Dentistry Uncensored with Howard Farran
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1470 Dr. Chris S. Villanueva, DMD, CEO of MB2 Dental Explains Dental Partnership Organizations : Dentistry Uncensored with Howard Farran

1470 Dr. Chris S. Villanueva, DMD, CEO of MB2 Dental Explains Dental Partnership Organizations : Dentistry Uncensored with Howard Farran

9/29/2020 3:00:00 AM   |   Comments: 0   |   Views: 240
Dr. Villanueva is the founder and CEO of MB2 Dental—a first-of-its-kind Dental Partnership Organization with a mission to empower dentists to preserve their profession. Since its founding in 2007, MB2 has partnered with hundreds of dentists to help them stay in the driver’s seat as they maximize their talents, connect as part of a community and build exceptional practices.  MB2 currently partners with over 230 practices in over 19 states.

VIDEO - DUwHF #1470 - Chris Villanueva

AUDIO - DUwHF #1470 - Chris Villanueva

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It is just a huge honor for me today to be podcast interviewing Dr Chris S Villanueva he's the founder and CEO of mb2 dental I’ve been trying to get him on the show big time I’m right here in Arizona and I got I’m right here in phoenix we got two dental schools we got midwestern over and Glendale we got at still in mesa and um the only people hiring are you uh Stephen Thorne’s um pacific dental workman's heartland Fontana’s um aspen dental and every time  I run into some young kid they always say I know the owner of those other three but when are you going to podcast the owner mb2 well here he is today he's the founder and CEO of mb2 dental a first of its kind dental partnership organization with a mission to empower dentists to preserve their profession since its founding in 2007 mb2 has partnered with hundreds of dentists to help them stay in the driver's seat as they maximize their talents um connect as part of a community and build exceptional practices mb2 currently partners with over 230 practices in 17 states and like I tell every old dentist my age man if you can't learn something from some dentist that owns 230 practices in 17 states you need to get your ego checked at the door um it's just an honor to have you on the show today and also what i like about you is um in the in the dso world you do a lot of unique things i mean you um you purchase practices differently instead of buying the whole thing and saying you got to work for me for this amount of time then leave um you best buy like um from what I’ve heard on dental time you've got some big fans on dental town who um who's your biggest fan on downtown I’m thinking it's um my gosh who was um oh my gosh bill uh Phil I have a hard time saying his name is Zelda now Zelman al uh Phil Zelman like say you got a bunch of big fans and you got a big Facebook group on uh some county has a big Facebook group who who's the county that has a Facebook group uh i believe uh Glenn Voe and Chris Hoffman have Facebook groups both owners with us yeah okay so that's uh let me um just find that real quick Glenn beau um g l e thrifty dentist yeah thrifty dentist I’ve had him on the show there i am uh he is he's a nifty thrifty dentists  smiles so Glenn Veau um he's a partner too yes and who was the um and who's the other one that has the Facebook group on dentaltown that loves you to death um i don't know if he's on dental town uh but the doctor hof our doc hof pair is uh has his own group it's uh how do you spell hockey power the business of dentistry so that's the name of the group no that was the name of my book uh back in 2000 b-o-d how do you spell his name hof what h-o-f-f p-a-u-i-r p-a-u let's see if microsoft oh there i got bill gates finally did something right so oh he's in Texas too and i podcast him he was number 748 748 so my gosh at the same time so is that right yeah so um so basically i want to talk well first of all um the thing everybody wants to know about the most is you know you're overlooking a couple of hundred dental offices and um out of nowhere we said we got this pandemic on march and everybody is um debating what um how they should have adjusted for infection control this and that what i remembered from the hiv because i went this is my second rodeo with the virus back in 87 it was so bizarre because it was the same things as hearing now i remember when um dentistry had to start wearing gloves i can give you the names of dentists in which talk hand says yeah if somebody comes in here and makes me wear a glove off you know that they're ready to shoot them i mean they were not gonna have the government tell them they had to wear gloves now you have the gut you know people saying the same thing the government's not gonna tell me to wear a mask and all this stuff but i noticed a lot about everything we did for hiv we still did it we started wearing gloves um the cuspidor went away um bottled water in the operatory instead of having a water line you know um the weird and there were a lot of weird things like my staff was most upset that we couldn't wear shorts anymore and here i am in 1987 trying to explain to two hygienists have a four-year degree well how am i gonna catch hiv from wearing shorts and I’m like i know the government you know they're it is what it is so but what have how have you had to adjust now that you think 20 years from now you know way beyond the pandemic you'll still be doing and your 230 offices that you started because of the pandemic that's probably here to stay yeah no obviously we have unique challenges given our different geographies right we have practices in Alaska all the way to Florida and keeping up with the different advice and regulation over the last few months has been challenging it's a full-time it's a full-time job just to understand all the guidance that's being put out there that's constantly changing and so i feel like you know it's still to be determined what the long lasting effects of the new infection control protocols are going to be but like you said i mean things are going to change they're going to change people are going to get used to different ways of providing care and the cadence in which the patients come into the office they're all going to be different and i think that's going to be applicable not only in dentistry but healthcare as a whole so i still think that we're in the meat of it there's still a lot of story to be told here in the next few months and how we weather this next season but ultimately um there will be drastic changes i feel in the way we provide care and keep our patients healthy you know basically all these dentists had to shut down for two months i had to shut down between um ST Patrick’s day um all the way to Cinco de mayo you know the my two favorite drinking days i had to close in between my two favorite drinking days and um and then it's come back and some uh the ada statistics are saying we're cruising at about 71 percent of pre-pandemic some people um are say they're back to full norm for your entire sample size of 230 are you back to pre-pandemic um where are you at now so we're actually above 100 for um the last 15 weeks so we obviously monitor week by week um you know there are specific markets that have downturns whether it's uh related to covered increases or weather for that matter because we have a lot of offices uh income south um but net i mean we're well above 100 for the last 15 weeks which is something we're really proud of um really it's a function of our ability to not worry about um supplies and equipment quite frankly i mean as a large group we're able to get the required ppe to the providers and they can simply focus on the patient care so that's been a testament to our structure and our organization well you know rick workman um is the CEO of the heartland dental he says they're back up to 100 and then um rick Kirshner he's on got 300 comfort dentals he's back over 100 why do you so it it's obviously an operations and logistics issue if the rix comfort dental and heartland and um chris uh dr v at mb2 if you guys are all back over 100 for 15 weeks and with a big sample size spread out all over the united states it looks like um getting back to pandemic level is an issue of operational logistics not how do you find the mb2 by the way how did you get that name mb2 nobody can find the mb2 and you have to go name your company after the biggest uh heart ache in all of endodontics is the mb2 well it's funny we're all sitting around after a dinner or a company dinner and this was you know many years ago and we just thought it would be funny because our company doesn't really face patients it was kind of an inside joke amongst peers and we're like it was between mb2 or like carabelli dental or falcon cus metal or we just came with a bunch of silly names and it kind of stuck them cusp we're throwing a lot out there that is funny at cuspa carabelli 82 customer care ability or they falcom cuss uh you'll have to uh explain what that one is yeah no for us it was or it was I’m sorry it's talent oh talent cuts okay august and so for us it was kind of an inside joke and just knew that dentists would understand it and if you actually look at our logo it's actually a highly stylized access orifice when you go to mv1 and mv2 so oh my gosh now I’m