March 26, 2025 • 32 mins
What if working less could actually make your practice more profitable? Dr. David Maconi proves it's not just possible—it's achievable for committed practice owners willing to challenge conventional wisdom.
Whether you're burning out from too many clinical days or simply curious about creating more flexibility in your practice, this conversation provides actionable strategies for working smarter, not harder. Join us to discover how strategic staffing, targeted marketing, and a willingness to challenge dental practice norms can transform both your business and your life.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Paul Etchison (00:02):
What if you could reduce your clinical days in
half and still grow yourpractice?
Well, today's guest has provedthat it is possible.
Dph coaching client, dr DavidMcHoney, has been able to
increase his profitability,increase his efficiency, all the
while cutting back to just twodays a week.
We are talking today about howhe made it happen, what worked,
(00:24):
what didn't, and how you canstart making similar changes in
your own practice and startliving the life that you've
always dreamed of.
You are listening to DentalPractice Heroes, where we help
you create and scale your dentalpractice so that you are no
longer tied to the chair.
I'm Dr Paul Etcheson, author oftwo books on dental practice
management, dental coach andowner of a $6 million group
(00:44):
practice in the suburbs 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.
Hello and welcome back toDental Practice Heroes.
I'm your host, dr Paul Edgison,and joined by somebody very
(01:04):
special that I'm really excitedto interview here today.
It is a previous DentalPractice Heroes coaching client,
he's a 2017 graduate ofUniversity of Maryland and he's
the owner of Havertown DentalArts in Pennsylvania.
Welcome to the podcast, drDavid McHoney.
What's happening, dave, thanksfor having me on man.
Yeah, dude, I'm so pumped totalk to you, and we've talked
(01:30):
about doing this for a while.
Dave is actually a podcastertoo.
He has a fitness podcast, andso we share some podcasting
stories over the time that wework together.
But what I really excited toget Dave on is that he has cut
his days from four days to threedays to two days, which is a
really sexy thing.
But before we get into it, tellthe listeners a little bit
about your practice and when youtook it over, and just how many
(01:52):
apps, what kind of things areyou guys into, so that they know
a little bit more about whatyou're running.
David Maconi (01:57):
So I took over the practice at the end of 2021.
I was originally close to thearea as far as where I grew up,
maybe an hour away, but I movedto that area to become an owner
of a practice.
Kind of like the classic storyhere.
I was going to take over for anolder dentist who was going to
retire.
He was 68 and was going toretire at 69 and then 70 and
(02:17):
then 71, and it just kept nothappening.
So that ended after about twoyears there and at first it was
kind of this big hit.
We had moved to the area forthat, but I really just didn't
know what else was out there.
So I started looking foranother associateship just while
I could try to find a place tobuy.
So after about a year at thenext associateship I had found a
(02:37):
good practice, a place that Ithought there was a lot of room
for improvement as far asbringing different procedures to
the mix and all of that, andthey weren't really doing any
marketing any of that stuff.
So I bought that practice, gota pretty good deal on it and
they were only practicing threedays a week.
At that time they were kind oflike really slowing down and I
knew like that was a goodopportunity I could add there, I
(02:58):
could add hours.
And so for the first year totwo years I first year to two
years I had basically gone tolike a full well, what we call
full in dental like four days aweek.
I never worked any Fridays,just on Monday through Thursday.
And it was kind of funny likepeople outside of dental be like
I don't know why you're notworking Fridays, and I was like
well, I need time to actuallywork on some of these other
things.
And I was working all the time.
(03:19):
Like people are like what areyou doing at the office?
I was there until like 9pm.
I mean it was a lot, definitelya lot early on.
And then eventually I hearddifferent coaching people
talking about cutting to threedays and it was just nice to see
it could be done and I justfigured, if they're doing it,
why wouldn't I be able to dothat?
So after about a year and ahalf to two years I cut back and
(03:39):
this was actually when you andI kind of first started talking.
It was like in the plan and Iremember you saying like okay,
is this actually happening?
Because I know a lot of peoplejust talk about it and I'm
talking to some other dentistsabout it as well.
So we cut back and it was great, it was really nice just
(04:00):
cutting back to three days.
That was basically all 2024.
And I basically just had hygienegoing on Thursdays and I was
very strict to my team.
I said I'm not seeing patientsUnless this is an emergency that
I would go in for a weekendcall.
I'm not going to see them on aThursday and of course initially
they're like, well, can't youjust do this, can't you just do
that?
And from day one, because Ijust had a lot of people warn me
like, don't let that happen.
So I and it was great, ourproduction and collections went
(04:26):
up from initially the owner theywere doing about $700,000 when
I bought the practice.
So the first year we did 1.1 andthen we did 1.5.
And my goal was just to matchthat 1.5.
When I cut to three days a week, I just thought that would be
great because you're gettingmore efficient.
But we ended up doing about $2million the year, going to three
days a week and I was veryhappy On three days.
On three days a week, yep,amazing.
(04:48):
So I was very happy with that.
And then the next step was allright, do I want to add an
associate?
We talked about some of theassociate horror stories, but
talking with you and some otherpeople, it just seemed like what
I was kind of meant to do formy career.
If I look at a day and there'sall this production and I'm not
necessarily breaking my body todo that, it's nice to see.
(05:08):
And now you're down to two days, yeah.
So basically I said, okay, inthe new year I'm going to cut to
two days.
And again there was theconcerns with it, but we
actually opened a fifth day forthe office.
So it's not like things weregoing to be overall dropping.
It was just me and there wasthe concerns and it's not like
there's been no issues with it.
But so far I've really beenenjoying it.
Paul Etchison (05:27):
What do you think the biggest challenge was, or
what were you going up againstwhen you had to, like mentally
plan this out?
What was the hardest part aboutdoing it and not losing
production or collections?
David Maconi (05:39):
So I think the answer is different for going
from four to three and three totwo.
So do you want me to addressone?
Yeah, let's do four to threefirst.
Yeah, so four to three.
I was pretty confident that I'dbe able to match the production
because there were still a lotof inefficiencies and we still
were going to do somenegotiations with insurances.
I figured I could make that up.
So I really wasn't tooconcerned about dropping
(06:00):
production or even income.
I just kind of wanted to matchit.
The big thing was going to bewith the team and then patients.
But I had enough dentiststelling me like look, it's not
the end of the world.
You know, we're notcardiologists where there's some
emergency constantly, where youhave to go in.
Most things can wait.
And you did have some peoplewho would maybe be upset that if
there was an emergency onThursday they would be seen
until Monday.
(06:21):
But to be honest, I was evensurprised at how rare that was.
It really did not come up asmuch as one might think.
So that was not as hard.
I think mentally it was a lotharder to drop from three to two
because in that case I verymuch expect and I mean still
expect an income drop.
Now how much that will be, Idon't know.
(06:41):
But I mean, at that pointyou're cutting a third of the
days that you can see patients,a third of the days that you can
treatment plan.
The difference here is we arealso more or less concurrently
adding an associate, so maybe itwon't drop that much, but just
mentally and then just the hangup of like, is it being lazy?
You know, should you be?
Paul Etchison (07:05):
I mean you shame, the shame that comes with it,
the shame with choosing yourlife instead of what everybody
expects, exactly exactly.
David Maconi (07:11):
But ultimately I just I kind of had to realize
like, look, it's not thispermanent decision.
If you don't want it to be, Ifyou do it for three months and
it sucks or your income drops tohalf, like you, you can undo
this change and it's a verysimple thing.
