June 16, 2025 • 34 mins
Most owners manage the day-to-day; Dr. Sten Erickson is turning doctors into partners. He joins me in this episode to share how he stepped into a true leadership role and expanded his practice after leaving clinical work behind.
From scheduling weekly meetings across multiple practices to case reviews, we talk about the strategies and systems that help him get doctors ready to lead, drive culture, and grow a multi-location practice without micromanaging or seeing patients. Tune in to hear how he structures his time to mentor doctors and scale without burning out!
Topics discussed in this episode:
- Mistakes as a young practice owner
- The ideal practice size of new owners
- Maintaining culture as you expand
- Dr. Erickson’s meeting schedule and training system
- How your role changes when you step back from clinical
- Strategies to keep associates engaged and growing
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Paul Etchison (00:02):
What do you actually do when you stop seeing
patients?
So many owners ask me thisquestion when they finally
decide to cut back on clinicaldays and suddenly they don't
know what their role is outsideof the operatory.
Today, I'm joined by Dr StenErickson, who has stepped away
from all clinical work to mentorhis doctors and lead his team
across three practices.
He's sharing exactly how hespends his time, the surprising
(00:25):
way they run their team meetingsand what he does to turn his
doctors into great partners, notjust clinicians.
You are listening to DentalPractice Heroes, where we help
you to create a team andsystem-driven dental practice,
one that allows you to practiceless and make more money.
I'm Dr Paul Etcheson, a dentalcoach, author of two books on
dental practice management andthe owner of a five-doctor
(00:47):
practice in the south suburbs ofChicago.
I want to show you how beingintentional about ownership can
create a practice that supportsyour life instead of consuming
it.
So if you're ready to create atrue business that runs without
you, you're in the right place.
Let's get started.
Hello everyone, welcome back tothe Dental Practice Heroes
(01:07):
podcast.
I'm your host, dr Paul Etchison.
We got a good guest today.
We got Dr Sten Erickson.
He is the owner of PathwayDental Group in Santa Barbara
County.
There's three practices, somultiple practice owner.
He's also mentoring youngerdentists who want to follow in
his path.
So we're going to pick aparthis brain today and see what
it's like to have threepractices.
(01:27):
So welcome to the podcast, dan.
Thank you, paul.
Sten Erickson (01:30):
Yeah, look at Borda.
Paul Etchison (01:31):
Dude.
So tell me about your journeyfrom just dental school to
ownership and to the firstpractice.
What did that look like for you?
Sten Erickson (01:38):
It looked rocky.
That's what it looked like.
I think for a lot of people itdoes.
But I went to USC dental schoolkind of first year out ended up
working for the clinical deanat USC.
He had a practice in the areaso worked with him for a year.
It was kind of a clinicatmosphere, which I think a lot
of people did, and just churningand burning and learning how to
get efficient and do what we doKind of always knew that I
(01:59):
wanted to be have a largerpractice or potentially
multi-practice, wanted to behave a larger practice or
potentially multi-practice.
So one day just kind of moved upto Santa Barbara.
We figured out that we wantedto live here and started
knocking on doors and that's howI found my first office and we
actually actually partnered upwith my, my first partner, for
we bought 50% of the practicealmost immediately and about
(02:20):
nine months later about thesecond 50%.
And then when that closed,about two months later I
actually had a doctor next doorto me and the building that we
were in passed away so his wifeasked me to take over.
Paul Etchison (02:33):
So it was like overnight, within three months,
you know, a couple strokes ofthe pen, my life changed quite a
bit, so you mentioned that youalways you felt like you always
wanted multi-practice, Like whatabout?
It drew you.
Sten Erickson (02:44):
You know, one of the things that always drew me
to dentistry was theentrepreneurship of it, and I
really I love the technicalaspect.
I mean I did a ton of CE andMcCoy Sky, I did a ton of
implant CE kind of a lot ofstuff like that.
I was sitting on boards withAEC so I loved all the clinical
stuff, but I always, you know,what originally kind of
attracted me was being an ownerof a business and kind of
(03:05):
getting to, you know, write yourown script, and so I really
didn't have it in my mind thatyou know we were going to create
a DSO or anything like that.
But I always knew that I wantedto have something bigger.
I knew I wanted to havedentists kind of work for me.
I know I wanted to have abigger shop no-transcript.
Paul Etchison (03:49):
First practice Like how long were you since
graduation?
Sten Erickson (03:52):
Not even a year, oh wow.
So yeah, not even a year.
There's.
You could call it hot to trotor just blind ambition, whatever
it is.
But uh, I knew I wanted to owna practice pretty, pretty
quickly, and I don't know if Iwas ready for it, but I,
whatever, I, I made it happen.
So yeah.
Paul Etchison (04:08):
So I'd say, like, looking back, like do you wish
you would have waited a littlebit longer?
Do you think you made it harderon yourself than it needed to
be, or was it about the righttime?
Sten Erickson (04:16):
I think it was about the right time, but I
definitely made a lot of thingsharder on myself.
There's no doubt about that.
I ended up buying a biggerpractice.
It was kind of in the $1.5million range, which I know
wasn't like I couldn't handlethat from a volume standpoint.
I definitely could at thatpoint, but it's a big nut to
have when you're out of school,and so I think in retrospect
(04:39):
there's a number of things Iwould have done differently, but
one of them definitely wouldhave been buy a smaller practice
and then grow it, instead ofkind of trying to hold on to a
bigger practice that had alreadybeen more or less optimized in
a lot of ways.
Paul Etchison (04:51):
What makes it hard about acquiring a practice
that's doing it's alreadysuccessful, versus one that's
underperforming?
Sten Erickson (04:58):
For me, I think it was that in order to grow it
significantly and really get anROI on my loan and everything
else I put into it, it was goingto take a lot.
And so in Santa Barbaraspecifically, there's not a lot
of large practices.
We're a smaller town and so thetown you know there really
wasn't room for four or fivemillion dollar practices.
(05:19):
You know, I think that's kindof changing in certain areas and
I think it's definitelychanging a little bit in Santa
Barbara, kind of changing incertain areas and I think it's
definitely changing a little bitin Santa Barbara.
But I think it just became moredifficult for me to make a big
splash with the practice when I,when I came in, versus if I
would have gone in with a 500 or750 practice.
I think I could have doubledthat in very short time, you
know, and doubling a $1.5million practice is a little bit
(05:40):
more difficult, especially whenit's just me, and so that was
something I think you know now Iwould have the confidence to do
it, no doubt about that.
But when I was, you know,whatever, 29 years old,
something like that, that was 28years old.
That was something I hadn'tdone before and so I just didn't
have the, you know, theknowledge of kind of how do I?
Paul Etchison (05:57):
how do I get this done?
So it's more from like an ROIstandpoint is that you weren't
able to grow from where youstarted, but were you able to
sustain where you were at atthat 1.5?
.
Sten Erickson (06:06):
Definitely able to sustain and I actually grew
at about 30% kind of in thefirst year, which I think was
pretty good.
But I still looking back and Ithink a lot of the guys that
I've talked to that have beenreally successful with practice
purchases, especially kind oftheir first practice.
They've really started in thatkind of smaller to medium size
range and then they've reallyseen a big jump in some of their
production With your firstpractice.
Paul Etchison (06:28):
What would you say?
The biggest challenge was thatyou remember Staff team.
Yeah, always Just taking over,just like getting into there and
getting them on your side.
Sten Erickson (06:39):
Yeah, I always worked with them before we
bought the practice and so youknow I knew the team and they
knew me and so they were verycomfortable.
I was working on there four orfive days a week and then my
partner who retired after aboutthe second half, he was only
working a day or two.
So it was essentially mypractice.
When I had bought it I hadalready been pretty established
there.
Some of it's the overhead withthis team and you know just
(07:01):
people that have a little bit ofa bloated salary and sometimes
performance was iffy, and soit's kind of making those hard
decisions Are the people kind ofdo we kind of bring them along?
Do we kind of get someone inthere?
That's kind of fresh blood?