gonna have to look at it so if i look at your logo I’m looking at it now uh yeah i think you have an axis orifice you're looking down into wow i never even saw that and that is really the best way to find the mb2 because um you know the reason when i started root cause i always do the final restoration first because you know if you got all these cusps and valleys you know your measurements or this is 18 this is 20 this is 19. but you prepare it for the crown the final restoration all the all the files are going to be the same length but when you find that mb um you know when you find those three canals you know it's going to be a line between what you did find and the palatal you know what i mean that's right it's going to be right in the same space and it's um it's really frightening because um i mean i know endodontists that will go six months without a four canal maxillary molar and then i got dennis friends that have never found an mb2 and they're as old as i am so um but there is and that and that is a big explanation of why endodontists when they do a million root canals in 60 months five years five percent are extracted versus doing general dentist to it it's ten percent and um root canals in a nutshell is just fining all the canals getting rid of all the infection and when you leave a whole bunch in the mb2 that that's that is the problem um so back to the rix there's a rick workman heartland where if they come into phoenix Arizona and they buy a practice say they buy it for a dollar uh maybe the maybe those um the contract will you have to stay with them for like three years then there's all the way over to um rick and Cindy Kirshner where they don't like um they don't like uh associates they don't want him the employee mentality they want an owner mentality and um they just find partners so every one of rick's dentist is a in you know they got the same skin in the game and i see your business model is kind of a hybrid you buy like uh we'll say 60 let's say two thirds so the dentist has to remain a third so he still has skin in the game so he kind of sold out but he's still a skin in the game partner am i am i summarizing this correctly or have i got this right or no it's really a hybrid model right and so the local owner doctor owns a minority interest in the practice on top of obviously being paid for their chair side production but what's unique about us is that the average owner owns a little over three practices within their business model right the average owner is in the early 40s and these are guys and gals that that want to grow that want to have multiple practices want to not only provide great care but also mentor other associates right and so um we have a what some call a hybrid model others call it more of a co-op where at the office level we are extremely differentiated the practices in Alaska are different than the ones in Oklahoma and so on and so forth it's a representation of the individual owner doctor and so um you know we have offices that are in rural markets urban markets in-network out-of-network it's really what the doctor built on their own we're here to facilitate their growth but also give them a platform to invest in each other and so what's unique about our model is every doctor has an opportunity to actually bind to the other doctor's practices um at the office level effectively and so that creates a tremendous amount of alignment it creates a tremendous network of individual doctors who are helping one another but without having a formulaic playbook one size fits all approach i believe that's the right way to approach dentistry a lot of people um a lot of people understand that this is what dentists have been doing for decades right i mean a lot of doctors they build their practice they get a certain point they hire an associate grows up becomes an owner and then they effectively have a true partnership in that practice and that's really all we are we are a true partnership with the doctor who's providing the care calls the shots um we are a great sounding board and great support we provide a slew of services including increasing their equity value in the practice they've built well congratulations i mean i love innovation i mean talk about i mean you're a true dental entrepreneur um just you know a quarter of my listeners are still in dental kindergarten school uh by the time they get out of dental school after about five years they're smart enough to not ever want to listen to me again uh but so for um for the kids still in school um you've already used a lot of terms that might have flying overhead so just what is the difference between private practice dso dpos and buying clubs yeah so great question um maybe would be helpful is kind of why we even built this i mean my wife is actually a physician primary care physician i kind of watch what happened in primary care space where they went from being independent sole proprietors just like dentists and started to migrate towards hospital systems where they no longer had to deal with the business aspects of it but it came at a very high cost mainly their autonomy having to ask permission to go on vacation and so on and so forth and so i kind of watched what happened and i decided that's not what i wanted for our profession i didn't want to migrate in that direction and in 2004 when i graduated that's kind of what was happening right the private practitioners were considering a more traditional dso model where they would sell their practice into these de facto corporate structures where they would be relieved of the administrative burden but once again it came at a cost and so i effectively created what we call a hybrid model or a dpo where basically we are fiercely independent at our office but when it behooves us we negotiate as a group whether that's supply ordering whether that's talent acquisition having economies of scale and obviously when we attract investors into our business we're considered a larger group which comes with its own benefits and so that's kind of why the dpo model came about i think there's newer models that are starting to take to try to take hold in our profession there's buying clubs which are pretty self-explanatory where you know you have a membership and they facilitate purchasing i see a lot of these new groups come up that have loose affiliations with call options or the option to buy you once they amass a group of practices together there's a lot of those are starting up a lot of what i call corporate marauders that just come in and bundle a bunch of prices together and sell them off to another investor and so it's important that that dentists know um the difference and it may sound like the a binary decision between private practice and corporate practice but that's far from the truth i think there's important distinctions um between the different models and how to encourage them to understand them before making any commitments um i gotta go back just to clear up so um the dso um what is your um is that dental services organization for you i know um is that what you're calling that uh yeah the dso is what we traditionally think about as corporate dentistry right i mean but are those the um I’ve heard dental services organization I’ve heard dental support organization uh what is the s standard i know i know it's dental and organization but is the s um services or support I’ve seen it both ways I’ve seen it both ways but i think the effective model is like a hospital system where they own um the practice doctors becoming employees with contractual work back agreements and it's kind of one of those you know arrangements where the doctor may have clinical uh discretion but when it comes to scheduling staffing uh supplies equipment they have minimal involvement and so that that's kind of what traditionally is viewed as a dso and so that's on one side of the spectrum and the other side of the spectrum you have you have the private practitioners that can do whatever they like but they just don't have the support of a larger organization so we're in the middle where you have the benefit of autonomy equity ownership with the support of a larger organization with systems efficiencies uh and economies of scale so again um so in the dpo it's dental what's the p stand for partnership okay partnership that was uh that was where my uh mind which is the width of a plank length um uh dental partnership organization yes okay and then when you do buying clouds then my question is then is Glenn beau is his nifty thrifty dentist is that the mb2 supply is that the supply thing i mean is that what you use for is or is he just a partner with mb2 but the nifty thrifty thing is totally separate than mb2 yeah he has his own membership and he's just found a way to give some deficiencies to private practitioners he's had that for many years and he just recently joined us so if he was to bring um a great deal to the organization i would put it in front of all the 165 owners 400 doctors and say hey if this works for you guys are up to work we don't we don't force um any provider to use any supplier material per se it's all of them well i like his uh i like his name nifty third i just like Glenn he's just a great guy he's a great i like nifty thrifty um but since we're talking about um