I mean, I can just add back aWednesday.
It's not actually thispermanent thing.
But, as I mentioned earlier, Ikind of tend to think in these
categories and like when this isdone, like if I have a goal,
I'm going to hit that goal.
And so I kind of had to realizelike, no, you can change things
(07:34):
if it's not going according toplan.
Paul Etchison (07:36):
What motivated this change from going like to
four to three?
I mean, you mentioned that youhad heard it.
Can you think?
David Maconi (07:49):
Yeah.
So it's something I think aboutall the time in terms of what I
want out of life.
It has nothing to do withlaziness I mean, almost nobody
who knows me in real life wouldsay I'm lazy it's just a
calculated decision on the workinvolved.
And so if somebody says theywant something and they're just
not going to do the hard work, Ithink that's maybe a problem.
I think, on the other hand, ifyou're looking at it and you're
(08:11):
saying, hey, just objectivelyspeaking, the work involved to
get to XYZ place is not worth itand it's a net negative, if you
weigh it all out and it's a netnegative, then just decide
rationally and objectively notto do it.
And so when I looked at theincome that I wanted years ago,
I said, okay, this is the incomeI want, and once I hit that I'm
going to cut back.
(08:31):
And as long as I can continueto make that income, I have so
many other things in my lifethat I want to do.
Now, fortunately, that has beenfar exceeded.
And I you know we talked beforeabout you know I just didn't
realize what was possible indentistry.
So that's been great.
But I still follow that sameethos and I enjoy dentistry, but
I just I wouldn't be thatperson who's just practicing 40,
(08:52):
50 hours a week and runningmultiple practices.
It's just.
There's other things in lifefor me.
Paul Etchison (08:57):
Let's talk about the jump from four to three.
You mentioned there were somany inefficiencies that you
were easily able to keep yourproduction the same.
By completely, I mean takingout 25% of your producing time.
What kind of inefficiencies areyou talking about that you were
able to improve on, so to makethis possible?
David Maconi (09:15):
so part of it was growing the team.
You know, initially when I tookover there was one person at
the front desk and she's amazing, but it was just one person one
and a half pygenus kind of andone assistant, and so just
getting the right team memberswas very helpful, like, and
there was a clear jump.
Like there was one particularassistant who's now my lead
assistant and when we added herthere was just a clear
difference there.
(09:35):
So having the right team again,the insurance negotiations were
pretty big.
Everything's going upsignificantly and just learning
how to pack in more without thequality going down at all.
So at the time, I think mostdays we were doing maybe 7,000
to 8,000.
And I said, okay, so if I wantto hit $1.5 million on the three
(09:57):
days, then I've got to do likeXYZ per day.
And then I figured maybe alittle bit more on the hygiene
only day and I just calculatedout of what I need to do and
most days were over that.
Most days the office was doingover $10,000.
We started doing marketing andthe returns on that were pretty
immediate.
I think you or somebody elsewas saying how they didn't find
(10:17):
mailers to be effective.
We had great results withmailers.
We had great results with doingGoogle Ads, so the marketing
has been very effective and it'sjust kind of taken off.
And obviously there's all theunderlying stuff about patient
communication and buildingrapport and all that stuff as
well.
That really goes into it,because that first year they
don't know you and after a whileyou start, the patients who are
(10:39):
going to leave have probablyleft and the patients who, like
you, have stayed, and then theyrefer more people.
So it just kind of snowballsfrom there.
Paul Etchison (10:44):
Talk about this lead assistant.
I'd love to hear about how youfound this person and how did
that role evolve, because Ithink this is one of the biggest
things for all practice ownersis is smaller practice.
You got to have at least one ortwo.
You know, like I've got fourleads right now, my practice is
almost 40 people, but like it'sit's so useful to have, just
(11:06):
like you know, that key person.
David Maconi (11:08):
Well, I knew she was a very quality assistant.
We didn't really get into theleads too much until working
with you.
I hadn't really thought abouthaving leads until that point,
and I remember when you and Istarted working together, there
was a little bit of uncertaintyof if we could have leads
because a lot of the departmentshad two people and so you just
had two assistants or twohygienists.
To me it felt and I don't know,maybe you disagree with me here
(11:30):
, but it felt like by having alead with only two people, one
was just kind of the boss of theother and it just, I don't know
, it's like not discriminatory.
The other one becomes like thenot lead.
Yeah, yeah, exactly.
So it was more in these lastfew months, I would say, where
we've now got 10 team members,that there is a lead in each
department.
So this individual I mean shewas great the whole time, but
(11:52):
she wasn't an official leaduntil about a few months ago.
Paul Etchison (11:56):
And what are her responsibilities now that have
changed from previously?
David Maconi (12:00):
Yes.
So now it's basically and it'sbeen nice a lot of checklists.
I know you just had a podcastout on checklists recently and
just kind of having somebodyelse where if there's something
that's not done, I can go to herfirst and say you know, I mean
again not like blame her, butjust say like this is kind of
your responsibility at thispoint and I can't oversee every
(12:20):
little thing.
So like if notes, for example,are not completed, or you know,
a lab slip was not sent, whywasn't that done?
And again, I mean, she's beengreat, that hasn't happened much
.
But it's nice to kind of have aperson to turn to to say like
hey, this is the system and likewhy wasn't it done, versus just
kind of talking to a whole teamand everybody's pointing
fingers at each other and nobodyknows who was supposed to do it
(12:41):
.
Paul Etchison (12:47):
Do you feel like, looking at her from an employer
standpoint, that you see traitsin her that you don't always
and I'm not saying we're goingto throw your team under the bus
but are there traits in herthat are unique, that make good
for that position?
David Maconi (12:56):
Yeah, for sure.
And, like you said, we're notthrowing anybody under the bus.
All of my team members I talkabout having an A-plus team and
all of my team members havedifferent qualities that really
help out.
She's actually very studious.
She may eventually go to dentalschool, which will break my
heart from an employerstandpoint.
Paul Etchison (13:15):
I'm so happy for you.
Deep down, you're like am I?
Yeah, I think I am.
David Maconi (13:21):
She's very intelligent.
But the biggest thing is Ithink she's dedicated to the
practice.
She's on my team.
You know what I mean In thesense that it's not like and
obviously there's always goingto be some clashing between
employer and employee.
But I feel like she's on teamHabertown Dental Arts and team
Dr McHoney and I can talk to herabout struggles of the office
(13:42):
and just kind of be open withher about it and she's just very
reliable too.
She had a baby and she was backat the office in six weeks.
She wanted to come back.
She liked the culture of ouroffice.
You and I talked about it.
We were like, is she reallygoing to come back?
You never really know.
She was back in six weeks andshe just doesn't really take
much time off.
She's just dedicated.
(14:02):
It's honestly she is an A-plusplayer but I'd rather have a
B-plus player who is reallydedicated to the cause than
somebody who was maybe a littlebit better.
But then you know they'relooking to get $1 per hour more
elsewhere and you know you justnever really feel like they're
on your team.
Paul Etchison (14:19):
Yeah, it's so true, and if you think about it
like, hearing you say that justmade me think that the people
that are super loyal tend to belike the best employees, and
it's almost like, even if theskills aren't there, that
dedication seems to matter somuch more than the actual
execution, the ability of themfor just to deep down, do it for
(14:42):
reasons that are internal thatmotivate them rather than just
do it maybe the best way.
It just more matters that it'sgetting done.
I mean, would you agree?
David Maconi (14:50):
For sure.
Yeah, the loyalty there is abig thing.
