April 27, 2023 • 40 mins
Introduction:
In this episode, we welcome Dr. Brady Frank, a dentist, author, and co-founder of Freedom Dental Partners. Dr. Frank is passionate about elevating the financial positions of not only dentists but also hygienists, office managers, and assistants in the dental industry. He teaches unique ownership structures and strategies to help staff members own shares of their privately held companies and achieve financial freedom.
Main Segment:
Dr. Frank shares the history and benefits of DSOs or dental service organizations. He emphasizes that DSOs allow dentists to make more money and have more control over their partnership terms with private equity. Dr. Frank believes that hourly pay in a dental practice is an antiquated model, and aligning the whole team's incentives behind the business goals is crucial. He discusses how he and his team fix up DSOs to enable clinical freedom, lifestyle freedom, and financial freedom. Dr. Frank explains how he helps staff members become owners of the companies they work for through unique ownership structures and shares practical tips on finding deals on practices to buy as a hygienist. He also shares information on his books, DDSO Strategies, and the Become The DSO Seminar.
Conclusion:
Dr. Frank's work is revolutionizing the dental industry by allowing staff members to elevate their financial positions and have a stake in the companies they work for. Dental service organizations provide a path to clinical freedom, lifestyle freedom, and financial freedom for dentists and staff members alike. Visit drbradyfrank.com and becomethedso.com for more resources and information on DSOs and unique ownership structures in the dental industry.
Resources, discount codes, and links to connect with Dr. Brady are at: www.rootuon.com
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:05):
Welcome to the Dental Elements podcast.
I am your host today,
Cindy Rogers.
I'm a hygienist and a compliance consultant who works with a team environment in this episode.
I sit down with Dr Brady Frank,
who is a dentist author and co-founder of Freedom.
Dental partners.
Talks about his passion for elevating the financial positions of not only dentists but also hygienists,
(00:29):
office managers and assistants in the industry.
He talks about unique ownership structures and strategies to help staff members own shares of their privately held companies and achieve financial freedom.
He also shares practical tips on finding deals on practices to buy as a hygienist.
So lots of different things to unpack in this episode and I love his energy,
(00:50):
super fun interview.
So I hope you enjoy it.
Ok,
here's Doctor Brady Frank.
Hey,
Cindy.
Thank you so much for having me.
So excited to be here.
Wow,
exciting.
Your podcast has grown like wildfires.
So,
congratulations to you.
Oh,
thank you.
Yeah,
it's great to have you on here as well.
So,
yeah,
we're really excited to see the growth and the fun everybody's having and to have you as a guest today.
(01:13):
So,
thank you?
Awesome.
Well,
since you're a hygienist,
you've got hygienists on your assistance.
A lot of dentists and I thought it'd be really fun to talk about how it's not just dentists who are elevating their financial status with all this money pouring into the dentistry,
but its hygienists,
it's office managers,
(01:33):
it's assistants and it might be fun to kinda certainly talk about what,
what I'm doing over at freedom partners.
But really talk about,
you know,
this new era of dental staff elevating their,
their finances and really going to the top of their positions because so much more is available now than say,
(01:56):
40 years ago.
Right.
So,
I think it'd be great to chat about.
And,
uh,
what percentages have you seen in the past on your podcast?
Hi,
Genist assistants,
dentists.
You know,
a lot of dentists,
a lot,
a lot of hygienists,
a lot of assistants,
everybody,
a little bit of everybody.
To be honest,
I'm not sure exactly who's who because like I said,
I'm all team oriented.
(02:17):
So I agree with you.
Everybody can elevate and the more people elevate,
the more people elevate,
we elevate each other,
elevate by ourselves.
Yeah,
I might kind of give you the background.
Like you've asked,
how did freedom partners start?
You know,
what's my history and how do all the providers fit into that?
And it really starts back in,
(02:38):
believe it or not.
1999.
I was a,
I don't know,
I was a junior in dental school.
I had a wrist injury and the wrist surgeon said you might not want to choose dentistry as a career in dental school in dental school.
Oh,
my goodness.
I was already a dental school debt and I was past the proverbial point of no return.
(03:01):
I already spent a lot already two years in a dental school.
So I realized I might have to learn how to make money in dentistry without the ability to practice.
So you have all this knowledge from school,
you wanna use it,
right.
Yeah,
you want to use it.
And traditionally,
you know,
my grandpa and my uncle were dentists and you know,
they made money with their two hands doing crowns,
(03:24):
right?
And hygienists make their money,
scaling root planning and doing that.
And assistants are actively assisting,
but few dental providers think about what would happen if I was disabled.
What if I got in a car wreck?
What if I couldn't physically do this stuff?
Where does that leave us with our actual training?
And the answer oftentimes is,
(03:47):
is nowhere.
And so I realized I needed to study the business side of dentistry in 1999.
After getting that news,
I went to the Marquette dental school library.
I studied dental transition books and I ended up making the decision as a junior in dental school that I would to protect myself because I knew at any time fusing my carpal bones together would mean it would make it tougher impossible to practice dentistry.
(04:13):
So I bought two practices.
Uh right out of dental school,
ended up buying five more,
had 28 different associates over a seven year period.
And I realized that yes,
I loved clinical dentistry,
but I also loved the business aspect of dentistry.
And that propelled me on to helping other dentists buy practices,
(04:36):
create groups.
And then as private equity really got deep into dentistry,
I started helping Ds Os expand,
create partner models where assistants,
hygienists and dentists could actually own part of the company because in a DS O structure,
you know,
there's the business assets and the clinical assets and the business assets are what are recapitalized by private equity.
(05:03):
So a lot of differing staff persons in the field of dentistry ended up doing very well,
getting shares of these privately held companies.
And so I ended up helping several dozen Ds Os create unique ownership structures that included staff and hygienists much of the time.
And uh ended up,
(05:23):
you know,
realizing that some of these Ds Os were really good players,
some of them didn't have the clinicians best interests in mind.
So I started supporting just the Ds Os that gave autonomy both from a business aspect and a clinical aspect to the providers.
And from there,
I ended up creating an organization that supported those what we call autonomous Ds Os versus the other type of Ds O that I talk about,
(05:53):
which is a corporate DS O corporate DS O is where they kind of put their brand on your door.
You do what they tell you right?
And you kind of have golden handcuffs.
Whereas an autonomous DS O is where you partner with this big money that's in dentistry,
but there's an autonomous line above it is private equity below it is yourself your pre practice.
(06:17):
So you continue to run your team as you run it,
have your staffing structure as you'd have it,
do your clinical dentistry as you would do it and maintain full autonomy.
So freedom,
dental partners works with a variety of DS OS out there that are autonomous DS OS.
And then we also have our own DS O inside of freedom.
(06:39):
Dental partners that really focuses on practices that in many cases are unwanted by the other Ds OS because we've got a team uh that includes a lot of hygienists that fixes them up,
elevates them,
brings them them to that next level so that they can now,
you know,
not just enjoy kind of the the benefits of in,
(07:01):
you know,
clinical dentistry or clinical hygiene or even the assisting side.
But that can bring them to what I call total dental freedom,
you know,
clinical freedom,
doing the procedures you love in the practice,
lifestyle,
freedom,
you know,
geographically,
being able to have a vacation home if you want or live where you want to and those two are fueled by financial freedom.
(07:26):
So,
the three of those being total dental freedom.
So that's where we're at right now.
And it's,
uh,
exciting to chat with you about some of this stuff.
Yeah.
So,
T D F total dental freedom.
I love it.
Yeah,
I got in dentistry in 1998 but I kind of did the opposite issue.
I got into the business side,
you know,
started in the front office and then decided to go to hygiene school.
(07:47):
And then I learned the clinical side and I always love the business side.
So it's great to have both to have that knowledge behind you.
Makes a huge difference.
Even if you're doing the business side without the clinical knowing that stuff really makes a difference.
I was like,
why do you have to learn about history in school?
But now I see why just the background makes a huge difference.
So that's great.
I mean,
it all worked out for you and if you can't use your hands,
you can use your hand,
right?
(08:07):
That was the point back then.
And,
and I'll tell you what it was interesting because in the early two thousands,
you know,
when you get out of school,
you really are not that great clinically.
You think you are,
you think you're awesome,
right?