supplies um what should supplies be in a dental office i mean in fact will you just go through the numbers of um i mean you're coaching 230 dental offices what are you trying to coach them in terms of what should be their labor their lab their supplies their general costs that's a great question and i feel like um there's just a huge variance in the type of practices that we support i mean we have a practice that does 10 million in in-network revenue in Colorado and they're a huge practice and we have practices that that do a little over a million and obviously the metrics change what our approach is drastically different than one would think of a larger group in the sense that you know as a as a dentist i never wanted to be told what lab to use i didn't want to be told what supplies to use and so i view our job simply to curate what everyone wants to use try to drive down pricing and then offer to them at that price whether that's you know lab supplies um clear correct liners um gloves you name it extends all the way out to healthcare i mean it's the same concept like we don't impose any buying structure per se we know that when the doctor owner owns a practice with us they're going to make the right decision for the practice i mean one example i always give is there was a doctor that joined us and he was expanding his practice and he went from four chairs to seven chairs and he really wanted to buy these nice eight deck chairs and ada chairs everyone knows they're a premium brand and they're extremely expensive and but obviously doctors um enjoy that and value that i told them like listen if it's important to you it's important to me there's much more cost effective options out there and we've we have that pricing but if it's important to you it's important to me and we went ahead and purchased as a partnership the chairs that he wanted and that is a good metaphor for the way our organization operates it's not a top-down command and control operation it's really an amalgamation of all the private practitioners this is truly a co-op the doctors that own the practices are the ones making the decisions for the practice and we're not there to convince them otherwise um that is um that is it's so true i mean I’ve when i talk okay so when a kid's five years out of school it seems like they've had five jobs i mean it seems like you know that they do i mean they always say well i don't think uh opening you know i graduated may 11 i had my own office open by September 11 and then black Monday was in October i mean you know you just couldn't have made it worse so i totally understand the kid coming out of a pandemic um but when they a lot of them say well you know I’m just going to go work for aspen and I’m just going to be an associate blah blah but they don't ever seem to be happy because if they've been out five years they've had five different jobs and a lot of them end up now i know that the dso is obviously in Arizona it's ground zero for dsos because um you your dental license from anywhere is good in Arizona and so specialists endodontists oral surgeons everybody's flogging Arizona 18.6 of the dentist in Arizona work for dsos and so some of them i mean i have friends that have stayed with um thorn for god 10 15 20 years i mean so they're keeping some but when they have the turnover it's always the same things it's always um yeah they made me use this lab and i hated this lab and it was so frustrating to try my hardest and they gave me this crappy crown from what you know for 70 bucks and you know they hated that but the biggest thing that they actually tell me that just it's always the last straw is they were you know they're kids they're stressed out they had a hard time sleeping last night because today they had to do a muller endo uh and then you have to name it mb2 to give them you know take their bad dream into a full-fledged nightmare and then they get there and with they're overwhelmed and their assistant is no longer there you know the assistant turnover the assistant turnover and I’ve had more than my share of associates tell me you know um you know when they gave me my third different dental assistant in three months on the day of my big procedure i just quit and so um so staff turnover not using your own lab you know things like that and then with supplies the same thing um i couldn't believe it when i started hygiene town i started hygiene town because hygienists are very different than dentists and i never backseat drove my hygienist with supplies like i mean i couldn't imagine a hygienist come out to me and they'd say well should i get this paste or this paste or should i it's like you got a four-year degree you're a nurse in a hospital i I’m not gonna backseat drive my hygienist and i think that's why my hygienists have been with me for decades um because i don't do that so um but labor um well when we look at overhead you know if you go back far enough you know insurance used to be they just agreed to pay a percent of my fee they'd agree to pay a hundred percent for clean exam and x-ray eighty percent of fillings root canals half of crowns dentures partials and then about ten years out of graduation they started saying no we're going to do it differently we're going to give you the fee well the difference between the fee i was charging and the fee that all the uh ppos um and by the way you know anybody who sets your fee so many dentists tell me they don't do any ppos and i say really you don't take delta and they go oh well i take delta well delta give you a fee schedule and then yeah it's okay so that's a ppo someone else setting your fees and i think the you know the dentist charges a thousand for a crown but he signed up on this insurance um that you know give him 650 so immediately 35 of their overhead is an adjustment adjusted fee by signing up for an insurance plan which is basically a volume discount you're saying okay you charge a thousand dollars for a crown but sign up with us we're going to give you a bunch of patience so the volume discount is that so the number one fee is the um the adjusted fee production between your fee and the insurance but second is labor i mean labor and a lot of people I’ve seen this how many times have i seen this where labor was uh 25 and overhead was uh 60 and they thought well I’m gonna bring in a second shift so i work Monday through Thursday to five I’m going to work Monday through Thursday six to noon and I’m going to have a whole nother office come in from noon to 6 p.m so I’m going to double my availability and the same fixed cost and i always say well your fixed cost isn't your big cost it's your variable cost the labor lab supplies your fixed costs rent mortgage equipment build out computer insurance that's pretty easy to get efficient but where it's really hard to get efficient is with labor and I’ve seen them double their you know their utilization of their fixed cost but their labor slipped up from like 25 to 29 to 30 percent their overhead went from 60 to 65 to 68 to 70. so in trying to um utilize more efficiently their fixed cost they um went from an a on variable cost labor lab supplies down to a c and the whole thing wasn't a great idea uh for the stewards of capital um so do you see this and what is the labor that you try to shoot for and is it more efficient in small versus large like that office in Colorado you said it's doing what 10 million a year or how about was it awesome so does the does the 10 million dollar company have higher labor than the 1 million dollar company but you know you said a lot of things there i thought really interesting from a labor standpoint you know the hope is that once you have your leadership in place which are the higher dollar uh variable cost that you can scale accordingly right i think that's the philosophy that's actually applicable to mb2 support network right we have the leadership and then every time we add support um it's less than a dollar for dollar edition and so yes we do see that but if you don't know how to execute it properly that's when you get what you see today where doctors are just over hiring or don't have the capacity to do partial hiring right which is unique within our model is that maybe you don't need another four day weekend play maybe you just need it one or two days and then we can now distribute their other labor amongst other practices so that it runs more efficiently and scales more gradually what i will say is that unlike other large groups that have targets and try to manipulate staffing metrics we view practices kind of like uh playing golf man it's like as is where is we don't like to mess around with staffing metrics everyone has their comfort level number of front desk and back in support we like to keep it as is and so when people partner with us there isn't a drastic change in their staffing metrics and so we really uh value it off what they currently own what you said earlier was it was fascinating to me about what i used to do presentations at dental schools about the natural life cycle of a dentist and it's exactly what you said they would we would graduate we'd work at a few corporate outfits for a couple years and we all knew going in there that we're just gonna get our um our bearings and then open up our own practice and then they