The Lifestyle Dental Practice Myth

Several years back when I was an associate grinding out 5-6 clinical days a week looking to embark on practice ownership I started to hear about this concept of the “Lifestyle Dental Practice”. In essence, the definition was for a solo doc to work 3 clinical days a week, take several weeks off a year and make a $500k + income.

Don’t get me wrong this is super respectable, and likely a great model for many. Less than 1 year into my startup I was well on my way to achieving this and I started to realize that there were a few missing components to this model.

The owner is stuck as the primary technician. If something happens to the owner doc there is no hedge to protect the revenue generated from clinical work.

There is a ceiling on the productivity and value of the practice.

Components of this model are great, but it is NOT a resilient business model. It is my belief that a more resilient model is “THE MEGA LIFESTYLE” practice. I would define this as the owner could work as many clinical days as they enjoy (likely the sweet spot would be 2 or fewer to allow room for at least 2 associates to make a great living). Why 2 associates? With one associate the owner would get sucked back into an even greater volume of clinical if something were to happen to the single associate. In this model…

The owner can elevate from technician to CEO (this allows for a much better lifestyle where the leads are empowered and the doc isn’t stuck in management)

Assuming Overhead is in the right spot, there is potential for much greater EBITDA valuation & take home for the owner.

What does is take to scale from solo doc to 3 doc practice? the short answer is it’s not easy. a few keys are

developing a real leadership team
having enough patient flow to support multiple docs

There are so many ways to build a dental practice or multiple, often what we think we want pre-ownership changes & evolves as we become more capable and knowledgable and see what’s possible.

Let me know what you think?

What model were you attracted to and how’s that going? What am I missing?

Atmospheric Turbulance

Atmospheric Turbulence

At night time, have you ever wondered why light sources always seem to flicker? Whether it is the rogue nature of stars in the sky or a cityscape shimmering in the distance, it is not by pure chance or some mystical source of intermittent current driving the pulse. The variance in air temperature and wind speed occupying the space in between establishes a refractory force upon the light such that by the time it registers on the retina, it will appear to flicker. This is commonly known as atmospheric turbulence.

Metaphorically speaking, leadership is wrought with similar challenges which is why so much is made out of the intestinal fortitude required to truly define oneself as a leader. The air can be a bit rarefied at times making for potential hypoxic decision-making when challenging times arise. However, through self-awareness, humility, and a sprinkling of forgiveness, the shackles start loosening up and confidence emerges from the perpetual fog.

If there were ever a light source more symbolic and relevant to combatting uncertainty while also fostering hope, the lighthouse is just that example. Developed to simultaneously warn seafaring groups of imminent peril while representing a beacon of safety for those lost at sea, the lighthouse has stood the test of time. Considered one of the more iconic of structures in human history, its connection to leadership is uncanny. Servitude to others while simultaneously operating within an earnest set of parameters reflects the hallmark of a true leader. Having the means and wherewithal to maintain a safe and thriving environment is invaluable to the success of a company. Establishing a perpetual level of communication throughout the organization, anticipating challenges, and guiding through even the most unpleasant conditions exemplifies true lighthouse leadership. It eliminates the scatter and static from the environment and in turn, decreases the atmospheric turbulence.

First by inspiration then by virtue of aspiration, ascension to leadership mastery is wrought by challenges often unforeseen until deep into the process. This requires an inordinate amount of time and effort to foster. Having a community of like-minded colleagues genuinely dedicated to each other’s success is essential. Dental practice leadership is inherently lonely and often lacks any form of fellowship. However, there now exists hope in the form of a concerted effort to optimize the connectivity. Today, more than ever before, masterminding is on center stage in the life and routine of a practice owner. Not all opportunities are created equal, so it behooves the mentee to assess all options. The allegiance found in a group wholly committed to growth and development while minimizing atmospheric turbulence is by far one of the most essential elements of success for today’s practice leader.

If this is of interest or feels like a calling, then consider Dynamic Dental Ascension as a potential resource for you.

There is no ‘I’ in Team

Humans are universally created and introduced into the planetary ecology with one common characteristic, unconditional love. We then spend the remainder of time in pursuit of dismantling and rebuilding the scaffolding when therein lies a far simpler answer: STOP TAKING THINGS FOR GRANTED AND START SHARING THE LOVE.

It should come as no surprise there is an overwhelm within the dental profession over recruiting and retaining qualified talent. Far too many contributors have migrated away from the industry in search of greater opportunities with no shortage of data to showcase the deficit. Yet, it remains largely doctrine that the dental team is by far the top client of any practice. And, it must be treated as such despite the natural tendency toward a patient-first mindset. However, stepping back for a minute to pour over the patient experience will shed light on how leveraging a committed and magnanimous team will naturally translate into the delivery of exquisite, enthusiastic, and empathetic “love” to the patient.