Those decisions were definitelyhard, but just kind of keeping
everyone motivated and alignedand rowing in the same direction
(07:23):
was always a really bigchallenge for me in the
beginning for sure, especiallywhen we were growing, because I
think they I wasn't as good atexplaining my vision and so I
think when we were making thesebig strides for growth whether
it was a marketing push or evenbuying a second practice, things
like that, hiring an associateI don't think they really
understood why I was doing itand I was kind of not as
(07:46):
confident myself to explain it,because I thought they might
think that we're trying to be,you know, the next DSO and they
wouldn't want to stay around,and so I think that was a
shortcoming of mine.
But staff overhead, especiallyin California, is always a
challenge, that's for sure.
Paul Etchison (08:00):
Yeah, so you realize that vision is important
, and projecting that to theteam and explaining it.
Was there like a certaininstance in which you, when you
learned that, yeah, there wereprobably multiple, you know.
Sten Erickson (08:11):
I think one of the main ones was when I tried
to attempted to kind of splitmyself in two between when we
bought our second location,which was about a year, a little
over a year after I purchasedthe second half of the first
practice, which was about a year, a little over a year after I
purchased the second half of thefirst practice, I basically
attempted to work seven to one,one to seven, you know, in one
office, one in the other office,and so you know that was going
(08:36):
pretty much every day throughthe week, and during that time
when I'm just running aroundwith my hair on fire, you know
you don't have a lot of time tocoach team members or build the
culture or things like that.
So you're kind of relying onthem and themselves to kind of
really create their own culture.
It's, you know, people who saywhat has been told is, you know,
whether you think you have aculture or you don't, you
definitely do.
It just might not be exactlywhat you've guided or what
(08:58):
you've, you know, intentionallybuilt.
So that was where we lostcontrol a little bit and we were
finding a lot of things that wedidn't like.
And it was a big realizationthat we really needed to kind of
rein in the culture and Ireally maybe needed to take a
step out of clinical a littlebit just to kind of focus on
some of the coaching with thedoctors.
And it was kind of a big wakeup call.
(09:19):
We did lose some people goodpeople, I think along the way.
I take full blame for that,just not having that culture in
place, but I think it really wasa wake-up call for me to say,
okay, we had a good culture inour first practice.
I can just copy-paste and putthat an hour away and that was
naive at best.
You know, it really takes anintentional effort to kind of
(09:45):
continue that culture.
Paul Etchison (09:47):
So if you said, if you had to look back from the
first practice to the secondpractice, what was the
difference Like?
What was the major differencein the culture?
Sten Erickson (09:54):
You know the culture.
I think the second practicedefinitely was a very closely
held practice from the previousdentist that owned it and it was
meaning that he was, you know,friends in the community.
They're almost at the samechurch, almost at the same high
school and things like that, andso to go into that location and
kind of be the new dentist youfelt like a little bit of an
(10:16):
invader, and I know that happensa lot with very closely held
practices everywhere.
But to do that when I also hada practice that I was holding
onto an hour away was anespecially hard challenge.
So that was a tough one.
A lot of patients no-transcriptthat are not, you know, wild
(11:05):
about the old doctor retiringand things like that.
That always happens.
But we know how to get newpatients, we know how to treat
and plan, we know how to produce, you know, at this point so it
becomes a little bit more ofwhat our skills are versus
trying to act and operate likethat previous dentist just to
hold on to those patients.
And so I think that was alittle bit of a realization for
(11:27):
me, not to say that went bad,but I think it could have been a
lot easier.
Paul Etchison (11:31):
One of the things that I strongly believe is that
it's really hard to growpractices.
You know, from a managerial,entrepreneurial standpoint, when
you're just seeing patients allthe time.
It just becomes very difficultBecause in one is like you want
to say you don't have the time,but sometimes you just don't
have the energy.
You've got the time but youdon't have the energy to do it.
What did you do to like changethis culture at the second
practice?
Sten Erickson (11:52):
That's exactly what I did.
I took a lot.
I took a big step backclinically, and I remember
exactly how many days oranything like that.
But I essentially reserved alot of time in my day to either
shadow different doctors orshadow the team and just kind of
be there working with them whenI wasn't seeing patients.
And so I think that that was abig one.
And then on the days that I wasworking clinically, I would
always make sure that I was nextto a doctor working clinically.
(12:14):
I would always make sure that Iwas next to a doctor, and part
of it was just hey, this is howI operate, this is how I roll,
take what you can and kind oflearn from me a little bit.
And then I had kind of built mypractice over a fairly short
period of time and was doing alot of IV sedation and bigger
cases and a lot of surgery andthings like that, and so that
was the way I knew to build apractice.
That was my strategy.
So I was trying to really forcethat on them.
(12:36):
I think they wanted some of it,but I also do think I was maybe
forcing it a little too quickon some of them.
So I think really getting inthere and kind of seeing where's
their capability, where's theircompetency right now and seeing
that firsthand, and then it'sokay, I can meet you where you
are from a coaching standpoint.
I can see where you are hey,this is how we're going to get
to the next step, instead of hey, I think you're right here,
(12:59):
let's go ahead and do a fullmouth implant case right now.
You know, I think that it'sexciting for some docs, but
they're just not ready for it.
Paul Etchison (13:04):
Yeah, I think that's great information,
because a lot of docs like howdo you run your business?
And often like what I tell themis that it's not things that
you'll schedule.
You're just there, like workingwith people, and they're like
(13:26):
well working, what?
So I love if you could share,like other than shadowing
doctors, like what are someother things that you were doing
when you took a step out ofthat clinical role to step more
into the running the business?
Sten Erickson (13:37):
Yeah, so I mean at the time my actually my
assistant, who had been myassistant, and then she'd been
our office manager, my sedationassistant, and now she's our COO
.
So she, she works very close,so we actually do a lot of our
coaching and mentoring together.
She was really working with ateam and having one-on-ones
frequently with them, reallyworking with a team and having
one-on-ones frequently with them.
Because what happens is, youknow, you have something happen,
(13:58):
whether it's with a team memberor a patient, and then when you
start to kind of dig underneaththe surface to kind of find out
what happened, do a littletriage, you realize that there's
numerous places along the waythat you could have prevented
that.
And you know, I think a perfectexample is just, you know, when
(14:20):
you have someone quit and youjust weren't expecting it, right
, they were expecting it, theywere probably thinking about it,
there were signs here and thereall along the way, right, and
so I think that really helped uskind of hone that in a little
bit as this.
Let's have these one-on-onesvery, really frequently.
That's how these groupdiscussions is how these group
training meetings you knowpretty frequently, and so that
really kind of helped us get afinger on the pulse of kind of
(14:40):
what was going on in our ownpractice a little bit more, and
then I would kind of take thelead on on training the doctors,
but I definitely am still chairside with them for a lot of
cases.
I got all my doctors.
Right now I'm wanting to placeimplants, so I'm placing every
implant with them, letting themdo it.
Everything's guided.
I'm kind of walking themthrough it.
But we're doing that.
I got a lot of them, you know,doing wisdom teeth, doing some
full mouth stuff.
So I'm in the office and then,you know, we also have a really
(15:03):
pretty ironed out meetingcadence with the doctors.
So when we do training sessionsand morning meetings and
lunchtime kind of clinicalcalibration calls things like
that, so we really structure itand split between three offices.
A lot of it ends up being overZoom, which I don't think is a
bad thing.
We've actually had a lot ofgood results in Zoom because you
have a really captive audience.
You know no one can kind ofhave something else going on in
(15:24):
the other room and whensomeone's on Zoom they're right
in front of you and they'reusually not as distracted
sometimes if you're in theoffice.
So you know that's.
That's kind of been our secretsauce, I guess, is what's worked
for us is to just really reallyfocus on the training and
really kind of have a setmeeting schedule with the
doctors and with the team.
Paul Etchison (15:44):
So what is your meeting schedule with the
doctors?
What does that look like inyour practices?
Sten Erickson (15:47):
Yeah, so you know , every morning, every Monday
morning, we do an all teammeeting.
It's usually pretty quick,usually kind of a little bit
more motivation Look at somenumbers real, real, briefly, not
too much and you know, alwayskind of go over some kind of
training topic that we'reworking on for the week.