I mean, obviously, at somepoint the person has to be
competent, right of course, andstill be able to talk to people
and whatnot.
But I think that's one of themost difficult things with newer
employees.
I know everybody always talksabout the new generation, but I
will say it is harder whenwhether it's hygiene or anything
else if you're hiring somebodyand you just kind of feel like
(15:13):
it's of course we all work tomake a living and to better our
families and all that stuff.
But it's tough when you go towork and you feel like this is
completely transactional.
It just makes it less enjoyableversus like, okay, we're all
kind of pulling together andjust feeling like the office as
a whole is growing.
And I had somebody recentlytell me they felt like dentistry
was really lonely and thisperson was an owner of two
(15:36):
practices.
I ended up selling them due tothe stress and whatnot.
I feel like she wasn'tcollaborating with the team.
It was just kind of her and Ithink that collaboration can be
very helpful.
Paul Etchison (15:47):
So, looking back at when you took this practice
over to what you know now,having a few years under your
belt and you know massivesuccess, is there something you
think about like a mistake thatyou used to make or something
that changed in your, the wayyou thought about the practice
that you look back at now andyou kind of laugh about?
David Maconi (16:04):
I'm kind of fortunate A lot of us are
fortunate now that we are comingup in this time where podcasts
and coaching is so common.
You know, because you seepeople who are in their 50s or
60s and you think, what did youdo for 30 years?
You've been practicing thislong and the practice is still
only doing X, y, z and sofortunately, I don't look back
and think, oh, my God, I shouldhave done this so differently.
(16:26):
I do think maybe coachingearlier could have been helpful.
I think certain things likemarketing earlier and coaching
earlier could have been helpful.
I think certain things likemarketing earlier and hiring
earlier could have been helpful.
I was very hesitant to.
I didn't want to be overstaffed.
So we had the first year wherewe did the 1.1 million.
That was with one assistantthat was only there three days a
week, and then the fourth day Ididn't have an assistant.
I just, like you know, thefront desk would come back and
(16:47):
help sometimes, so I would havehired more people earlier.
I come back in health sometimes, so I would have hired more
people earlier.
I just didn't know the level ofgrowth that we would have.
So same thing with like hygiene, like I was at one like one and
a half hygienists.
And then we were at eighthygiene days and I remember
thinking, well, I mean, this wasonly like six months ago.
I was like, well, we can kindof support nine hygiene days,
you know, maybe nine and a half.
And then now we have 13 hygienedays and they're all full.
(17:10):
And I'm not saying that'salways the case, I'm not saying
everybody's just over hire, butin my case I probably should
have had a little bit moreconfidence in the ability to
fill the schedule.
Paul Etchison (17:19):
Yeah, and I went through the same thing in my
career.
The expansion of my practiceearly on was very slow and then
at a certain point it was justlike let's go, let's just find
people, let's grow to it.
But I think that's such acommon fear for dental practice
owners is that we always look atman.
Do I have too many people atthe front desk?
Do I really need anotherassistant?
Can I really fill anotherhygienist?
(17:40):
What type of advice would youhave for someone?
Because I see this so much thatwe're so slow to hire because
we think for some reason oneadditional employee is going to
bankrupt us and we don't see howwe can get a return on that
investment in human capital.
David Maconi (17:56):
So I think this is where the flexibility that
production provides is veryhelpful.
So it's kind of like in life,right, if you have a lot of
money it's not that money iseverything but you just don't
have to care as much aboutthings right?
Let's say, you got pulled overand you got a ticket and it's
like $200.
It's like, oh, that sucks.
But if you're doing really well, it's kind of like okay, I'm
just going to brush this off,whatever it is.
(18:18):
And same thing with otherlittle things in life that are
expenses.
It's just nice to have thatcomfort.
And similarly with a practice,if you are doing $700,000 and
you've only been doing 700,000for a long time and you look at
your percentage for staff andit's 32%, it could make sense
that somebody is worried aboutadding somebody else.
But I think when you get to thepoint where you're like okay,
(18:39):
we're going to improve ourefficiency, we're going to learn
more procedures, whatever it isthat allows you to produce more
, you can think, okay, well,maybe now we're at 24% staff,
we're going to add somebody thatmight temporarily bump us up to
27%, let's say, but that'sgoing to allow us to do X amount
more in production and you nowhave that confidence from past
years to see that adding a teammember allows that.
(19:04):
And again, nowadays we have somany ways that we can run these
reports to see the actualnumbers that we kind of don't
have to guess.
Hey, I added an assistant.
We did this much in productionbefore and now we're doing this
much in production.
And if you think about anoffice your size where you're
doing like six million, payingan assistant $50,000, you can
probably do another $50,000 atleast in production with that
extra assistant Again, assumingyou have the capacity and the
(19:27):
room for it.
And in many cases I think withthe type of people that you'd be
dealing with with coaching,they're going to be able to get
that improvement.
Now I'm not just sayingeverybody should just hire, you
know, and just anybody thatcomes their way, but I think in
most cases if you're kind oflike type A, you're going to be
able to make that up and morewith a new team member.
Paul Etchison (19:45):
I think it always comes down to new patients too
is these are offices, and theseare the offices that I work with
typically, are people areseeing a decent new patient flow
and if they're not, we figureout a way for them to get more
new patients.
What has your new patient flowbeen like?
What is your office seeingabout a month, would you say?
David Maconi (20:03):
So when I took over they were seeing about
eight to 10 new patients a month.
You know, no market or anythinglike that.
And the first year I didn'treally market at all because I
was seeing all these new mouthsand there was a lot of
underdiagnosis and whatnot.
So I didn't do any marketing.
I started with mailers and webumped up to about 15 to 20 new
(20:23):
patients a month for a whilethere.
And I find that the mailers,while the number of new patients
you get, isn't as good as maybesome other methods.
It seems like there are biggercases at least in my area I've
found that.
And then since then we've beenseeing closer to 40 to 50 pretty
routinely and that's been agreat jump.
And I don't know what's goingon this month, but we're at
(20:45):
about 90 for January.
So we had some crazy spike inJanuary.
I don't know how next monthwill be, but I would say closer
to 50 most months now.
Yeah Well, you just set the barreally high.
Paul Etchison (20:56):
Now you've got a taste of it and now you're going
to be like every month needs tobe 90.
That's what most of us would dowith that.
Talk about adding the associate.
You mentioned that.
You know you were three days byyourself, but then two days,
you know, bringing on anassociate.
And when you said that, Ithought about do I know any
two-day solo dentists?
And I can't think of any.
I think it would be very hardto have any level of
(21:17):
profitability two days a week.
But what has that been likehaving another provider in your
office servicing your patientsand with the team?
David Maconi (21:27):
I'm glad you made that.
One point, though, about youknow there's no solo dentist
doing two days a week, becausethat was kind of the thing.
It was like, all right, you cancut from five to four, for sure
, and you can cut from four tothree.
Even though some people may goagainst that and say you
shouldn't, we've seen it work.
But, as you mentioned, youreally can't have a functioning
business that's only open twodays a week.
(21:49):
It just doesn't really work.
I mean, maybe there's somebodyout there who's doing it or
they're really slowing down, butfor the most part it doesn't.
So that's kind of in part why Idecided to add the associates.
I have to still have afunctioning business, and the
cool thing is it's more of afunctioning business.
So when we opened up the ad, I'min an area that's I'm like 30
minutes outside of a pretty city.
So, unlike hygiene, we had 20applicants in the first week and
(22:14):
that was just from Indeed.