go off and then they build uh their own practice um they get the intestinal fortitude to take that risk right and so what i figured out earlier in my career was like man we're investing a tremendous amount of energy and effort training our associates right and then just for them to leave and start their own business even if though it's amicable doesn't sound like a good strategy so that's where the partnership came in so um interesting statistic is 46 of all our owners used to be associates within the group and so if you like say that again 45 46 of all the owners 16 5 owners i guess 165 owners um used to be associates within a practice within our network and so they've had a great a long time to basically interview us see how we help um facilitate the practice we've had an opportunity to interview them through the owner doctor of the practice and then they raised their hand and said okay i want to move to this state can you help us identify or help me identify a location and we support them that happens very often i mean we've gone to a point where a lot of dental students know that they want to ownership and we make commitments to them if we feel strongly about their aptitude we make commitments to them and say okay you're gonna if you work here for a year and you like it and we like you and you get your bearings we will go ahead and find you an office in this other state where you want to go back home or you want us you want to settle down and we'll partner with you and that's happened multiple times where doctors may not have originally thought about working in new mexico but they wanted to settle down in Colorado and so it has it was been a smooth transition from associateship to ownership and then multi-site ownership and so i like to think when associates join us it's not for a job it's not for a 12-month period it's really a potential career decision where if they join us they know that there's a path a clear path to ownership within our organization if they like and we like um the relationship during their associateship so i think that's what drives a lot of newer doctors to join us um and to address what you said earlier all too common doctors may see a lot of changes in these larger corporate organizations whether it's staffing-wise material supplies we have the stability of effectively private practices i mean we have the 10-year the staff is tenured like a private practice because that's how it was prior to joining the co-op and so doctors have the mentorship associates have the mentorship of the owner doctor paired with the consistency of the staff paired with the flexibility and liberty to order the proper supplies and equipment that works in their hands really it's a it's um a recipe for success when they're happy in their practice they can now grow into ownership in the market they want and replicate what they've learned when they're comfortable and that's a really big part of our growth strategy is taking associates from the bench many times you know sub five-year um graduates um and put them in a position of ownership of very with highly reduced risk execution and financial risk when we do that with the support of our organization interesting um I’m just i love business models i mean you can tell there's a lot of thought that went into that and um i mean it's just amazing what you said i still um so i want to go to um when you said that you know with labor that you know if i only need you two days a week here if you're part of an organization that's got a couple hundred offices you could work two days a week here and two days a week there um I’m seeing this and i just wanted to see what your opinion is of what I’m saying um obviously it's difficult hiring some kid out of school because they've only done a few of everything and they do they come into a dental office and the dsos have the best data and a lot of the kingpins of the dsos are very transparent and very helpful to uh me and the solo practitioner but they'll say okay this kid will come in and he'll do 10 molar root canals and he'll work first for a year then he'll go on and he'll go work somewhere else and then a lot of these fail and we have to send them to an endodontist and have them redone implants are the disaster i mean if you come into ma um and work here and i send you to some implant training facility and the first and you work for me for two years and you place your first ten implants uh well let's just say you place five um if one of them fails and i gotta send it over to a periodontist and have the whole thing redone to pay that period on us to redo the whole thing took the profits of the other four so you have four successful implants say the uh the owners of capital made 15 net on each one that they lost all their profit redoing the one so I’ve seen this big trend to where a lot of group practices and really we should talk about group practices because when you talk about dsos um the majority of group pro the majority of dsos technically are just group practices in two or three locations very few dsos are like where you're at with a couple hundred locations in multiple states but what they're doing these dso's saying you know from now on we're only going to have the endodontists do the molar root canals and we're going to only have periodontist place implants and it's kind of a great insurance decision because um the insurance companies pay an endodontist more money to do a molar root canal than a general dentist and then the downside if this thing fails when it ended on his fails he's just like hey I’m an endodontist i did it failed the boards stay away from you the attorneys stay away from you but whenever a general dentist does something it fails you always got some attorney or some board guy thinking well maybe uh Howard shouldn't have done it maybe he should have sent it over to an endodontist so are you seeing that trend i mean you're here in Arizona um are do you see going forward trying to have endodontists do all the molars and periodontists place all the implants just because the insurance companies are going to give you higher reimbursement um the downside is um pretty much eliminated because you're a specialist is that is that where the trends are going yeah no and you hit the nail on the head you know when you when you look at it statistically there's decisions to be made by an organization um of signs what i would say is once again we're drastically different like i do not like making um global decisions for the business when it pertains to clinical care because there's some great so there's some great gps that provide a phenomenal care I’m seeing a rise of gps that limit their practice to oral surgery for example and they're phenomenal at it and they have the training to do it and i would hate to be the guy that tells them you know i don't want you to do that i want the oral surgeons to do that or the periodontist to do that i think that's too much of a generalization and really it comes down to the individual offices and their training and their competency um you know it always surprises people when i tell them we don't have a clinical arm to our to our dpo like there is no clinical czar or group of clinical czars judging people's work i mean it truly is a group of private practitioners that are grown men and women they're providing great care and we definitely have you know um a standard deviation from what we believe is good clinical care and that kind of self-regulates i mean the individuals um who limit their practice to implants or to oral surgery um are gonna be um are gonna be monitored by their peers and that's the way we like to approach it not from a financial standpoint but really from a clinical delivery standpoint like i want the doctors to be in control of how they're treating their patients and their competency and be in charge of their ces and be in charge of their supplies and equipment um i think that you know large strategic edicts from kind of a corporate standpoint could really be detrimental to the morale of an organization like i don't want to be the ones telling people that you know I’ve seen I’ve seen financial decisions come down from corporate groups on staffing metrics on who's doing the procedures or often i think doctors are smart enough to figure out what they need and what they're capable of doing we have we have for example we have practices that are specialty practices that only do that are you know board certified orthodontist that's their business they join the group and they get efficiencies and economies of scale and then i have gb practices that say okay i don't want to refer out all my uh on my ortho i'd like to an orthodontist to come once a week and that's great uh in private practice that'd be very difficult to hire an orthodontist to come once a week right i mean what commitments does he have the other four days or three days um and so that's where our model shines once again where that doctor where that orthodontist has a full schedule but amongst five practices they're able to go to the practices and provide the care that the owner doctor um wants but once again with the flexibility of the owner doctor saying you know what i took the straight wire course or i feel confident in in providing that care or just Invisalign or