And then when you own a business for the first time and I didn't have a business background,
you think,
you know what you're doing,
but you really don't.
(08:28):
And both clinically and business wise,
I think a lot of folks,
including myself fell on their faces and I fell on my face a lot.
And so the term failing forward,
I think for those of you listening that are worried about getting into more of the business side or elevating yourself financially.
You know,
my best advice would be to take action.
(08:49):
It's the action takers that do really well and you have to be ok with failing a little bit right before you kind of get into that groove and find where your place is.
Like learning to walk.
Nobody learns to walk without hauling if you do.
That's just weird.
There's something else going on,
you know,
so tell us about freedom,
dental partners and how's that possible to have autonomy but still be part of A Ds O I mean,
(09:13):
that sounds like having the best of both worlds and some people do would like just hand everything over and that's great and some people want to have autonomy and how,
how do you make that possible?
Yeah.
So I'll give you a little mini history of Ds Os.
There were eight Ds Os that started in the early nineties and only a couple of those actually gave autonomy and those were the ones that were big money partnered with actual dentists.
(09:39):
And there was one high dentist in there as well.
Six out of the eight Ds Os in the nineties bankrupted in the late nineties.
And those six were corporate Ds OS where the providers weren't tied to kind of the financial benefit of conglomerating this business.
(10:00):
And so those two that survived,
and I'll be able to give more details if I don't give names,
if I give the names of these Ds Os,
since I know the inside of them,
I can't really go that detail.
So I'm not gonna give Ds O names because then I can go real deep.
So the two of the eight that survived,
um they ended up becoming over $1 billion Ds Os and they were autonomous.
(10:26):
And what they found was this initially,
they thought that having a corporate DS O structure versus an autonomous DS O structure would allow us to have more control of the doctor,
more control of the staff,
more control of the fees,
more control of the systems,
more control of the patients,
more control of the,
(10:46):
the vendors.
And they figured from a business standpoint,
you know,
intuitively,
that's got to be better because we get to control it.
Well,
they found that there's a key word that they really didn't understand at that time and that was alignment and especially financial alignment.
And what,
what that simply meant was that if it was good for the private equity company or is good for the private equity company,
(11:13):
it's gotta be good for the provider as well,
both financially and clinically So,
what they did is they looked back on the two Ds Os that survived out of the initial eight Ds Os that were big ones in the nineties.
They found that when the providers were tied to the financial rewards of that business and they let the clinicians do what they did best,
(11:37):
right,
that the clinicians and their teams were able to elevate those practices financially and it wasn't the big smart Wall Street folks that were able to grow it.
So the autonomous Ds Os now are winning big time.
And so I believe in our profession in dentistry.
(11:57):
It's not a question of will Ds Os win at the end of the day or not.
Everyone believes that dentistry is having big money come in and there's no stopping that.
I believe the battle is this.
Do we become like medicine corporatized with a corporate MS O right now,
all of medicine is corporate MS Os.
(12:19):
They never got the chance to fight the battle and have autonomous MS Os.
You can see it with the insurance companies,
CNA Blue Cross Blue Shield,
they have golden handcuffs,
these physicians.
And right now,
if we can win the battle of autonomous DS O versus corporate DS O,
then we as providers can run our practices like we want to run them,
(12:41):
we can be tied to the financial gains as we are conglomerated as an industry.
And then at the end of the day,
once we do become conglomerated because I think we all understand that that is gonna be a fact.
Well,
at least let's be conglomerated with us providers making our fair share of the tens of billions of dollars that are pouring into dentistry and let us providers continue to have freedom in our practices and freedom equals autonomy.
(13:13):
If we can have autonomy with our patient basis,
with who we add as partners uh to the business,
even hygiene partners,
assistant partners,
managers,
that can be partners at that level because we can do that as opposed to the old PC models do that,
I think is the battle.
We're,
we're fighting,
you know,
the,
the autonomy versus the corporate uh structure in the DS L market today.
(13:37):
Yeah.
And so it's like giving the actual provider and the,
the people doing the work,
the team,
the money instead of the insurance company.
Really.
Let's be honest,
they control everything.
That's,
yeah,
that's the biggest DS L corporate thing ever.
So that's another topic that we need to address at some point.
Yeah.
So I think that's great.
When did freedom?
(13:57):
Demo partners start?
And how did that get going?
And you saw a need for wanting to have Ds Os health practices out with services.
And what do you provide?
And what's all involved in that?
I uh operated something called the D DS O Alliance.
Dennis Own Ds O Alliance wrote a couple of books here and all D D O strategies and talking about thriving in dentistry's new economy.
(14:23):
And through that alliance,
a lot of the dentists were selling to Ds Os and I was helping them themselves and they would tell me what they liked and what they didn't like about their partnership with private equity through A DS O and a lot of them were getting pretty good values.
Right,
better values than if they sold to a dentist.
(14:46):
But what we found is they could reap back a lot more on their sales if they clump together and sell as groups to these private equity firms.
So that's when I started putting groups together to go to my market.
And the dentists would get a lot more like many millions more in many cases.
(15:07):
And beyond that,
they didn't just get higher valuations,
higher sale prices,
they actually got to control their terms better.
So they get,
it was almost like a union.
You get a few people together and you're gonna get better terms.
And so ended up doing that um in small scale,
then we started doing it in larger scale.
(15:27):
So now we have hundreds of dentists banding together to get better pricing and better terms for their unique partnership with private equity when it becomes time for them,
whether they're in their thirties or seventies and it's different for everybody.
So that's kind of where it started uh myself just helping smaller groups end up uh finding their ideal transition strategy to kind of match groups up or dentists or practice up together and have kind of joined forces.
(15:58):
Kind of like we do a lot of collaborations and join forces and you kind of sell them or you have people invest in them and so that helps keep them going,
gives them resources without all the extra stress to keep their businesses going and then they give some a percentage to the,
the DS O or the manager.
(16:18):
Yeah.
So the way it typically works is to create this alignment.
What happens is this dentist who typically has some debt,
wants to aid,
get rid of all their debt,
both business and personal and then be left with maybe two or $3 million in their retirement account and then have this upside,
(16:40):
this business benefit as from being part of a bigger group that is funded or capitalized by one of these big private equity groups.
And so the dentist typically will partner with private equity on their practice or through A DS O and they,
they on average,
get 70% in cash and 30% in stock in the whole and a lot of this big company with all these general practices.
(17:06):
So what happens is they get a lot more money upfront than they would selling through any other resource,
they get rid of all their debts.
And now they have the ability to be part of a growing company that would eventually be recapitalized again by another private equity company,
but now they're doing it on someone else's dime and that's private equity dime.
(17:28):
So they're not having to take on new debt to expand.
They're not having to pay,
you know,
big sign on bonuses for staff and,
you know,
they get,
of course discounts on supplies.
Lab,
better insurance,
reimbursement.
Yeah.
More enterprise pricing.
And that makes sense to me because talk with a lot of innova innovators and entrepreneurs and a lot of people do like any startups,
(17:52):
they do get private equity money or investments.
And so for,
for one dentist to have to do it all by himself.
You know,
that's a lot to,
besides doing clinically like the business and just holding so much on your back and the team and the responsibility and the only money you have been coming in for some of these people are what the insurance company trickle,
you know,
give you a few pennies here and there and that is a lot to hold for one person.
(18:16):
So,
having that option,
that freedom,
you know,
it is really great for a lot of people I would think.
Yeah,
it,
it isn't for some dentists.
I mean,
they say the majority of dentists,
you know,
don't love the business side.
They love the clinical.
And so this super funds,
the retirement lets them still have full control of their team,
(18:36):
their patient base and they have that kind of weight lifted off their shoulders of the financial side and it can be a lot more fun working in collaboration,
like you said,
with a team of others who have the same goal that are aligned.
And you know,
the ad a had a survey,
it showed that it's almost the majority of dentists are depressed.
(18:58):
Well,
they found that in large part and I think this might hit hygiene as well.
We're in that single room treatment room with one patient,
not a lot of collaboration and it can be very tedious work,
both hygiene and dental.
And you know,
when groups get together,
when dentists get together,
when teams get together,
the collaboration,
(19:20):
you know,
is a lot more of a team environment.