You know ready break and that'salways over Zoom, because it's
between all three offices, so weget everyone on Zoom.
There's a bunch of differentsquares on there and that's it.
(16:08):
And then my I'll kind of gothrough my meeting first.
Every Tuesday we have a just adoctor call.
We kind of go over someleadership topics, things that
are happening with the team.
Hey, I'm noticing this, I'mnoticing our x-rays are not
coming as quick.
I'm noticing my setups are notwhere they should be or not on
time, something like that.
Hey, how can we work withdifferent doctors?
And usually it's notnecessarily a team issue, it's
(16:29):
it's the doctors that are eithernot portraying what they expect
out of the team, and so there'sa little bit of a communication
issue.
But we always try to hold themirror to the doctors first.
So that's on Tuesday, that'sabout 30 minutes.
Wednesday, we usually have aone-on-one with one of the
doctors.
Thursday, we have a clinicalcalibration at lunch, where we
just bring cases.
So we used to do cases kind ofon one-off basis, where they
(16:52):
would send me cases, they wouldsend me records, and then we
would just do a call or I'd meetthem in the office and we'd
kind of run through a case.
What I realized, though, isthat was with one person, and
all my doctors probably couldhave gotten a lot of benefit out
of hearing all that, and so weended up kind of doing it all
together, and so we have kind ofa set way that they're supposed
to present some of the records.
This is their first attempt atkind of where they're going to
(17:14):
treat and plan where they wantto go from a stepwise
appointment standpoint and howthey're going to design the case
, and so, then, we kind of justbreak it down, and we do that on
the Thursday afternoon calls,so those are great, and we go
everything from you know an endocase that someone's having to
struggle with, to an implantcase to you know, hey, this is
where wave one doctor doing alot more of the thirds right now
(17:35):
.
This is where I want to youknow, yes on this, there's no on
that third, things like thatand we'll big topic is implants
right now.
So we're talking a lot aboutimplants and everyone's going.
One person has a case.
Everyone gets the benefit of atleast working that case up and
seeing how that goes.
We get the post-ops and we kindof get a little debrief on kind
of what.
You know how that case wentfrom the other doctor's
(17:59):
standpoint not from mystandpoint, but I want them to
kind of talk about hey, this iswhat I learned from this case.
So, and then if we ever have adoctor going to CE courses,
which we do a lot of throughoutthe year, we'll kind of have a
reserve, another meeting thatthey can basically present
everything they learned to therest of the doctor team and kind
of break it down with differentslides and different docs and
things like that.
So we can all kind of get alittle bit of a benefit from
from whatever they learned.
So it's really cool how manydoctors do you have total?
(18:22):
We have five doctors now.
Paul Etchison (18:24):
Yeah, Okay, Logistically, how do you
schedule like so that everybodycan be on these meetings?
Sten Erickson (18:30):
So we have our doctors are working four days.
Right now.
We and that's something we arepretty firm believers in I think
five days a week is.
This is manual labor, what wedo, right, it's tough.
So it's tough.
I mean, every once in a while,on a Tuesday morning meeting or
a Thursday afternoon, they mightmiss it if they have a certain
day off.
We kind of have a rotatingschedule that goes over four
weeks, so there's always goingto be, you know, some doctor
(18:52):
that has some day off, that's onTuesday or Thursday, something
like that.
We'll shift them around.
Sometimes if there's animportant topic that we need to
kind of get everyone on boardwith and make sure that you know
, hey, it's Wednesday afternoonthis time because everyone's
going to be in the office,something like that.
But a lot of these meetingswhich has been something I
didn't expect and we've neverasked out of them, but a lot of
these meetings will have doctorslog in from home and just
(19:13):
because they want to, they justwant to be a part of the meeting
or they have something to sayor they have something to
present.
So it doesn't happen all thetime and we definitely don't
push it.
We want people to have theirtime away when they have their
day off, but it's been kind ofcool to see doctors take it that
seriously, that you know theyreally want to come to the
meeting and be a part of theteam.
So, yeah, it's not perfect, butI think by having that many
meetings throughout the week andmonth we're going to hit all of
(19:35):
them most days.
Paul Etchison (19:37):
I mean it's more attention that most people give
their associates.
I find that most owners arelucky if they do a one hour
meeting once a week, if not onceevery other week, with their
associates.
And here you are, having thesetouch points all along the week.
Sten Erickson (19:51):
Yeah, I mean to your point.
I was wondering the same thingwhat the hell am I going to do
if I'm not going to see patients?
And I kind of just decided I'mnot going to let them fail, yeah
, and this is my way to do it.
And so, if I can kind of be andI'm really trying hard not to
be overbearing, because I hatedwhen I had, you know, an owner
doc looking over my shoulder hey, why'd you do that?
When did you treat and planthis?
(20:12):
So I'm definitely trying to doit more in a collaborative.
Yeah, me too.
Hey, this is what I would doinstead of you know, hey, you
missed this freaking fillingright there or something like
that, or some stupid thing likethat.
So we're definitely trying tolet them, you know, develop
their own practice or buildtheir own practice within our
ecosystem, but we definitelyknow a lot just to try things
(20:37):
out and see how it works,especially on my dime.
Paul Etchison (20:40):
I've had associates over the years that
are like oh my gosh, give memore information, pour into me,
listen to my exams, do this, andthey really want it.
And I remember one associatethat she really needed it and I
poured into her and back in mymind I'm like you are so lucky
girl, you are getting so much ofmy attention and so much of my
coaching.
And then at a certain point shesaid I find myself really not
(21:02):
liking working here because Ifeel like I'm under the
microscope all day long.
And that was an eye opener forme, where I was like, oh wow,
like there is such a thing astoo much coaching.
So how do you walk that linewith giving the doctors their
autonomy and letting them feellike they're okay just the way
they are, but at the same time,I'm sure you could find a
million things that you want topick at.
(21:24):
How do you do that?
Sten Erickson (21:25):
Very carefully.
I know exactly, and I mean thething that my CEO and I talk
about really a lot is they wantit when they want it and they
don't want anything when theydon't want it.
So it's almost like you need tokind of be there when you think
, or right before they're goingto ask, or right before you kind
of see them wondering aboutsomething, and no more than that
(21:47):
, because I have been thatoverbearing owner, I think, a
couple of times in my career andit doesn't work out well.
I think it kind of pushespeople out the door a little bit
.
Like you said, you know, onething we do in our practice we
actually just did this with ourdocs this morning is we kind of
do a day in the life where myCOO will flash up like four or
five numbers and they won't haveany labels on them and they're
just you know these randomnumbers, and then we'll kind of
(22:07):
label them.
And so one of the day in thelife numbers we put up this
morning was their schedulingpercentage what a 10% bump in
scheduling percentage would beas far as a daily production,
what a 10% bump in schedulingpercentage would be as far as a
daily production, and then whatthat would mean from a yearly
income standpoint and what theyrealized, because they were
going to make $100 to $150,000more with a 10% bump in
(22:29):
scheduling, which is not crazy.
I mean, it's something, youknow.
I think a lot of dentists thathave been around for a while
just all have to do is make uptheir mind.
They can just go out and do it,but they didn't realize that.
And so, kind of seeing thenumbers and kind of seeing them
how they kind of extrapolate outinto something they really care
about, which is their take homepay, plant some seeds about
okay, maybe I do need to notcomplain about having eight
(22:50):
exams on my side, you know.
Maybe I do need to, you know,not complain about having all
these new patients.
Maybe these new patients arekind of getting me towards my
goals, and so, versus if wewould have just said, hey, you
got to see eight or 10 newpatients a day and they're gonna
say, well, it's too much, Ican't do that.
Well, here's why and we're notgiving them eight or 10 new
patients every day.
(23:10):
But I mean, I want them to kindof be hungry for that and not
necessarily it being me pushingthem or kind of forcing them to
do something kind of, becausethat has a little bit of a that
kind of, you know, clinic DSOatmosphere when you start to
push things.
I think people really, reallypull back when they get that
vibe.
So but if we have them come upwith that realization on their
own, I think it makes a lot alot bigger impact.