whatever it may be um they can make the decision for their practice um that's not something that we make a decision for them well that was um so obviously brilliant i mean it's always been uh think global act local and you just perfectly summarize that um and that really um distance um I’m always amazed when I’m reading anthropology psychology business how distance is the major variable i mean um distance is going to determine um your spouse your language your religion i mean if you were born i tell my oldest sister who's a who's a catholic nun i said okay but just remember every day that if you had been born in Riyadh Saudi Arabia you'd be Muslim so just don't you know never forget that um when guys tell me they introduced their wife oh my god this is a love of my life it's like okay but you both were born in the same town of 5 000 and went to the same high school that had 300 um and the reason um free enterprise democracy always outdid um like um centrally planning soviet union is when Moscow was determining what to plant and when to harvest they were net importers of wheat and then in the united states where the government's like we're not going to tell you what to plant you're the one who decides what to plant and we were a net wheat exporter i mean so the person but i think my favorite line is um think globally act locally and panic internally so uh if you're the one who decides that that you're gonna do that mb2 and uh you're gonna do the root canal that's great uh dr v is not gonna tell you what to do you decided you're gonna do that molar root canal now you can panic internally think globally act locally and panic internally until you find the damn mb2 and then i just want to say um so do you would you say your um take all insurances that's always going to be a question um do you take all insurance well going back to um i think you'll see a common thread here i mean insurance and what they take is really dependent on the geography i mean we run a report and we use data to advise doctors okay in your market these are the insurance rates these are the carriers that we've negotiated pricing with it's up to you if you want to take this insurance or not in some cases they say yes in some cases they say no in some cases we run um we use data to run studies on what they're currently taking and then they end up dropping off the insurance plan when they realize what it is but i think that's the biggest challenge when it comes to insurance and being in or out of network is that you don't have it's really difficult to extract the data and make good data-driven decisions as a private practitioner and so when we are when we are able to present that in a way that's unbiased and just informative to the doctors they can they can make decisions on their own but yeah we go everywhere from we have 100 fee-for-service practices with very stable patient bases in the northeast to in-network um higher volume practices in urban markets and so once again that's a market-driven and owner-driven decision so um well that's the next question um heartland if they buy if they bought my dental office today's dental in phoenix it'd still be today's dental phoenix um aspen when they build an office they all look the same it's kind of like a like a mcdonald's or a Wendy’s or um they have a franchise look um where are you at um if you bought my today's dental would it be called mb2 dental would it still be today's dental what is your brain and i want to give one other example that the biggest example in united states is Kroger um when Kroger buys a grocery store chain like in Kansas when they bought Dylan’s it's still called Dylan’s when i moved to Arizona after going to several different grocery stores when i walked into fries i thought damn I’m home what is it about fries and then i figured out a couple weeks later oh it's owned by Kroger so are you kind of Kroger where you're the underlying systems and you can still call it fries and Dillon’s Dylan’s already come in and redo the brand and call it uh mb2 no we don't redo the brand you know what's funny is people think that we buy dental offices and we don't buy dental offices what i do is i back doctors and so if a doctor has a brand local brand with brand recognition we keep it i mean that's really the best strategy i think healthcare is a local initiative i think dentistry in particular is a local initiative i never i never believed that the economies of scale of having a single brand would ever outweigh the benefits of keeping a neighborhood cornerstone intact and we've done extremely well with that i mean we have doctors with multiple offices in the same geographic area with different names because they bought out um a different practice they manage and they are in charge of the clinical delivery but they know it's a recognized brand to keep it as such and so we never changed the only exception to that is if and we had a deal where um the associate was buying equity into a practice and the older doctor was retiring and the practice was named after that doctor and obviously it made sense to change um change the name of the practice but that associate has been there for seven years um the patients knew him and so that transition was pretty smooth and so um i see a lot i see less and less of that branding strategy in our interspace i think people are starting to see that there's benefits to keeping local brands intact and inheriting the brand that the doctor has created over the years huh and i just want to say one last thing on insurance um so if you're if you're affiliate that you're helping you buy a dental office and they take all dental insurance then you'll you support that and if they decide not to take a certain insurance you support that you don't really on the think global act local you're not telling your docs what insurance to use and i only have one caveat on that is um and I’ve said this on my show for four years um i take i don't take any hmos um i do take six ppos and when you look at seo dentists will you know people will if they don't have insurance they say dennis near me and they're looking for availability affordability someone close their office but if they get a subsidy from their employer or their government or whatever um they'll say dennis ceremony who takes blue cross and blue shield or united concordia or delta dental or whatever so those should be on your website for seo because that's what they're searching for they're searching out subsidy but i don't do hmo and i'll tell you why because um i don't believe in the transfer of risk analysis i mean um and i saw this you know I’ve already lived through this where they said okay well the insurance when i got to school the intern studies were saying well at the end of the day um this dental insurance company is giving you about 20 a month per patient you're like okay and then they say okay well we and you know we know incentives matter people chase incentives so if we just you know um cover some you might do crowns instead of mod amalgams you might um retreat a root canal instead of an extraction and we want you to have skin in the game so we're just going to transfer you the money and then you get the same whether you do a crown or an mod or reach your to failing root canal or extract it and i'll be the same and i thought well that's pretty interesting and then you look at the math but they reduce the 20 a month down to six and it's like oh i thought we were talking philosophy of chasing incentives but you just you just cut the fee if they would have done that and kept the even steven money um it would have been a very interesting thing to watch um how did that affect the difference between the amount of mods and crowns um you know if you got 20 a month per person but they didn't do that so it was a great sales pitch and then at the end they stuck a knife and then the other thing i want to say is taking medicaid um if i have a dispute with blue cross blue shield or delta or whatever it's a civil dispute and even if we went to court it'd be a civil court thing but whenever you deal with medicaid if they have any billing issue or whatever they're gonna address it with a sledgehammer and a prison and take all your money i had a very good friend whose wife was adorable and uh gosh i loved her to death and she screwed up all the all the billing and um he got the best attorney in missouri and the best attorney said you know i all i can do for you is if you plead guilty um you'll do seven years in jail so they had to move to mexico city where they lived out the rest their life and the dentist just died i think about last year thanksgiving but it's like you know the government is the mob and if you're if I’m doing business with Kroger or walmart it's civil but when you do business with a mob and something goes wrong they'll kill you um i just categorically do not do business with the mob because they're gangsters and your mama told you not to kidnap people put them in cages and kill them and this is what the governments have done for 5 000 years so um and then the best summary is just know your numbers and so then the next thing i want to ask you is um to run 200 dental offices you got to have a great management information system are they at least all on the same practice management system