I mean, that wasn't like usingany sort of like you know the
crazy stuff like on Facebook oranything.
And ironically, this associatewas the first person I spoke to
and she just had a greatdemeanor.
She could hold a conversation,to be honest, like it's not that
the clinical doesn't matter,but I wasn't that interested in
their clinical other than thatthey could do the basics because
(22:35):
that's more trainable.
It's very hard to changepersonality and I've found that
patients have really liked her.
The team-like search is verysweet and at this point now now
there's just a stress of if thisperson leaves, then what do you
do with that and all thepotential there, whole new set
of worries, right, whole new setof things to worry about.
Paul Etchison (22:52):
So now you've got this freedom, you work in two
days a week.
You can work more days if youlike.
You can take more time off,because your practice is still
open.
When you're not there, what doyou see yourself doing, and I
mean, what is the near futureand what's your longer term
goals for your professional life?
David Maconi (23:10):
Yeah.
So as far as for professionallife, I'm kind of just trying to
enjoy this time.
I know it's like cliche onevery podcast on.
You know you got to enjoy thetime and you know be in this
moment and all of that.
But I mean that's something Ithought about for even since my
early 20s.
I feel like I'm fortunate thatI've kind of again had those
early influences, that I've kindof again had those early
influences that I was notsomebody who said I just want
(23:31):
more, more, more.
I'm very happy with what I'vebeen able to accomplish both
inside of dental and out ofdental.
And I do feel like I'm somebodywho, again, not that there's
like enough as far as like adefined time point, but I am
somebody who, you know, there'sbeen a lot of for anybody any
dentist.
There's a lot of for anybodyany dentist there's a lot of
delayed gratification.
You're studying hard throughouthigh school and college and
(23:52):
dental school and I'm very atpeace with the idea that you
know what.
We're going to still grow andit's going to go up.
But I want to enjoy family time,time with friends, just kind of
exploring things.
And again, I say that assomebody who is still working a
lot in and out of the office,but I'm very at peace with the
(24:12):
idea of scheduling morevacations and things like that.
And I want to grow, and whetheror not we will ever expand or
move the office is still kind ofup in the air right now.
Going back to the new patientflow, much sooner than I
realized we're going to be atcapacity and then I have to
decide do we keep growing andexpanding or do we cut
insurances?
That'll probably be aconversation in the next year or
two, but for now I'm kind ofjust enjoying it.
Paul Etchison (24:34):
Yeah, Cross that bridge when it comes right.
Yeah, that's awesome, man.
You know one thing I want toask you is there any chance that
you would go back and work moreclinical days, now that you've
gotten yourself down to just twoclinical days a week?
David Maconi (24:47):
Yeah.
So I think different scenarioskind of pop up there.
So one is with a differentprocedure mix.
So I've really grown to enjoyortho getting more into like TMD
and then sleep work and all ofthat.
And so again, part of thereason that I cut back was
physically demanding work onthose other days and ortho and
(25:08):
night guards and things likethat.
It's just not physicallydemanding and it's obviously a
lot of assistant-driven work.
So I've talked to my team abouthow on Wednesdays I may just
open it up to a half day of justortho where I'm not doing
hygiene checks, I'm just kind ofthere consult, seeing ortho
patients, things like that andsome big cases.
I've told the team we've got acouple of cases coming up where
(25:29):
it's like eight to 10 crowns orveneers and I'll do that on
Wednesday and it's prettyenjoyable to just go in and I'm
just with that one patient andobviously it's very productive.
So in that sense adding back alittle bit.
But then longer term, I said ifI have an associate and she's
out for maternity leave or ifshe were to leave, then
(25:50):
temporarily I would add backthose days.
It's hard to imagine at thispoint going back to just being
solo.
I mean I joked before about,like you know, the stress of
like is that person going toleave?
But honestly it's actually notthat stressful in the sense that
being at just one office youcan cover for that person.
I think it's different when youhave multi-practice and
(26:11):
obviously you can't be twoplaces at once or you have many
associates.
Then it becomes a little bitmore problematic.
But it honestly is a nicebalance right now where it's
like again, I really enjoy myassociate, we get along and
she's great.
But if she were to give noticeand leave, it's really not that
difficult for me to just jumpback in to happy Wednesdays
again and taking my time to findanother associate.
(26:32):
You know what I mean.
Like, even compared to hygiene,you have a hygienist quit and
it's like who's going to fillthat whole slot?
Like you're not going to do thehygiene, whereas with an
associate you can pretty easilydo that work.
So again, obviously I wouldn'twant them to leave, but it's an
easy transition and so that'sthe time where I would say
adding back.
But other than that, I don'treally see adding back just
because I, similar to like whenI went from four to three, I saw
(26:54):
it was a better life and itworked.
Like I had clear demonstrationthat it worked, so I don't see
why I would ever go back.
Paul Etchison (27:01):
Yeah, I love that man.
All right, final question whatis the best piece of advice
you've ever gotten when it comesto dental practice ownership?
David Maconi (27:10):
So, while it's somewhat cliche, I really
believe that the mentorship andcoaching aspect is huge.
Ever since I was pretty young, Iwas reading books from like
Dale Carnegie and like justthese various self-help books,
to try to have, in a sense, likethose people become mentors for
you.
Right, there's somebody thatyou can kind of look back.
Somebody had told me about yourbook and I had read the book
(27:31):
and that's how we eventually gotconnected.
But even before I had anofficial coach, I have a friend
who's very dedicated to hispractices and we would just talk
about it all the time.
And then I was put in contactwith it was kind of a family
friend actually who hadbasically done the finances for
many, many offices, and whilethere were things I disagreed
with him on, as I learned moremyself, it was instrumental to
(27:54):
kind of get in the door withcertain opportunities.
And then you know we talk aboutour mutual friend Talon.
He helped me out a lot.
And then, of course, you andjust having a soundboard that
you can balance these ideas offof, because the reality is like,
if you listen, even like foryour coaches, you guys don't
agree on everything, butsometimes it's not about having
like the perfect protocol.
It's somebody who can give youthe confidence to try a protocol
(28:18):
and then you can adjust alongthe way.
I mean, again, I make theanalogy to fitness things all
the time and it's like with myclients.
It's not like I'm going to giveyou the perfect program and
then you're going to see theseamazing results.
I'm going to give you a goodprogram for you and then, week
to week, we're going to adjustit and that's the big thing.
And so, whether you're usinglike PBN or dental intel or
whatever, it's having somethingto go off of and then having
(28:40):
somebody who's a few steps aheadof you who can then guide you
through it.
You know, sometimes if they'relike too too far ahead, it can
almost seem like it's somethingthat can't be reached.
But if you have somebody who's,like you know five to 10 years
ahead of you and has done whatyou want to do, that mentorship
is huge.
And it's motivating too to feellike I can.
That's why I said about goingto three days a week.
It's like, hey, these peoplehave done it, I know it can be
(29:02):
done.
Paul Etchison (29:02):
You know what I mean, yeah, that's a, a client
man.
You have been one of myfavorites to work with.
You've always been.
I don't think you've ever saidI don't think that's going to
work, not once.
You're like let's try it, let'ssee.
And I think that it's just likepiggybacking off what you said.
The people that move forward inlife are the people that
(29:23):
implement and try things out anddon't get stuck in that
analysis, paralysis, thinkingthey don't have the right
information.
You just got to get moving andyou'll figure it out when you
get there and I think that's atestament to that.