Paul Etchison (23:34):
So how long has that been that you stopped
seeing patients clinically?
Sten Erickson (23:38):
A little bit on and off.
So I stopped about five or sixyears ago.
Once lost an associate, one ofthem that I probably was
overbearing on.
It was kind of a big.
It was a big painful time in mycareer so I was kind of thrown
back in.
I was thrown back in duringCOVID and then I've been out
clinically this time for acouple years now, two, two and a
half, three years now.
Paul Etchison (23:59):
Yeah, how do you keep from getting pulled back in
when an associate moves on orsomething like that, when it's
just convenient, well, you'vegot a license.
Sten Erickson (24:06):
And I always and that's part of the strategy is,
if I need to, I mean it's, youknow.
You know, call up the bullpenand I'm in, but I it's
definitely not an exercise inmaking more money.
I'll tell you that If I get usgoing back in or we can either
make room for me or let go of adoc.
You know I can definitely havea lot more take home income.
I'm definitely aware of that,but the lifestyle is not there
(24:28):
and I don't think I'd do as gooda job of being a leader.
So I have really tried to focusthem on.
You're going to make more moneyand you're going to do bigger
cases.
You're going to have moregrowth and more and more
coaching under our wings thanyou would anywhere else.
Paul Etchison (24:44):
But we've got a lot of dental colleagues that
don't necessarily love doingdentistry and they say, man, I
would love to be non-clinicalbut I don't see how that could
financially work.
Yeah, now you've got threepractices, multiple docs.
You're at a scale where you saythat, where obviously it does
work.
But what would you say tosomeone who says that is the
(25:05):
trajectory I want to go in?
How would you suggest they getthere faster?
Sten Erickson (25:10):
Well, first of all, I think they need to figure
out is that really what theywant?
You know, because I think, likeyou said, if someone goes
non-clinical and they'rewondering what the hell they're
doing with their lives, right?
So, unless you really love kindof the coaching and the
managing of the leadership, Idon't know that that's going to
be a worthwhile trajectory,because I think you're going to
kind of get to where you thoughtyou wanted to go and realize
(25:30):
that this isn't for me and a lotof people end up just selling
their practice.
At that point the one mindsetshift for me was really making
decisions and kind of thinkingabout my practice as an owner
and not even a leader, not evenas a manager.
But if I was an investor in myown practice completely outside
of the practice, didn't haveanything to do with it, never on
a call, never on a meeting howwould I want those decisions to
(25:54):
be made?
And I think you really need tosit down and calculate if
someone were to come in and buyyour practice as an owner and
not work clinically and justhire you, you know, where would
the profitability need to beafter paying doctors?
And I think that's somethingthat's missed from a lot of
dentists is they, you know?
They just you know, take theiroverhead, say I'm doing, hey,
I'm doing 55, 45% overhead, sothat means I have a 45, 55%
(26:18):
profit, right?
No, that's not what that means.
And so I think, reallyrealizing what the numbers mean,
understand what level youreally need to get to to replace
your income, or at least makesure that your income is going
to support your personal life,so making sure that, after
paying a doctor to produce thatdentistry, there is something
left Enough left over, yeah, butyou can have the life that you
(26:39):
want, right, yeah, left, enough,left over, yeah, but you can
have the life that you want,right, yeah, yeah.
Paul Etchison (26:45):
So now you've scaled this to three practices,
I mean, what is your futuretrajectory look like?
Do you have any ambition to dosome more practices?
Sten Erickson (26:50):
Yeah, yeah, we definitely do, and we did our
last acquisition about threeyears ago.
So we're kind of back in thatmode.
I think I told you we did alittle bit of an underperforming
practice, which was a lot moreunderperforming than we realized
going into it, but we'vemaintained it and actually now
we've kind of, you know, tripledor more the growth.
So we just did a chart salewhich is kind of just done.
We've done a couple of thoserecently.
(27:10):
But we're definitely lookingfor the fourth location.
My doctors right now have kindof an earn in equity program
where they can earn equity.
So I'm definitely looking toexpand that to you know, really
they're owners right now but Ireally want them to kind of, you
know, feel like and actuallyact like owners even more.
So that's my kind of the bigpush is okay.
(27:30):
How do we really kind of bringthem into the fold about certain
leadership and certainownership lessons and ways we
want them to operate, you know,on a day-to-day basis?
So we're kind of going throughfinancials, we're going through
growth trajectories, we're goingthrough how we're evaluating
practice, acquisition targets,things like that with them.
So, because I want partners, youknow, at this point and say I
want, you know, major partners,but I want people that act like
(27:50):
partners, because if I'm notgoing to, you know, be in the
office that much, I need peoplethat are making those decisions
very similar to the way that Iwould make those leadership
decisions.
So that's kind of my push, youknow.
As far as long term, I reallydon't know.
I'm leaving a lot of doors open.
You know, I think at some point, you know, having either an
internal buyout or externalbuyout is in the cards.
(28:11):
But I'm having fun right nowand I think we got a lot more
meat on the bone.
Paul Etchison (28:14):
Awesome man.
Sten Erickson (28:14):
So like you're offering mentorship to docs who
maybe want to follow in yourfootsteps, Talk about that One
of the things I think we reallydo well in our practices is a
lot of the training, a lot ofsystems.
We have training platforms,videos, hundreds and hundreds of
videos and things like that,from anything from a doctor to
team member, front office, backoffice, things like that.
So we have that going out to alot of people right now in
(28:34):
doctors that want to really kindof take their training of their
team members from.
What we really found is thekind of magic sauce is really
getting these people onboardedand trained within a 60 day
period.
You know cause.
We will kind of look back on mycareer and we.
How did we fail on a lot ofthese things?
We a lot of times we've failedand really just kind of bringing
someone on and then it was juston the job, training, right,
(28:56):
and so what we've really made apush in the last five years or
so is to they have a wholecurriculum that they kind of go
through, and so we've reallykind of shortened and condensed
the timeframe to 60 days wheresomeone can really be in the
room they're doing the surgery,they're doing chair site,
they're checking out patients,they're presenting treatment
plans.
They're doing all that kind ofwithin the first month, second
month is kind of fine tuningthose things and we really have
(29:17):
a team member that'scontributing in a big way, very,
very quickly.
Not to mention the fact thatafter 90 days it becomes a lot
harder to terminate someone or alittle more sticky, and so that
60 days it kind of gives you a30 day buffer to really find out
if that person is where theyneed to be.
From a team member standpoint.
So that's been a big push.
We're having all of our teamhire and fire.
(29:38):
So myself and my COO does noneof it so but they decide who
they hire, they decide who theyfire.
We're doing presenting themwith resumes and things like
that, but they're making allthose decisions and so different
things like that.
So docs that kind of want toincorporate things like that
into their own practice andreally see a need to kind of
onboard someone without dentalexperience and that that's been
our forte is really takingpeople from other industries
(29:59):
that want to start a new career.
And then we really kind oflooking at helping docs.
I've been reached out by anumber of people that I've just
had interactions with to kind offigure out how do we get
associates.
You know, kind of over thatmillion dollar mark, you know,
because I think that kind ofseems to be a little bit of the
magic number where they reallystart to make an impact on the
(30:21):
practice and not necessarily adrain and not necessarily just
kind of filling in gaps.
Is, you know, when associatescan kind of get to that million
dollar number, then we canreally kind of start to build a
team around them and really kindof, you know, do some fun
things, and so that's anotherpush.
Is that we're trying to mentor.
You're having a lot of peoplethat want us to mentor them on
how do we get docs?
You know they're producing five, six $700,000.
(30:42):
How do we get them to a milliondollars?
Paul Etchison (30:43):
So if anyone's interested in like learning more
about that, where can they findout more information?
Sten Erickson (30:47):
Yeah, so email, email us.
We have a connect at PathwayDental Solutions.
We're my COOs.
She's on all the all the goodstuff, all the LinkedIn and all
the social and all that stuff.
Paul Etchison (31:01):
So in and all the social and all that stuff
Awesome, man.
But, dude, thanks so much fortaking some time out of your day
and spending it with thelisteners.
