpatient attrition, you're really
going backwards.
So I think that's super key.
Speaker 1 (19:12):
Was there one moment during your practice growth
where you said we've made it, Iam successful?
Speaker 2 (19:20):
Yeah, I think after my first solid year we saw
really good growth and I sawthat our overhead was obviously,
when you do a practicetransition, they're going to
give you evaluations of wherethe office numbers are now.
And then my CPA, they did itlike, hey, if you have 10%
attrition or 10% growth, this iskind of where you're going to
be financially.
And we had about 25% growthafter the first year and I was
(19:43):
like, okay, this is awesome.
And then the second year waspretty consistent from there and
so at that point it was like,okay, I think whatever I'm doing
is working, let's continue downthat road.
But I didn't try to reinventthe wheel.
I listened to you.
I listened to other peoplewho've done this successfully.
I think that's where a lot ofmy successes come from is just
really listening and being opento what other people have done
(20:05):
and not trying to pretend like Iknow everything.
Speaker 1 (20:08):
Yeah, awesome, all right.
Final question what is the bestpiece of practice management
advice you've ever gotten?
Speaker 2 (20:14):
Know your numbers.
If you can do as much dentistryas you want, but if your
overhead is super high, that'snot going to put you in a good
spot.
Speaker 1 (20:23):
So really looking at your numbers month over month,
knowing what good numbers aresupposed to be, yeah, it's so
true, and there's a lot ofdentists that are still doing
their own books and they don'tget their numbers until the
quarter, until they actuallyhave to turn in something to the
IRS, and it's hard to operate apractice that way.
So, dude, right, it's beenawesome having you on, man.
(20:43):
It's been great to watch yourjourney.
I appreciate it.
Thank you so much for coming onto the podcast and sharing some
knowledge with the listeners.
Really appreciate it.
Speaker 2 (20:50):
Yeah, thanks, get a coach.
They'll accelerate your growthexponentially.
Any recommendations?
This guy, paul Etcheson.
He's a really solid guy.
Thanks for that man.
Is low turnover, fast growth and work-life balance
really possible.
Today, dr Ryan Bradley is onthe show to share how he made it
happen as a new practice owner,even through stressful
transitions, mergers and cuttingclinical days.
This is a quick episode thatwill give you ideas on how to
have better relationships withyour team, get more patients
(00:36):
without relying too much onmarketing, and avoid making
common growth mistakes ofChicago.
I want to teach you how to growand systematize your dental
practice so you can spend lesstime practicing and more time
enjoying a life that you love.
Let's get started.
Hey, welcome back to the DentalPractice Heroes podcast.
(00:56):
Very excited for my guest today, I got a current DPH client and
somebody that I had just reallyenjoyed working with.
Really cool guy, 2019 graduateof OHSU.
He's the owner of PacificNorthwest Dental.
That's in Beaverton, oregon.
It's a big practice, gotassociates and he's just
somebody who I've got to watchgrow the practice and choose and
(01:19):
intentionally choose the lifethat he wants to live.
So please, welcome to thepodcast, dr Ryan Bradley.
What's happening, man?
Speaker 2 (01:25):
Hey, paul, thanks for having me Appreciate it.
Speaker 1 (01:27):
Tell the listeners about what led you to practice
ownership.
Because you ended up doing anacquisition and I want to get
into that.
Yeah, but why this practice?
Why any practice?
Why did you want to be an ownerand how did you find this
practice?
Speaker 2 (01:41):
At the very start, if you go way back.
I always wanted to be inhealthcare.
I thought I wanted to go intomedicine.
You know didn't love the waymedicine was going.
I liked the idea of four yearsand done with dental school.
Always loved practice ownership.
You know we have small businessowners in the family.
I just love the idea ofautonomy, you know, just being
(02:03):
able to run an practice forabout a year.
At that time owner wanted me topartner.
Covid hit.
It was a weird time in the world.
I didn't love the structure ofthe office.
I wanted to go off and do myown thing.