And, man, what a success you'vehad at your practice in such a
short time and I hope you'veinspired some people listening
to maybe think there might beworking too much or maybe
working a little inefficient topossibly do a little bit what
(29:46):
you did.
So thanks so much for coming on.
Dave, appreciate it.
Thanks, man.
What if you could reduce your clinical days in
half and still grow yourpractice?
Well, today's guest has provedthat it is possible.
Dph coaching client, dr DavidMcHoney, has been able to
increase his profitability,increase his efficiency, all the
while cutting back to just twodays a week.
We are talking today about howhe made it happen, what worked,
(00:24):
what didn't, and how you canstart making similar changes in
your own practice and startliving the life that you've
always dreamed of.
You are listening to DentalPractice Heroes, where we help
you create and scale your dentalpractice so that you are no
longer tied to the chair.
I'm Dr Paul Etcheson, author oftwo books on dental practice
management, dental coach andowner of a $6 million group
(00:44):
practice in the suburbs 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.
Hello and welcome back toDental Practice Heroes.
I'm your host, dr Paul Edgison,and joined by somebody very
(01:04):
special that I'm really excitedto interview here today.
It is a previous DentalPractice Heroes coaching client,
he's a 2017 graduate ofUniversity of Maryland and he's
the owner of Havertown DentalArts in Pennsylvania.
Welcome to the podcast, drDavid McHoney.
What's happening, dave, thanksfor having me on man.
Yeah, dude, I'm so pumped totalk to you, and we've talked
(01:30):
about doing this for a while.
Dave is actually a podcastertoo.
He has a fitness podcast, andso we share some podcasting
stories over the time that wework together.
But what I really excited toget Dave on is that he has cut
his days from four days to threedays to two days, which is a
really sexy thing.
But before we get into it, tellthe listeners a little bit
about your practice and when youtook it over, and just how many
(01:52):
apps, what kind of things areyou guys into, so that they know
a little bit more about whatyou're running.
David Maconi (01:57):
So I took over the practice at the end of 2021.
I was originally close to thearea as far as where I grew up,
maybe an hour away, but I movedto that area to become an owner
of a practice.
Kind of like the classic storyhere.
I was going to take over for anolder dentist who was going to
retire.
He was 68 and was going toretire at 69 and then 70 and
(02:17):
then 71, and it just kept nothappening.
So that ended after about twoyears there and at first it was
kind of this big hit.
We had moved to the area forthat, but I really just didn't
know what else was out there.
So I started looking foranother associateship just while
I could try to find a place tobuy.
So after about a year at thenext associateship I had found a
(02:37):
good practice, a place that Ithought there was a lot of room
for improvement as far asbringing different procedures to
the mix and all of that, andthey weren't really doing any
marketing any of that stuff.
So I bought that practice, gota pretty good deal on it and
they were only practicing threedays a week.
At that time they were kind oflike really slowing down and I
knew like that was a goodopportunity I could add there, I
(02:58):
could add hours.
And so for the first year totwo years I first year to two
years I had basically gone tolike a full well, what we call
full in dental like four days aweek.
I never worked any Fridays,just on Monday through Thursday.
And it was kind of funny likepeople outside of dental be like
I don't know why you're notworking Fridays, and I was like
well, I need time to actuallywork on some of these other
things.
And I was working all the time.
(03:19):
Like people are like what areyou doing at the office?
I was there until like 9pm.
I mean it was a lot, definitelya lot early on.
And then eventually I hearddifferent coaching people
talking about cutting to threedays and it was just nice to see
it could be done and I justfigured, if they're doing it,
why wouldn't I be able to dothat?
So after about a year and ahalf to two years I cut back and
(03:39):
this was actually when you andI kind of first started talking.
It was like in the plan and Iremember you saying like okay,
is this actually happening?
Because I know a lot of peoplejust talk about it and I'm
talking to some other dentistsabout it as well.
So we cut back and it was great, it was really nice just
(04:00):
cutting back to three days.
That was basically all 2024.
And I basically just had hygienegoing on Thursdays and I was
very strict to my team.
I said I'm not seeing patientsUnless this is an emergency that
I would go in for a weekendcall.
I'm not going to see them on aThursday and of course initially
they're like, well, can't youjust do this, can't you just do
that?
And from day one, because Ijust had a lot of people warn me
like, don't let that happen.
So I and it was great, ourproduction and collections went
(04:26):
up from initially the owner theywere doing about $700,000 when
I bought the practice.
So the first year we did 1.1 andthen we did 1.5.
And my goal was just to matchthat 1.5.
When I cut to three days a week, I just thought that would be
great because you're gettingmore efficient.
But we ended up doing about $2million the year, going to three
days a week and I was veryhappy On three days.
On three days a week, yep,amazing.
(04:48):
So I was very happy with that.
And then the next step was allright, do I want to add an
associate?
We talked about some of theassociate horror stories, but
talking with you and some otherpeople, it just seemed like what
I was kind of meant to do formy career.
If I look at a day and there'sall this production and I'm not
necessarily breaking my body todo that, it's nice to see.
(05:08):
And now you're down to two days, yeah.
So basically I said, okay, inthe new year I'm going to cut to
two days.
And again there was theconcerns with it, but we
actually opened a fifth day forthe office.
So it's not like things weregoing to be overall dropping.
It was just me and there wasthe concerns and it's not like
there's been no issues with it.
But so far I've really beenenjoying it.
Paul Etchison (05:27):
What do you think the biggest challenge was, or
what were you going up againstwhen you had to, like mentally
plan this out?
What was the hardest part aboutdoing it and not losing
production or collections?
David Maconi (05:39):
So I think the answer is different for going
from four to three and three totwo.
So do you want me to addressone?
Yeah, let's do four to threefirst.
Yeah, so four to three.
I was pretty confident that I'dbe able to match the production
because there were still a lotof inefficiencies and we still
were going to do somenegotiations with insurances.
I figured I could make that up.
So I really wasn't tooconcerned about dropping
(06:00):
production or even income.
I just kind of wanted to matchit.
The big thing was going to bewith the team and then patients.
But I had enough dentiststelling me like look, it's not
the end of the world.
You know, we're notcardiologists where there's some
emergency constantly, where youhave to go in.
Most things can wait.
And you did have some peoplewho would maybe be upset that if
there was an emergency onThursday they would be seen
until Monday.
(06:21):
But to be honest, I was evensurprised at how rare that was.
It really did not come up asmuch as one might think.
So that was not as hard.
I think mentally it was a lotharder to drop from three to two
because in that case I verymuch expect and I mean still
expect an income drop.
Now how much that will be, Idon't know.
(06:41):
But I mean, at that pointyou're cutting a third of the
days that you can see patients,a third of the days that you can
treatment plan.
The difference here is we arealso more or less concurrently
adding an associate, so maybe itwon't drop that much, but just
mentally and then just the hangup of like, is it being lazy?
You know, should you be?
Paul Etchison (07:05):
I mean you shame, the shame that comes with it,
the shame with choosing yourlife instead of what everybody
expects, exactly exactly.
David Maconi (07:11):
But ultimately I just I kind of had to realize
like, look, it's not thispermanent decision.
If you don't want it to be, Ifyou do it for three months and
it sucks or your income drops tohalf, like you, you can undo
this change and it's a verysimple thing.
I mean, I can just add back aWednesday.
It's not actually thispermanent thing.
But, as I mentioned earlier, Ikind of tend to think in these
categories and like when this isdone, like if I have a goal,
I'm going to hit that goal.