And really,
I found staves off any depression that one might be uh at,
at risk of,
yeah,
the hygienist,
you missed out a lot on that because it's kind of like you're being whipped to get back to work because you're producing and you're costing so much money.
If you talking,
if you're saying hi to any of your team members or if you're even taking a lunch or for a bit and break and then you just feel like you're the enemy,
(19:43):
you know,
and so it is really lonely.
It can't be depressing and only,
you know,
you get to talk to your patients if you're lucky to have enough time.
Some,
some places.
But,
and,
and so a dentist as well and then if you do have a second,
you have to go do the business side and if you're lucky enough to enjoy the business and be good at it and you can balance both of that fantastic.
But that,
I mean,
that has to be rare and to be happy and to have a family.
(20:08):
Guess what I saw today.
A squeezed pee.
That's right.
A squeeze.
Pee.
Do you know what a squeeze pee is?
Well,
if you don't,
I'm gonna tell you a squeeze pee is a pea pod.
So it's a pea pod and there's three little peas in the pod and one of them has a key level smiley face on them.
And what you can do is give these to your patients if they're anxious or nervous or perhaps if you want one yourself and you just squeeze the little pods until you pop the peas out.
(20:33):
Kind of like a,
you know,
you can pop a little peas out anyway.
Super cute little green peas and one of them has a cute little smile,
smiley face on them.
So yes.
Squeeze peas.
I know you want one.
I know you want to squeeze one.
I know I do.
I'm gonna get me one.
So check out Smile Makers dot com and use code D A P 20 to get yourself some squeezed peas,
(20:53):
D A P 20 for 20% off of any order.
It doesn't have to be squeezed peas.
Just go to Smile Makers dot com.
Cheers.
And to speak a little bit about the hygiene component of a lot of these groups that we put together through freedom.
You know,
a lot of hygienists because of the shortage of hygiene have asked for higher hourly rates and a lot of them feel comfortable with their hourly rate.
(21:20):
But the reality is many of these models throughout the freedom system relate to the profitability of the business,
which can be a lot higher than the hourly rate.
And so really a lot of the new hygiene models out there relate to that hygienist productivity and the soft tissue program,
(21:40):
not just an hourly rate.
And if I were a hygienist,
I would prefer to,
you know,
have business profits from my sector that I'm working in.
Not just an hourly rate.
Yes.
And you're gonna do better and you're gonna work harder and you're gonna be happy about it.
I,
I just worked for commission for the first time at my last position.
It was so much better before I'd be like,
(22:01):
oh my gosh,
I gotta do a full mouth and,
you know,
I can't want the assistant deal.
They're not doing anything.
And now I'm like,
no,
don't help me.
I got it like I can do this in 10 minutes.
It totally changes your perspective because you're getting paid for it.
It makes it so much better.
And then the assistants are happier.
The front office is happier because you want patients to come in instead of hoping your patients don't show up because you still get paid whatever hour you want them to show up.
(22:22):
So energy in the practice changes because you want your patients to come in.
You're not given that everybody's like,
oh,
please don't come in.
You know,
I just need a break and I get,
you know,
you get paid no matter what,
sometimes you want them to come in and it just changes the whole perspective for everybody.
Well,
and think about this,
I,
I I think hourly pay rate related to both dental assistant management hygiene is antiquated.
(22:51):
Uh you know,
all the models to pay dentists are all based on a percentage that relates to the,
to the business.
And um it not only influences the revenue to the provider,
whether it be a hygienist or,
or whoever,
but it also influences patient care because they have shown in multiple studies that business owners care more about the customer than someone who's hired to manage someone else's business because they care about that experience of the customer or experience of the patient.
(23:24):
And when you're paid on commission,
if you will or a percentage of profit,
if you will,
you actually care about getting great reviews,
having that customer or person come back again.
Right?
A lot more I believe.
And that's kind of the way America's system has been built,
whether we like it or not.
(23:46):
And so I really do believe to treat providers like hourly paid physician positions in some dollar store.
Isn't the way that patients with,
or staff or teams or this as well.
You could tell the difference when you walk into some place.
Like,
oh,
they're working on commission,
you know,
commission or whatever or they're part of the team or they take ownership or,
(24:06):
oh,
they,
you know,
they could care less.
You could just tell when you go into some places as well.
I might say 11 thing that a lot of dentists think,
oh,
I can't pay on profit or commission.
You can,
it is non clinical persons that cannot use those types of profit sharing revenue,
(24:27):
stream sharing,
commission streams,
licensed clinicians like hygienic can receive a percentage of,
of profits and that's due in large part to the movement of,
you know,
a lot of states have adopted this a lot more independence of hygiene.
And so just as a dentist who's employed by another dentist receives a percentage or commission,
(24:51):
commission based paycheck and 95% of the time if you're a hygienist and you're not in one of those systems,
just know that you can find practices out there where you can be paid a percentage of the profits and do two times three times better in many cases and you know,
really run your own schedule and have a lot more freedom uh in practice.
(25:14):
Yes.
So it,
it makes a huge difference for sure.
I think when I first started in dentistry in 1998.
The doctor I worked for,
we did,
it was called Bonuses,
which I know it's kind of,
but it's still profit sharing.
It was,
you know,
you kind of get your,
whatever your salary is.
But then everybody gets a percentage,
the same percentage if we go over that.
And so we all hustled and worked our butts off and we did.
(25:36):
Right.
So everybody profit shared at the end of the month and it made a huge difference and the energy was great.
We did just what you're saying.
And so,
and that was in the,
you know,
for an office or office manager.
And so,
you know,
I was able to participate in that as well.
Not even being a clinician,
it changes everything,
somebody calls in and wants to get in.
I find room for on the schedule.
They're not sad about it,
they're happy about it.
(25:57):
You know,
they say they're happy about it instead of pouting about it.
And for a good reason,
I mean,
really agree with you.
The best alignment financially is where the,
it's not just certain providers like hygienists are tied into you and then you're extra,
it's gotta be the whole team and yes hygienists,
(26:18):
it costs more to go to school.
They are providing the actual service they usually do end up because of what they put in having a bigger chunk of that piece.
But when the whole team is added to that.
You're right.
Then people aren't lamenting why the hygiene department gets X Y or Z.
So there's really good holistic ones nowadays that align the whole team and,
(26:42):
you know,
so I might say this Cindy,
so that whole ecosystem of,
of having a good,
what we all refer to as bonus system in the practice really is the main difference between an autonomous DS O and a corporate DS O A corporate DS O runs their DS O as a dental practice does with paid employees who check in,
(27:05):
check out,
just do their job,
right?
An autonomous DS O if you were to liken it through an analogy with the dental practice would be a situation where that practice is rewarding its employees as a revenue share from the whole practice.
They got retirement accounts,
right?
They get to choose that treatment for their patients.
(27:26):
They work hand in hand with the doctor to get it done diagnosis wise and the whole teams involved.
So that's really in the DS O world.
What an autonomous DS O is it,
it's like the best dental practice that has the whole team on a wonderful revenue sharing platform.
Yeah,
I was just thinking,
man,
ha and the best of both worlds.
(27:48):
That's right.
Like because it really is,
it,
it just sounds,
I mean,
it sounds great.
So,
hey,
Cindy,
what states now is independent Hien through the boards and,
and good.
I know Colorado.
Uh what other states or?
I'm in Oregon.
And so we could do a lot more than most states.
I think there's some business owners as well and they're independent hygienists.
(28:13):
I'm not sure of all the terms or legalities of that.
I'm not sure.
Probably Washington because they're pretty advanced as far as hygiene.
Colorado.
I don't,
I don't know for sure.
To be honest,
they're so different across the states,
which is crazy.
It,
it is true.
Well,
so there is a movement right now where hygienists are owning practices and a lot of hygienists think that their ownership of a practice,
(28:36):
a dental practice is related to what the hygienist can do in that state.
So any of you hygienists that are listening right now,
your ability to own a practice is more related to DS O law,
the separating of the business assets from the clinical assets.
So I believe in the next five years,
(28:58):
more and more hygienists will own practices because I believe there are hygienists that have been around for a while,
have great patient base,
understand running a business.
And sadly,
a lot of our dentists getting out of school are not business people.
Have you noticed that?
Yeah.
And I think a lot of them would love to work for a hygienist.
Honestly,
(29:18):
that's what some of us,
you know,
having the dental business background.