I realized that pretty quickinto associating at that other
office that I wanted to run theship and so I looked for offices
right in the peak of COVID,which was crazy.
There's a lot of people lookingto retire, which was nice, so I
(02:23):
had my pickup offices.
The place that I landed.
It's kind of near where I grewup.
I understand the demographicsin the area.
It's a really solid patientbase.
I can tell that they have thefinancial means to get the
dentistry done but also careabout their oral health.
And that wasn't really where Iwas at previous.
It was sort of anemergency-based dental office.
Not a lot of re-care going onand so landed on this office
4-op office.
(02:44):
They're doing around 800,000 ayear pretty solid patient base.
They've been there for a long,long time.
Speaker 1 (02:52):
What was the one thing about that office?
I mean, I imagine you werelooking at different places
where you're like this is theone.
I just know it, this is the one.
Speaker 2 (02:59):
Yeah, so I did a lot of research.
You don't learn anything aboutpractice management when you're
in dental school, so I read alot of books.
Read your book, read somepractice transition books, just
how to look at numbers.
I think the numbers were superimportant.
In hindsight, having a bigpatient base is super important.
Growing an office is probablythe most difficult thing in
practice ownership that I'velearned.
(03:20):
Outside of that, they had areally strong re-care percentage
, really good collection rate.
I could just tell that theoffice was really solid from
their overhead numbers and ithad all the infrastructure.
I didn't have to scan a millionpaper charts.
They had a CT.
They had digital records.
It was pretty up-to-date, so Ididn't have to do a lot on that
front, which was nice.
Speaker 1 (03:40):
Now, when you showed up at this acquisition, you're
like hey, I'm new boss, DrBradley, what was the vision for
the office going in?
Or did you even have a vision?
Speaker 2 (03:50):
I'm sure a lot of people can relate to this.
Ask the previous owner hey, canI meet the team?
I think that's super important.
You know, I've always kind ofhad, and this is why we ended up
working together because you'rebig into culture in the office
and that was kind of my visiontoo is have a really solid place
for the employees to work andthe patients to come, and I
think that all flows andaccelerates that growth.
And so the dentist let the teamknow on a Friday.
(04:11):
I met them Friday afternoon andthen I started working on
Monday and that was the moststressful situation I've ever
been through all week.
I didn't sleep at all.
The weekend before I was likeno patients are going to show up
, the team's not going to showup.
The team looked kind of pissed.
They were upset that I was.
He was a younger guy, he's likehis mid-40s.
So he just up and left, movedto California.
(04:32):
Here I'm this new grad, say heyguys, how's it going?
Brought some cookies like I'myour new boss, and they were
just shock.
Since then it's been a reallysolid transition.
I was talking to you before theprevious owner.
He was a real micromanager.
He would do everything.
The hygienists were notsupposed to talk to the patients
about treatment.
He was the dentist.
(04:54):
He did all his temps for crowns.
The assistants they were spitsuckers, that was about it.
Front office team they didn'treally know what their role was
because he dictated everythingin the office, and so when I
came in, I wanted that solidculture Let people be in the
role that they're supposed to bein, give them a framework to
work in and then let them off tothe races.
(05:14):
I don't want to be everything.
I want to be the dentist andthe owner and the visionary.
I don't want to have to bedoing treatment plans and making
temporaries and doing all thosethings that other people can do
.
Speaker 1 (05:26):
How did you win the team over?
Do you remember a time whereyou're going into a conversation
with a team member and you'reslightly worried that, oh, I'm
doing this wrong?
Speaker 2 (05:35):
Yeah, I think just from the start I've just been
super open and honest with theteam as far as like hey, here's
my vision for the office.
I want to grow in thisdirection.
I hope you guys are on boardwith me.
I think previous they didn'treally have a structure in the
office.
It was just kind of like we diddentistry and it was just chaos
every day and implementingsystems doing that kind of
structure.
They kind of eventually sort ofjust saw through example that I
(05:59):
showed up early, I left late.
I really met them where theywere at.
I didn't give them the hey, I'mdentist, you are below me sort
of feel.