And so I kind of had to realizelike, no, you can change things
(07:34):
if it's not going according toplan.
Paul Etchison (07:36):
What motivated this change from going like to
four to three?
I mean, you mentioned that youhad heard it.
Can you think?
David Maconi (07:49):
Yeah.
So it's something I think aboutall the time in terms of what I
want out of life.
It has nothing to do withlaziness I mean, almost nobody
who knows me in real life wouldsay I'm lazy it's just a
calculated decision on the workinvolved.
And so if somebody says theywant something and they're just
not going to do the hard work, Ithink that's maybe a problem.
I think, on the other hand, ifyou're looking at it and you're
(08:11):
saying, hey, just objectivelyspeaking, the work involved to
get to XYZ place is not worth itand it's a net negative, if you
weigh it all out and it's a netnegative, then just decide
rationally and objectively notto do it.
And so when I looked at theincome that I wanted years ago,
I said, okay, this is the incomeI want, and once I hit that I'm
going to cut back.
(08:31):
And as long as I can continueto make that income, I have so
many other things in my lifethat I want to do.
Now, fortunately, that has beenfar exceeded.
And I you know we talked beforeabout you know I just didn't
realize what was possible indentistry.
So that's been great.
But I still follow that sameethos and I enjoy dentistry, but
I just I wouldn't be thatperson who's just practicing 40,
(08:52):
50 hours a week and runningmultiple practices.
It's just.
There's other things in lifefor me.
Paul Etchison (08:57):
Let's talk about the jump from four to three.
You mentioned there were somany inefficiencies that you
were easily able to keep yourproduction the same.
By completely, I mean takingout 25% of your producing time.
What kind of inefficiencies areyou talking about that you were
able to improve on, so to makethis possible?
David Maconi (09:15):
so part of it was growing the team.
You know, initially when I tookover there was one person at
the front desk and she's amazing, but it was just one person one
and a half pygenus kind of andone assistant, and so just
getting the right team memberswas very helpful, like, and
there was a clear jump.
Like there was one particularassistant who's now my lead
assistant and when we added herthere was just a clear
difference there.
(09:35):
So having the right team again,the insurance negotiations were
pretty big.
Everything's going upsignificantly and just learning
how to pack in more without thequality going down at all.
So at the time, I think mostdays we were doing maybe 7,000
to 8,000.
And I said, okay, so if I wantto hit $1.5 million on the three
(09:57):
days, then I've got to do likeXYZ per day.
And then I figured maybe alittle bit more on the hygiene
only day and I just calculatedout of what I need to do and
most days were over that.
Most days the office was doingover $10,000.
We started doing marketing andthe returns on that were pretty
immediate.
I think you or somebody elsewas saying how they didn't find
(10:17):
mailers to be effective.
We had great results withmailers.
We had great results with doingGoogle Ads, so the marketing
has been very effective and it'sjust kind of taken off.
And obviously there's all theunderlying stuff about patient
communication and buildingrapport and all that stuff as
well.
That really goes into it,because that first year they
don't know you and after a whileyou start, the patients who are
(10:39):
going to leave have probablyleft and the patients who, like
you, have stayed, and then theyrefer more people.
So it just kind of snowballsfrom there.
Paul Etchison (10:44):
Talk about this lead assistant.
I'd love to hear about how youfound this person and how did
that role evolve, because Ithink this is one of the biggest
things for all practice ownersis is smaller practice.
You got to have at least one ortwo.
You know, like I've got fourleads right now, my practice is
almost 40 people, but like it'sit's so useful to have, just
(11:06):
like you know, that key person.
David Maconi (11:08):
Well, I knew she was a very quality assistant.
We didn't really get into theleads too much until working
with you.
I hadn't really thought abouthaving leads until that point,
and I remember when you and Istarted working together, there
was a little bit of uncertaintyof if we could have leads
because a lot of the departmentshad two people and so you just
had two assistants or twohygienists.
To me it felt and I don't know,maybe you disagree with me here
(11:30):
, but it felt like by having alead with only two people, one
was just kind of the boss of theother and it just, I don't know
, it's like not discriminatory.
The other one becomes like thenot lead.
Yeah, yeah, exactly.
So it was more in these lastfew months, I would say, where
we've now got 10 team members,that there is a lead in each
department.
So this individual I mean shewas great the whole time, but
(11:52):
she wasn't an official leaduntil about a few months ago.
Paul Etchison (11:56):
And what are her responsibilities now that have
changed from previously?
David Maconi (12:00):
Yes.
So now it's basically and it'sbeen nice a lot of checklists.
I know you just had a podcastout on checklists recently and
just kind of having somebodyelse where if there's something
that's not done, I can go to herfirst and say you know, I mean
again not like blame her, butjust say like this is kind of
your responsibility at thispoint and I can't oversee every
(12:20):
little thing.
So like if notes, for example,are not completed, or you know,
a lab slip was not sent, whywasn't that done?
And again, I mean, she's beengreat, that hasn't happened much
.
But it's nice to kind of have aperson to turn to to say like
hey, this is the system and likewhy wasn't it done, versus just
kind of talking to a whole teamand everybody's pointing
fingers at each other and nobodyknows who was supposed to do it
(12:41):
.
Paul Etchison (12:47):
Do you feel like, looking at her from an employer
standpoint, that you see traitsin her that you don't always
and I'm not saying we're goingto throw your team under the bus
but are there traits in herthat are unique, that make good
for that position?
David Maconi (12:56):
Yeah, for sure.
And, like you said, we're notthrowing anybody under the bus.
All of my team members I talkabout having an A-plus team and
all of my team members havedifferent qualities that really
help out.
She's actually very studious.
She may eventually go to dentalschool, which will break my
heart from an employerstandpoint.
Paul Etchison (13:15):
I'm so happy for you.
Deep down, you're like am I?
Yeah, I think I am.
David Maconi (13:21):
She's very intelligent.
But the biggest thing is Ithink she's dedicated to the
practice.
She's on my team.
You know what I mean In thesense that it's not like and
obviously there's always goingto be some clashing between
employer and employee.
But I feel like she's on teamHabertown Dental Arts and team
Dr McHoney and I can talk to herabout struggles of the office
(13:42):
and just kind of be open withher about it and she's just very
reliable too.
She had a baby and she was backat the office in six weeks.
She wanted to come back.
She liked the culture of ouroffice.
You and I talked about it.
We were like, is she reallygoing to come back?
You never really know.
She was back in six weeks andshe just doesn't really take
much time off.
She's just dedicated.
(14:02):
It's honestly she is an A-plusplayer but I'd rather have a
B-plus player who is reallydedicated to the cause than
somebody who was maybe a littlebit better.
But then you know they'relooking to get $1 per hour more
elsewhere and you know you justnever really feel like they're
on your team.
Paul Etchison (14:19):
Yeah, it's so true, and if you think about it
like, hearing you say that justmade me think that the people
that are super loyal tend to belike the best employees, and
it's almost like, even if theskills aren't there, that
dedication seems to matter somuch more than the actual
execution, the ability of themfor just to deep down, do it for
(14:42):
reasons that are internal thatmotivate them rather than just
do it maybe the best way.
It just more matters that it'sgetting done.
I mean, would you agree?
David Maconi (14:50):
For sure.
Yeah, the loyalty there is abig thing.
I mean, obviously, at somepoint the person has to be
competent, right of course, andstill be able to talk to people
and whatnot.
But I think that's one of themost difficult things with newer
employees.