Well,
if you think about hygienists,
the ones that are really running great soft tissue programs that are leading teams.
They are hygienists that have worked their way up the business ladder as office managers first then became hygienists.
They are awesome uh prototypes for practice ownership.
(29:42):
And so uh freedom,
dental is also about empowering uh any clinician or any person in dentistry to own a practice,
right?
Practice.
Practice.
That,
that's right.
And then they,
and,
and in that model that they bring on dentists,
yes,
they're hiring the dentist.
(30:03):
But once again,
that dentist is also,
if you do it right,
aligned incentivized by the business profits,
they just didn't take on,
you know,
the financial obligation to buy the practice.
Right.
But,
but they,
you have the stress that they can become a minority owner and all these good things.
But so I think we're gonna see that in the next five years,
(30:23):
more and more hygienic owning practices,
not through this independent hygiene movement,
but more through the legal structure of a true Ds O which costs a little more to set up.
Um,
it's getting more and more reasonable as more and more Ds Os get out there.
But hygienist owning practices through a compliant DS O structure will be really big across our nation in the next five,
(30:48):
probably 10 years as well.
Yeah,
I see that.
I think,
I think that would be great for sure and preventative care,
you know,
a lot of dentists know,
because we do preventative care and pretty much we don't do everything but we do a whole assessment and the dentist will come in and pretty much we kind of kind of tell them what's there and they just have to go confirm,
you know,
so they really,
(31:09):
a lot of them already do rely on us because they trust us and they know that,
you know,
we can see things and then they kind of see and confirm and so,
or some of us are already doing that anyway.
So why not make it more beneficial?
Yeah.
Yeah.
So how does somebody get into that if they were interested in starting their own,
owning their own,
um,
business as a hygienist,
(31:29):
uh,
is,
uh,
something that they would contact like you or for like a DS O or the,
to get the legalities of that?
Yeah.
So if you're a hygienist and you want to be able to own here are the really good opportunities that are out there.
The Ds Os are only really partnering with or buying practices over 1.4 million and those practices are pretty expensive.
(31:54):
Most hygienists that have been around a while realize how quickly a practice can grow with just some good business practices in there.
A nice bonus system,
getting some marketing out,
a good recall system,
keeping more of the procedures in house,
not referring all the root canals out and implants.
And so the hygienists that have done the best doing this are typically the ones that find practices that are doing under 1.4 million.
(32:22):
And because the Ds Os don't want those,
you can buy them dirt cheap,
ok,
dirt cheap.
And so what you want to do is buy a practice where the provider,
the dentist provider is also in minority ownership because a hygienist that owns a practice without a doctor is at risk.
(32:44):
So if you have a doctor and you let the doctor own 20% of,
of the practice,
then you're in great shape.
You've got that doctor and you can add another doctor to that,
an associate or partner or what I call a trial partner.
And so you can also get really good deals on these practices where the sellers actually sell or finance,
you,
you don't have to go to the bank.
(33:06):
And so in every community out there,
there are practice deals available.
So if you're a hygienist and you're,
you want to look for an opportunity,
oftentimes what you would do is find a,
a dentist,
many hygienists know of a,
a dentist that they've met,
right?
Who may work for a DS O may work for someone else if you can bring a dentist with you to do that.
(33:29):
And you can say,
hey,
dentist,
let's do this together.
Let's buy a practice,
right?
I'll take on X Y and Z.
Those have been some of the best situations where hygienists can get into.
They've got a dentist,
they're partnering with maybe a minority partner,
the hygienic has found this deal they're gonna do and now they end up going in kind of being the practice manager,
(33:52):
managing the manager growing it as an investment.
And that has worked really well.
And there's also sorts of combinations in between.
But this practice is all over right now.
And once you get them over that 1.4 million a year threshold,
they become really,
really valuable like 2 to 3 to $4 million upside.
(34:13):
And just one practice that a hygienist can buy for like four or 500,000,
the cost of a rental house,
right.
That one practice you buy can totally fund your retirement with 23 or $4 million if you,
you know,
go out there and figure out how to do it.
And I can certainly recommend certain legal firms that are able to set up that compliant DS O structure that allows you whether you're a hygienist or just a layperson who isn't even in down street to own a practice.
(34:44):
So anybody can own a practice if they have a dentist,
does the dentist do,
does it have to be 20% at least?
And do they have to actually practice dentist or do they just have to be an owner the way it works for the DS O structures?
You don't have to even have a dentist owner involved.
You do have to have a dentist that signs these agreements between the DS O or the management company and the PC,
(35:08):
which would be the,
the clinical entity.
And it's that clinical entity that has to be owned by a licensed person.
OK.
So typically you would have a dentist in that state sign on behalf of that entity,
but all the money then rolls up to the management company and that dentist does not need to own any part of your management company or DS O but you usually want them to because if they don't own a part of the management company,
(35:37):
there have been some cases where the dentist tries to run away with the business,
which makes sense,
right?
Because they're there signing on behalf of that PC.
So the best models are where,
you know,
the hygienist might own 80% of the DS O and the dentist 20% and the dentist owns the PC underneath of it.
And those have been great,
great working relationships.
(35:58):
Even there's some 50 50 deals where a dentist and a hygienist partner together,
the hygienist usually is kind of the business person.
The dentist is someone that's like,
I see all these great opportunities in dentistry.
I want her to deal with that team.
Right.
Because let's face it.
Most introverted dentists get steamrolled by their type.
(36:20):
A oftentimes,
majority female teams,
right.
These dentists who are introverts,
they are not good at managing teams,
they're really,
really bad.
Right.
And so a introverted dentist with a type A and let's face it hygienist uh,
it's hard to get into the hygiene school.
A lot are driven,
(36:42):
uh,
achievement oriented females in hygiene.
They're like awesome managers.
So that it's,
you're generally an introverted dentist with an awesome business hygiene manager type person that team up together.
And that has been a,
a winning combination,
which by the way is neat for your podcast because you've got Dennis and high Ds and you could create a little matchmaking thing.
(37:06):
right?
Because it's pretty powerful for folks watching your podcast.
Yeah.
Yeah.
And I think it's great.
I think this is great information for people that aren't even aware of this and it's something that people could be aware of and,
and you bringing this out and letting people know about it.
It's great what they can do in the industry and the business side and what's out there,
there's so many different options that are available that we don't even hear about.
(37:30):
So it's,
yeah,
it's so true and it,
it'll be an exciting five years and really what a lot of this relates to with hygienists investing in practices.
Dentists investing in multiple practices is really just about,
you know,
how do we a keep dentistry in our own hands,
(37:51):
keep it autonomous or having that freedom?
But b how do we make sure that from the tens of billions that are pouring into dentistry,
how can we as providers that really are the lifeblood of the whole dental ecosystem in the US how do we as providers end up with a big chunk of those billions?
(38:12):
Right.
And not just let it go to the Wall Street suits.
And at the end of the day,
that's what freedom dental partners is all about.
Maintain your freedom as a clinician.
But getting your fair share of the tens of billions that are pouring into dentistry.
And that's whether you're a dentist,
a high dentist,
an office manager or even a dental assistant.
(38:34):
So this is really the age of empowerment of all providers at the practice level,
I believe.
Yes,
I love it.
Yes.
Well,
thank you for being on the show today.
I could talk to you forever.
I have so much insight and maybe we can have you back again someday to,
uh,
follow up and talk some more.
How can our listeners find you or get a hold of you?
(38:55):
There's a website that I think is Doctor Brady Frank dot com.
I'm gonna,
I should check it out.
I think it's Doctor Brady Frank dot com,
um,
or become the DS O dot com.
Freedom Dental Partners is out out there as well.
Um,
but there's a bunch of,
uh,
supporting information that folks can grab there and I can certainly give that to you,
(39:17):
Cindy.
So you can share it with any of your listeners.
Uh,
and if you are a dentist and you do have a practice and you're like,
hey,
I wanna add it to the mix.
We do a seminar for about 100 dentists every 10 weeks and,
and it's to become the DS O seminar where the dentist become the DS O and that really allows you to free up a lot more finances for yourself and maintain that freedom also.
(39:44):
So,
coming to a seminar,
uh,
may be a good idea for a lot of you or checking out one of our websites.
Ok,
great.
