February 23, 2026 • 44 mins
UK Dentists: Collect your verifiable CPD for this episode here >>> https://courses.dentistswhoinvest.com/smart-money-members-club
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Money worries steal focus from clinical care, yet most of us were trained to drill, fill, and bill—not to design profit. We take a candid look at why dentists often feel underpaid, then map the path from noisy busyness to calm, predictable income. With Dr Barry Holton’s growth lens and Shishir Kudka’s financial x-ray, we blend practical production levers—pricing confidence, diary zoning, and strong case acceptance—with the cash flow literacy that keeps a practice breathing.
We start by challenging the turnover myth. Higher gross without margin control is a hamster wheel, not a win. Barry shares how fear of rejection drives undercharging, why too many recalls clog chairs, and how a simple follow-up system can uncover a hidden fortune in proposed but uncompleted treatment. Expect real numbers: one two-surgery site sat on £2.4m of diagnosed care. We talk language, team roles, and the discipline of zoning to prioritise high-value care without adding hours.
Then we flip the chart to the finance side. Shishir outlines a level-zero toolkit any owner can use today: track gross profit after direct costs, set a margin floor, and run a quick liquidity stress test. We go beyond the profit and loss to cash flow and the balance sheet—because you pay bills with cash, not paper profit. Learn a simple TIPs review for your bank movements—spot trends, irregularities, patterns, and spikes—and see how better receivables, lab negotiations, and expense controls lift margins fast. We also demystify tax timing so you can forecast payments, avoid over-parking cash, and fund growth without surprises.
Data quality is the clincher. Generic AI dashboards can tidy messy ledgers into pretty lies. We talk about dental-specific tooling that validates entries, connects clinical and financial views, and delivers a true 360-degree diagnosis so you can reward the right behaviour and intervene early when conversion slips. The outcome is freedom: fewer, better appointments, fees that reflect value, and a practice you steer with confidence.
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Disclaimer: All content on this channel is for education purposes only and does not constitute an investment recommendation or individual financial advice. For that, you should speak to a regulated, independent professional. The value of investments and the income from them can go down as well as up, so you may get back less than you invest. The views expressed on this channel may no longer be current. The information provided is not a personal recommendation for any particular investment. Tax treatment depends on individual circumstances and all tax rules may change in the future. If you are unsure about the suitability of an investment, you should speak to a regulated, independent professional. Investment figures quoted refer to simulated past performance and that past performance is not a reliable indicator of future results/performance.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr James (01:43):
In another episode of the Dentists Who Invest Podcast,
we're here to talk today aboutwhy lots of dentists don't
really feel like they're beingremunerated to the standard that
they would hope for.
As to why that happens, I'mjoined by Mr.
Shishir Khadka and Dr.
Barry Oulton, and we're heretoday to talk about the science
of boosting your income, whatyou can do to be more
(02:04):
profitable.
Not that it's all about money,but of course it's nice to feel
valued for what we do wheneverit comes to our clinical
dentistry.
Looking forward to this one asever.
As ever, you can claim your CPDfor this episode within the
official Dentists who investSmart Money Members Club.
Smart Money Members Club alsoincludes multiple mini courses
and webinar series on financefor dentists, including how to
become as tax efficient aspossible, as well as
(02:27):
understanding investing.
All of this content counts asverifiable CPD, and you can
download your certificates thereand then upon completion of
each lesson.
In addition to this, we alsoinclude a whopping 10% discount
on your dental indemnity and a5% discount on lab bills for
dental principals, amongst otherperks and discounts for
members.
Please use the link in thedescription to claim your
(02:48):
verifiable CPD for this episode.
Well, as we were saying in theintro to this podcast, we were
here today to talk about the theI word in verticomas, which is
income.
And we need to normalizetalking about this in dentistry,
I feel, because really, when weknow that we are correctly
(03:13):
remunerated and hitting theright income number, that means
that we don't have to sweat itabout our bills, about all the
things that are going on athome.
We can be your best self atwork.
So we have to talk about it tosome level.
It's not about that, but it isan essential thing, it is an
essential component to ourdentistry.
Dr.
Barry, thoughts on what I'vejust said?
Agree?
Dr Barry (03:32):
I think it's a hundred percent.
Absolutely.
I mean, even for me, when Iowned my practices for like 20
years, um, I didn't have it thefinances dialed in.
I think, you know, my my phraseis it's really hard to cock it
up in dentistry, right?
Most of us earn an okay incomedespite our inability to have
(03:54):
our finger on the pulse of ourfinances.
And so I always had financialstress.
And what I'm finding now isthat, you know, I'm really good
at helping my clients toincrease their gross revenue,
but actually, you know, uhSashir Sashir to me and my
clients is like um a BPE perioprobe is is now that you're
(04:15):
aware that a business hasfinancial periodisease, you
can't ignore it.
And so everything I'm doing nowis bringing Sashir in because
he's the master of plugging theholes in the bucket.
Whilst I'm pouring the water inand helping them to build it
up, he's actually plugging it,which means he's gonna be
responsible for leveragingprofit as opposed to just me
(04:37):
leveraging production.
Dr James (04:39):
Well, well, you know what, just on that, Sashir,
because it'll be interesting tohear your thoughts as well.
I mean, what I've always foundin business is that a lot of
people focus purely onincreasing their turnover, so to
speak, right?
But that only provides you somelevel of comfort if you have no
idea what's actually going onunder the bonnet because you
(05:00):
will be uncertain how much youactually need to hit that
break-even point and to manageall your outgoings and take some
profit out.
And that is also not a niceplace to be at all, and you'll
still be operating out of fearand just trying to earn as much
as possible.
Shishir (05:16):
Yes, James.
Uh, it it reminds me of uh oneof my clients.
Um, I'll tell you a littlestory that a few weeks ago, one
of my clients uh he's like 52and he has some kind of
arthritis problem, and uh and hemessaged me saying, Sissy, can
we postpone our call uh to thenext one?
(05:37):
Uh because I'm gonna have tosee an implant patient.
Because that for me that islike an immediate £3,000 money
coming into my bank account.
But after the call, after uhafter a week, then when we
reschedule a call, I asked him,like, uh, how long do you think
you can keep on going like this?
I mean your body can handlelike this for you know, like you
already have an arthritisproblem.
(05:59):
You see, that's the problembecause with that money that he
would have saved 20% margin ofsomething like that, but he was
never ever ever going to getback the the three hours of his
time that he already investedmaking this treatment back.
So you can get your money back,but you can't get your time
back.
So if you're hung up on theproduction game, you lose
(06:19):
because you don't know what towhat what sort of leverage that
you can have in the business andyou're missing out on.
And that's the issue that mostuh dental practice owners game
that I come across that are sohung up on the production game,
saying, I just want to see theproduction of mine, production
of my associates, and thingslike that.
As long as I'm hitting theprocessing target, I'm there,
(06:40):
but it doesn't really work likethat.
Business is like anintellectual sport, you know,
like you have to play the game,you have to play as win as a
team.
We have team members indifferent areas, you know.
We're talking about football,you're talking about strikers,
you're talking about defenders,all have a job to do, you know,
like and if if you're onlysolely relying on strikers to
(07:01):
just win matches, it doesn'tyes, you may win a match, but
you don't you're not gonna win achampionship, and that's the
problem.
Dr James (07:08):
You know, it always when I hear stuff like that, it
always kind of reminds me, it'slike I can't I don't know the
exact name of this experiment,but I'm sure we've all seen it.
They have these, you know, backin the day when they were
learning about psychology andanimals and things like that,
there was they basically hookedthis rat up to this um electrode
in its brain, right?
(07:29):
Okay, and the electrodestimulated the pleasure center
of its brain, and they give thisrat the butt a button to press,
okay, in its cage, okay?
And the rat would just push thebutton like like ah like this
all day long because it felt sogood for the rat.
And even though the rat feltreally good, okay, the rat
literally eventually just uhdied basically because it it
(07:51):
forgot to eat and drink, okay,because it was having so much
fun in the moment by doing this,right?
Anyway, to relate that back towhat we're talking about, I
think business is a lot likethat sometimes, because
oftentimes there's these thingsthat give us, you know, people
like to make money, right?
We we can say that out loud,that's fine, you know.
It's it gives us a dopamineboost in our brain, right?
(08:12):
And it's like people will chasethat short-term dopamine hit
versus sitting on a zoom andthinking about these things with
yourself uh Sishir, which whichmay not give that immediate
dopamine hit, but it's probablyworth far more to them in the
long run.
And I always try I literallyalways try to visual that to my
visualize that to myself.
Am I chasing the short-termhit, or if I sacrifice that, how
(08:36):
can I make things so muchbetter for myself in the long
term?
And that that that that littleuh I guess visual description
just it it it kind of alwayssticks in my head.
I can't remember where I sawthat, but anyway, we're trying
not to be that person.
Dr Barry (08:48):
We're trying to think about these things strategically
because I think I think Jamesthat something that's in
parallel with that is I think alot of dentists confuse busy
with successful.