I think it's just a wealth ofinformation and really admire
the consistency that you havewith your doctors.
I mean, it's like I'm listeningto you say this.
I'm like man, that would be sonice if I did that with my
doctors, but I always plan to,but it's the follow through.
It doesn't always work out likethat.
So, but yeah, and thanks forcoming on and thanks for sharing
(31:24):
all that stuff with thelisteners.
It's been great, a lot of fun,paul, thank you.
What do you actually do when you stop seeing
patients?
So many owners ask me thisquestion when they finally
decide to cut back on clinicaldays and suddenly they don't
know what their role is outsideof the operatory.
Today, I'm joined by Dr StenErickson, who has stepped away
from all clinical work to mentorhis doctors and lead his team
across three practices.
He's sharing exactly how hespends his time, the surprising
(00:25):
way they run their team meetingsand what he does to turn his
doctors into great partners, notjust clinicians.
You are listening to DentalPractice Heroes, where we help
you to create a team andsystem-driven dental practice,
one that allows you to practiceless and make more money.
I'm Dr Paul Etcheson, a dentalcoach, author of two books on
dental practice management andthe owner of a five-doctor
(00:47):
practice in the south suburbs ofChicago.
I want to show you how beingintentional about ownership can
create a practice that supportsyour life instead of consuming
it.
So if you're ready to create atrue business that runs without
you, you're in the right place.
Let's get started.
Hello everyone, welcome back tothe Dental Practice Heroes
(01:07):
podcast.
I'm your host, dr Paul Etchison.
We got a good guest today.
We got Dr Sten Erickson.
He is the owner of PathwayDental Group in Santa Barbara
County.
There's three practices, somultiple practice owner.
He's also mentoring youngerdentists who want to follow in
his path.
So we're going to pick aparthis brain today and see what
it's like to have threepractices.
(01:27):
So welcome to the podcast, dan.
Thank you, paul.
Sten Erickson (01:30):
Yeah, look at Borda.
Paul Etchison (01:31):
Dude.
So tell me about your journeyfrom just dental school to
ownership and to the firstpractice.
What did that look like for you?
Sten Erickson (01:38):
It looked rocky.
That's what it looked like.
I think for a lot of people itdoes.
But I went to USC dental schoolkind of first year out ended up
working for the clinical deanat USC.
He had a practice in the areaso worked with him for a year.
It was kind of a clinicatmosphere, which I think a lot
of people did, and just churningand burning and learning how to
get efficient and do what we doKind of always knew that I
(01:59):
wanted to be have a largerpractice or potentially
multi-practice, wanted to behave a larger practice or
potentially multi-practice.
So one day just kind of moved upto Santa Barbara.
We figured out that we wantedto live here and started
knocking on doors and that's howI found my first office and we
actually actually partnered upwith my, my first partner, for
we bought 50% of the practicealmost immediately and about
(02:20):
nine months later about thesecond 50%.
And then when that closed,about two months later I
actually had a doctor next doorto me and the building that we
were in passed away so his wifeasked me to take over.
Paul Etchison (02:33):
So it was like overnight, within three months,
you know, a couple strokes ofthe pen, my life changed quite a
bit, so you mentioned that youalways you felt like you always
wanted multi-practice, Like whatabout?
It drew you.
Sten Erickson (02:44):
You know, one of the things that always drew me
to dentistry was theentrepreneurship of it, and I
really I love the technicalaspect.
I mean I did a ton of CE andMcCoy Sky, I did a ton of
implant CE kind of a lot ofstuff like that.
I was sitting on boards withAEC so I loved all the clinical
stuff, but I always, you know,what originally kind of
attracted me was being an ownerof a business and kind of
(03:05):
getting to, you know, write yourown script, and so I really
didn't have it in my mind thatyou know we were going to create
a DSO or anything like that.
But I always knew that I wantedto have something bigger.
I knew I wanted to havedentists kind of work for me.
I know I wanted to have abigger shop no-transcript.
Paul Etchison (03:49):
First practice Like how long were you since
graduation?
Sten Erickson (03:52):
Not even a year, oh wow.
So yeah, not even a year.
There's.
You could call it hot to trotor just blind ambition, whatever
it is.
But uh, I knew I wanted to owna practice pretty, pretty
quickly, and I don't know if Iwas ready for it, but I,
whatever, I, I made it happen.
So yeah.
Paul Etchison (04:08):
So I'd say, like, looking back, like do you wish
you would have waited a littlebit longer?
Do you think you made it harderon yourself than it needed to
be, or was it about the righttime?
Sten Erickson (04:16):
I think it was about the right time, but I
definitely made a lot of thingsharder on myself.
There's no doubt about that.
I ended up buying a biggerpractice.
It was kind of in the $1.5million range, which I know
wasn't like I couldn't handlethat from a volume standpoint.
I definitely could at thatpoint, but it's a big nut to
have when you're out of school,and so I think in retrospect
(04:39):
there's a number of things Iwould have done differently, but
one of them definitely wouldhave been buy a smaller practice
and then grow it, instead ofkind of trying to hold on to a
bigger practice that had alreadybeen more or less optimized in
a lot of ways.
Paul Etchison (04:51):
What makes it hard about acquiring a practice
that's doing it's alreadysuccessful, versus one that's
underperforming?
Sten Erickson (04:58):
For me, I think it was that in order to grow it
significantly and really get anROI on my loan and everything
else I put into it, it was goingto take a lot.
And so in Santa Barbaraspecifically, there's not a lot
of large practices.
We're a smaller town and so thetown you know there really
wasn't room for four or fivemillion dollar practices.
(05:19):
You know, I think that's kindof changing in certain areas and
I think it's definitelychanging a little bit in Santa
Barbara, kind of changing incertain areas and I think it's
definitely changing a little bitin Santa Barbara.
But I think it just became moredifficult for me to make a big
splash with the practice when I,when I came in, versus if I
would have gone in with a 500 or750 practice.
I think I could have doubledthat in very short time, you
know, and doubling a $1.5million practice is a little bit
(05:40):
more difficult, especially whenit's just me, and so that was
something I think you know now Iwould have the confidence to do
it, no doubt about that.
But when I was, you know,whatever, 29 years old,
something like that, that was 28years old.
That was something I hadn'tdone before and so I just didn't
have the, you know, theknowledge of kind of how do I?
Paul Etchison (05:57):
how do I get this done?
So it's more from like an ROIstandpoint is that you weren't
able to grow from where youstarted, but were you able to
sustain where you were at atthat 1.5?
.
Sten Erickson (06:06):
Definitely able to sustain and I actually grew
at about 30% kind of in thefirst year, which I think was
pretty good.
But I still looking back and Ithink a lot of the guys that
I've talked to that have beenreally successful with practice
purchases, especially kind oftheir first practice.
They've really started in thatkind of smaller to medium size
range and then they've reallyseen a big jump in some of their
production With your firstpractice.
Paul Etchison (06:28):
What would you say?
The biggest challenge was thatyou remember Staff team.
Yeah, always Just taking over,just like getting into there and
getting them on your side.
Sten Erickson (06:39):
Yeah, I always worked with them before we
bought the practice and so youknow I knew the team and they
knew me and so they were verycomfortable.
I was working on there four orfive days a week and then my
partner who retired after aboutthe second half, he was only
working a day or two.
So it was essentially mypractice.
When I had bought it I hadalready been pretty established
there.
Some of it's the overhead withthis team and you know just
(07:01):
people that have a little bit ofa bloated salary and sometimes
performance was iffy, and soit's kind of making those hard
decisions Are the people kind ofdo we kind of bring them along?
Do we kind of get someone inthere?
That's kind of fresh blood?
Those decisions were definitelyhard, but just kind of keeping
everyone motivated and alignedand rowing in the same direction
(07:23):
was always a really bigchallenge for me in the
beginning for sure, especiallywhen we were growing, because I
think they I wasn't as good atexplaining my vision and so I
think when we were making thesebig strides for growth whether
it was a marketing push or evenbuying a second practice, things
like that, hiring an associateI don't think they really
understood why I was doing itand I was kind of not as
(07:46):
confident myself to explain it,because I thought they might
think that we're trying to be,you know, the next DSO and they
wouldn't want to stay around,and so I think that was a
shortcoming of mine.