We'll put your link in the show notes as well and then also on the website root you on dot com,
we'll have that and then if you can provide those resources,
we could get those up there as well.
Well,
thank you,
Doctor Brady Frank.
Cheers to the future in the next five years.
Yes.
Right.
(40:04):
Empowering our providers,
right.
Hygienist,
dentists,
office managers,
staff,
everyone empower each other.
Everybody.
Thank you for listening to this episode of the Dental Elements podcast.
We truly appreciate your support and helping all these fine dental professionals share information with you,
our listeners and a very special.
(40:25):
Thank you to smile makers for helping us make that happen.
They are offering our listeners 20% off of any order by using code D A P 20.
That's right,
20% off any order.
So D A P 20 smile makers dot com,
check them out.
Welcome to the Dental Elements podcast.
I am your host today,
Cindy Rogers.
I'm a hygienist and a compliance consultant who works with a team environment in this episode.
I sit down with Dr Brady Frank,
who is a dentist author and co-founder of Freedom.
Dental partners.
Talks about his passion for elevating the financial positions of not only dentists but also hygienists,
(00:29):
office managers and assistants in the industry.
He talks about unique ownership structures and strategies to help staff members own shares of their privately held companies and achieve financial freedom.
He also shares practical tips on finding deals on practices to buy as a hygienist.
So lots of different things to unpack in this episode and I love his energy,
(00:50):
super fun interview.
So I hope you enjoy it.
Ok,
here's Doctor Brady Frank.
Hey,
Cindy.
Thank you so much for having me.
So excited to be here.
Wow,
exciting.
Your podcast has grown like wildfires.
So,
congratulations to you.
Oh,
thank you.
Yeah,
it's great to have you on here as well.
So,
yeah,
we're really excited to see the growth and the fun everybody's having and to have you as a guest today.
(01:13):
So,
thank you?
Awesome.
Well,
since you're a hygienist,
you've got hygienists on your assistance.
A lot of dentists and I thought it'd be really fun to talk about how it's not just dentists who are elevating their financial status with all this money pouring into the dentistry,
but its hygienists,
it's office managers,
(01:33):
it's assistants and it might be fun to kinda certainly talk about what,
what I'm doing over at freedom partners.
But really talk about,
you know,
this new era of dental staff elevating their,
their finances and really going to the top of their positions because so much more is available now than say,
(01:56):
40 years ago.
Right.
So,
I think it'd be great to chat about.
And,
uh,
what percentages have you seen in the past on your podcast?
Hi,
Genist assistants,
dentists.
You know,
a lot of dentists,
a lot,
a lot of hygienists,
a lot of assistants,
everybody,
a little bit of everybody.
To be honest,
I'm not sure exactly who's who because like I said,
I'm all team oriented.
(02:17):
So I agree with you.
Everybody can elevate and the more people elevate,
the more people elevate,
we elevate each other,
elevate by ourselves.
Yeah,
I might kind of give you the background.
Like you've asked,
how did freedom partners start?
You know,
what's my history and how do all the providers fit into that?
And it really starts back in,
(02:38):
believe it or not.
1999.
I was a,
I don't know,
I was a junior in dental school.
I had a wrist injury and the wrist surgeon said you might not want to choose dentistry as a career in dental school in dental school.
Oh,
my goodness.
I was already a dental school debt and I was past the proverbial point of no return.
(03:01):
I already spent a lot already two years in a dental school.
So I realized I might have to learn how to make money in dentistry without the ability to practice.
So you have all this knowledge from school,
you wanna use it,
right.
Yeah,
you want to use it.
And traditionally,
you know,
my grandpa and my uncle were dentists and you know,
they made money with their two hands doing crowns,
(03:24):
right?
And hygienists make their money,
scaling root planning and doing that.
And assistants are actively assisting,
but few dental providers think about what would happen if I was disabled.
What if I got in a car wreck?
What if I couldn't physically do this stuff?
Where does that leave us with our actual training?
And the answer oftentimes is,
(03:47):
is nowhere.
And so I realized I needed to study the business side of dentistry in 1999.
After getting that news,
I went to the Marquette dental school library.
I studied dental transition books and I ended up making the decision as a junior in dental school that I would to protect myself because I knew at any time fusing my carpal bones together would mean it would make it tougher impossible to practice dentistry.
(04:13):
So I bought two practices.
Uh right out of dental school,
ended up buying five more,
had 28 different associates over a seven year period.
And I realized that yes,
I loved clinical dentistry,
but I also loved the business aspect of dentistry.
And that propelled me on to helping other dentists buy practices,
(04:36):
create groups.
And then as private equity really got deep into dentistry,
I started helping Ds Os expand,
create partner models where assistants,
hygienists and dentists could actually own part of the company because in a DS O structure,
you know,
there's the business assets and the clinical assets and the business assets are what are recapitalized by private equity.
(05:03):
So a lot of differing staff persons in the field of dentistry ended up doing very well,
getting shares of these privately held companies.
And so I ended up helping several dozen Ds Os create unique ownership structures that included staff and hygienists much of the time.
And uh ended up,
(05:23):
you know,
realizing that some of these Ds Os were really good players,
some of them didn't have the clinicians best interests in mind.
So I started supporting just the Ds Os that gave autonomy both from a business aspect and a clinical aspect to the providers.
And from there,
I ended up creating an organization that supported those what we call autonomous Ds Os versus the other type of Ds O that I talk about,
(05:53):
which is a corporate DS O corporate DS O is where they kind of put their brand on your door.
You do what they tell you right?
And you kind of have golden handcuffs.
Whereas an autonomous DS O is where you partner with this big money that's in dentistry,
but there's an autonomous line above it is private equity below it is yourself your pre practice.
(06:17):
So you continue to run your team as you run it,
have your staffing structure as you'd have it,
do your clinical dentistry as you would do it and maintain full autonomy.
So freedom,
dental partners works with a variety of DS OS out there that are autonomous DS OS.
And then we also have our own DS O inside of freedom.
(06:39):
Dental partners that really focuses on practices that in many cases are unwanted by the other Ds OS because we've got a team uh that includes a lot of hygienists that fixes them up,
elevates them,
brings them them to that next level so that they can now,
you know,
not just enjoy kind of the the benefits of in,
(07:01):
you know,
clinical dentistry or clinical hygiene or even the assisting side.
But that can bring them to what I call total dental freedom,
you know,
clinical freedom,
doing the procedures you love in the practice,
lifestyle,
freedom,
you know,
geographically,
being able to have a vacation home if you want or live where you want to and those two are fueled by financial freedom.
(07:26):
So,
the three of those being total dental freedom.
So that's where we're at right now.
And it's,
uh,
exciting to chat with you about some of this stuff.
Yeah.
So,
T D F total dental freedom.
I love it.
Yeah,
I got in dentistry in 1998 but I kind of did the opposite issue.
I got into the business side,
you know,
started in the front office and then decided to go to hygiene school.
(07:47):
And then I learned the clinical side and I always love the business side.
So it's great to have both to have that knowledge behind you.
Makes a huge difference.
Even if you're doing the business side without the clinical knowing that stuff really makes a difference.
I was like,
why do you have to learn about history in school?
But now I see why just the background makes a huge difference.
So that's great.
I mean,
it all worked out for you and if you can't use your hands,
you can use your hand,
right?
(08:07):
That was the point back then.
And,
and I'll tell you what it was interesting because in the early two thousands,
you know,
when you get out of school,
you really are not that great clinically.
You think you are,
you think you're awesome,
right?
And then when you own a business for the first time and I didn't have a business background,
you think,
you know what you're doing,
but you really don't.
(08:28):
And both clinically and business wise,
I think a lot of folks,
including myself fell on their faces and I fell on my face a lot.
And so the term failing forward,
I think for those of you listening that are worried about getting into more of the business side or elevating yourself financially.
You know,
my best advice would be to take action.
(08:49):
It's the action takers that do really well and you have to be ok with failing a little bit right before you kind of get into that groove and find where your place is.
Like learning to walk.
Nobody learns to walk without hauling if you do.
That's just weird.
There's something else going on,
you know,
so tell us about freedom,
dental partners and how's that possible to have autonomy but still be part of A Ds O I mean,
(09:13):
that sounds like having the best of both worlds and some people do would like just hand everything over and that's great and some people want to have autonomy and how,
how do you make that possible?