Firm is that is that when theyare super busy and they have
long days and they've gotstress, they've got reactive
decisions, constantfirefighting, that doesn't equal
(09:10):
high margin strategic growthand freedom.
And I think we often can get sobusy being busy that we don't
take the time to sit on a zoomand have a conversation and go,
oh, there's another way of doingthis.
So I think that's kind of likethe rap pressing the button is
that they're so busy pushing thebutton that actually they
forget that there are thingsgoing on that they could they
(09:33):
could move some levers andactually have a huge impact.
Dr James (09:37):
There we go.
Exactly, it's exactly analogousto that.
And that allows us to seguevery nicely on in the next part
of this podcast is how the heckdo Dentists actually do what
we're talking about.
And this is great that I haveyou both on the podcast today
because it's kind of two anglesthat we're gonna come this from.
One is, I mean, we have tothink about boosting income to
some level, there has to besomething there to optimize,
(10:00):
right?
And then the second part isokay, what do we actually do?
How can we actually look atwhat we're bringing in
forensically so we can ensurethat we're actually making
profit and we've got a realhandle on our numbers, which is
more Sishir's remit.
Maybe if we start withyourself, Barry, a little bit on
boosting income, what youbelieve is important.
Dr Barry (10:19):
So I I mean, what and I spend five minutes just giving
you some of the high-levelthings that I will look at and
work with with my clients, andthen actually we can get Sashir
to be the guy that startslooking at where the holes in
the bucket are.
Because for me, there's anumber of levers where we're
able to increase production andprofit um without looking at the
(10:43):
spreadsheets.
And then the the next level iswhen you actually really
understand the finances, that'swhen things just take off.
So for me, um often dentistscan undercharge, often
emotionally, fear of rejection,fear of being too expensive,
identity conflict, impostersyndrome, things like that is
(11:05):
that helping them to communicatewith themselves better and with
their patients.
Second one is they don'tcontrol their diary, they have
random scheduling, they have toomany uh exams and recalls, and
they are not looking at thedaily production, they're
looking at again how busy theyare, and so we zone the diaries
(11:27):
beautifully for maximumproduction.
They have poor case acceptance.
I've got clients at the moment,uh, I won't name them because
that would be very unfair.
I have a client who has a twosurgery.
This is gonna shock you, right?
I I have a client that has atwo surgery practice, and I
said, because he has dentally, Iwent, let's just jump on, let's
(11:48):
run a report.
I want to find out about yourrecalls and your outstanding
treatment, treatment that hasbeen diagnosed, presented, and
not accepted.
And I said, let's do it for 24months, right?
Two surgery practice.
What is the treatment that hehas diagnosed, treatment
planned, presented, and has notbeen completed?
How much do you think that is?
(12:09):
Two surgery practice.
A mail private?
Dr James (12:15):
Yeah.
So basically treatment plansthat he hasn't closed, in other
words, in is another way ofsaying it.
Um two hundred thousand.
Shishir (12:30):
I was gonna say something could be like two
hundred eighty-nine likebeautiful around thirty percent.
Are you both sat down?
Dr James (12:41):
Yes, yeah, I'm holding to my chair.
Dr Barry (12:50):
No, how no way.
Look at the two of you, look atthe two of you.
You don't believe me.
Oh, I mean, I could I could gointo that, but hey, what an
amazing opportunity becausethey're doing quite well.
But oh my god.
Two surgery practice, 2.4 mil.
And then I had anotherconversation with another client
of mine, and uh, they were onlyable to get results over the
(13:12):
last 12 months, they couldn'tget anything before, uh, and
they were 489,000.
So this is a big problem,right?
One isolated case, I mean twopoints four is off the scale.
One isolated case is one thing,but actually, there's an awful
lot of this, right?
Poor case acceptance, poorfollow-up, poor follow-up.
I ran a I ran a trainingyesterday on follow-up.
(13:34):
Uh, my daughter, who's nowworking for me, has just put
together a 30-page document onreigniting and bringing patients
back in, how to do that, thelanguage skills, because we've
got team members that that feelawkward about phoning somebody
up about outstanding treatment.
So there's that, you know,there's overheads without
strategic control.
(13:54):
Honestly, most people that owna business avoid leadership,
they're really good at dentists,being dentists, they were
taught how to be technicians.
Um, and so there's a load ofthings, but ultimately no
financial targets, so on and soforth.
So I I could go on about thisforever, but what's recently
come into my life is thisgentleman here who I have
(14:16):
plugged him into my clients, andthe difference that he's making
is phenomenal in theirfinancial education and
understanding, and actually howthat's shifting some of the very
important decisions that we'remaking as businesses.
It's even helping me become amuch better coach.
So I think actually, you know,it it's the stuff that people
(14:38):
like me, I own my practices, butI didn't I didn't have my
finger on the pulse lights asshe does now.
Dr James (14:45):
Interesting, and that yeah, that brings us on to the
second part of thisconversation, which is how can
we master numbers, which issuper duper duper important.
Shishir (14:56):
Uh James, the uh in in terms of mastering the numbers,
and from what I've come acrossworking with dentists uh since
2019, is that uh if they're notactually passionate about this
topic, and this they want toavoid this trend this topic as
much as possible.
And it's it's a bit like uhthink about the moment, like you
(15:17):
know, when we have really uh nomoney in the bank account, we
don't really want to look at itbecause because they could you
don't want to have that kind offeeling, you know, like and it's
the same thing like when youdon't understand in finances, I
don't even want to talk about itbecause that will make me feel
bad, you know.
And and and I think it's thefirst thing that I would say is
that you have to love yourbusiness, you know, to love your
(15:39):
business, you have to love yournumbers, regardless of how bad
how uh how good it is, and youyou wouldn't do it to your
child, would you?
You know, like you know, likeand my son is so bad.
I don't love him, I don't thinkyou would do that.
You know, like why would youneglect your finances, you know,
in your business?
And the first thing is to loveyour numbers, you know.
(15:59):
I would start with that withfirst, you know.
Dr James (16:03):
Yeah, let's do it.
I'm all ears.
Shishir (16:07):
And and and the secondly, secondly, once you
know that you know you you yougot to love your numbers because
this is what I've learned frommy business coach that uh this
is the guy who uh is not anaccountant, but he's a brilliant
um per uh you know in what hedoes.
This is the guy who took abusiness from five hundred five
hundred million dollars to fivebillion dollars in five years'
(16:30):
time.
His name is Sevan Srivasta, anduh and he this is what he said
to me.
CC like the thing is like ifyou don't know your numbers in
business, you lose because youdon't know what to focus on.
It's simple as that, and mecoming into like me as an
accountant and saying, like,yeah, I get it, but you know, my
(16:53):
clients they don't get it.
And this is what you have to toshow them, you know, like show
them, and and so yeah, so notunderstanding mass and the
economic like the the the timingaspect, the logical aspect of
all of this, it just keeps themlike of uh financially
paralyzed.
That's why I called it, andthey're like, should I do this,
should I not do this?
And they're stuck in thisanalysis paralysis for a
(17:14):
prolonged time, and they arestuck, and it's like uh they are
stuck while the competitors aremoving forward much faster, and
they're making decisions basedon data, and they're moving uh
and making good choices in termsof saying this shouldn't be
treatment pricing, or theconversion is not good enough.
This associated performing notperforming well, this is
(17:35):
actually performing well,actually.
Let me reward him so that hedoesn't move away to another
practice.
You see, like small, smalldecisions like this makes a huge
difference.
Imagine that a a good uhassociate like who's really
performing well and he's notbeing rewarded, leaves.
Now you have you go with somuch problem.
You have to find a person, youhave to train the person, it is
so much a headache, and andyou're risking so much.
(17:56):
So, so you can only do thiswhen you have financial clarity
in place, you know.
I call this like clarity breedsfocus.
So we need the financialclarity first.
Dr James (18:09):
Love that, love that.
And where I guess the firstquestion to ask is in your
wisdom, Seshir, we would breakthis down really simply for
Dentists, because I I think Ifeel having been a dentist
clinically myself for manyyears, that I guess the thing
that really gave me analysisparalysis was I just didn't know
(18:31):
where to start.
Like, what is I get that youcan go to like version 10 and
have all these metrics that youcan analyze?
What is what is version one ofthat look like for dentists?
Like they're very basics,they're very, very, very basics.
Shishir (18:44):
Yeah, so I call this like a uh like a level zero to
like level five that that I havefor that.
Dr James (18:50):
Oh, I you've already thought about this.
I love this.
Great.
Shishir (18:53):
So so that you understand, like you know, so
when you when you go into thisuh you know the power BI
reports, like analyticalsoftware tools out there, and
you'll you'll come across thislevel one information, James.
Like it tells you what youraverage daily production is, it
tells you what your average uhyou know profit is per associate
and things like that.
That's great, uh, but you haveto go it's much deeper in in
(19:14):
terms of uh why it's happening,what's happening, you know.
These are the critical thingsthat answers the importance of
uh of of how you actually makegood decisions.