But staff overhead, especiallyin California, is always a
challenge, that's for sure.
Paul Etchison (08:00):
Yeah, so you realize that vision is important
, and projecting that to theteam and explaining it.
Was there like a certaininstance in which you, when you
learned that, yeah, there wereprobably multiple, you know.
Sten Erickson (08:11):
I think one of the main ones was when I tried
to attempted to kind of splitmyself in two between when we
bought our second location,which was about a year, a little
over a year after I purchasedthe second half of the first
practice, which was about a year, a little over a year after I
purchased the second half of thefirst practice, I basically
attempted to work seven to one,one to seven, you know, in one
office, one in the other office,and so you know that was going
(08:36):
pretty much every day throughthe week, and during that time
when I'm just running aroundwith my hair on fire, you know
you don't have a lot of time tocoach team members or build the
culture or things like that.
So you're kind of relying onthem and themselves to kind of
really create their own culture.
It's, you know, people who saywhat has been told is, you know,
whether you think you have aculture or you don't, you
definitely do.
It just might not be exactlywhat you've guided or what
(08:58):
you've, you know, intentionallybuilt.
So that was where we lostcontrol a little bit and we were
finding a lot of things that wedidn't like.
And it was a big realizationthat we really needed to kind of
rein in the culture and Ireally maybe needed to take a
step out of clinical a littlebit just to kind of focus on
some of the coaching with thedoctors.
And it was kind of a big wakeup call.
(09:19):
We did lose some people goodpeople, I think along the way.
I take full blame for that,just not having that culture in
place, but I think it really wasa wake-up call for me to say,
okay, we had a good culture inour first practice.
I can just copy-paste and putthat an hour away and that was
naive at best.
You know, it really takes anintentional effort to kind of
(09:45):
continue that culture.
Paul Etchison (09:47):
So if you said, if you had to look back from the
first practice to the secondpractice, what was the
difference Like?
What was the major differencein the culture?
Sten Erickson (09:54):
You know the culture.
I think the second practicedefinitely was a very closely
held practice from the previousdentist that owned it and it was
meaning that he was, you know,friends in the community.
They're almost at the samechurch, almost at the same high
school and things like that, andso to go into that location and
kind of be the new dentist youfelt like a little bit of an
(10:16):
invader, and I know that happensa lot with very closely held
practices everywhere.
But to do that when I also hada practice that I was holding
onto an hour away was anespecially hard challenge.
So that was a tough one.
A lot of patients no-transcriptthat are not, you know, wild
(11:05):
about the old doctor retiringand things like that.
That always happens.
But we know how to get newpatients, we know how to treat
and plan, we know how to produce, you know, at this point so it
becomes a little bit more ofwhat our skills are versus
trying to act and operate likethat previous dentist just to
hold on to those patients.
And so I think that was alittle bit of a realization for
(11:27):
me, not to say that went bad,but I think it could have been a
lot easier.
Paul Etchison (11:31):
One of the things that I strongly believe is that
it's really hard to growpractices.
You know, from a managerial,entrepreneurial standpoint, when
you're just seeing patients allthe time.
It just becomes very difficultBecause in one is like you want
to say you don't have the time,but sometimes you just don't
have the energy.
You've got the time but youdon't have the energy to do it.
What did you do to like changethis culture at the second
practice?
Sten Erickson (11:52):
That's exactly what I did.
I took a lot.
I took a big step backclinically, and I remember
exactly how many days oranything like that.
But I essentially reserved alot of time in my day to either
shadow different doctors orshadow the team and just kind of
be there working with them whenI wasn't seeing patients.
And so I think that that was abig one.
And then on the days that I wasworking clinically, I would
always make sure that I was nextto a doctor working clinically.
(12:14):
I would always make sure that Iwas next to a doctor, and part
of it was just hey, this is howI operate, this is how I roll,
take what you can and kind oflearn from me a little bit.
And then I had kind of built mypractice over a fairly short
period of time and was doing alot of IV sedation and bigger
cases and a lot of surgery andthings like that, and so that
was the way I knew to build apractice.
That was my strategy.
So I was trying to really forcethat on them.
(12:36):
I think they wanted some of it,but I also do think I was maybe
forcing it a little too quickon some of them.
So I think really getting inthere and kind of seeing where's
their capability, where's theircompetency right now and seeing
that firsthand, and then it'sokay, I can meet you where you
are from a coaching standpoint.
I can see where you are hey,this is how we're going to get
to the next step, instead of hey, I think you're right here,
(12:59):
let's go ahead and do a fullmouth implant case right now.
You know, I think that it'sexciting for some docs, but
they're just not ready for it.
Paul Etchison (13:04):
Yeah, I think that's great information,
because a lot of docs like howdo you run your business?
And often like what I tell themis that it's not things that
you'll schedule.
You're just there, like workingwith people, and they're like
(13:26):
well working, what?
So I love if you could share,like other than shadowing
doctors, like what are someother things that you were doing
when you took a step out ofthat clinical role to step more
into the running the business?
Sten Erickson (13:37):
Yeah, so I mean at the time my actually my
assistant, who had been myassistant, and then she'd been
our office manager, my sedationassistant, and now she's our COO
.
So she, she works very close,so we actually do a lot of our
coaching and mentoring together.
She was really working with ateam and having one-on-ones
frequently with them, reallyworking with a team and having
one-on-ones frequently with them.
Because what happens is, youknow, you have something happen,
(13:58):
whether it's with a team memberor a patient, and then when you
start to kind of dig underneaththe surface to kind of find out
what happened, do a littletriage, you realize that there's
numerous places along the waythat you could have prevented
that.
And you know, I think a perfectexample is just, you know, when
(14:20):
you have someone quit and youjust weren't expecting it, right
, they were expecting it, theywere probably thinking about it,
there were signs here and thereall along the way, right, and
so I think that really helped uskind of hone that in a little
bit as this.
Let's have these one-on-onesvery, really frequently.
That's how these groupdiscussions is how these group
training meetings you knowpretty frequently, and so that
really kind of helped us get afinger on the pulse of kind of
(14:40):
what was going on in our ownpractice a little bit more, and
then I would kind of take thelead on on training the doctors,
but I definitely am still chairside with them for a lot of
cases.
I got all my doctors.
Right now I'm wanting to placeimplants, so I'm placing every
implant with them, letting themdo it.
Everything's guided.
I'm kind of walking themthrough it.
But we're doing that.
I got a lot of them, you know,doing wisdom teeth, doing some
full mouth stuff.
So I'm in the office and then,you know, we also have a really
(15:03):
pretty ironed out meetingcadence with the doctors.
So when we do training sessionsand morning meetings and
lunchtime kind of clinicalcalibration calls things like
that, so we really structure itand split between three offices.
A lot of it ends up being overZoom, which I don't think is a
bad thing.
We've actually had a lot ofgood results in Zoom because you
have a really captive audience.
You know no one can kind ofhave something else going on in
(15:24):
the other room and whensomeone's on Zoom they're right
in front of you and they'reusually not as distracted
sometimes if you're in theoffice.
So you know that's.
That's kind of been our secretsauce, I guess, is what's worked
for us is to just really reallyfocus on the training and
really kind of have a setmeeting schedule with the
doctors and with the team.
Paul Etchison (15:44):
So what is your meeting schedule with the
doctors?
What does that look like inyour practices?
Sten Erickson (15:47):
Yeah, so you know , every morning, every Monday
morning, we do an all teammeeting.
It's usually pretty quick,usually kind of a little bit
more motivation Look at somenumbers real, real, briefly, not
too much and you know, alwayskind of go over some kind of
training topic that we'reworking on for the week.
You know ready break and that'salways over Zoom, because it's
between all three offices, so weget everyone on Zoom.
There's a bunch of differentsquares on there and that's it.
(16:08):
And then my I'll kind of gothrough my meeting first.
Every Tuesday we have a just adoctor call.
We kind of go over someleadership topics, things that
are happening with the team.
Hey, I'm noticing this, I'mnoticing our x-rays are not
coming as quick.