Yeah.
So I'll give you a little mini history of Ds Os.
There were eight Ds Os that started in the early nineties and only a couple of those actually gave autonomy and those were the ones that were big money partnered with actual dentists.
(09:39):
And there was one high dentist in there as well.
Six out of the eight Ds Os in the nineties bankrupted in the late nineties.
And those six were corporate Ds OS where the providers weren't tied to kind of the financial benefit of conglomerating this business.
(10:00):
And so those two that survived,
and I'll be able to give more details if I don't give names,
if I give the names of these Ds Os,
since I know the inside of them,
I can't really go that detail.
So I'm not gonna give Ds O names because then I can go real deep.
So the two of the eight that survived,
um they ended up becoming over $1 billion Ds Os and they were autonomous.
(10:26):
And what they found was this initially,
they thought that having a corporate DS O structure versus an autonomous DS O structure would allow us to have more control of the doctor,
more control of the staff,
more control of the fees,
more control of the systems,
more control of the patients,
more control of the,
(10:46):
the vendors.
And they figured from a business standpoint,
you know,
intuitively,
that's got to be better because we get to control it.
Well,
they found that there's a key word that they really didn't understand at that time and that was alignment and especially financial alignment.
And what,
what that simply meant was that if it was good for the private equity company or is good for the private equity company,
(11:13):
it's gotta be good for the provider as well,
both financially and clinically So,
what they did is they looked back on the two Ds Os that survived out of the initial eight Ds Os that were big ones in the nineties.
They found that when the providers were tied to the financial rewards of that business and they let the clinicians do what they did best,
(11:37):
right,
that the clinicians and their teams were able to elevate those practices financially and it wasn't the big smart Wall Street folks that were able to grow it.
So the autonomous Ds Os now are winning big time.
And so I believe in our profession in dentistry.
(11:57):
It's not a question of will Ds Os win at the end of the day or not.
Everyone believes that dentistry is having big money come in and there's no stopping that.
I believe the battle is this.
Do we become like medicine corporatized with a corporate MS O right now,
all of medicine is corporate MS Os.
(12:19):
They never got the chance to fight the battle and have autonomous MS Os.
You can see it with the insurance companies,
CNA Blue Cross Blue Shield,
they have golden handcuffs,
these physicians.
And right now,
if we can win the battle of autonomous DS O versus corporate DS O,
then we as providers can run our practices like we want to run them,
(12:41):
we can be tied to the financial gains as we are conglomerated as an industry.
And then at the end of the day,
once we do become conglomerated because I think we all understand that that is gonna be a fact.
Well,
at least let's be conglomerated with us providers making our fair share of the tens of billions of dollars that are pouring into dentistry and let us providers continue to have freedom in our practices and freedom equals autonomy.
(13:13):
If we can have autonomy with our patient basis,
with who we add as partners uh to the business,
even hygiene partners,
assistant partners,
managers,
that can be partners at that level because we can do that as opposed to the old PC models do that,
I think is the battle.
We're,
we're fighting,
you know,
the,
the autonomy versus the corporate uh structure in the DS L market today.
(13:37):
Yeah.
And so it's like giving the actual provider and the,
the people doing the work,
the team,
the money instead of the insurance company.
Really.
Let's be honest,
they control everything.
That's,
yeah,
that's the biggest DS L corporate thing ever.
So that's another topic that we need to address at some point.
Yeah.
So I think that's great.
When did freedom?
(13:57):
Demo partners start?
And how did that get going?
And you saw a need for wanting to have Ds Os health practices out with services.
And what do you provide?
And what's all involved in that?
I uh operated something called the D DS O Alliance.
Dennis Own Ds O Alliance wrote a couple of books here and all D D O strategies and talking about thriving in dentistry's new economy.
(14:23):
And through that alliance,
a lot of the dentists were selling to Ds Os and I was helping them themselves and they would tell me what they liked and what they didn't like about their partnership with private equity through A DS O and a lot of them were getting pretty good values.
Right,
better values than if they sold to a dentist.
(14:46):
But what we found is they could reap back a lot more on their sales if they clump together and sell as groups to these private equity firms.
So that's when I started putting groups together to go to my market.
And the dentists would get a lot more like many millions more in many cases.
(15:07):
And beyond that,
they didn't just get higher valuations,
higher sale prices,
they actually got to control their terms better.
So they get,
it was almost like a union.
You get a few people together and you're gonna get better terms.
And so ended up doing that um in small scale,
then we started doing it in larger scale.
(15:27):
So now we have hundreds of dentists banding together to get better pricing and better terms for their unique partnership with private equity when it becomes time for them,
whether they're in their thirties or seventies and it's different for everybody.
So that's kind of where it started uh myself just helping smaller groups end up uh finding their ideal transition strategy to kind of match groups up or dentists or practice up together and have kind of joined forces.
(15:58):
Kind of like we do a lot of collaborations and join forces and you kind of sell them or you have people invest in them and so that helps keep them going,
gives them resources without all the extra stress to keep their businesses going and then they give some a percentage to the,
the DS O or the manager.
(16:18):
Yeah.
So the way it typically works is to create this alignment.
What happens is this dentist who typically has some debt,
wants to aid,
get rid of all their debt,
both business and personal and then be left with maybe two or $3 million in their retirement account and then have this upside,
(16:40):
this business benefit as from being part of a bigger group that is funded or capitalized by one of these big private equity groups.
And so the dentist typically will partner with private equity on their practice or through A DS O and they,
they on average,
get 70% in cash and 30% in stock in the whole and a lot of this big company with all these general practices.
(17:06):
So what happens is they get a lot more money upfront than they would selling through any other resource,
they get rid of all their debts.
And now they have the ability to be part of a growing company that would eventually be recapitalized again by another private equity company,
but now they're doing it on someone else's dime and that's private equity dime.
(17:28):
So they're not having to take on new debt to expand.
They're not having to pay,
you know,
big sign on bonuses for staff and,
you know,
they get,
of course discounts on supplies.
Lab,
better insurance,
reimbursement.
Yeah.
More enterprise pricing.
And that makes sense to me because talk with a lot of innova innovators and entrepreneurs and a lot of people do like any startups,
(17:52):
they do get private equity money or investments.
And so for,
for one dentist to have to do it all by himself.
You know,
that's a lot to,
besides doing clinically like the business and just holding so much on your back and the team and the responsibility and the only money you have been coming in for some of these people are what the insurance company trickle,
you know,
give you a few pennies here and there and that is a lot to hold for one person.
(18:16):
So,
having that option,
that freedom,
you know,
it is really great for a lot of people I would think.
Yeah,
it,
it isn't for some dentists.
I mean,
they say the majority of dentists,
you know,
don't love the business side.
They love the clinical.
And so this super funds,
the retirement lets them still have full control of their team,
(18:36):
their patient base and they have that kind of weight lifted off their shoulders of the financial side and it can be a lot more fun working in collaboration,
like you said,
with a team of others who have the same goal that are aligned.
And you know,
the ad a had a survey,
it showed that it's almost the majority of dentists are depressed.
(18:58):
Well,
they found that in large part and I think this might hit hygiene as well.
We're in that single room treatment room with one patient,
not a lot of collaboration and it can be very tedious work,
both hygiene and dental.
And you know,
when groups get together,
when dentists get together,
when teams get together,
the collaboration,
(19:20):
you know,
is a lot more of a team environment.
And really,
I found staves off any depression that one might be uh at,
at risk of,
yeah,
the hygienist,
you missed out a lot on that because it's kind of like you're being whipped to get back to work because you're producing and you're costing so much money.
If you talking,
if you're saying hi to any of your team members or if you're even taking a lunch or for a bit and break and then you just feel like you're the enemy,
(19:43):
you know,
and so it is really lonely.
It can't be depressing and only,
you know,
you get to talk to your patients if you're lucky to have enough time.
Some,
some places.
But,
and,
and so a dentist as well and then if you do have a second,
you have to go do the business side and if you're lucky enough to enjoy the business and be good at it and you can balance both of that fantastic.
But that,
I mean,
that has to be rare and to be happy and to have a family.
(20:08):
Guess what I saw today.
A squeezed pee.
That's right.
A squeeze.