So when you come back to thelevel level zero, we're talking
about the you know uh you'reyou're talking about the what is
the production based on what isa gross profit, which is just
(19:36):
after cost of delivery, and thatneeds to be at a certain
percentage, and anythinganything below 50%, and you
you're risking it that there isnot uh you're you're losing
money on that front.
I I I came across a client uhother day and he was on 30.37
percent gross profit, it's it'spurely 95% private, it's a small
(19:59):
bit of NHS.
And they're like, Paul, you'reon the 30.3 percent, assuming
that the data is right, youknow, like you know, he's right.
We can I can bring you up likeanything like over 45 percent
and imagine that you're doinglike 1.5 million, and think
about that 17 like 12, 13, 14percent gap that you already
(20:22):
have, you have extra profit justby just optimizing a few
things.
Nice, and and so I would saylike the first thing you you
look at is the gross profitmargin because that is the key
driver of the business.
Because uh once the businesscross over 800,000 pounds
production-wise, the most of thefixed expenses that happen in
(20:43):
the business are recouped uh andcan be consumed by uh by this
the turn-up itself.
So anything over that one.
So, what I've seen is that evenyou go to 1.5, you are
relatively spending much less onoverheads, the expenses.
This what you paid just to openthe door, clinical door in the
practice, and you'll have abetter leverage.
(21:06):
So, we'll be looking at grossprofit and the overhead spend on
the on on the production side.
Then we're going to break downall these overheads.
Um, James, we're going to likelevel two kind of territory, and
and uh, but I'll be looking atfor the first thing like it is
like a biking x-ray.
I'm just looking at saying,okay, what is the production,
how many chairs, and uh how whatis gross profit with the net
(21:28):
profit margin.
At this level, they should beon this level.
So I know instantly thatthere's some some like the holes
in dental practice, just likeholes in teeth.
Yeah.
Dr James (21:39):
Boom.
I see what you did there.
I see what you did there, butyeah, 100%.
Okay, cool.
And maybe hey, to take thatanalogy one step further, it's
like maybe things can lookclinically fine, but you take
the x-ray, the radiograph, andthey don't look radiographically
fine, yeah.
When you do your special testsor your your further
investigations, and um yeah, Ijust coined that right then, but
I think it works.
Dr Barry (22:00):
That's where the BPE comes in, mate.
Is this kind of listen?
Dr James (22:04):
You guys can use that one if you want, because I I I I
think that would work quitewell.
There you go.
Anyway, okay, cool.
So that those are I guess whatwe want is the yeah, the
absolute basic.
So you think that's the bestplace to start for Dentists this
year?
Shishir (22:18):
Yes, and you start with the PL.
But here's the problem, James.
You know, like uh most dentalpractice owners, they're just
stuck in this profit loss game.
This look at uh they just lookat production and just look at
in profit loss in zero, and thisis where this is where they
actually um uh they finish thejourney and look at all my
business is profitable, but itdoesn't tell you the whole story
(22:42):
of your business.
Uh because it's it's it's a bitlike uh uh it's a bit like you
know, you need healthy teeth,you need healthy gums, you also
need a healthy level of bonelevels, right?
Then then only the oral healthis fine.
So uh in in in a dentalcontext, in terms of finances,
(23:02):
your teeth are your uh teeth areyour profit and loss, because
that's what is making the money,and and your cash flow is like
your gums, because that actuallyholds the teeth, uh, you know,
hold the business.
Because you pay by cash, youdon't pay by profit, you know,
like you know, and then yourbone level is like a balance
sheet.
You that everything is wholethere.
And here's the big problem,James.
(23:23):
That I say, you have you heardof this phrase like in in
marketing, like uh you know, youcan even hide a dead body in in
the second place of Googlebecause hardly anyone goes
there.
Have you heard of that?
Dr James (23:36):
Uh I haven't, but yeah, I I I hear you.
Shishir (23:40):
So I can say the same thing to dentists, I can even
Hide a dead board even dentistbalance sheet because no one
goes there.
Or how do you anyone goesthere?
Dr James (23:47):
Fair enough.
Yeah, that is true.
Yeah.
Shishir (23:50):
Because the the most important part of the finances
are held in the balance sheet,not in profit loss.
Because the the most importantcomponent of profit loss, which
is the profit made in thatcurrent year, is already the
part of the balance sheet.
And the balance sheet is simplypart of what you own and what
you owe.
And if if what you owe is ismuch higher, then you have a
(24:12):
problem.
But if you're not seeing that,then you don't know.
And then then you come to like,okay, I have 10,000 pounds in
the bank account, I owe thetaxman 20,000.
Um I have a problem.
Yes, my business is profitable,but it's not liquid yet.
So you have to look at fromthis angle as well.
(24:34):
So these are like level onekind of thing I look at.
Like I do something calledbalance sheet stress test.
You know, like if we were tohave no income, say for the next
two weeks, like how long canyou pay your bills?
Because you have to pay for thematerials, you have to pay for
lap, you have to be associates,yeah.
Your subscription is going on.
Maybe you have to be also EMIand for loan uh higher purse,
(24:55):
things like that, you know.
It's called a stress test, andyeah.
Dr James (24:59):
And you know, the tax one, just to home in on that,
that's a really common one fordentists, right?
And that applies to bothassociates and principals, and
it's like people just put away acertain percentage every year
because they'll they'll want tosave, but they don't know
exactly how much they owe,right?
(25:19):
And I actually have thisproblem a lot, right?
Where um I put away money forVAT and I put away money for
corporation tax, right?
And I actually find myself in aplace where I'm usually
oversaved way more than I need,right?
And that sounds good.
It's like, oh, you get thislittle bonus, right?
But actually that's a bad thingas well, because that cash
(25:40):
could have been doing otherthings for you, you know, like
you that could have been cashthat you could have invested in
something, and it's I see I seeliquid cash in your bank account
beyond a certain level.
Um, beyond a certain level,obviously you need your six
months uh emergency fund andmaybe a few months of turnover
in the business or however youwant to do it.
There's different ways of doingit in your company, uh, just as
(26:01):
a cushion, okay?
But after that, it's literallyjust wasted potential, like it
could be doing something for youbusiness-wise, or it could be
invested in an asset that'sgoing to appreciate with time.
But anyway, so what you'resaying is how can dentists get
better at that?
Like, how can they have somesort of met what what are the
methods that dentists can use toestimate how much tax they owe
(26:23):
properly?
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of this podcast.
Shishir (29:31):
And then the next phase is if you want to have a really
good driving experience, thenyou look as further as possible.
Why?
Because you can spot thehazards and uh hazards uh, you
know, any potential problems upfront in the in the same way the
controlling having this cashflow is in the same way.
First, you learn how to manageyour your what's in and what's
(29:53):
out, or in like what should bein, what should be out, how much
should be in, how much so youhave a control on your
receivables and on yourcollection wise, and you also
have a control on the payables.
You'll see that in you when yousee the supply invoices in
zero, like you'll see that.
So you know that.
Then you able to analyze theinformation of cash flow, like
(30:13):
uh you know, on and I go throughlike a four-step process on
this one.
I call it the tips technique.
Like we look at we are lookingfor trends, we are looking for
irregular activities here, andwe are looking for uh we're
looking for patterns and we'relooking for spikes.
So I call this the tipstechnique.
That the first things that wedo this and we're starting to
analyze the cash flow, like um,and then we look for projection.
(30:37):
So, because it's just like thefurther you look ahead while
you're driving, that uh you knowyou can do uh you can plan for
whether you want to change theuh the the the lane or not.
So you if you can plan for yourcash flow, uh then you'll have
a better control on your cashflow.
And here's the thing here'swhat I believe like when you
have control in your cash flow,you'll have control in your
(31:01):
business, period.
Because um from what I can see,like uh from most uh dental
business owners, they feel liketheir business is controlling
them rather than theircontrolling the business.
They're forcing to make uhsometimes I come across a
dentist saying, Oh, sorry,Cecil, I even had to skip my
(31:21):
lunch uh just to uh just to fitin, you know, like I'm trying to
do different things.
So you want to have a controlin your cash flow so that you
can have a control in yourbusiness.
Dr James (31:33):
Nice, and then that leads on to the taxing as well.
So it kind of comes back tocash flow.
Have I got that right?
Shishir (31:38):
Yeah, so so then uh then the uh then like when you
can project your future cashflow, uh uh what cash person
that you will be on, and if youdon't have uh cash to to pay the
tax, and maybe you need uh somekind of you know tax loan in
place, or maybe uh maybe you cangenerate enough cash flow to
pay on time, but it's all it'sall down to numbers, you know.
(32:00):
But you can act much faster,and you can make a decision
based on that.
Dr James (32:09):
I hear you, so it it really all comes what you're
saying is that these common painpoints that Dentists have, will
I have enough money, which isliterally the title of this
podcast, right?
Or well, it's another way toparaphrase it, um, or the the
whole tax thing, will I haveenough, won't I have enough as
(32:30):
well?