It's like hey, we're allcolleagues together.
I just happened to be theleader of the team and I think,
just through example, I thinkthey bought into sort of what my
vision was Was there anyemployees that just weren't
(06:19):
having it like that were out ofhere?
Honestly.
No, I have had kind of similarto yourself, really low turnover
in the office.
I think everyone's been reallysolid.
The only turnover we had was acouple assistants that we tried
out, but I think very quicklythey realized that this was not
the office for them and I thinkthe team kind of weeded them out
.
What I did to empower the teamis if we brought someone else on
(06:42):
, I would send them out to lunchand I have my lead assistant
give me a text message, thumbsup or thumbs down, as far as can
we bring this person on, and Iwas just like, hey, you guys
tell me.
So that's kind of how Iempowered them as well.
Speaker 1 (06:55):
What do you think your secret is to low turnover?
Speaker 2 (06:57):
I think like I said, just having a good place to work
.
We've all been employees beforeat various offices through our
life or even before dentalschool, working at a job, and I
don't think the pay is superimportant.
Obviously you have to hitrelative where your area is at,
but I think just having a solidplace to work that has structure
, where there's not a lot ofteam drama, everyone's very
(07:18):
mature and is rowing in the samedirection, knows what the
office goals are, and a lot ofmy front office team has worked
as dental assistants before,which is really nice because
there's a lot of well, I don'twant their job, you don't want
my job and they understand thefrustrations of both, and so I
think that helps a lot.
Speaker 1 (07:36):
Yeah, it's so true.
It's like any front desk thathas assisted, or any.
Vice versa there is a differentlevel of compassion for the
other person.
Now, you mentioned when youcame into the practice you had
this vision of just making it agreat place for employees and a
great place for the patients tocome to.
Has that vision changed overthe years?
Speaker 2 (07:56):
Not necessarily.
I mean, I think the directionthat we're going right now is
kind of making it a one-stopshop for our patients to come in
, not have to be referred,because they really do love our
office.
I've provided a lot ofamenities to the office.
We've done remodel in theoffice.
So our office, as far astreatment goes, it's now a
two-doc office.
We've gone from four ops toeight ops and then now we have a
(08:16):
couple of surgical ops whichhas been awesome to have an
associate in there where they'redoing a lot of the bread and
butter.
I'm doing a lot more of thesurgical complex treatment and
just investing super heavilyinto continuing education.
I think that's huge.
I've really come to realize Ilike the complex dentistry.
I think if I do less days justdoing that, I'm going to be
really fulfilled in my career.
And I've talked with you beforethere are kind of two camps of
(08:38):
dentists.
It's like, hey, I just want tobe hands-off dentist and I want
to go in and just maybe open upmultiple offices and so on and
so forth.
Or like the hey, we just growone big office and you just get
to do the specialty procedures,and I think that is kind of
where I'm at right now.
Speaker 1 (08:54):
Yeah, are you only doing specialty procedures at
this point?
Speaker 2 (08:56):
No, and I need to slowly start to give the reins
off.
But I think there's just a lotof dentistry coming through
right now.
I really like where our officeis at.
Back to the cultural thing Icheck in with all my employees
individually all the time, seehow their lives are going, so on
and so forth.
I think that's really key.
I think eventually, as we domore specialty procedures and
just have a higher volume ofpatients, I'd like to bring on
(09:19):
maybe one more associate to takeon all the bread and butter
that's coming through and then Ijust focus on the complex
surgical stuff.
Yeah, totally.
Speaker 1 (09:26):
Now you had four ops and you went to eight ops when
you were just four ops.
Like at that part of yourpractice growth, what was the
biggest challenge?
I?
Speaker 2 (09:36):
think just continuing to grow, getting new patients,
and I think that was the biggestthing.
And then the hygiene part ofthings.
If we would template and blockoff new patient blocks, I didn't
realize coming into how hardpatient acquisition is.
We're in an urban area, there'sother dentists there and I
think just really hammeringonline reviews, being a player
(09:59):
in the space in the local areayour name out there helps a lot.