If burnout has hit you, the practitioner, owner, or jack-of-all-trades, then it has most certainly doused the team. A lot has been made over tactical solutions for managing burnout, and it is critical to take an inventory of your personal situation. One underpinning force is by far the relationship between the practice and 3rd party payment systems or aka: dental insurance programs. Naturally remodeled into a coupon book and/or tepid financial assistance platform, there is no doubt the deflationary forces have delivered a healthy uppercut to the chins of most modern-day clinicians. The equilibrium point has since passed and rendered the bifurcated dental economy of today. Consumers will ultimately drive the bus as they pay for what they want ahead of need. Buying cycles, economies of scale, the elasticity of price/supply/demand, and a host of other financial factors meld to enforce a real interesting horizon when a defined plan does not exist. Couple it with the ongoing inflationary forces upon the input side and one most likely will need to pivot. However, prior to any unforced errors of emotional overload taking center stage, pause. Take a hard look at why dentistry. What specifically empowered you to take the leap?

Irrespective of consolidation FOMO or pure angst over cut-rate reimbursement, there exists an overriding love of the profession. An intrinsic drive toward excellence. People are attracted to the profession for largely similar reasons. Including your team. The people we empower to help us serve our communities are invaluable to the process and must not be taken for granted. Perhaps we have been less than stellar in the previous chapters of practice management? The live and learn mantra is not short on experience. The humility to seek forgiveness and the willingness to level up to a better and brighter version attracts new tranches of universal fuel. Perfection is, at best, a form of procrastination while forgiveness is, by nature, a thing of the past should we fail to recognize its beauty.

There is no more profound way to reinvent greatness than a team training day. The time almost evaporates within the allotted hours despite the quantity and quality of content provided. Making this a priority within the operational schedule is a crux move. Backfilling around training days with deliberate growth sessions laser-focused upon essential elements of clinical and/or managerial systems will ultimately translate into more efficient and profitable operations. Start small and build with intention and conviction. Embracing a can-do attitude within the culture pays enormous dividends. Your team and your patients will be eternally grateful.

Humans are unconditionally their most vocal self-critic, and too often we cast this patterned quilt upon the support crew we seemingly take for granted. Smothering what we truly are in support of growth and ascension. Literally carving out time away from actual clinical operation to train, retrain, retool, reboot, rework, etc. is paramount. This recharge will refill the tank with that high-octane spirit the engine so desperately yearns for. It may appear counterintuitive and/or counterproductive, but it is of preeminent status for a thriving dental practice.

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Seasonality Of An Entrepreneur

The Seasonality Of An Entrepreneur

The degree of false positives in life presents a unique juxtaposition for an aspiring entrepreneur. Head down, pushing the sled, and spinning the grindstone without ever once sharpening and polishing the scythe. Perhaps it is equally attributable to a lack of seasonality applied to the management of the operation as it is an omnipotent sense of self.

In nature, there exist incredible examples upon which to model operational systems. A perennial plant, for example, is rather analogous to the lifecycle of a business. The average perennial endures an approximate 20-year life span predicated upon the unique architecture of its meristems. These undifferentiated zones serve an invaluable purpose of survivability for the plant. Without a steadfast commitment to following the guidelines of nature’s economic cycle, meristems would hastily expose the plant unprepared to grapple with the unknown.

Mental status is generally elevated by long days, warm weather, and an almost endless presumption of a bountiful harvest. In contrast, the first hard frost or persistent charcoal-colored snow piles and perpetual gray skies of winter reflect an almost endless doom and gloom cycle. The cyclicality of weather motivates a perennial to plan and prepare for what lies ahead. Without these trigger points, the meristems would likely never shut down thus deploying precious energy on growth at all costs. On the surface, the presentation of economic expansion, super high-level prosperity, record low inflation, and unbridled consumerism represents a backdrop all too familiar to the past few decades. The past decade has been a perpetual jug of Kool Aid akin to a hummingbird feeder ripe with baited hook connected to a speed dial cranking up the treadmill’s RPMs fueled by FOMO.

The entrepreneurial meristems are unable to cut the motor, coast into port, anchor up, and take a much-needed break. Overlay a list of unplanned macro events, and suddenly, the unraveling thread has released a button from the favorite shirt without warning. Why is it some truly thrive in these moments? How does one financial institution not flinch while another caves under the onslaught of a bonafide bank run so far removed from the perils of the Great Recession? The preparedness manifesto deployed from maintaining a meristem cache dedicated to embracing a full economic cycle.