It basically comes back tobeing able to understand cash
flow and understand youroutgoings, it's all a
permutation of that.
Is that fair to say?
Shishir (32:42):
Yes, and that's uh that's a big chunk of that, uh
part of that is yes, and and uhand I I like the fact that well
when you uh when you said Jamesthat you know if you're setting
aside say 30%, uh 35% like thatin terms of paying taxes in like
a tax port and like uh like do.
And uh uh you correctly tomention that you know that money
(33:07):
is like park, that means I'mnot able to use that right now.
So like today is like 20th ofFebruary 2026.
Uh as a self-assessment, youwould pay the next instalment on
31st of July and the followingone on the 31st of Jan.
So you might have a limitedcompany saying a 31st of March,
so you might have paid yourcorporation tax at the end of
(33:28):
December 2025 for the previousyear.
So when you know these dates,how uh when it is due, so and
and so what I come across likeuh a smart dental practice
owners, they're saving money topay as a taxpayer.
Uh but uh but we both agreethat actually the cash in the
business is the resource, it isthe fuel in the business.
(33:52):
So you want to invest in now,not park it to be paid on 31st
of July.
Yes, but you just need to knowunderstand like how much you
need to pay.
You don't have to pay today'smoney, like you know, I don't
you don't have to pay like withtoday's money to say you tax me
30,000 pounds, so you so you yousave 30,000 pounds is parked
(34:12):
there.
You don't have to save it nowto pay uh on 31st of July.
You can pay the money that youhave on 30 30th of July, 30,000
pounds you can pay on the 31stof July.
But you have utilized, you haveused, you have used the
resources, money is the is theenergy, is the fuel in the
business for 30,000 pounds indifferent marketing campaigns,
something now you're generatingextra income from this extra
(34:35):
income.
You're utilizing that one topay on 31st of July.
So we so but you can only dothat when you have a clear,
accurate financial visibility ofyour finances.
Dr James (34:45):
Nice, and once upon a time, we used to just this was
all written uh down, right?
But I believe now things haveevolved in 2026 in that we have
software solutions that canhandle this as well.
Shishir (35:01):
Yes, so um so here's uh you know, like because uh
because mostly I've been workingas a CFO over for different
businesses, and and uh and by uhlike uh like mid 2023, James,
that I came across like so manyuh like financial planning and
automation, not automation, uh,analysis software like data
(35:24):
roles and things like that.
Uh, they are just usingMicrosoft Powered BI reports uh
like that to create this uhdashboards and things like that.
Uh, but what I found is uhdentists they are like a
different beast on its ownbecause this NSS contract, this
and some SSC working two days aweek, uh but they plan to work
three days a week, they're doingextra hours.
(35:45):
There's a lot of complicated uhbring around this ones, so uh
so so they needed a uh acustomized software solution
just for them only.
So, so so yeah, so we we builda financial software um when we
call and uh it's called dentals,and uh uh it's it's purely
about uh improving finances inthe business, and we find uh the
(36:09):
hidden gaps in the in thebusiness, and and first we
ensure the accuracy of data, andthen then we help them with the
cash flow, profitability, um,and taxes, financing the
business.
These are the areas that wethat we cover, we cover.
Dr James (36:25):
Excellent.
And you know what?
It sounds good that it's takenuntil 2026 to someone for
someone to uh create somethinglike that.
Um if I'm honest with you,because it sounds like it's just
so obvious that this might beneeded uh for dentists and
dental.
Dr Barry (36:41):
Is it worth touching upon?
Can I can I jump in and say, isit worth touching upon this
this idea that there are thingsthat are already out there that
we're assuming work the same,but they're not, because they're
AI based?
So Shea, would you be able tojust share what you told me
about the difference betweenwhat is out there in terms of AI
(37:02):
and actually what Dem Pulsedoes?
Because it's significantlydifferent, right?
Shishir (37:07):
Yeah, um the the the main issue here is the uh the
accuracy of data because uh uhwhen when I when I started first
developing this, Barry, uhthree and a half years ago, I
started creating with the powerBI reports, just like what we
have with current seeing in themarket.
Uh it just gets the data fromdifferent sources, then it gets
(37:29):
passed on to AI to clean thedata and present with it and
present with the with thedashboard.
But Barry and I were like wewe've seen that with with our
own clients there the the sourceof accounting data is wrong in
the first place.
So when you you so you cannotyou can automate, but you you're
(37:50):
automating the wronginformation, wrong data in the
first place, you know, like thisthis is what the problem is.
So we uh so uh in this in asense I call this financial data
integrity.
And and it it's uh if the dataintegrity is is not there, then
the decisions are based, uh itdoesn't it's not really
(38:11):
meaningful.
If you still have to havesomeone to make it uh you know
manual process to make adecision, then it's not much of
a value, you know.
As opposed to if you'reautomating decisions, then
that's great, as opposed toautomating data.
And and and uh and and alsowhat we do is just like uh
(38:35):
James, we're talking about thisbalance sheet being you know,
putting the dead body in thethat no one goes there, and uh
what the software does is itgoes through the balance sheet
and looks at the whole picture,like you know, you're not only
doing a bite-wing x-ray, you'reyou're doing a fully city scan
you know of your mouth, and anduh you're going to every single
aspect of your profit lossbalance sheet cash flow and
(38:55):
figuring out where the gaps areand what you need to do as an
individual owner, and that'smore that's more holistic
approach, you know.
And and that's what's neededrather than just saying, Well, I
fixed my teeth, but uh and I uhmy my my but my gums are not
healthy, and that that's notthat's not uh that's not where
we want to be as a patient, youknow.
Dr James (39:17):
Sure.
Or another way of saying it isthe sign or symptom of the
disease, if you will, is thatyou feel like you don't have
enough money or you feel likeyou don't have enough to pay the
tax man, but the actualtreatment is to understand your
cash flow and how that works, sothat you can make decisions
that will allow you to not havethose problems uh based off the
(39:40):
back of clear data.
I think that's a basicallyanother way of saying it.
So it's kind of like dentistsknow when the patient comes to
us with toothache and wediagnose what's going on, right?
A lot of the time we havefinancial pain, I guess you
could say, or financialfinancial signs of financial
disease, if you will, in thatthere are uh symptoms that we
(40:01):
would observe that we don't haveenough money, right?
And this is literally thetreatment, you know, is the
remedy.
You go just like you go to adentist uh to sort your teeth
problems and to diagnose whatthose issues are, you j you
might go to someone likeyourself, uh Sisher or Barry uh
to diagnose the exact cause ofthese issues that people are
having.
And uh, as you were saying asecond ago, it sounds like the
(40:23):
very first stage in that remedyevery single time is the cash
flow side of things, and it'sinteresting that you should
mention what solutions exist outthere these days are are brand
new, and obviously that's partof what you do as well.
Sishair, is it fair to say thatto start off that uh treatment
process that you'd be able tooffer some sort of checkup, I
guess, if you will, or adiagnostic appointment, like an
(40:45):
examination when someone goes tothe dentist?
Is that is that how that beginsusually?
Shishir (40:50):
Yeah, so I I just send them like a two-minute uh of uh
of a diagnostic uh test in termsof where they are in the in the
business journey and in thewhat the problems are, and I I
give them like uh his what'syour wealth score and um wealth
score wealth score.
Um because the the whole ideaof uh setting up a business is
that they want to build apersonal financial wealth that
(41:13):
lasting, and uh uh if they arejust focusing on profit only, uh
um only, and then you'remissing out on huge opportunity,
but not by looking at cashflow, by not looking at the
balance sheet as a holisticapproach.
Uh so so yeah, a two-minute umyou know, questionnaire would
would actually reveal so muchabout them, you know.
Dr James (41:35):
Nice, okay, brilliant.
And how can someone get thatquestionnaire that we talked
about just a second ago?
Shishir (41:40):
Yeah, so I can I can provide you the link and you can
uh you can share that with the.
Dr James (41:45):
Yeah, let's put it in the podcast description.
That's a great idea.
That's actually a really goodidea.
Dr Barry (41:49):
Again, can I uh just jump onto this for a little bit?
Is that um I think you know I Ijokingly said that uh Shashia
is is to my clients what uh aBPE in a period probe was to
dentistry uh 20 years ago.
Uh which is you know, patientswould would walk in and uh even
(42:12):
the dentist would say, Oh,you've got a little bit of
bleeding, and nobody reallyacknowledged that it could be
quite serious disease.
And I think that's the samewith the finances, is that oh,
you've got a bit of stress aboutyour your tax, or you've got a
little bit of a cash flowproblem.
And because it's so common,because we've always had it, no
(42:34):
one's really going, well, hangon a minute, let's just take a
look and see what's the bonesupport like?
What's your balance sheet like?
What's really going on here?
Is this something that you'regonna end up in the in the deep
doo-doo?
Or is this something that youwould just come out of?
So, yes, there's the two minutereport, but I think because
(42:54):
there's so much in the financialside of dentistry where we
don't know what we don't know.