i mean are they all on ventrix eagle soft or open dental or so is that a standard thing that you would need i don't know how you'd run two hours so in terms of ehrs when we were growing i would interview a lot of the other groups and say hey have you guys converted to universal ehr and i never really had a resounding um resounding yes uh to any of those questions everyone had their problems with their with their enterprise products and so what he did you're saying hr and ehr standing for electronic health records um there's their systems right the everyone um tried creating their own mediocre ehr or adopting an enterprise option with very little success and so what we did as a group is we created we outsourced and we created a cloud-based api which is basically a system that sits behind Dentrix or Eaglesoft that usurps the data and then presents it to us in one way and so you know we have the majority of our practices are in Dentrix the second leading being Eaglesoft the orthodontists have their own system so on and so forth when we partner with a practice that means we don't have to disrupt the business i mean if you ever enter a mature practice a mature practice where they've been using um eagle soft for 20 years and then you tell them hey you know you guys have to change to Dentrix let they'll be catastrophic i mean the staff not only will dislike you because it's more work on them but you know the efficiencies are reduced and so the elegant solution that we found was finding what's creating a cloud-based system that basically takes the relevant data points from each system and then presents it to us in real time right and so it doesn't matter if you're on Dentrix or Eaglesoft we get the data we need in order to create um dashboards that will be helpful to the to the provider and that that goes for operations kpis um marketing and it it's constantly evolving where the doctors are asking for more data and marketing for example and then we then develop we outsource but we help guide development of their request to add on to our system and so the answer is yes or no we don't have the same system at every office but yes in the sense that we use the same dashboard for every practice in real time wow that so you bought that or you created it yourself we created it we negotiated with a developer and said this is what we do on spreadsheets go make it for us in a program in real time um and we will then subscribe per location to that product and so was it was it a uh was it an already existing dental practice a software company or is totally no totally they they've never done it before but you know i'll plug them now i mean messa6 with jarvis analytics has a product say it again mesa six mesa six yeah how do you spell that m-e-s-a-s-i-x i believe m-e-s-a-s-i-x yes mesa sex um what else what's it called jarvis is the name of the program which is yeah jarvis is the name of the program that we helped create now they have different variants now that they're offering it to um other providers but we were the original kind of brainchild behind developing that program um i will say for those of you who see video I’m a big comic book nerd over here and that's why our logo is red and yellow because I’m an iron man fan and jarvis was the name we use for our platform because that's a that's a nod to the comic book they just inherited that from us and so it's a obviously we don't just full disclosure we don't own any of it i get no revenue from it but that is how we developed it we said hey we'll teach you how to develop i will teach you what metrics a dental office would need in return you'll develop it and then we would subscribe to it after it's completion and then you can offer it to others who find it valuable nice so uh so you um you are a fan of messa6 yeah nice guys uh Steve Maroulis is a great guy i think you know we use the product and all of our offices and once again if you don't want to have the capital outlay to build your own system which is extremely expensive this was just an elegant solution where you know it's a subscription-based solution so that it keeps everyone honest if you don't like it and you find a better system you can drop off of it and try a different enterprise system if you'd like and so and the other thing that's um so tough in the united states is united states you know a good programmer is a lot of money and some of these big companies um will go to Asia and um where they can get you know just a lot more programming for the dollar yeah and i think they do have a hybrid model where they have some form programmers but you know they're based out of here in Dallas as well so I’m able to give them guidance on what we need in real time um and once again i get nothing for advertising for them but i think it is a good solution if you are an acquisition mode and you're looking for um looking not to disrupt um operations this may be a good solution for you well i am advertising and i expect mesa x to send me that new beer that Connor McGregor i mean my Irish buddy has a new beer and i just felt like i just feel like an Irish if I’m not going to go out there and support uh Connor’s new beer so you're saying that the founder in Denver was uh you said um steven Morales oh Dallas stephen Maroulis yeah he's up here in Dallas but he's there in Dallas so so you recommend him then yeah great guy that's awesome um well is is he going to be in the market for um either this dental product for other dentists i mean yeah he has a lot more i mean we developed we helped we'd help develop this years ago we're talking about five six years ago since then um he's been growing offering it to other providers i don't know how many there are but i know there's more than us a lot of smaller groups use this platform but but i think that that's that's really one of the biggest benefits of being part of a large organization i mean is simply extracting the data and providing in a way that is is digestible and actionable because um now does that also hook up with your accounting um so um you know so doing all your um accounting does this um product help you know like my deal is the reason i switched to open dental is because i saw you know whenever i would uh podcast interview someone programming anything new especially if it was fintech or anything exciting um obviously delta Dentrix is owned by henry shine that has offices in 56 countries so that's obviously the biggest brand and probably half the systems next would be Patterson which owns Eaglesoft and Effingham Illinois but those are closed proprietary systems and a lot of people have been moving towards an open system and my holy grail was that you know the worst phone calls years when your cap calls you on august 14th and say oh tomorrow you owe the irs a hundred grand and they're like 100 grand my savings account doesn't have a hundred dollars in it because they're on their accounting's on quickbooks pro they can do their tax on turbo tax but it's not related do you think that's something where steven could connect open dental to turbo tax to quick quicken and give my homie who's all by himself the individual all those tools in one do you think that's something he could do that's the holy grail man that's what he's working towards and so that's what he's working for that's ultimately where it's working towards is to have a single platform we obviously are a lot more complicated than a sole provider and so we still have to use very robust accounting software um for our books but an individual provider is much more realistic to have a single program and i know that's on the docket for his company to try to create a one-stop solution but yeah i think that's a that's a pain point for many private practitioners well tell him uh hook me up tell him i want him to come on tell him to come on the show yeah and that's uh actually very big of me considering he's probably one of those Dallas cowboy fans i mean you know those uh i mean how i would let a cowboy come on into Arizona cardinal country is a blasphemy of the highest order but uh my dentist they don't know their numbers man i mean they'll have a height they'll have the same hygienist in room one for ten years and she'll leave the room she'll do a cleaning exam and bite when he's on to say hey doc did you did you net five dollars and 12 cents after taxes or did you just lose 18 bucks he doesn't know he doesn't know and dsos i think their biggest advantage isn't that they can find the mb2 for you i mean they're thinking global acting local they're not in your operator they don't know where the mb2 is anymore than you do but they're getting a's in the business the finance the legal the marketing their everything that doesn't have to do with finding the mb2 they're doing better than someone who spends all their time trying to learn how to do endo place implants and bone grafts so i'll share a story with you um we were at office number 40 and it was me and a bunch of dentists sitting around the conference table and we thought we had it all figured out we had 40 offices we had a bunch of dentists running this place and i was sitting back and i said you know if we if we showed or if we taught a business guy how to do a root canal you think he'd do a good job and everyone started laughing like nah