Pee.
Do you know what a squeeze pee is?
Well,
if you don't,
I'm gonna tell you a squeeze pee is a pea pod.
So it's a pea pod and there's three little peas in the pod and one of them has a key level smiley face on them.
And what you can do is give these to your patients if they're anxious or nervous or perhaps if you want one yourself and you just squeeze the little pods until you pop the peas out.
(20:33):
Kind of like a,
you know,
you can pop a little peas out anyway.
Super cute little green peas and one of them has a cute little smile,
smiley face on them.
So yes.
Squeeze peas.
I know you want one.
I know you want to squeeze one.
I know I do.
I'm gonna get me one.
So check out Smile Makers dot com and use code D A P 20 to get yourself some squeezed peas,
(20:53):
D A P 20 for 20% off of any order.
It doesn't have to be squeezed peas.
Just go to Smile Makers dot com.
Cheers.
And to speak a little bit about the hygiene component of a lot of these groups that we put together through freedom.
You know,
a lot of hygienists because of the shortage of hygiene have asked for higher hourly rates and a lot of them feel comfortable with their hourly rate.
(21:20):
But the reality is many of these models throughout the freedom system relate to the profitability of the business,
which can be a lot higher than the hourly rate.
And so really a lot of the new hygiene models out there relate to that hygienist productivity and the soft tissue program,
(21:40):
not just an hourly rate.
And if I were a hygienist,
I would prefer to,
you know,
have business profits from my sector that I'm working in.
Not just an hourly rate.
Yes.
And you're gonna do better and you're gonna work harder and you're gonna be happy about it.
I,
I just worked for commission for the first time at my last position.
It was so much better before I'd be like,
(22:01):
oh my gosh,
I gotta do a full mouth and,
you know,
I can't want the assistant deal.
They're not doing anything.
And now I'm like,
no,
don't help me.
I got it like I can do this in 10 minutes.
It totally changes your perspective because you're getting paid for it.
It makes it so much better.
And then the assistants are happier.
The front office is happier because you want patients to come in instead of hoping your patients don't show up because you still get paid whatever hour you want them to show up.
(22:22):
So energy in the practice changes because you want your patients to come in.
You're not given that everybody's like,
oh,
please don't come in.
You know,
I just need a break and I get,
you know,
you get paid no matter what,
sometimes you want them to come in and it just changes the whole perspective for everybody.
Well,
and think about this,
I,
I I think hourly pay rate related to both dental assistant management hygiene is antiquated.
(22:51):
Uh you know,
all the models to pay dentists are all based on a percentage that relates to the,
to the business.
And um it not only influences the revenue to the provider,
whether it be a hygienist or,
or whoever,
but it also influences patient care because they have shown in multiple studies that business owners care more about the customer than someone who's hired to manage someone else's business because they care about that experience of the customer or experience of the patient.
(23:24):
And when you're paid on commission,
if you will or a percentage of profit,
if you will,
you actually care about getting great reviews,
having that customer or person come back again.
Right?
A lot more I believe.
And that's kind of the way America's system has been built,
whether we like it or not.
(23:46):
And so I really do believe to treat providers like hourly paid physician positions in some dollar store.
Isn't the way that patients with,
or staff or teams or this as well.
You could tell the difference when you walk into some place.
Like,
oh,
they're working on commission,
you know,
commission or whatever or they're part of the team or they take ownership or,
(24:06):
oh,
they,
you know,
they could care less.
You could just tell when you go into some places as well.
I might say 11 thing that a lot of dentists think,
oh,
I can't pay on profit or commission.
You can,
it is non clinical persons that cannot use those types of profit sharing revenue,
(24:27):
stream sharing,
commission streams,
licensed clinicians like hygienic can receive a percentage of,
of profits and that's due in large part to the movement of,
you know,
a lot of states have adopted this a lot more independence of hygiene.
And so just as a dentist who's employed by another dentist receives a percentage or commission,
(24:51):
commission based paycheck and 95% of the time if you're a hygienist and you're not in one of those systems,
just know that you can find practices out there where you can be paid a percentage of the profits and do two times three times better in many cases and you know,
really run your own schedule and have a lot more freedom uh in practice.
(25:14):
Yes.
So it,
it makes a huge difference for sure.
I think when I first started in dentistry in 1998.
The doctor I worked for,
we did,
it was called Bonuses,
which I know it's kind of,
but it's still profit sharing.
It was,
you know,
you kind of get your,
whatever your salary is.
But then everybody gets a percentage,
the same percentage if we go over that.
And so we all hustled and worked our butts off and we did.
(25:36):
Right.
So everybody profit shared at the end of the month and it made a huge difference and the energy was great.
We did just what you're saying.
And so,
and that was in the,
you know,
for an office or office manager.
And so,
you know,
I was able to participate in that as well.
Not even being a clinician,
it changes everything,
somebody calls in and wants to get in.
I find room for on the schedule.
They're not sad about it,
they're happy about it.
(25:57):
You know,
they say they're happy about it instead of pouting about it.
And for a good reason,
I mean,
really agree with you.
The best alignment financially is where the,
it's not just certain providers like hygienists are tied into you and then you're extra,
it's gotta be the whole team and yes hygienists,
(26:18):
it costs more to go to school.
They are providing the actual service they usually do end up because of what they put in having a bigger chunk of that piece.
But when the whole team is added to that.
You're right.
Then people aren't lamenting why the hygiene department gets X Y or Z.
So there's really good holistic ones nowadays that align the whole team and,
(26:42):
you know,
so I might say this Cindy,
so that whole ecosystem of,
of having a good,
what we all refer to as bonus system in the practice really is the main difference between an autonomous DS O and a corporate DS O A corporate DS O runs their DS O as a dental practice does with paid employees who check in,
(27:05):
check out,
just do their job,
right?
An autonomous DS O if you were to liken it through an analogy with the dental practice would be a situation where that practice is rewarding its employees as a revenue share from the whole practice.
They got retirement accounts,
right?
They get to choose that treatment for their patients.
(27:26):
They work hand in hand with the doctor to get it done diagnosis wise and the whole teams involved.
So that's really in the DS O world.
What an autonomous DS O is it,
it's like the best dental practice that has the whole team on a wonderful revenue sharing platform.
Yeah,
I was just thinking,
man,
ha and the best of both worlds.
(27:48):
That's right.
Like because it really is,
it,
it just sounds,
I mean,
it sounds great.
So,
hey,
Cindy,
what states now is independent Hien through the boards and,
and good.
I know Colorado.
Uh what other states or?
I'm in Oregon.
And so we could do a lot more than most states.
I think there's some business owners as well and they're independent hygienists.
(28:13):
I'm not sure of all the terms or legalities of that.
I'm not sure.
Probably Washington because they're pretty advanced as far as hygiene.
Colorado.
I don't,
I don't know for sure.
To be honest,
they're so different across the states,
which is crazy.
It,
it is true.
Well,
so there is a movement right now where hygienists are owning practices and a lot of hygienists think that their ownership of a practice,
(28:36):
a dental practice is related to what the hygienist can do in that state.
So any of you hygienists that are listening right now,
your ability to own a practice is more related to DS O law,
the separating of the business assets from the clinical assets.
So I believe in the next five years,
(28:58):
more and more hygienists will own practices because I believe there are hygienists that have been around for a while,
have great patient base,
understand running a business.
And sadly,
a lot of our dentists getting out of school are not business people.
Have you noticed that?
Yeah.
And I think a lot of them would love to work for a hygienist.
Honestly,
(29:18):
that's what some of us,
you know,
having the dental business background.
Well,
if you think about hygienists,
the ones that are really running great soft tissue programs that are leading teams.
They are hygienists that have worked their way up the business ladder as office managers first then became hygienists.
They are awesome uh prototypes for practice ownership.
(29:42):
And so uh freedom,
dental is also about empowering uh any clinician or any person in dentistry to own a practice,
right?
Practice.
Practice.
That,
that's right.
And then they,
and,
and in that model that they bring on dentists,
yes,
they're hiring the dentist.
(30:03):
But once again,
that dentist is also,
if you do it right,
aligned incentivized by the business profits,
they just didn't take on,
you know,
the financial obligation to buy the practice.
Right.
But,
but they,
you have the stress that they can become a minority owner and all these good things.