Forecasting for what lies ahead filtered through past experiences and humility to know the limitations fosters certainty. Hop off the treadmill and take inventory by slowing down to speed up. Clean and sharpen the implements, explore the elements, prune off all the overgrown vegetation, and reinvest into personal development. Are the basic provisions for survival on board? Is the long game in focus? Rooted within this gameplan is a backbone belief that nothing is permanent. Seasonality grips every life form, for it is truly a blessing as nature’s way of fostering a lasting legacy.

In the words of Jimmy Cliff: “I can see clearly now the rain is gone. I can see all obstacles in my way. Gone are the dark clouds that had me blind. It’s gonna be a bright sunshiny day.”

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Common Leadership Challenges in the Workplace

Dental Practice Ownership Challenges

Despite a rigorous selection process, the lion’s share of experience and development of leadership muscle in the dental practice tends to mirror the rest of the marketplace. The ongoing series of checklists, operations, and nuances unique to successfully leading a team is largely left to chance or essentially a “baptism by fire” approach. The profession self-selects a rather unique subset of the population obsessed with compassionate and nurturing care of its patients through a lens devoted to perfection. Yet, statistics show an unprecedented level of dissatisfaction amongst its rank and file. Why? Too often, dental professionals seek to address the how before identifying the why and what of any particular situation. Strategic pearls are put before any sort of purpose or passion. This cart-before-the-horse approach is widespread with no palpable end in sight.

Addressing and hopefully resolving this dilemma is the foundation and context of our work at Dynamic Dental Ascension. Having taken up the call to arms, your decision to pursue the profession of dentistry is actually a gift. The opportunity cost of taking a different trajectory is not pocket change. It is time to distill down the basics of your journey so far and where its potential leads.

In everyday life as a practice owner, you will be faced with relentless stimulation of the leadership muscles all while balancing the ongoing challenges of clinical responsibilities. The minds of a dentist do not necessarily cooperate either. Learning to appreciate a brief pause when assessing a situation will deftly parse the cause and effect while allowing a more effective response. The everyday trek is marked by numerous encounters with some being more noteworthy and worth exploring a bit further. Distilled out of many personal experiences as well as countless hours observing others, here are a few of the top most common instances where practice leadership is put to the test:

Premature Failure and/or Substandard Treatment Outcomes
Gossip or Status Trading Amongst Personnel
Chronic Illness and Absenteeism
Handling Raises
Negative Reviews
Premature Failure and/or Substandard Treatment Outcomes

Sworn to uphold clinical standards is essential to successful matriculation through dental school. There are no exceptions once in private practice except that the binary process of clinical care is no longer valid. It is not our desire or by design to engage in clinical failures or imperfect results. However, statistically speaking, they occur. Acknowledgment and ownership are essential. Treating others by the platinum rule and showing recognition by second-order acknowledgment will avert and diffuse any crisis. Taking pride and ownership in craftsmanship by reproducing an acceptable result or remedying the situation is the way.

Gossip or Status Trading Amongst Personnel

In society, there is no shortage of outlets to express or opine with almost no recourse. Oftentimes it is shrouded in electronic cover and brushed off. The dental practice is not immune to ill-fated attempts to gain at the expense of others. In an environment full of deadlines, emotions, sensitivity, financials, strict guidelines, exacting standards, et al, there is no shortage of tension. When faced with these ugly truths, it is imperative to hold to a standard. The culture of the organization should effectively serve the purpose of diffusing any attempts at undermining by virtue of its ability to provide a safe and inclusive environment where accountability is standard and grace is second nature. Start by engaging the offenders in their own honest dialogue and proceed from there on the premise of high standards and low tolerance.

Chronic Illness and Absenteeism

No leader relishes in the notion of questioning the validity of illness and/or the need to miss work for health-related reasons. However, there may come a point where an individual may call into question the limits of time off. Should this present itself, the deficit can deleteriously affect the mood and performance of the more reliable team members and cast doubt on the leadership of the organization. Taking the time to explore via active listening and reconcile the issues for the offender will lead to an effective solution or reprimand of either freeing them up to explore other more suitable employment opportunities or reform and get with the program.

Handling Raises

Who doesn’t respond favorably to the opportunity to increase their livelihood? Time and money are often deemed interchangeable units of measurement, at least figuratively, so when it comes to a request to increase compensation it is often marked by angst and uncertainty for many practice leaders. A meritocracy naturally rewards a progressive approach or ascension upon some sort of skills development path. All too often, raises are substantiated upon the past performance or essentially on an entitled basis. There could be some merit to this approach, but it is imperative to connect a salary augmentation with future outcomes and performance that fosters an advancement for the organization. This could entail a myriad of options, so it behooves the practice leader to continually explore options and solicit thoughts from the team.