One of the things that we'redoing together, Sasha and I, is
regular live workshops where wetake people on a three-hour
journey of discovery, right?
It's like 29 quid.
The i the idea is that it's notabout making an income from it,
(43:16):
it's about making people awareof what they don't know, and
then if they're interested tofind out, we can share with them
what Dempulse does, what Sashirdoes.
If they're interested in mead,they can be.
But actually, it is giving thema true diagnostic at a very
little cost.
You know, that they for thatdiagnostic, they'd be charging
69-89 quid for a patient.
(43:38):
They're gonna pay 29 quid tocome and find out where they
are, so that then they can atleast not be burying their heads
and choose to do somethingabout it.
It's kind of like telling apatient, look, we've got BPEs of
threes and fours, we need to doan ordinance survey map mapping
out what's going on.
It's then your choice as towhether you treat that
(43:59):
periodisease, but at least nowyou are aware what's going on,
which means you can't go, nobodyever told me.
Because that's what's happenedwith the majority of our
clients, is with theiraccountants.
No one's ever told them whatreally is going on underneath
the financial covers.
They just know that the stress,they've got a bit of bleeding,
they've got some stress, they'vegot some sensitivity, but
(44:21):
actually they don't really knowhow bad it is or how actually
quite good it is.
We just need to tweak a fewlevers and everything would be
okay.
So that's that's our aim overthe next few months is to
provide more of these clinics sopeople can come and find out
what's going on.
In another episode of the Dentists Who Invest Podcast,
we're here to talk today aboutwhy lots of dentists don't
really feel like they're beingremunerated to the standard that
they would hope for.
As to why that happens, I'mjoined by Mr.
Shishir Khadka and Dr.
Barry Oulton, and we're heretoday to talk about the science
of boosting your income, whatyou can do to be more
(02:04):
profitable.
Not that it's all about money,but of course it's nice to feel
valued for what we do wheneverit comes to our clinical
dentistry.
Looking forward to this one asever.
As ever, you can claim your CPDfor this episode within the
official Dentists who investSmart Money Members Club.
Smart Money Members Club alsoincludes multiple mini courses
and webinar series on financefor dentists, including how to
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(02:27):
understanding investing.
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(02:48):
verifiable CPD for this episode.
Well, as we were saying in theintro to this podcast, we were
here today to talk about the theI word in verticomas, which is
income.
And we need to normalizetalking about this in dentistry,
I feel, because really, when weknow that we are correctly
(03:13):
remunerated and hitting theright income number, that means
that we don't have to sweat itabout our bills, about all the
things that are going on athome.
We can be your best self atwork.
So we have to talk about it tosome level.
It's not about that, but it isan essential thing, it is an
essential component to ourdentistry.
Dr.
Barry, thoughts on what I'vejust said?
Agree?
Dr Barry (03:32):
I think it's a hundred percent.
Absolutely.
I mean, even for me, when Iowned my practices for like 20
years, um, I didn't have it thefinances dialed in.
I think, you know, my my phraseis it's really hard to cock it
up in dentistry, right?
Most of us earn an okay incomedespite our inability to have
(03:54):
our finger on the pulse of ourfinances.
And so I always had financialstress.
And what I'm finding now isthat, you know, I'm really good
at helping my clients toincrease their gross revenue,
but actually, you know, uhSashir Sashir to me and my
clients is like um a BPE perioprobe is is now that you're
(04:15):
aware that a business hasfinancial periodisease, you
can't ignore it.
And so everything I'm doing nowis bringing Sashir in because
he's the master of plugging theholes in the bucket.
Whilst I'm pouring the water inand helping them to build it
up, he's actually plugging it,which means he's gonna be
responsible for leveragingprofit as opposed to just me
(04:37):
leveraging production.
Dr James (04:39):
Well, well, you know what, just on that, Sashir,
because it'll be interesting tohear your thoughts as well.
I mean, what I've always foundin business is that a lot of
people focus purely onincreasing their turnover, so to
speak, right?
But that only provides you somelevel of comfort if you have no
idea what's actually going onunder the bonnet because you
(05:00):
will be uncertain how much youactually need to hit that
break-even point and to manageall your outgoings and take some
profit out.
And that is also not a niceplace to be at all, and you'll
still be operating out of fearand just trying to earn as much
as possible.
Shishir (05:16):
Yes, James.
Uh, it it reminds me of uh oneof my clients.
Um, I'll tell you a littlestory that a few weeks ago, one
of my clients uh he's like 52and he has some kind of
arthritis problem, and uh and hemessaged me saying, Sissy, can
we postpone our call uh to thenext one?
(05:37):
Uh because I'm gonna have tosee an implant patient.
Because that for me that islike an immediate £3,000 money
coming into my bank account.
But after the call, after uhafter a week, then when we
reschedule a call, I asked him,like, uh, how long do you think
you can keep on going like this?
I mean your body can handlelike this for you know, like you
already have an arthritisproblem.
(05:59):
You see, that's the problembecause with that money that he
would have saved 20% margin ofsomething like that, but he was
never ever ever going to getback the the three hours of his
time that he already investedmaking this treatment back.
So you can get your money back,but you can't get your time
back.
So if you're hung up on theproduction game, you lose
(06:19):
because you don't know what towhat what sort of leverage that
you can have in the business andyou're missing out on.
And that's the issue that mostuh dental practice owners game
that I come across that are sohung up on the production game,
saying, I just want to see theproduction of mine, production
of my associates, and thingslike that.
As long as I'm hitting theprocessing target, I'm there,
(06:40):
but it doesn't really work likethat.
Business is like anintellectual sport, you know,
like you have to play the game,you have to play as win as a
team.
We have team members indifferent areas, you know.
We're talking about football,you're talking about strikers,
you're talking about defenders,all have a job to do, you know,
like and if if you're onlysolely relying on strikers to
(07:01):
just win matches, it doesn'tyes, you may win a match, but
you don't you're not gonna win achampionship, and that's the
problem.
Dr James (07:08):
You know, it always when I hear stuff like that, it
always kind of reminds me, it'slike I can't I don't know the
exact name of this experiment,but I'm sure we've all seen it.
They have these, you know, backin the day when they were
learning about psychology andanimals and things like that,
there was they basically hookedthis rat up to this um electrode
in its brain, right?
(07:29):
Okay, and the electrodestimulated the pleasure center
of its brain, and they give thisrat the butt a button to press,
okay, in its cage, okay?
And the rat would just push thebutton like like ah like this
all day long because it felt sogood for the rat.
And even though the rat feltreally good, okay, the rat
literally eventually just uhdied basically because it it
(07:51):
forgot to eat and drink, okay,because it was having so much
fun in the moment by doing this,right?
Anyway, to relate that back towhat we're talking about, I
think business is a lot likethat sometimes, because
oftentimes there's these thingsthat give us, you know, people
like to make money, right?
We we can say that out loud,that's fine, you know.
It's it gives us a dopamineboost in our brain, right?
(08:12):
And it's like people will chasethat short-term dopamine hit
versus sitting on a zoom andthinking about these things with
yourself uh Sishir, which whichmay not give that immediate
dopamine hit, but it's probablyworth far more to them in the
long run.
And I always try I literallyalways try to visual that to my
visualize that to myself.
Am I chasing the short-termhit, or if I sacrifice that, how
(08:36):
can I make things so muchbetter for myself in the long
term?
And that that that that littleuh I guess visual description
just it it it kind of alwayssticks in my head.
I can't remember where I sawthat, but anyway, we're trying
not to be that person.
Dr Barry (08:48):
We're trying to think about these things strategically
because I think I think Jamesthat something that's in
parallel with that is I think alot of dentists confuse busy
with successful.
Firm is that is that when theyare super busy and they have
long days and they've gotstress, they've got reactive
decisions, constantfirefighting, that doesn't equal
(09:10):
high margin strategic growthand freedom.
And I think we often can get sobusy being busy that we don't
take the time to sit on a zoomand have a conversation and go,
oh, there's another way of doingthis.
So I think that's kind of likethe rap pressing the button is
that they're so busy pushing thebutton that actually they
forget that there are thingsgoing on that they could they
(09:33):
could move some levers andactually have a huge impact.
Dr James (09:37):
There we go.
Exactly, it's exactly analogousto that.
And that allows us to seguevery nicely on in the next part
of this podcast is how the heckdo Dentists actually do what
we're talking about.
And this is great that I haveyou both on the podcast today
because it's kind of two anglesthat we're gonna come this from.
One is, I mean, we have tothink about boosting income to
some level, there has to besomething there to optimize,
(10:00):
right?
And then the second part isokay, what do we actually do?
How can we actually look atwhat we're bringing in
forensically so we can ensurethat we're actually making
profit and we've got a realhandle on our numbers, which is
more Sishir's remit.
Maybe if we start withyourself, Barry, a little bit on
boosting income, what youbelieve is important.
Dr Barry (10:19):
So I I mean, what and I spend five minutes just giving
you some of the high-levelthings that I will look at and
work with with my clients, andthen actually we can get Sashir
to be the guy that startslooking at where the holes in
the bucket are.