But so I think we're gonna see that in the next five years,
(30:23):
more and more hygienic owning practices,
not through this independent hygiene movement,
but more through the legal structure of a true Ds O which costs a little more to set up.
Um,
it's getting more and more reasonable as more and more Ds Os get out there.
But hygienist owning practices through a compliant DS O structure will be really big across our nation in the next five,
(30:48):
probably 10 years as well.
Yeah,
I see that.
I think,
I think that would be great for sure and preventative care,
you know,
a lot of dentists know,
because we do preventative care and pretty much we don't do everything but we do a whole assessment and the dentist will come in and pretty much we kind of kind of tell them what's there and they just have to go confirm,
you know,
so they really,
(31:09):
a lot of them already do rely on us because they trust us and they know that,
you know,
we can see things and then they kind of see and confirm and so,
or some of us are already doing that anyway.
So why not make it more beneficial?
Yeah.
Yeah.
So how does somebody get into that if they were interested in starting their own,
owning their own,
um,
business as a hygienist,
(31:29):
uh,
is,
uh,
something that they would contact like you or for like a DS O or the,
to get the legalities of that?
Yeah.
So if you're a hygienist and you want to be able to own here are the really good opportunities that are out there.
The Ds Os are only really partnering with or buying practices over 1.4 million and those practices are pretty expensive.
(31:54):
Most hygienists that have been around a while realize how quickly a practice can grow with just some good business practices in there.
A nice bonus system,
getting some marketing out,
a good recall system,
keeping more of the procedures in house,
not referring all the root canals out and implants.
And so the hygienists that have done the best doing this are typically the ones that find practices that are doing under 1.4 million.
(32:22):
And because the Ds Os don't want those,
you can buy them dirt cheap,
ok,
dirt cheap.
And so what you want to do is buy a practice where the provider,
the dentist provider is also in minority ownership because a hygienist that owns a practice without a doctor is at risk.
(32:44):
So if you have a doctor and you let the doctor own 20% of,
of the practice,
then you're in great shape.
You've got that doctor and you can add another doctor to that,
an associate or partner or what I call a trial partner.
And so you can also get really good deals on these practices where the sellers actually sell or finance,
you,
you don't have to go to the bank.
(33:06):
And so in every community out there,
there are practice deals available.
So if you're a hygienist and you're,
you want to look for an opportunity,
oftentimes what you would do is find a,
a dentist,
many hygienists know of a,
a dentist that they've met,
right?
Who may work for a DS O may work for someone else if you can bring a dentist with you to do that.
(33:29):
And you can say,
hey,
dentist,
let's do this together.
Let's buy a practice,
right?
I'll take on X Y and Z.
Those have been some of the best situations where hygienists can get into.
They've got a dentist,
they're partnering with maybe a minority partner,
the hygienic has found this deal they're gonna do and now they end up going in kind of being the practice manager,
(33:52):
managing the manager growing it as an investment.
And that has worked really well.
And there's also sorts of combinations in between.
But this practice is all over right now.
And once you get them over that 1.4 million a year threshold,
they become really,
really valuable like 2 to 3 to $4 million upside.
(34:13):
And just one practice that a hygienist can buy for like four or 500,000,
the cost of a rental house,
right.
That one practice you buy can totally fund your retirement with 23 or $4 million if you,
you know,
go out there and figure out how to do it.
And I can certainly recommend certain legal firms that are able to set up that compliant DS O structure that allows you whether you're a hygienist or just a layperson who isn't even in down street to own a practice.
(34:44):
So anybody can own a practice if they have a dentist,
does the dentist do,
does it have to be 20% at least?
And do they have to actually practice dentist or do they just have to be an owner the way it works for the DS O structures?
You don't have to even have a dentist owner involved.
You do have to have a dentist that signs these agreements between the DS O or the management company and the PC,
(35:08):
which would be the,
the clinical entity.
And it's that clinical entity that has to be owned by a licensed person.
OK.
So typically you would have a dentist in that state sign on behalf of that entity,
but all the money then rolls up to the management company and that dentist does not need to own any part of your management company or DS O but you usually want them to because if they don't own a part of the management company,
(35:37):
there have been some cases where the dentist tries to run away with the business,
which makes sense,
right?
Because they're there signing on behalf of that PC.
So the best models are where,
you know,
the hygienist might own 80% of the DS O and the dentist 20% and the dentist owns the PC underneath of it.
And those have been great,
great working relationships.
(35:58):
Even there's some 50 50 deals where a dentist and a hygienist partner together,
the hygienist usually is kind of the business person.
The dentist is someone that's like,
I see all these great opportunities in dentistry.
I want her to deal with that team.
Right.
Because let's face it.
Most introverted dentists get steamrolled by their type.
(36:20):
A oftentimes,
majority female teams,
right.
These dentists who are introverts,
they are not good at managing teams,
they're really,
really bad.
Right.
And so a introverted dentist with a type A and let's face it hygienist uh,
it's hard to get into the hygiene school.
A lot are driven,
(36:42):
uh,
achievement oriented females in hygiene.
They're like awesome managers.
So that it's,
you're generally an introverted dentist with an awesome business hygiene manager type person that team up together.
And that has been a,
a winning combination,
which by the way is neat for your podcast because you've got Dennis and high Ds and you could create a little matchmaking thing.
(37:06):
right?
Because it's pretty powerful for folks watching your podcast.
Yeah.
Yeah.
And I think it's great.
I think this is great information for people that aren't even aware of this and it's something that people could be aware of and,
and you bringing this out and letting people know about it.
It's great what they can do in the industry and the business side and what's out there,
there's so many different options that are available that we don't even hear about.
(37:30):
So it's,
yeah,
it's so true and it,
it'll be an exciting five years and really what a lot of this relates to with hygienists investing in practices.
Dentists investing in multiple practices is really just about,
you know,
how do we a keep dentistry in our own hands,
(37:51):
keep it autonomous or having that freedom?
But b how do we make sure that from the tens of billions that are pouring into dentistry,
how can we as providers that really are the lifeblood of the whole dental ecosystem in the US how do we as providers end up with a big chunk of those billions?
(38:12):
Right.
And not just let it go to the Wall Street suits.
And at the end of the day,
that's what freedom dental partners is all about.
Maintain your freedom as a clinician.
But getting your fair share of the tens of billions that are pouring into dentistry.
And that's whether you're a dentist,
a high dentist,
an office manager or even a dental assistant.
(38:34):
So this is really the age of empowerment of all providers at the practice level,
I believe.
Yes,
I love it.
Yes.
Well,
thank you for being on the show today.
I could talk to you forever.
I have so much insight and maybe we can have you back again someday to,
uh,
follow up and talk some more.
How can our listeners find you or get a hold of you?
(38:55):
There's a website that I think is Doctor Brady Frank dot com.
I'm gonna,
I should check it out.
I think it's Doctor Brady Frank dot com,
um,
or become the DS O dot com.
Freedom Dental Partners is out out there as well.
Um,
but there's a bunch of,
uh,
supporting information that folks can grab there and I can certainly give that to you,
(39:17):
Cindy.
So you can share it with any of your listeners.
Uh,
and if you are a dentist and you do have a practice and you're like,
hey,
I wanna add it to the mix.
We do a seminar for about 100 dentists every 10 weeks and,
and it's to become the DS O seminar where the dentist become the DS O and that really allows you to free up a lot more finances for yourself and maintain that freedom also.
(39:44):
So,
coming to a seminar,
uh,
may be a good idea for a lot of you or checking out one of our websites.
Ok,
great.
We'll put your link in the show notes as well and then also on the website root you on dot com,
we'll have that and then if you can provide those resources,
we could get those up there as well.
Well,
thank you,
Doctor Brady Frank.
Cheers to the future in the next five years.
Yes.
Right.
(40:04):
Empowering our providers,
right.
Hygienist,
dentists,
office managers,
staff,
everyone empower each other.
Everybody.
Thank you for listening to this episode of the Dental Elements podcast.
We truly appreciate your support and helping all these fine dental professionals share information with you,
our listeners and a very special.
(40:25):
Thank you to smile makers for helping us make that happen.
They are offering our listeners 20% off of any order by using code D A P 20.
That's right,
20% off any order.
So D A P 20 smile makers dot com,
check them out.
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