It has to be organic at somepoint.
You can't just spend a bunch ofmoney and expect a million new
patients to come through.
So growing on that end,everyone deals with the hygiene
thing.
We had two hygienists andfinding month over month over
month is like hey, we needanother hygienist, but I can't
find anyone.
I can't find a hygienists.
And finding month over monthover month is like hey, we need
another hygienist, but I can'tfind anyone.
(10:20):
I can't find a hygienist.
The dentistry I don't think thedentistry is too hard, it's the
people thing.
We have a really solid team.
So I just think the growth partis really difficult.
It's not as easy as everyonetries to make it to be.
Speaker 1 (10:33):
Yeah, I think a lot of people right now are really
hung up on growth because theirbottleneck is hygiene.
And it's unfortunate becauseit's like for me, when I was
growing, that was one of theeasiest pieces of the puzzle.
Like you know, I'm talking 10years ago.
There were so many hygienistsit was almost like they were
graduating too many and peoplewere saying that there's too
many hygienists, like it reallystinks for you hygienists, and
(10:56):
now it's just like what happened.
It really stinks for youhygienist, and now it's just
like what happened and it seemsto be like that bottleneck for
people and it's reallyunfortunate.
Let's talk about you going fromfour to eight ops.
Walk me through what happenedthere and what motivated you to
do that.
Speaker 2 (11:08):
Yeah, I think I just saw that hey, I'm young, I
wanted to continue to grow theoffice.
We kind of had two directionsto go, I guess three.
It was hey, open up, maybewe're at capacity here, maybe we
expand hours.
And I just like my team toomuch.
They all have young families.
It's like hey, do we doextended hours, do we do split
shifts?
I just knew that that wasn'twhat my team necessarily was
(11:31):
best for the team.
I thought that was superimportant, or it's hey, do we go
build another location?
Well then we're kind of back tomy original comment about
culture and maintaining thatculture.
And your overhead doubles.
It doesn't get smaller when youbuy another office.
You're just doing the samething twice over.
So we're in a medical complex.
The guy next door, he waslooking to retire, really small
(11:53):
office, needed a lot of remodelwork.
But they had the infrastructure, they had a couple hygienists.
So we ended up doing a merger,which is super non-traditional
but we just had the ability todo that.
We actually got a city grant,which is really amazing, yeah,
and so we ended up doing amerger and so we ended up
outfitting three ops.
We ended up outfitting anotherone, remodeled the whole thing.
(12:13):
So I think that was definitelya way to get to growth a lot
quicker.
It was just patient acquisitionthrough a merger.
Speaker 1 (12:19):
So let's talk about work-life balance.
I mean, because you're not atthe practice five days a week,
how often are you working?
How often are you seeingpatients?
Speaker 2 (12:25):
Yeah.
So originally doing thetraditional four days a week at
the initial office when Istarted working with you, you
were really pushing hey, go downto three days.
Whatever.
Your scheduling is making itsuper efficient.
I think that's helped a lot,giving the autonomy to the
assistants making temps, doingnight guard deliveries, doing
all those things that they cando.
All of a sudden we'reconsolidating.
(12:47):
I went from one assistant totwo and, yes, my overhead went
up, but the second assistantpays for themselves so fast.
And then my four days gotshrunk down to three.
But looking at the numbers,everything was still where it
needs to be.
And just having thoseefficiencies in the office and
trusting the team that they canNot micromanaging freed me up to
do a lot more dentistry, andthen that extra day I could
(13:09):
spend working on the office andgrowing it that way.
So I think honestly, if you cando three days a week, you're
going to grow an office a lotfaster, even though it sounds
counterintuitive.
Speaker 1 (13:19):
Talk about what did you do on your non-clinical day.
Yeah, because I think a lot ofowners they say like I get it, I
should be working on thebusiness, but what does that
really mean?
Speaker 2 (13:28):
Some weeks would be nothing.