Because for me, there's anumber of levers where we're
able to increase production andprofit um without looking at the
(10:43):
spreadsheets.
And then the the next level iswhen you actually really
understand the finances, that'swhen things just take off.
So for me, um often dentistscan undercharge, often
emotionally, fear of rejection,fear of being too expensive,
identity conflict, impostersyndrome, things like that is
(11:05):
that helping them to communicatewith themselves better and with
their patients.
Second one is they don'tcontrol their diary, they have
random scheduling, they have toomany uh exams and recalls, and
they are not looking at thedaily production, they're
looking at again how busy theyare, and so we zone the diaries
(11:27):
beautifully for maximumproduction.
They have poor case acceptance.
I've got clients at the moment,uh, I won't name them because
that would be very unfair.
I have a client who has a twosurgery.
This is gonna shock you, right?
I I have a client that has atwo surgery practice, and I
said, because he has dentally, Iwent, let's just jump on, let's
(11:48):
run a report.
I want to find out about yourrecalls and your outstanding
treatment, treatment that hasbeen diagnosed, presented, and
not accepted.
And I said, let's do it for 24months, right?
Two surgery practice.
What is the treatment that hehas diagnosed, treatment
planned, presented, and has notbeen completed?
How much do you think that is?
(12:09):
Two surgery practice.
A mail private?
Dr James (12:15):
Yeah.
So basically treatment plansthat he hasn't closed, in other
words, in is another way ofsaying it.
Um two hundred thousand.
Shishir (12:30):
I was gonna say something could be like two
hundred eighty-nine likebeautiful around thirty percent.
Are you both sat down?
Dr James (12:41):
Yes, yeah, I'm holding to my chair.
Dr Barry (12:50):
No, how no way.
Look at the two of you, look atthe two of you.
You don't believe me.
Oh, I mean, I could I could gointo that, but hey, what an
amazing opportunity becausethey're doing quite well.
But oh my god.
Two surgery practice, 2.4 mil.
And then I had anotherconversation with another client
of mine, and uh, they were onlyable to get results over the
(13:12):
last 12 months, they couldn'tget anything before, uh, and
they were 489,000.
So this is a big problem,right?
One isolated case, I mean twopoints four is off the scale.
One isolated case is one thing,but actually, there's an awful
lot of this, right?
Poor case acceptance, poorfollow-up, poor follow-up.
I ran a I ran a trainingyesterday on follow-up.
(13:34):
Uh, my daughter, who's nowworking for me, has just put
together a 30-page document onreigniting and bringing patients
back in, how to do that, thelanguage skills, because we've
got team members that that feelawkward about phoning somebody
up about outstanding treatment.
So there's that, you know,there's overheads without
strategic control.
(13:54):
Honestly, most people that owna business avoid leadership,
they're really good at dentists,being dentists, they were
taught how to be technicians.
Um, and so there's a load ofthings, but ultimately no
financial targets, so on and soforth.
So I I could go on about thisforever, but what's recently
come into my life is thisgentleman here who I have
(14:16):
plugged him into my clients, andthe difference that he's making
is phenomenal in theirfinancial education and
understanding, and actually howthat's shifting some of the very
important decisions that we'remaking as businesses.
It's even helping me become amuch better coach.
So I think actually, you know,it it's the stuff that people
(14:38):
like me, I own my practices, butI didn't I didn't have my
finger on the pulse lights asshe does now.
Dr James (14:45):
Interesting, and that yeah, that brings us on to the
second part of thisconversation, which is how can
we master numbers, which issuper duper duper important.
Shishir (14:56):
Uh James, the uh in in terms of mastering the numbers,
and from what I've come acrossworking with dentists uh since
2019, is that uh if they're notactually passionate about this
topic, and this they want toavoid this trend this topic as
much as possible.
And it's it's a bit like uhthink about the moment, like you
(15:17):
know, when we have really uh nomoney in the bank account, we
don't really want to look at itbecause because they could you
don't want to have that kind offeeling, you know, like and it's
the same thing like when youdon't understand in finances, I
don't even want to talk about itbecause that will make me feel
bad, you know.
And and and I think it's thefirst thing that I would say is
that you have to love yourbusiness, you know, to love your
(15:39):
business, you have to love yournumbers, regardless of how bad
how uh how good it is, and youyou wouldn't do it to your
child, would you?
You know, like you know, likeand my son is so bad.
I don't love him, I don't thinkyou would do that.
You know, like why would youneglect your finances, you know,
in your business?
And the first thing is to loveyour numbers, you know.
(15:59):
I would start with that withfirst, you know.
Dr James (16:03):
Yeah, let's do it.
I'm all ears.
Shishir (16:07):
And and and the secondly, secondly, once you
know that you know you you yougot to love your numbers because
this is what I've learned frommy business coach that uh this
is the guy who uh is not anaccountant, but he's a brilliant
um per uh you know in what hedoes.
This is the guy who took abusiness from five hundred five
hundred million dollars to fivebillion dollars in five years'
(16:30):
time.
His name is Sevan Srivasta, anduh and he this is what he said
to me.
CC like the thing is like ifyou don't know your numbers in
business, you lose because youdon't know what to focus on.
It's simple as that, and mecoming into like me as an
accountant and saying, like,yeah, I get it, but you know, my
(16:53):
clients they don't get it.
And this is what you have to toshow them, you know, like show
them, and and so yeah, so notunderstanding mass and the
economic like the the the timingaspect, the logical aspect of
all of this, it just keeps themlike of uh financially
paralyzed.
That's why I called it, andthey're like, should I do this,
should I not do this?
And they're stuck in thisanalysis paralysis for a
(17:14):
prolonged time, and they arestuck, and it's like uh they are
stuck while the competitors aremoving forward much faster, and
they're making decisions basedon data, and they're moving uh
and making good choices in termsof saying this shouldn't be
treatment pricing, or theconversion is not good enough.
This associated performing notperforming well, this is
(17:35):
actually performing well,actually.
Let me reward him so that hedoesn't move away to another
practice.
You see, like small, smalldecisions like this makes a huge
difference.
Imagine that a a good uhassociate like who's really
performing well and he's notbeing rewarded, leaves.
Now you have you go with somuch problem.
You have to find a person, youhave to train the person, it is
so much a headache, and andyou're risking so much.
(17:56):
So, so you can only do thiswhen you have financial clarity
in place, you know.
I call this like clarity breedsfocus.
So we need the financialclarity first.
Dr James (18:09):
Love that, love that.
And where I guess the firstquestion to ask is in your
wisdom, Seshir, we would breakthis down really simply for
Dentists, because I I think Ifeel having been a dentist
clinically myself for manyyears, that I guess the thing
that really gave me analysisparalysis was I just didn't know
(18:31):
where to start.
Like, what is I get that youcan go to like version 10 and
have all these metrics that youcan analyze?
What is what is version one ofthat look like for dentists?
Like they're very basics,they're very, very, very basics.
Shishir (18:44):
Yeah, so I call this like a uh like a level zero to
like level five that that I havefor that.
Dr James (18:50):
Oh, I you've already thought about this.
I love this.
Great.
Shishir (18:53):
So so that you understand, like you know, so
when you when you go into thisuh you know the power BI
reports, like analyticalsoftware tools out there, and
you'll you'll come across thislevel one information, James.
Like it tells you what youraverage daily production is, it
tells you what your average uhyou know profit is per associate
and things like that.
That's great, uh, but you haveto go it's much deeper in in
(19:14):
terms of uh why it's happening,what's happening, you know.
These are the critical thingsthat answers the importance of
uh of of how you actually makegood decisions.
So when you come back to thelevel level zero, we're talking
about the you know uh you'reyou're talking about the what is
the production based on what isa gross profit, which is just
(19:36):
after cost of delivery, and thatneeds to be at a certain
percentage, and anythinganything below 50%, and you
you're risking it that there isnot uh you're you're losing
money on that front.
I I I came across a client uhother day and he was on 30.37
percent gross profit, it's it'spurely 95% private, it's a small
(19:59):
bit of NHS.
And they're like, Paul, you'reon the 30.3 percent, assuming
that the data is right, youknow, like you know, he's right.
We can I can bring you up likeanything like over 45 percent
and imagine that you're doinglike 1.5 million, and think
about that 17 like 12, 13, 14percent gap that you already
(20:22):
have, you have extra profit justby just optimizing a few
things.
Nice, and and so I would saylike the first thing you you
look at is the gross profitmargin because that is the key
driver of the business.
Because uh once the businesscross over 800,000 pounds
production-wise, the most of thefixed expenses that happen in
(20:43):
the business are recouped uh andcan be consumed by uh by this
the turn-up itself.
So anything over that one.
So, what I've seen is that evenyou go to 1.5, you are
relatively spending much less onoverheads, the expenses.
This what you paid just to openthe door, clinical door in the
practice, and you'll have abetter leverage.
(21:06):
So, we'll be looking at grossprofit and the overhead spend on
the on on the production side.