Negative Reviews

Society lives and breathes by the ways of the internet, SEO, and reviews. Our social proof pivots upon optimizing what patients have to say about us online. When a subpar assessment arrives, it feels like an utter defeat by way of a lethal gut punch. Often referred to as NPS or Net Promoter Score, it enables a more rapid exposure to a greater TAM or Total Addressable Market when the reviews are optimized. Take a negative review as an opportunity to reflect and reassess. Remember, the patient is uniquely qualified to opine about their experience, and perhaps it was not the best that particular day. The humanistic and humble side of us all recognizes this and takes the feedback as a growth moment. It is only acceptable to respond maturely and professionally to all reviews regardless of their ranking. Over time, if the dominance is that of 5 stars, those occasional black eyes shall fade.

If this resonates with your personal situation, bear in mind, you are not alone. Many who have elected the same formidable path, have discovered the value of mentorship. Consider Dynamic Dental Ascension as a potential partner on your journey. Schedule a discovery call today!

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Any Validity to Tactical Retrospective Advice?

Everything is great. Clinical proficiency is palpable. Immersion into the subjects at hand is full board with a rather exuberant level of confidence. How could a fly ever stand a chance in this ointment? Except that it is final exam time second semester senior year, and you have yet to make it to a class. Hold up the printing press, that diploma is now in question for delivery on commencement day, and there is serious doubt whether or not you will even get to walk. How can this be? Where did the time go? Only then does reality set in, and thank the lucky stars for the morning alarm clock to throttle you out of a bad dream into a mortal reminder it’s Tuesday and the real-life schedule is about to unfold.

Do you often stew over what it would be like to actually go back and retell the story armed with today’s knowledge? What a gift this ought to present to that unsuspecting nascent clinical want-to-be. Yet, does the notion of time traveling back to those tumultuous interludes where the mind was pre-occupied with not spending another precious moment chasing signatures, returning borrowed equipment, transferring caseloads to D3s, and any other gyration deemed worthy of another fluid ounce of blood, sweat, and tears tempt even the most stoic thread within your soul? Albeit therapeutic at its base, the journey would necessitate an antediluvian-like rewind of the years in order to revisit those fateful and foundational moments to rehash the memories equitably intertwined by fondness and indifference. Thanks to the inherent lack of viable time travel, you should honestly not fathom a single scenario whereby any alterations would make a meaningful impact and simply embrace the journey as it unfolds. Rather, give consideration to the prodigal tenets of deliberate mindfulness and discover the insurmountable level of inner serenity that awaits.

Forcing yourself out of the echo chamber and exposing a bountiful array of life lessons, daily reflections, modest confidence, and a general level of benevolence to guide you is far more valuable. Let’s face it, who would not want to go back in time to course correct and relive the story armed with a fresh batch of future brownie bites? Flip the switch, dim the lights and pop a little corn, it is sure to be an instant hit. Caught in the seemingly endless tug-of-war between past, present, and future defines itself remarkably in the following twist of a Buddhist principle…”when you keep one foot stuck in yesterday and one foot tinkering with tomorrow all you end up doing is peeing on today.” Rather trite but true, the simplicity of being present is an art form which undoubtedly requires tons of practice. It boils down to relevancy in a world geared for negativity.

Shawn Achor explores this rather deftly in The Happiness Advantage. So many experts in the field of psychology have produced study results in an attempt to dissect the complex hierarchy of the human mind and solve for why we do what we do. The crossover and comparison of results is uncanny once all the nitty-gritty details are removed. He likens decision making at one point to the principles of Tetris. Repetition over time can ultimately imprint and reprogram the brain to only view the world in a particular manner. The Tetris Effect can work both positively and negatively, so once one clearly comprehends its peculiarities, the magic begins to unfold. As an inherent optimist, I gravitate to his notion of “rose-tinted” glasses as an effective method to positively navigate life.

“Science has shown that seeking out the positive has too many tangible advantages to be dismissed as mere cockeyed optimism or wishful thinking.” – The Happiness Advantage by Shawn Achor

You must fully expect your D4 self to embody this notion should you happen to show up ready to serve up a hot “ham sandwich” loaded with impeccable advice. It is literally impossible, impractical, and downright inappropriate to look at life through a lens that completely filters out all negative or deleterious events and moments. Instead, it is crucial to adopt a global perspective by virtue of perpetually grazing and absorbing cognitive nutrients from all around in order to purely engage with one’s mind as well as the psyche of others. Retrospective self-directed advice is a vain attempt at forgiveness. A flimsy apology to a former acquaintance that no longer has a formal stake in the game. This message embodies exquisitely in the following statement…

“Forgiveness means giving up all hope for a better past.” – Lily Tomlin

You have elected for an incredible journey, so buckle up and hang in there! Trust your instincts and put more credence into a forward-thinking approach to being present. If the retrospective nightmare is keeping you awake t night, fear not for you are not alone. Consider reaching out for a discovery call and explore all that Dynamic Dental Ascension has to offer.