I know everybody always talksabout the new generation, but I
will say it is harder whenwhether it's hygiene or anything
else if you're hiring somebodyand you just kind of feel like
(15:13):
it's of course we all work tomake a living and to better our
families and all that stuff.
But it's tough when you go towork and you feel like this is
completely transactional.
It just makes it less enjoyableversus like, okay, we're all
kind of pulling together andjust feeling like the office as
a whole is growing.
And I had somebody recentlytell me they felt like dentistry
was really lonely and thisperson was an owner of two
(15:36):
practices.
I ended up selling them due tothe stress and whatnot.
I feel like she wasn'tcollaborating with the team.
It was just kind of her and Ithink that collaboration can be
very helpful.
Paul Etchison (15:47):
So, looking back at when you took this practice
over to what you know now,having a few years under your
belt and you know massivesuccess, is there something you
think about like a mistake thatyou used to make or something
that changed in your, the wayyou thought about the practice
that you look back at now andyou kind of laugh about?
David Maconi (16:04):
I'm kind of fortunate A lot of us are
fortunate now that we are comingup in this time where podcasts
and coaching is so common.
You know, because you seepeople who are in their 50s or
60s and you think, what did youdo for 30 years?
You've been practicing thislong and the practice is still
only doing X, y, z and sofortunately, I don't look back
and think, oh, my God, I shouldhave done this so differently.
(16:26):
I do think maybe coachingearlier could have been helpful.
I think certain things likemarketing earlier and coaching
earlier could have been helpful.
I think certain things likemarketing earlier and hiring
earlier could have been helpful.
I was very hesitant to.
I didn't want to be overstaffed.
So we had the first year wherewe did the 1.1 million.
That was with one assistantthat was only there three days a
week, and then the fourth day Ididn't have an assistant.
I just, like you know, thefront desk would come back and
(16:47):
help sometimes, so I would havehired more people earlier.
I come back in health sometimes, so I would have hired more
people earlier.
I just didn't know the level ofgrowth that we would have.
So same thing with like hygiene, like I was at one like one and
a half hygienists.
And then we were at eighthygiene days and I remember
thinking, well, I mean, this wasonly like six months ago.
I was like, well, we can kindof support nine hygiene days,
you know, maybe nine and a half.
And then now we have 13 hygienedays and they're all full.
(17:10):
And I'm not saying that'salways the case, I'm not saying
everybody's just over hire, butin my case I probably should
have had a little bit moreconfidence in the ability to
fill the schedule.
Paul Etchison (17:19):
Yeah, and I went through the same thing in my
career.
The expansion of my practiceearly on was very slow and then
at a certain point it was justlike let's go, let's just find
people, let's grow to it.
But I think that's such acommon fear for dental practice
owners is that we always look atman.
Do I have too many people atthe front desk?
Do I really need anotherassistant?
Can I really fill anotherhygienist?
(17:40):
What type of advice would youhave for someone?
Because I see this so much thatwe're so slow to hire because
we think for some reason oneadditional employee is going to
bankrupt us and we don't see howwe can get a return on that
investment in human capital.
David Maconi (17:56):
So I think this is where the flexibility that
production provides is veryhelpful.
So it's kind of like in life,right, if you have a lot of
money it's not that money iseverything but you just don't
have to care as much aboutthings right?
Let's say, you got pulled overand you got a ticket and it's
like $200.
It's like, oh, that sucks.
But if you're doing really well, it's kind of like okay, I'm
just going to brush this off,whatever it is.
(18:18):
And same thing with otherlittle things in life that are
expenses.
It's just nice to have thatcomfort.
And similarly with a practice,if you are doing $700,000 and
you've only been doing 700,000for a long time and you look at
your percentage for staff andit's 32%, it could make sense
that somebody is worried aboutadding somebody else.
But I think when you get to thepoint where you're like okay,
(18:39):
we're going to improve ourefficiency, we're going to learn
more procedures, whatever it isthat allows you to produce more
, you can think, okay, well,maybe now we're at 24% staff,
we're going to add somebody thatmight temporarily bump us up to
27%, let's say, but that'sgoing to allow us to do X amount
more in production and you nowhave that confidence from past
years to see that adding a teammember allows that.
(19:04):
And again, nowadays we have somany ways that we can run these
reports to see the actualnumbers that we kind of don't
have to guess.
Hey, I added an assistant.
We did this much in productionbefore and now we're doing this
much in production.
And if you think about anoffice your size where you're
doing like six million, payingan assistant $50,000, you can
probably do another $50,000 atleast in production with that
extra assistant Again, assumingyou have the capacity and the
(19:27):
room for it.
And in many cases I think withthe type of people that you'd be
dealing with with coaching,they're going to be able to get
that improvement.
Now I'm not just sayingeverybody should just hire, you
know, and just anybody thatcomes their way, but I think in
most cases if you're kind oflike type A, you're going to be
able to make that up and morewith a new team member.
Paul Etchison (19:45):
I think it always comes down to new patients too
is these are offices, and theseare the offices that I work with
typically, are people areseeing a decent new patient flow
and if they're not, we figureout a way for them to get more
new patients.
What has your new patient flowbeen like?
What is your office seeingabout a month, would you say?
David Maconi (20:03):
So when I took over they were seeing about
eight to 10 new patients a month.
You know, no market or anythinglike that.
And the first year I didn'treally market at all because I
was seeing all these new mouthsand there was a lot of
underdiagnosis and whatnot.
So I didn't do any marketing.
I started with mailers and webumped up to about 15 to 20 new
(20:23):
patients a month for a whilethere.
And I find that the mailers,while the number of new patients
you get, isn't as good as maybesome other methods.
It seems like there are biggercases at least in my area I've
found that.
And then since then we've beenseeing closer to 40 to 50 pretty
routinely and that's been agreat jump.
And I don't know what's goingon this month, but we're at
(20:45):
about 90 for January.
So we had some crazy spike inJanuary.
I don't know how next monthwill be, but I would say closer
to 50 most months now.
Yeah Well, you just set the barreally high.
Paul Etchison (20:56):
Now you've got a taste of it and now you're going
to be like every month needs tobe 90.
That's what most of us would dowith that.
Talk about adding the associate.
You mentioned that.
You know you were three days byyourself, but then two days,
you know, bringing on anassociate.
And when you said that, Ithought about do I know any
two-day solo dentists?
And I can't think of any.
I think it would be very hardto have any level of
(21:17):
profitability two days a week.
But what has that been likehaving another provider in your
office servicing your patientsand with the team?
David Maconi (21:27):
I'm glad you made that.
One point, though, about youknow there's no solo dentist
doing two days a week, becausethat was kind of the thing.
It was like, all right, you cancut from five to four, for sure
, and you can cut from four tothree.
Even though some people may goagainst that and say you
shouldn't, we've seen it work.
But, as you mentioned, youreally can't have a functioning
business that's only open twodays a week.
(21:49):
It just doesn't really work.
I mean, maybe there's somebodyout there who's doing it or
they're really slowing down, butfor the most part it doesn't.
So that's kind of in part why Idecided to add the associates.
I have to still have afunctioning business, and the
cool thing is it's more of afunctioning business.
So when we opened up the ad, I'min an area that's I'm like 30
minutes outside of a pretty city.
So, unlike hygiene, we had 20applicants in the first week and
(22:14):
that was just from Indeed.
I mean, that wasn't like usingany sort of like you know the
crazy stuff like on Facebook oranything.
And ironically, this associatewas the first person I spoke to
and she just had a greatdemeanor.