Then we're going to break downall these overheads.
Um, James, we're going to likelevel two kind of territory, and
and uh, but I'll be looking atfor the first thing like it is
like a biking x-ray.
I'm just looking at saying,okay, what is the production,
how many chairs, and uh how whatis gross profit with the net
(21:28):
profit margin.
At this level, they should beon this level.
So I know instantly thatthere's some some like the holes
in dental practice, just likeholes in teeth.
Yeah.
Dr James (21:39):
Boom.
I see what you did there.
I see what you did there, butyeah, 100%.
Okay, cool.
And maybe hey, to take thatanalogy one step further, it's
like maybe things can lookclinically fine, but you take
the x-ray, the radiograph, andthey don't look radiographically
fine, yeah.
When you do your special testsor your your further
investigations, and um yeah, Ijust coined that right then, but
I think it works.
Dr Barry (22:00):
That's where the BPE comes in, mate.
Is this kind of listen?
Dr James (22:04):
You guys can use that one if you want, because I I I I
think that would work quitewell.
There you go.
Anyway, okay, cool.
So that those are I guess whatwe want is the yeah, the
absolute basic.
So you think that's the bestplace to start for Dentists this
year?
Shishir (22:18):
Yes, and you start with the PL.
But here's the problem, James.
You know, like uh most dentalpractice owners, they're just
stuck in this profit loss game.
This look at uh they just lookat production and just look at
in profit loss in zero, and thisis where this is where they
actually um uh they finish thejourney and look at all my
business is profitable, but itdoesn't tell you the whole story
(22:42):
of your business.
Uh because it's it's it's a bitlike uh uh it's a bit like you
know, you need healthy teeth,you need healthy gums, you also
need a healthy level of bonelevels, right?
Then then only the oral healthis fine.
So uh in in in a dentalcontext, in terms of finances,
(23:02):
your teeth are your uh teeth areyour profit and loss, because
that's what is making the money,and and your cash flow is like
your gums, because that actuallyholds the teeth, uh, you know,
hold the business.
Because you pay by cash, youdon't pay by profit, you know,
like you know, and then yourbone level is like a balance
sheet.
You that everything is wholethere.
And here's the big problem,James.
(23:23):
That I say, you have you heardof this phrase like in in
marketing, like uh you know, youcan even hide a dead body in in
the second place of Googlebecause hardly anyone goes
there.
Have you heard of that?
Dr James (23:36):
Uh I haven't, but yeah, I I I hear you.
Shishir (23:40):
So I can say the same thing to dentists, I can even
Hide a dead board even dentistbalance sheet because no one
goes there.
Or how do you anyone goesthere?
Dr James (23:47):
Fair enough.
Yeah, that is true.
Yeah.
Shishir (23:50):
Because the the most important part of the finances
are held in the balance sheet,not in profit loss.
Because the the most importantcomponent of profit loss, which
is the profit made in thatcurrent year, is already the
part of the balance sheet.
And the balance sheet is simplypart of what you own and what
you owe.
And if if what you owe is ismuch higher, then you have a
(24:12):
problem.
But if you're not seeing that,then you don't know.
And then then you come to like,okay, I have 10,000 pounds in
the bank account, I owe thetaxman 20,000.
Um I have a problem.
Yes, my business is profitable,but it's not liquid yet.
So you have to look at fromthis angle as well.
(24:34):
So these are like level onekind of thing I look at.
Like I do something calledbalance sheet stress test.
You know, like if we were tohave no income, say for the next
two weeks, like how long canyou pay your bills?
Because you have to pay for thematerials, you have to pay for
lap, you have to be associates,yeah.
Your subscription is going on.
Maybe you have to be also EMIand for loan uh higher purse,
(24:55):
things like that, you know.
It's called a stress test, andyeah.
Dr James (24:59):
And you know, the tax one, just to home in on that,
that's a really common one fordentists, right?
And that applies to bothassociates and principals, and
it's like people just put away acertain percentage every year
because they'll they'll want tosave, but they don't know
exactly how much they owe,right?
(25:19):
And I actually have thisproblem a lot, right?
Where um I put away money forVAT and I put away money for
corporation tax, right?
And I actually find myself in aplace where I'm usually
oversaved way more than I need,right?
And that sounds good.
It's like, oh, you get thislittle bonus, right?
But actually that's a bad thingas well, because that cash
(25:40):
could have been doing otherthings for you, you know, like
you that could have been cashthat you could have invested in
something, and it's I see I seeliquid cash in your bank account
beyond a certain level.
Um, beyond a certain level,obviously you need your six
months uh emergency fund andmaybe a few months of turnover
in the business or however youwant to do it.
There's different ways of doingit in your company, uh, just as
(26:01):
a cushion, okay?
But after that, it's literallyjust wasted potential, like it
could be doing something for youbusiness-wise, or it could be
invested in an asset that'sgoing to appreciate with time.
But anyway, so what you'resaying is how can dentists get
better at that?
Like, how can they have somesort of met what what are the
methods that dentists can use toestimate how much tax they owe
(26:23):
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of this podcast.
Shishir (29:31):
And then the next phase is if you want to have a really
good driving experience, thenyou look as further as possible.
Why?
Because you can spot thehazards and uh hazards uh, you
know, any potential problems upfront in the in the same way the
controlling having this cashflow is in the same way.
First, you learn how to manageyour your what's in and what's
(29:53):
out, or in like what should bein, what should be out, how much
should be in, how much so youhave a control on your
receivables and on yourcollection wise, and you also
have a control on the payables.
You'll see that in you when yousee the supply invoices in
zero, like you'll see that.
So you know that.
Then you able to analyze theinformation of cash flow, like
(30:13):
uh you know, on and I go throughlike a four-step process on
this one.
I call it the tips technique.
Like we look at we are lookingfor trends, we are looking for
irregular activities here, andwe are looking for uh we're
looking for patterns and we'relooking for spikes.
So I call this the tipstechnique.
That the first things that wedo this and we're starting to
analyze the cash flow, like um,and then we look for projection.
(30:37):
So, because it's just like thefurther you look ahead while
you're driving, that uh you knowyou can do uh you can plan for
whether you want to change theuh the the the lane or not.
So you if you can plan for yourcash flow, uh then you'll have
a better control on your cashflow.
And here's the thing here'swhat I believe like when you
have control in your cash flow,you'll have control in your
(31:01):
business, period.
Because um from what I can see,like uh from most uh dental
business owners, they feel liketheir business is controlling
them rather than theircontrolling the business.
They're forcing to make uhsometimes I come across a
dentist saying, Oh, sorry,Cecil, I even had to skip my
(31:21):
lunch uh just to uh just to fitin, you know, like I'm trying to
do different things.
So you want to have a controlin your cash flow so that you
can have a control in yourbusiness.
Dr James (31:33):
Nice, and then that leads on to the taxing as well.
So it kind of comes back tocash flow.
Have I got that right?
Shishir (31:38):
Yeah, so so then uh then the uh then like when you
can project your future cashflow, uh uh what cash person
that you will be on, and if youdon't have uh cash to to pay the
tax, and maybe you need uh somekind of you know tax loan in
place, or maybe uh maybe you cangenerate enough cash flow to
pay on time, but it's all it'sall down to numbers, you know.
(32:00):
But you can act much faster,and you can make a decision
based on that.
Dr James (32:09):
I hear you, so it it really all comes what you're
saying is that these common painpoints that Dentists have, will
I have enough money, which isliterally the title of this
podcast, right?
Or well, it's another way toparaphrase it, um, or the the
whole tax thing, will I haveenough, won't I have enough as
(32:30):
well?
It basically comes back tobeing able to understand cash
flow and understand youroutgoings, it's all a
permutation of that.
Is that fair to say?
Shishir (32:42):
Yes, and that's uh that's a big chunk of that, uh
part of that is yes, and and uhand I I like the fact that well
when you uh when you said Jamesthat you know if you're setting
aside say 30%, uh 35% like thatin terms of paying taxes in like
a tax port and like uh like do.
And uh uh you correctly tomention that you know that money
(33:07):
is like park, that means I'mnot able to use that right now.
So like today is like 20th ofFebruary 2026.
Uh as a self-assessment, youwould pay the next instalment on
31st of July and the followingone on the 31st of Jan.
So you might have a limitedcompany saying a 31st of March,
so you might have paid yourcorporation tax at the end of
(33:28):
December 2025 for the previousyear.
So when you know these dates,how uh when it is due, so and
and so what I come across likeuh a smart dental practice
owners, they're saving money topay as a taxpayer.
Uh but uh but we both agreethat actually the cash in the
business is the resource, it isthe fuel in the business.
(33:52):
So you want to invest in now,not park it to be paid on 31st
of July.
Yes, but you just need to knowunderstand like how much you
need to pay.
You don't have to pay today'smoney, like you know, I don't
you don't have to pay like withtoday's money to say you tax me
30,000 pounds, so you so you yousave 30,000 pounds is parked
(34:12):
there.