I'm noticing my setups are notwhere they should be or not on
time, something like that.
Hey, how can we work withdifferent doctors?
And usually it's notnecessarily a team issue, it's
(16:29):
it's the doctors that are eithernot portraying what they expect
out of the team, and so there'sa little bit of a communication
issue.
But we always try to hold themirror to the doctors first.
So that's on Tuesday, that'sabout 30 minutes.
Wednesday, we usually have aone-on-one with one of the
doctors.
Thursday, we have a clinicalcalibration at lunch, where we
just bring cases.
So we used to do cases kind ofon one-off basis, where they
(16:52):
would send me cases, they wouldsend me records, and then we
would just do a call or I'd meetthem in the office and we'd
kind of run through a case.
What I realized, though, isthat was with one person, and
all my doctors probably couldhave gotten a lot of benefit out
of hearing all that, and so weended up kind of doing it all
together, and so we have kind ofa set way that they're supposed
to present some of the records.
This is their first attempt atkind of where they're going to
(17:14):
treat and plan where they wantto go from a stepwise
appointment standpoint and howthey're going to design the case
, and so, then, we kind of justbreak it down, and we do that on
the Thursday afternoon calls,so those are great, and we go
everything from you know an endocase that someone's having to
struggle with, to an implantcase to you know, hey, this is
where wave one doctor doing alot more of the thirds right now
(17:35):
.
This is where I want to youknow, yes on this, there's no on
that third, things like thatand we'll big topic is implants
right now.
So we're talking a lot aboutimplants and everyone's going.
One person has a case.
Everyone gets the benefit of atleast working that case up and
seeing how that goes.
We get the post-ops and we kindof get a little debrief on kind
of what.
You know how that case wentfrom the other doctor's
(17:59):
standpoint not from mystandpoint, but I want them to
kind of talk about hey, this iswhat I learned from this case.
So, and then if we ever have adoctor going to CE courses,
which we do a lot of throughoutthe year, we'll kind of have a
reserve, another meeting thatthey can basically present
everything they learned to therest of the doctor team and kind
of break it down with differentslides and different docs and
things like that.
So we can all kind of get alittle bit of a benefit from
from whatever they learned.
So it's really cool how manydoctors do you have total?
(18:22):
We have five doctors now.
Paul Etchison (18:24):
Yeah, Okay, Logistically, how do you
schedule like so that everybodycan be on these meetings?
Sten Erickson (18:30):
So we have our doctors are working four days.
Right now.
We and that's something we arepretty firm believers in I think
five days a week is.
This is manual labor, what wedo, right, it's tough.
So it's tough.
I mean, every once in a while,on a Tuesday morning meeting or
a Thursday afternoon, they mightmiss it if they have a certain
day off.
We kind of have a rotatingschedule that goes over four
weeks, so there's always goingto be, you know, some doctor
(18:52):
that has some day off, that's onTuesday or Thursday, something
like that.
We'll shift them around.
Sometimes if there's animportant topic that we need to
kind of get everyone on boardwith and make sure that you know
, hey, it's Wednesday afternoonthis time because everyone's
going to be in the office,something like that.
But a lot of these meetingswhich has been something I
didn't expect and we've neverasked out of them, but a lot of
these meetings will have doctorslog in from home and just
(19:13):
because they want to, they justwant to be a part of the meeting
or they have something to sayor they have something to
present.
So it doesn't happen all thetime and we definitely don't
push it.
We want people to have theirtime away when they have their
day off, but it's been kind ofcool to see doctors take it that
seriously, that you know theyreally want to come to the
meeting and be a part of theteam.
So, yeah, it's not perfect, butI think by having that many
meetings throughout the week andmonth we're going to hit all of
(19:35):
them most days.
Paul Etchison (19:37):
I mean it's more attention that most people give
their associates.
I find that most owners arelucky if they do a one hour
meeting once a week, if not onceevery other week, with their
associates.
And here you are, having thesetouch points all along the week.
Sten Erickson (19:51):
Yeah, I mean to your point.
I was wondering the same thingwhat the hell am I going to do
if I'm not going to see patients?
And I kind of just decided I'mnot going to let them fail, yeah
, and this is my way to do it.
And so, if I can kind of be andI'm really trying hard not to
be overbearing, because I hatedwhen I had, you know, an owner
doc looking over my shoulder hey, why'd you do that?
When did you treat and planthis?
(20:12):
So I'm definitely trying to doit more in a collaborative.
Yeah, me too.
Hey, this is what I would doinstead of you know, hey, you
missed this freaking fillingright there or something like
that, or some stupid thing likethat.
So we're definitely trying tolet them, you know, develop
their own practice or buildtheir own practice within our
ecosystem, but we definitelyknow a lot just to try things
(20:37):
out and see how it works,especially on my dime.
Paul Etchison (20:40):
I've had associates over the years that
are like oh my gosh, give memore information, pour into me,
listen to my exams, do this, andthey really want it.
And I remember one associatethat she really needed it and I
poured into her and back in mymind I'm like you are so lucky
girl, you are getting so much ofmy attention and so much of my
coaching.
And then at a certain point shesaid I find myself really not
(21:02):
liking working here because Ifeel like I'm under the
microscope all day long.
And that was an eye opener forme, where I was like, oh wow,
like there is such a thing astoo much coaching.
So how do you walk that linewith giving the doctors their
autonomy and letting them feellike they're okay just the way
they are, but at the same time,I'm sure you could find a
million things that you want topick at.
(21:24):
How do you do that?
Sten Erickson (21:25):
Very carefully.
I know exactly, and I mean thething that my CEO and I talk
about really a lot is they wantit when they want it and they
don't want anything when theydon't want it.
So it's almost like you need tokind of be there when you think
, or right before they're goingto ask, or right before you kind
of see them wondering aboutsomething, and no more than that
(21:47):
, because I have been thatoverbearing owner, I think, a
couple of times in my career andit doesn't work out well.
I think it kind of pushespeople out the door a little bit
.
Like you said, you know, onething we do in our practice we
actually just did this with ourdocs this morning is we kind of
do a day in the life where myCOO will flash up like four or
five numbers and they won't haveany labels on them and they're
just you know these randomnumbers, and then we'll kind of
(22:07):
label them.
And so one of the day in thelife numbers we put up this
morning was their schedulingpercentage what a 10% bump in
scheduling percentage would beas far as a daily production,
what a 10% bump in schedulingpercentage would be as far as a
daily production, and then whatthat would mean from a yearly
income standpoint and what theyrealized, because they were
going to make $100 to $150,000more with a 10% bump in
(22:29):
scheduling, which is not crazy.
I mean, it's something, youknow.
I think a lot of dentists thathave been around for a while
just all have to do is make uptheir mind.
They can just go out and do it,but they didn't realize that.
And so, kind of seeing thenumbers and kind of seeing them
how they kind of extrapolate outinto something they really care
about, which is their take homepay, plant some seeds about
okay, maybe I do need to notcomplain about having eight
(22:50):
exams on my side, you know.
Maybe I do need to, you know,not complain about having all
these new patients.
Maybe these new patients arekind of getting me towards my
goals, and so, versus if wewould have just said, hey, you
got to see eight or 10 newpatients a day and they're gonna
say, well, it's too much, Ican't do that.
Well, here's why and we're notgiving them eight or 10 new
patients every day.
(23:10):
But I mean, I want them to kindof be hungry for that and not
necessarily it being me pushingthem or kind of forcing them to
do something kind of, becausethat has a little bit of a that
kind of, you know, clinic DSOatmosphere when you start to
push things.
I think people really, reallypull back when they get that
vibe.
So but if we have them come upwith that realization on their
own, I think it makes a lot alot bigger impact.
Paul Etchison (23:34):
So how long has that been that you stopped
seeing patients clinically?
Sten Erickson (23:38):
A little bit on and off.
So I stopped about five or sixyears ago.
Once lost an associate, one ofthem that I probably was
overbearing on.
It was kind of a big.
It was a big painful time in mycareer so I was kind of thrown
back in.
I was thrown back in duringCOVID and then I've been out
clinically this time for acouple years now, two, two and a
half, three years now.