that's garbage you'd suck and i said what are the chances that's how we are with business you know what are the chances there's actual people that went to school for business and went to school for accounting with school for marketing what if we built a team that everyone did what they were taught to do and that was in 2015 um that was the first year we had true business expertise in the organization our revenue went up by 12 which was great but our profit margin or even a margin profit margin went up by 62 and so we didn't work any harder we didn't work more it was simply understanding the numbers better and i think that when i graduated 2004 people said well dennis are so smart you know they have a 99 success rate and what i realize in running business is that is not because of ourselves that is in spite of ourselves i mean i think dentistry is a very um lucrative profession that gives you a large margin of error and so if you actually paid attention to the numbers and understood the consequences of your staffing decisions you just make better decisions the problem is between being a provider and being a business owner and having to do all that it just becomes overly complicated and the good news is even if you're not 100 efficient um you're still making a great living and so that's what you know we've found time and time again is that if we use systems like jarvis and we have a full-fledged accounting team that's dedicated to providing the information we as providers are just making a lot better decisions you know you always um talk about the importance of finding mentors um how did you find your early mentors who were your early mentors you came out of nova in what 2004 2004 2004. 16 years ago so how did you uh set out on a journey to find mentors to learn this business is you know faster than learning everything the hard way yourself well i always tell students you know or recent graduates that it's really quite simple i mean you just i think dentists in general they're just a fraternity amongst us where we tell each other the truth when well at least when you're on one on one maybe not on online forms but what i want you to talk to when you call and my advice is simply if you look at someone and said hey you know i would be really happy if in five years 10 years 20 years i was doing what this guy was doing um really blatantly ask them if they would teach you the way you do that and then you can make modifications along the way me personally my mentor was a doctor out here in Texas dr barry solomon he was kind of one of the first guys during the monarch dental type growth in the space he had something like 17 practices and he was spending most of his time mentoring doctors as opposed to um working chair side four or five days a week and i said you know that would be a nice end goal for me to have a handful of practices where i can work if i when i want to um but ultimately be a good mentor and be a good steward to the profession and obviously that kind of snowballed into what it is today where doctors appreciated our model and doctors appreciate the autonomy um but i think that was a big influence in my career early on was you know having a goal seeing you know yourself in in your mentors position years from where you are today and really just asking them to take you along for the ride i don't i don't see very many um doctors um turning uh mentees down i think that we're happy to help i personally um do that often because i think that you know the profession has given us so much and we need to continue to give back to it yep good old barry j solomon dds in Houston Texas uh he's a great guy and uh that's uh so cool uh that he has a mentor um he's a he's a uh townie and um he always um if I’m ever off on my column he always uh lets me know love that guy tell him i said hi next time you see him is he is he still practicing or what's he doing i would talk to him a little bit but yeah he was he was uh retired down in san Antonio plus i spoke to wow it was it was my uh it was one of my first jobs out of school so i want i want you to um i want you to um tell me about this because to me everybody who comes out of dentistry and whether they set up you know their goal is just one dental office or 10 or whatever their goals are it's always they're always able to attract a great executive team at least one other person i mean if you're a dentist and you graduate and you're all that in a bag of chips that's great but you got to have an office manager a hygienist a reception um how how would you describe um the journey of finding a great executive team i mean obviously if you got a couple hundred offices you got a great executive team but how much of all this was because you're you were just born greater than a bag of pretzels and how much was it that you were able to find and attract and develop an executive team who's been there with you since day one no it's extremely difficult and i truly give all the credit to my team i mean i always joke that my biggest preparation to be the CEO and founder was simply that i was the social chair of my dental fraternity right i just got along with dennis i have no formal business training but i realized early on surrounding myself with people that do is extremely powerful and letting them giving them the latitude to make decisions now with that said we've made a ton of bad decisions just like every other business startup but at the same time um giving great individuals the latitude to make decisions has been a godsend for us I’ve curated my team over the last 16 years we've been very blessed in being able to attract great talent something that actually is more difficult for um a single provider i mean just based on the fact that we can't afford those type of individuals um as a sole proprietor and yes there's consultants et cetera to bridge the gap but when an executive opera performs at that level it's hard to beat and so we've had I’ve had a very stable team for many years now the most difficult part i always say of scaling a business is acquiring the right talent i think once i have the model once people understand the program um you need people to actually go out there and execute on it that represent you and your vision and i think that if you spend most your time making sure that those surrogates are good representations of yourself um you'll save yourself a lot of headache down the line and so um you know it's just a grind and trial and error and then once you find that person you know make sure you treat them right they'll take them for granted and make sure they feel that they are making the decisions a part of the team um i view my job as CEO more along the lines of taking care of my subordinates you know making sure that my executive team is getting what they want and making sure they're happy so they can continue to grow this organization with me and i think that's the right approach whether it's in private practice or in a larger setting like I’m in tell me if this is true or false because the one thing I’ve noticed is the greatest ceos would rather have bad information than good i mean if I’m paying a bunch of people they all tell me every day how great i am i mean i call that the Saddam Hussein syndrome because if anybody told Saddam anything he didn't want to hear he just killed him so of course his generals were telling him the night before the big war that that he was going to win and you see these dentists well they'll have a staff meeting for an hour and they just lecture for an hour like they're at the local study club and if you disagree with them they get mad they get angry um i think the reason I’ve been able to keep so many people i mean like Lori i mean i could imagine to this Laurie and Stacy and Marcy and ken and dawn and brandy and Jamie i mean i mean these are all people Tom Giacobbe you know um Howard Goldstein these are people have been with me for decades and they can always tell me the worst damn news and because that's where you need to be and so many dentists if they could do a staff meeting they say okay i i remember i'll give you an example i remember when uh Sarah came out and I’m so damn old and we're talking creak one i bought the cerak one which is actually i think i think i could make better temporaries with acrylic than the cerak one but you know as intel made chips bigger cerak2 was better sarak3 then eventually it was uh you know it just was it was amazing but i remember the first time telling myself that i was going to buy this Sarah Kwan and the price of it and oh my god they just let into me they go you are such a hick from Wichita Kansas our bathroom looks the bathroom at walmart looks better than our bathroom and this thing is seven years old and we need to take that money and remodel and blah blah blah blah and then i realized at the end of the meeting that the only way i was going to get my cerec is i had to pay for a remodel and a cerak and because the option was i couldn't sit there and say well I’m right and you're always wrong that's not how you keep people for 20 30 years you know you need to be bad information um do you um or how do you handle the work bad news coming from people you're paying on your executive team yeah i mean that's extremely important what you just said and i think it's