It's like I just go golf withfriends or just hang out with my
family and just coming backinto the office and just being
fresh and just being like, hey,let's hit the ground running,
we're here to work, so justhaving that just fuel behind you
when you come in with a shorterwork week instead of coming in
dragging your feet Mondaymorning, the team kind of feels
it too and they're like, well,we're going to drag our feet too
(13:49):
.
I think that's huge.
Yes, we work on the business onthe off days and maybe doing
marketing calls or looking atnumbers or so on and so forth,
but trying to slam that in onyour lunch hour, trying to talk
to your accountant noon and thenpopping back to a patient 1230,
it's just chaos, yeah.
Speaker 1 (14:06):
How have you changed as a leader, I mean from going
into this to where you're at now?
Speaker 2 (14:11):
Yeah, I think just confidence.
Initially you came in, you kindof fake it till you make it.
Same thing with taking on newtreatment you're learning.
I in, you kind of fake it tillyou make it, and that's the same
thing with like taking on newtreatment you're learning, you
know.
I think just having theconfidence you know and really
meeting my team where they're at, like taking more of an
interest in them as people, Ithink that's kind of helped a
lot and grown in my confidenceleading I used to be very big on
, like everybody on my team.
Speaker 1 (14:31):
Now, eventually my team got to a size where that
just wasn't feasible.
I couldn't know all of them ona deep personal level.
I just didn't have the time.
But I still have my leadershipteam, which is my four people on
my leads man.
I can't remember the last timeI asked them about what's going
on in their lives, because we'vebeen so business and that's one
of the things is like we canget so set on the business that
(14:54):
we lose that relationalcomponent of knowing that these
are people and these are ourfriends.
And part of what makes thatgood culture is that, even
though that doesn't seem likeproductive work, I mean, would
you agree?
Speaker 2 (15:07):
Yeah, totally.
I mean, I got to put myself intheir shoes a lot of the time.
It's like okay, they havefamilies, they're trying to make
an income.
You know they're here more thanyou know they're at home, and
so to provide a good place forthem to work is super important.
Speaker 1 (15:20):
What is one of the biggest mistakes you've made in
practice ownership that you lookback on now and laugh?
Speaker 2 (15:24):
I would say bringing on new employees and thinking I
can change people.
I've always had that mindset oflike hey, I'm the leader, if
someone's not doing their jobit's because of me, and a lot of
times sometimes people justaren't in the right role.
I tried to force somebody intoa role that they just weren't
great at.
She was a dental assistant butalso worked at the front.
(15:44):
With the initial transition shewas a floater back and forth.
Really great person, terribledental assistant, really solid
front office team member.
And I think just finding theright role for people is really
important and trying to bring onassistants that, just like we
had one assistant that I broughton, she'd been a temp for the
last 15 years.
I think that should have been alittle bit of a red flag
(16:07):
because I don't think she eversaw in hindsight like the
terrible work she was doing andshe just things at the end of
the day just could not do herjob and I just I kept her on too
long.
Speaker 1 (16:15):
Yeah, it's funny when we look back in retrospect and
we're like the red flags, theywere so obvious.
Yeah.
Speaker 2 (16:20):
I know they should have been so obvious.
Speaker 1 (16:22):
So as far as like work-life balance goes, man, do
you feel like you've got enoughat your three days or is there
something?
Are you pushing for lessclinical dentistry?
What?
Speaker 2 (16:30):
are you?
Speaker 1 (16:30):
doing, going forward.
Speaker 2 (16:32):
I think you know me buying an office you know, only
a year out of school, was great.
We didn't have kids yet.
I was recently married, I had alot of free time and so just
really pushing to grow theoffice to where I felt
comfortable three days a weekcould step back, really just
enjoy life.
Since then we've had I gotmarried, had a son he's six
months right now.
(16:52):
So now just being able to spendtime with family and just enjoy
was really great.
I think the next step for me isbringing on one more associate
to take on the bread and butterwork and then just continue to
grow our full arch side of theoffice.
I really like surgery, implants, things like that, and so if I
can do that a couple days a weekfor a very long time, I'll be
(17:12):
very happy.