Paul Etchison (23:59):
Yeah, how do you keep from getting pulled back in
when an associate moves on orsomething like that, when it's
just convenient, well, you'vegot a license.
Sten Erickson (24:06):
And I always and that's part of the strategy is,
if I need to, I mean it's, youknow.
You know, call up the bullpenand I'm in, but I it's
definitely not an exercise inmaking more money.
I'll tell you that If I get usgoing back in or we can either
make room for me or let go of adoc.
You know I can definitely havea lot more take home income.
I'm definitely aware of that,but the lifestyle is not there
(24:28):
and I don't think I'd do as gooda job of being a leader.
So I have really tried to focusthem on.
You're going to make more moneyand you're going to do bigger
cases.
You're going to have moregrowth and more and more
coaching under our wings thanyou would anywhere else.
Paul Etchison (24:44):
But we've got a lot of dental colleagues that
don't necessarily love doingdentistry and they say, man, I
would love to be non-clinicalbut I don't see how that could
financially work.
Yeah, now you've got threepractices, multiple docs.
You're at a scale where you saythat, where obviously it does
work.
But what would you say tosomeone who says that is the
(25:05):
trajectory I want to go in?
How would you suggest they getthere faster?
Sten Erickson (25:10):
Well, first of all, I think they need to figure
out is that really what theywant?
You know, because I think, likeyou said, if someone goes
non-clinical and they'rewondering what the hell they're
doing with their lives, right?
So, unless you really love kindof the coaching and the
managing of the leadership, Idon't know that that's going to
be a worthwhile trajectory,because I think you're going to
kind of get to where you thoughtyou wanted to go and realize
(25:30):
that this isn't for me and a lotof people end up just selling
their practice.
At that point the one mindsetshift for me was really making
decisions and kind of thinkingabout my practice as an owner
and not even a leader, not evenas a manager.
But if I was an investor in myown practice completely outside
of the practice, didn't haveanything to do with it, never on
a call, never on a meeting howwould I want those decisions to
(25:54):
be made?
And I think you really need tosit down and calculate if
someone were to come in and buyyour practice as an owner and
not work clinically and justhire you, you know, where would
the profitability need to beafter paying doctors?
And I think that's somethingthat's missed from a lot of
dentists is they, you know?
They just you know, take theiroverhead, say I'm doing, hey,
I'm doing 55, 45% overhead, sothat means I have a 45, 55%
(26:18):
profit, right?
No, that's not what that means.
And so I think, reallyrealizing what the numbers mean,
understand what level youreally need to get to to replace
your income, or at least makesure that your income is going
to support your personal life,so making sure that, after
paying a doctor to produce thatdentistry, there is something
left Enough left over, yeah, butyou can have the life that you
(26:39):
want, right, yeah, left, enough,left over, yeah, but you can
have the life that you want,right, yeah, yeah.
Paul Etchison (26:45):
So now you've scaled this to three practices,
I mean, what is your futuretrajectory look like?
Do you have any ambition to dosome more practices?
Sten Erickson (26:50):
Yeah, yeah, we definitely do, and we did our
last acquisition about threeyears ago.
So we're kind of back in thatmode.
I think I told you we did alittle bit of an underperforming
practice, which was a lot moreunderperforming than we realized
going into it, but we'vemaintained it and actually now
we've kind of, you know, tripledor more the growth.
So we just did a chart salewhich is kind of just done.
We've done a couple of thoserecently.
(27:10):
But we're definitely lookingfor the fourth location.
My doctors right now have kindof an earn in equity program
where they can earn equity.
So I'm definitely looking toexpand that to you know, really
they're owners right now but Ireally want them to kind of, you
know, feel like and actuallyact like owners even more.
So that's my kind of the bigpush is okay.
(27:30):
How do we really kind of bringthem into the fold about certain
leadership and certainownership lessons and ways we
want them to operate, you know,on a day-to-day basis?
So we're kind of going throughfinancials, we're going through
growth trajectories, we're goingthrough how we're evaluating
practice, acquisition targets,things like that with them.
So, because I want partners, youknow, at this point and say I
want, you know, major partners,but I want people that act like
(27:50):
partners, because if I'm notgoing to, you know, be in the
office that much, I need peoplethat are making those decisions
very similar to the way that Iwould make those leadership
decisions.
So that's kind of my push, youknow.
As far as long term, I reallydon't know.
I'm leaving a lot of doors open.
You know, I think at some point, you know, having either an
internal buyout or externalbuyout is in the cards.
(28:11):
But I'm having fun right nowand I think we got a lot more
meat on the bone.
Paul Etchison (28:14):
Awesome man.
Sten Erickson (28:14):
So like you're offering mentorship to docs who
maybe want to follow in yourfootsteps, Talk about that One
of the things I think we reallydo well in our practices is a
lot of the training, a lot ofsystems.
We have training platforms,videos, hundreds and hundreds of
videos and things like that,from anything from a doctor to
team member, front office, backoffice, things like that.
So we have that going out to alot of people right now in
(28:34):
doctors that want to really kindof take their training of their
team members from.
What we really found is thekind of magic sauce is really
getting these people onboardedand trained within a 60 day
period.
You know cause.
We will kind of look back on mycareer and we.
How did we fail on a lot ofthese things?
We a lot of times we've failedand really just kind of bringing
someone on and then it was juston the job, training, right,
(28:56):
and so what we've really made apush in the last five years or
so is to they have a wholecurriculum that they kind of go
through, and so we've reallykind of shortened and condensed
the timeframe to 60 days wheresomeone can really be in the
room they're doing the surgery,they're doing chair site,
they're checking out patients,they're presenting treatment
plans.
They're doing all that kind ofwithin the first month, second
month is kind of fine tuningthose things and we really have
(29:17):
a team member that'scontributing in a big way, very,
very quickly.
Not to mention the fact thatafter 90 days it becomes a lot
harder to terminate someone or alittle more sticky, and so that
60 days it kind of gives you a30 day buffer to really find out
if that person is where theyneed to be.
From a team member standpoint.
So that's been a big push.
We're having all of our teamhire and fire.
(29:38):
So myself and my COO does noneof it so but they decide who
they hire, they decide who theyfire.
We're doing presenting themwith resumes and things like
that, but they're making allthose decisions and so different
things like that.
So docs that kind of want toincorporate things like that
into their own practice andreally see a need to kind of
onboard someone without dentalexperience and that that's been
our forte is really takingpeople from other industries
(29:59):
that want to start a new career.
And then we really kind oflooking at helping docs.
I've been reached out by anumber of people that I've just
had interactions with to kind offigure out how do we get
associates.
You know, kind of over thatmillion dollar mark, you know,
because I think that kind ofseems to be a little bit of the
magic number where they reallystart to make an impact on the
(30:21):
practice and not necessarily adrain and not necessarily just
kind of filling in gaps.
Is, you know, when associatescan kind of get to that million
dollar number, then we canreally kind of start to build a
team around them and really kindof, you know, do some fun
things, and so that's anotherpush.
Is that we're trying to mentor.
You're having a lot of peoplethat want us to mentor them on
how do we get docs?
You know they're producing five, six $700,000.
(30:42):
How do we get them to a milliondollars?
Paul Etchison (30:43):
So if anyone's interested in like learning more
about that, where can they findout more information?
Sten Erickson (30:47):
Yeah, so email, email us.
We have a connect at PathwayDental Solutions.
We're my COOs.
She's on all the all the goodstuff, all the LinkedIn and all
the social and all that stuff.
Paul Etchison (31:01):
So in and all the social and all that stuff
Awesome, man.
But, dude, thanks so much fortaking some time out of your day
and spending it with thelisteners.
I think it's just a wealth ofinformation and really admire
the consistency that you havewith your doctors.
I mean, it's like I'm listeningto you say this.
I'm like man, that would be sonice if I did that with my
doctors, but I always plan to,but it's the follow through.
It doesn't always work out likethat.
So, but yeah, and thanks forcoming on and thanks for sharing
(31:24):
all that stuff with thelisteners.
It's been great, a lot of fun,paul, thank you.
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