You don't have to save it nowto pay uh on 31st of July.
You can pay the money that youhave on 30 30th of July, 30,000
pounds you can pay on the 31stof July.
But you have utilized, you haveused, you have used the
resources, money is the is theenergy, is the fuel in the
business for 30,000 pounds indifferent marketing campaigns,
something now you're generatingextra income from this extra
(34:35):
income.
You're utilizing that one topay on 31st of July.
So we so but you can only dothat when you have a clear,
accurate financial visibility ofyour finances.
Dr James (34:45):
Nice, and once upon a time, we used to just this was
all written uh down, right?
But I believe now things haveevolved in 2026 in that we have
software solutions that canhandle this as well.
Shishir (35:01):
Yes, so um so here's uh you know, like because uh
because mostly I've been workingas a CFO over for different
businesses, and and uh and by uhlike uh like mid 2023, James,
that I came across like so manyuh like financial planning and
automation, not automation, uh,analysis software like data
(35:24):
roles and things like that.
Uh, they are just usingMicrosoft Powered BI reports uh
like that to create this uhdashboards and things like that.
Uh, but what I found is uhdentists they are like a
different beast on its ownbecause this NSS contract, this
and some SSC working two days aweek, uh but they plan to work
three days a week, they're doingextra hours.
(35:45):
There's a lot of complicated uhbring around this ones, so uh
so so they needed a uh acustomized software solution
just for them only.
So, so so yeah, so we we builda financial software um when we
call and uh it's called dentals,and uh uh it's it's purely
about uh improving finances inthe business, and we find uh the
(36:09):
hidden gaps in the in thebusiness, and and first we
ensure the accuracy of data, andthen then we help them with the
cash flow, profitability, um,and taxes, financing the
business.
These are the areas that wethat we cover, we cover.
Dr James (36:25):
Excellent.
And you know what?
It sounds good that it's takenuntil 2026 to someone for
someone to uh create somethinglike that.
Um if I'm honest with you,because it sounds like it's just
so obvious that this might beneeded uh for dentists and
dental.
Dr Barry (36:41):
Is it worth touching upon?
Can I can I jump in and say, isit worth touching upon this
this idea that there are thingsthat are already out there that
we're assuming work the same,but they're not, because they're
AI based?
So Shea, would you be able tojust share what you told me
about the difference betweenwhat is out there in terms of AI
(37:02):
and actually what Dem Pulsedoes?
Because it's significantlydifferent, right?
Shishir (37:07):
Yeah, um the the the main issue here is the uh the
accuracy of data because uh uhwhen when I when I started first
developing this, Barry, uhthree and a half years ago, I
started creating with the powerBI reports, just like what we
have with current seeing in themarket.
Uh it just gets the data fromdifferent sources, then it gets
(37:29):
passed on to AI to clean thedata and present with it and
present with the with thedashboard.
But Barry and I were like wewe've seen that with with our
own clients there the the sourceof accounting data is wrong in
the first place.
So when you you so you cannotyou can automate, but you you're
(37:50):
automating the wronginformation, wrong data in the
first place, you know, like thisthis is what the problem is.
So we uh so uh in this in asense I call this financial data
integrity.
And and it it's uh if the dataintegrity is is not there, then
the decisions are based, uh itdoesn't it's not really
(38:11):
meaningful.
If you still have to havesomeone to make it uh you know
manual process to make adecision, then it's not much of
a value, you know.
As opposed to if you'reautomating decisions, then
that's great, as opposed toautomating data.
And and and uh and and alsowhat we do is just like uh
(38:35):
James, we're talking about thisbalance sheet being you know,
putting the dead body in thethat no one goes there, and uh
what the software does is itgoes through the balance sheet
and looks at the whole picture,like you know, you're not only
doing a bite-wing x-ray, you'reyou're doing a fully city scan
you know of your mouth, and anduh you're going to every single
aspect of your profit lossbalance sheet cash flow and
(38:55):
figuring out where the gaps areand what you need to do as an
individual owner, and that'smore that's more holistic
approach, you know.
And and that's what's neededrather than just saying, Well, I
fixed my teeth, but uh and I uhmy my my but my gums are not
healthy, and that that's notthat's not uh that's not where
we want to be as a patient, youknow.
Dr James (39:17):
Sure.
Or another way of saying it isthe sign or symptom of the
disease, if you will, is thatyou feel like you don't have
enough money or you feel likeyou don't have enough to pay the
tax man, but the actualtreatment is to understand your
cash flow and how that works, sothat you can make decisions
that will allow you to not havethose problems uh based off the
(39:40):
back of clear data.
I think that's a basicallyanother way of saying it.
So it's kind of like dentistsknow when the patient comes to
us with toothache and wediagnose what's going on, right?
A lot of the time we havefinancial pain, I guess you
could say, or financialfinancial signs of financial
disease, if you will, in thatthere are uh symptoms that we
(40:01):
would observe that we don't haveenough money, right?
And this is literally thetreatment, you know, is the
remedy.
You go just like you go to adentist uh to sort your teeth
problems and to diagnose whatthose issues are, you j you
might go to someone likeyourself, uh Sisher or Barry uh
to diagnose the exact cause ofthese issues that people are
having.
And uh, as you were saying asecond ago, it sounds like the
(40:23):
very first stage in that remedyevery single time is the cash
flow side of things, and it'sinteresting that you should
mention what solutions exist outthere these days are are brand
new, and obviously that's partof what you do as well.
Sishair, is it fair to say thatto start off that uh treatment
process that you'd be able tooffer some sort of checkup, I
guess, if you will, or adiagnostic appointment, like an
(40:45):
examination when someone goes tothe dentist?
Is that is that how that beginsusually?
Shishir (40:50):
Yeah, so I I just send them like a two-minute uh of uh
of a diagnostic uh test in termsof where they are in the in the
business journey and in thewhat the problems are, and I I
give them like uh his what'syour wealth score and um wealth
score wealth score.
Um because the the whole ideaof uh setting up a business is
that they want to build apersonal financial wealth that
(41:13):
lasting, and uh uh if they arejust focusing on profit only, uh
um only, and then you'remissing out on huge opportunity,
but not by looking at cashflow, by not looking at the
balance sheet as a holisticapproach.
Uh so so yeah, a two-minute umyou know, questionnaire would
would actually reveal so muchabout them, you know.
Dr James (41:35):
Nice, okay, brilliant.
And how can someone get thatquestionnaire that we talked
about just a second ago?
Shishir (41:40):
Yeah, so I can I can provide you the link and you can
uh you can share that with the.
Dr James (41:45):
Yeah, let's put it in the podcast description.
That's a great idea.
That's actually a really goodidea.
Dr Barry (41:49):
Again, can I uh just jump onto this for a little bit?
Is that um I think you know I Ijokingly said that uh Shashia
is is to my clients what uh aBPE in a period probe was to
dentistry uh 20 years ago.
Uh which is you know, patientswould would walk in and uh even
(42:12):
the dentist would say, Oh,you've got a little bit of
bleeding, and nobody reallyacknowledged that it could be
quite serious disease.
And I think that's the samewith the finances, is that oh,
you've got a bit of stress aboutyour your tax, or you've got a
little bit of a cash flowproblem.
And because it's so common,because we've always had it, no
(42:34):
one's really going, well, hangon a minute, let's just take a
look and see what's the bonesupport like?
What's your balance sheet like?
What's really going on here?
Is this something that you'regonna end up in the in the deep
doo-doo?
Or is this something that youwould just come out of?
So, yes, there's the two minutereport, but I think because
(42:54):
there's so much in the financialside of dentistry where we
don't know what we don't know.
One of the things that we'redoing together, Sasha and I, is
regular live workshops where wetake people on a three-hour
journey of discovery, right?
It's like 29 quid.
The i the idea is that it's notabout making an income from it,
(43:16):
it's about making people awareof what they don't know, and
then if they're interested tofind out, we can share with them
what Dempulse does, what Sashirdoes.
If they're interested in mead,they can be.
But actually, it is giving thema true diagnostic at a very
little cost.
You know, that they for thatdiagnostic, they'd be charging
69-89 quid for a patient.
(43:38):
They're gonna pay 29 quid tocome and find out where they
are, so that then they can atleast not be burying their heads
and choose to do somethingabout it.
It's kind of like telling apatient, look, we've got BPEs of
threes and fours, we need to doan ordinance survey map mapping
out what's going on.
It's then your choice as towhether you treat that
(43:59):
periodisease, but at least nowyou are aware what's going on,
which means you can't go, nobodyever told me.
Because that's what's happenedwith the majority of our
clients, is with theiraccountants.
No one's ever told them whatreally is going on underneath
the financial covers.
They just know that the stress,they've got a bit of bleeding,
they've got some stress, they'vegot some sensitivity, but
(44:21):
actually they don't really knowhow bad it is or how actually
quite good it is.
We just need to tweak a fewlevers and everything would be
okay.
So that's that's our aim overthe next few months is to
provide more of these clinics sopeople can come and find out
what's going on.
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