And, like I said, I don't seeour office growing exponentially
bigger because I think thecultural piece kind of you know
it's hard when, like you said,just to talk to everybody in the
office and so you know thatmight change, but we have space
in our office to grow.
I just don't see us doing multioffice.
Speaker 1 (17:29):
So you bought a practice pretty early out of
school, and that's somethingthat some people have some
opinions about.
What are your thoughts?
Speaker 2 (17:36):
I think straight out of school is really tough.
I think my strong suit's alwaysbeen able to relate to patients
and talk to people.
I've worked a lot of sales jobsin the past and so I think
having that under my belt hasbeen really nice.
Not being that dentisttechnician that talks very
analytical to patients to kindof meet them where they're at
the dentistry side.
I think finding anassociateship on my front end
that was very busy was nice.
(17:58):
So I got to kind of practicewithin their practice.
So I thought a year out I wasvery comfortable with the
dentistry side of things.
I think once you feelcomfortable with the dentistry
by an office, I think it's toughto learn both at the same time
right out of school.
So I thought a year was apretty sweet spot.
Speaker 1 (18:14):
What's one thing that you wish more practice owners
understood about practiceownership.
Speaker 2 (18:19):
I think, kind of like what I said before, the
dentistry is not hard, it's thepeople thing.
So if you get a really solidteam behind you, turnover is the
hardest thing to do.
It looks bad for the office.
It's hard to retrain people.
The patients don't love it.
So if you can have a reallysolid culture and I know you've
talked about this over and overand over and people don't want
to hear it I think just havingthat really solid team behind
(18:40):
you is key and it's taken somuch stress off my plate.
I don't have to worry aboutteam drama.
It's hey, how can we grow theoffice?
I think that part is superimportant Knowing your numbers,
just self-educating on thosethings.
Looking at the back end, youmay have 100 new patients in,
but if you have 150 out the backend every month, that's what
everyone wants to brag about istheir production and their new
(19:02):
patient numbers.
But if you do all thatdentistry and you have a super
high overhead and a lot ofpatient attrition, you're really
going backwards.
So I think that's super key.
Speaker 1 (19:12):
Was there one moment during your practice growth
where you said we've made it, Iam successful?
Speaker 2 (19:20):
Yeah, I think after my first solid year we saw
really good growth and I sawthat our overhead was obviously,
when you do a practicetransition, they're going to
give you evaluations of wherethe office numbers are now.
And then my CPA, they did itlike, hey, if you have 10%
attrition or 10% growth, this iskind of where you're going to
be financially.
And we had about 25% growthafter the first year and I was
(19:43):
like, okay, this is awesome.
And then the second year waspretty consistent from there and
so at that point it was like,okay, I think whatever I'm doing
is working, let's continue downthat road.
But I didn't try to reinventthe wheel.
I listened to you.
I listened to other peoplewho've done this successfully.
I think that's where a lot ofmy successes come from is just
really listening and being opento what other people have done
(20:05):
and not trying to pretend like Iknow everything.
Speaker 1 (20:08):
Yeah, awesome, all right.
Final question what is the bestpiece of practice management
advice you've ever gotten?
Speaker 2 (20:14):
Know your numbers.
If you can do as much dentistryas you want, but if your
overhead is super high, that'snot going to put you in a good
spot.
Speaker 1 (20:23):
So really looking at your numbers month over month,
knowing what good numbers aresupposed to be, yeah, it's so
true, and there's a lot ofdentists that are still doing
their own books and they don'tget their numbers until the
quarter, until they actuallyhave to turn in something to the
IRS, and it's hard to operate apractice that way.
So, dude, right, it's beenawesome having you on, man.
(20:43):
It's been great to watch yourjourney.
I appreciate it.
Thank you so much for coming onto the podcast and sharing some
knowledge with the listeners.
Really appreciate it.
Speaker 2 (20:50):
Yeah, thanks, get a coach.
They'll accelerate your growthexponentially.
Any recommendations?
This guy, paul Etcheson.
He's a really solid guy.
Thanks for that man.
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