She could hold a conversation,to be honest, like it's not that
the clinical doesn't matter,but I wasn't that interested in
their clinical other than thatthey could do the basics because
(22:35):
that's more trainable.
It's very hard to changepersonality and I've found that
patients have really liked her.
The team-like search is verysweet and at this point now now
there's just a stress of if thisperson leaves, then what do you
do with that and all thepotential there, whole new set
of worries, right, whole new setof things to worry about.
Paul Etchison (22:52):
So now you've got this freedom, you work in two
days a week.
You can work more days if youlike.
You can take more time off,because your practice is still
open.
When you're not there, what doyou see yourself doing, and I
mean, what is the near futureand what's your longer term
goals for your professional life?
David Maconi (23:10):
Yeah.
So as far as for professionallife, I'm kind of just trying to
enjoy this time.
I know it's like cliche onevery podcast on.
You know you got to enjoy thetime and you know be in this
moment and all of that.
But I mean that's something Ithought about for even since my
early 20s.
I feel like I'm fortunate thatI've kind of again had those
early influences, that I've kindof again had those early
influences that I was notsomebody who said I just want
(23:31):
more, more, more.
I'm very happy with what I'vebeen able to accomplish both
inside of dental and out ofdental.
And I do feel like I'm somebodywho, again, not that there's
like enough as far as like adefined time point, but I am
somebody who, you know, there'sbeen a lot of for anybody any
dentist.
There's a lot of for anybodyany dentist there's a lot of
delayed gratification.
You're studying hard throughouthigh school and college and
(23:52):
dental school and I'm very atpeace with the idea that you
know what.
We're going to still grow andit's going to go up.
But I want to enjoy family time,time with friends, just kind of
exploring things.
And again, I say that assomebody who is still working a
lot in and out of the office,but I'm very at peace with the
(24:12):
idea of scheduling morevacations and things like that.
And I want to grow, and whetheror not we will ever expand or
move the office is still kind ofup in the air right now.
Going back to the new patientflow, much sooner than I
realized we're going to be atcapacity and then I have to
decide do we keep growing andexpanding or do we cut
insurances?
That'll probably be aconversation in the next year or
two, but for now I'm kind ofjust enjoying it.
Paul Etchison (24:34):
Yeah, Cross that bridge when it comes right.
Yeah, that's awesome, man.
You know one thing I want toask you is there any chance that
you would go back and work moreclinical days, now that you've
gotten yourself down to just twoclinical days a week?
David Maconi (24:47):
Yeah.
So I think different scenarioskind of pop up there.
So one is with a differentprocedure mix.
So I've really grown to enjoyortho getting more into like TMD
and then sleep work and all ofthat.
And so again, part of thereason that I cut back was
physically demanding work onthose other days and ortho and
(25:08):
night guards and things likethat.
It's just not physicallydemanding and it's obviously a
lot of assistant-driven work.
So I've talked to my team abouthow on Wednesdays I may just
open it up to a half day of justortho where I'm not doing
hygiene checks, I'm just kind ofthere consult, seeing ortho
patients, things like that andsome big cases.
I've told the team we've got acouple of cases coming up where
(25:29):
it's like eight to 10 crowns orveneers and I'll do that on
Wednesday and it's prettyenjoyable to just go in and I'm
just with that one patient andobviously it's very productive.
So in that sense adding back alittle bit.
But then longer term, I said ifI have an associate and she's
out for maternity leave or ifshe were to leave, then
(25:50):
temporarily I would add backthose days.
It's hard to imagine at thispoint going back to just being
solo.
I mean I joked before about,like you know, the stress of
like is that person going toleave?
But honestly it's actually notthat stressful in the sense that
being at just one office youcan cover for that person.
I think it's different when youhave multi-practice and
(26:11):
obviously you can't be twoplaces at once or you have many
associates.
Then it becomes a little bitmore problematic.
But it honestly is a nicebalance right now where it's
like again, I really enjoy myassociate, we get along and
she's great.
But if she were to give noticeand leave, it's really not that
difficult for me to just jumpback in to happy Wednesdays
again and taking my time to findanother associate.
(26:32):
You know what I mean.
Like, even compared to hygiene,you have a hygienist quit and
it's like who's going to fillthat whole slot?
Like you're not going to do thehygiene, whereas with an
associate you can pretty easilydo that work.
So again, obviously I wouldn'twant them to leave, but it's an
easy transition and so that'sthe time where I would say
adding back.
But other than that, I don'treally see adding back just
because I, similar to like whenI went from four to three, I saw
(26:54):
it was a better life and itworked.
Like I had clear demonstrationthat it worked, so I don't see
why I would ever go back.
Paul Etchison (27:01):
Yeah, I love that man.
All right, final question whatis the best piece of advice
you've ever gotten when it comesto dental practice ownership?
David Maconi (27:10):
So, while it's somewhat cliche, I really
believe that the mentorship andcoaching aspect is huge.
Ever since I was pretty young, Iwas reading books from like
Dale Carnegie and like justthese various self-help books,
to try to have, in a sense, likethose people become mentors for
you.
Right, there's somebody thatyou can kind of look back.
Somebody had told me about yourbook and I had read the book
(27:31):
and that's how we eventually gotconnected.
But even before I had anofficial coach, I have a friend
who's very dedicated to hispractices and we would just talk
about it all the time.
And then I was put in contactwith it was kind of a family
friend actually who hadbasically done the finances for
many, many offices, and whilethere were things I disagreed
with him on, as I learned moremyself, it was instrumental to
(27:54):
kind of get in the door withcertain opportunities.
And then you know we talk aboutour mutual friend Talon.
He helped me out a lot.
And then, of course, you andjust having a soundboard that
you can balance these ideas offof, because the reality is like,
if you listen, even like foryour coaches, you guys don't
agree on everything, butsometimes it's not about having
like the perfect protocol.
It's somebody who can give youthe confidence to try a protocol
(28:18):
and then you can adjust alongthe way.
I mean, again, I make theanalogy to fitness things all
the time and it's like with myclients.
It's not like I'm going to giveyou the perfect program and
then you're going to see theseamazing results.
I'm going to give you a goodprogram for you and then, week
to week, we're going to adjustit and that's the big thing.
And so, whether you're usinglike PBN or dental intel or
whatever, it's having somethingto go off of and then having
(28:40):
somebody who's a few steps aheadof you who can then guide you
through it.
You know, sometimes if they'relike too too far ahead, it can
almost seem like it's somethingthat can't be reached.
But if you have somebody who's,like you know five to 10 years
ahead of you and has done whatyou want to do, that mentorship
is huge.
And it's motivating too to feellike I can.
That's why I said about goingto three days a week.
It's like, hey, these peoplehave done it, I know it can be
(29:02):
done.
Paul Etchison (29:02):
You know what I mean, yeah, that's a, a client
man.
You have been one of myfavorites to work with.
You've always been.
I don't think you've ever saidI don't think that's going to
work, not once.
You're like let's try it, let'ssee.
And I think that it's just likepiggybacking off what you said.
The people that move forward inlife are the people that
(29:23):
implement and try things out anddon't get stuck in that
analysis, paralysis, thinkingthey don't have the right
information.
You just got to get moving andyou'll figure it out when you
get there and I think that's atestament to that.
And, man, what a success you'vehad at your practice in such a
short time and I hope you'veinspired some people listening
to maybe think there might beworking too much or maybe
working a little inefficient topossibly do a little bit what
(29:46):
you did.
So thanks so much for coming on.
Dave, appreciate it.
Thanks, man.
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