relevant once again to private practitioners for me listen i have a two hour meeting on Monday and it's all hands on deck and they we talk about the current state there's a lot of decisions to be made but i tend to manage through more of a democracy than probably a lot of ceos i listen to the pros and cons and when i make a decision i don't just make it i explain to them why i made the decision i explained to them why there's some difficult decisions that may not be so obvious to them here's a good example there was a there was a practitioner here in north Dallas that was doing four and a half million dollars in in revenue all fee for service been there for 25 years a steward of the community by any measure this would be a great practice to partner with right great practice for a do so for a private prior practitioner whatever it may be i actually went to dinner with these with his doctor i came back the next day which was happened to me over the weekend on Monday and i told my team listen um we're just not gonna put an offer in on this practice and they're they question me dr v you're crazy you know that's a great practice he's been there for 20 years he's very low risk he's staying on you know we should be paying up for this practice and i told him i said you know all i know was when i was full-time in private practice if i was booked out when i was booked out four or five months couldn't get another soul in my chair and a patient came in and the patient presented themselves and they had a 20 000 case and i was ready and prepared to do it but i realized the patient was a little bit of a prick it was just a hard difficult patient i had the luxury of saying I’m not the right provider I’m not the right one for you maybe there's someone else and having the intestinal fortitude to say that and i feel the same theory applies to a growing business like ours I’m like i don't need to be the biggest i just want to be the best and i want to be surrounded by good people and i don't have time to be dealing with drama and i think that's a good metaphor for our organization like i don't just say no we're not going to do it you know take it or leave it i explained to them so that they can that then when they're on their own when I’m not in front of them they can espouse the same values to their subordinates right and i think that's a that is a good strategy for anyone in a leadership position it's not just to make a decision and take it as gospel but you know take the feedback um and earn the respect by explaining your decisions even though they will follow you if you don't explain it right and that's what i tell the team like don't ever take people's loyalties for granted even if they don't ask for an explanation give them the explanation so they know that you are thoughtful about it so they know that there's reason behind it and then it doesn't turn into a dictatorship so i think balance of power is huge i think you know making sure those checks and balances is huge making sure that the doctor out in the clinical level has the right to veto you and you veto them i mean i think that's a very delicate balance but that is when executed and when executed properly is extremely powerful and i think that's why um good leaders with a sense of humilities um really succeed because they understand that they're constantly in a state of flux trying to make a good decision from a lot of data points and you know what when you look at world history i mean like um when you talk about like a government system i mean there's been several thousand different types of government systems but the only the only thing i can mathematically see that's important is checks and balances and transparency and if i and if you go into a room and close the door and don't tell anybody um you know um you know ask uh you know you know some something bad could happen ask poland they didn't see the blitzkrieg coming it wasn't transparent and with leaders um that's you know when they started this country they broke up the king into the executive branch the congressional legislative branch the judicial branch and then there's all these other institutions from you know i mean there's so many government agencies you can't even count on but I’ve always told them to stay in your own damn lane i mean you spent eight years to learn how to do a root canal and now you just signed a 10-year lease in a building and you didn't have a real estate attorney look at it and I’ve been out long enough to show you what happened when some guy's roof started leaking and he found out he had a triple net lease and he had to pay for the whole thing but he was part of a 10 000 square foot building and all the other tenants were like yoga people so they just closed up shop took their mat and went down the street and he was left with the decision either you fix the whole 10 000 square foot rent or you move your damn dental office and yeah you know so then it's just don't stay in their own lane government politicians don't stay in their own lane and you need to get an executive team that's transparent and um you stay in your lane and once you're working with someone who's not transparent who's not telling you what they're doing and then they're trying to make decisions that they know nothing about it's just a recipe for disaster hey i know you're busier than a one-armed dentist and we went over the hour just quick couple quick follow-up questions um my homies want to know in Arizona I’ve been asked this four times this week um are you hiring in Arizona i am I’m in phoenix i got i got a you know a.t still and midwestern and these uh these kids from the coveted class of 2020 they're unemployed they're looking for jobs do you have a central job board or is that something go to each office and who would be like who's the kingpin mb2 leader in Arizona who would be there so we've grown tremendously in Arizona last year we started with zero and we're up to 30 plus locations now with partners in every location and so i think it's difficult to identify kingpin because it's 30 individual practice owners that have joined the co-op um i'll help you out because the kingpin in dentistry it's always the bold one it's not the guy with perfect hair like yours in fact I’m looking at your hair it's so obvious it's a wig it's either a wig or it's perfect which one is it is it a wig it's a ball guy that's not a wig I’m keeping as long as i can man and keep it as long as i can um but who would you say he's a leader in Arizona I’m sorry who would be the mb2 leader in Arizona so just the way we work is we have our website and people can get on there and apply and we nb2 will triage all the applicants and say okay these are the 30 applicants that are interested in Arizona we then give it to the 30 owners in Arizona and say okay what are you guys hiring for what are your criteria they're able to then interview them individually so we mp2 is simply curating and organizing the applicants we then offer them to the individual owners the individual owners interview and make the final decision and so what's interesting about the model is then we can also get those applicants and they say okay well I’m open to working somewhere else for a year and then going back to Arizona they're in the system they're able to work in in other parts of the u.s that they may not have a reason to today knowing full well that they're going to return to Arizona when they're ready so that more often than not happens and obviously as we spoke about earlier they may then eventually say hey i actually want to be an owner in Arizona and then we can then segue into an ownership conversation if everyone gets along so um so I’m on your website now if you were a dentist come ask you i see the about services blog YouTube video start the conversation where would he go to put find that at the job sir well start the conversation i believe is where you can just put your information and it goes into our doctor advocacy group where then they can put it into the system and reach back out to you and say okay what are your interests what you know what type of practice are you looking for and what markets are you looking for okay um very good and then um and then last but not least i wanted um i yeah Phil is such a big town he Phil Zamano out in Connecticut you said you're in 26 states Alaska to Connecticut is that what you said we're in 17 states from Alaska to Connecticut to Florida we're geographically agnostic we really just support the doctors so if a doctor out of north Dakota called us and we liked them and they could use our support and they espouse our values and we partner with them tell Phil i got the big dog i got dr v now i need to get dr z tell Phil that we'll go uh v then z but i love Phil’s post uh he's always spot on um just an amazing guy but uh is there anything um that you wanted to talk about that i was too dumb to bring up or forgot or no it did a great job and hopefully your listeners will have a clear understanding now of the difference between a dso a dpo and a private practice you know i think one thing we always tell each other is to do our homework right and for me a part of that is talking to as many dentists as possible and so people always ask me whether they're partnering with or selling their practice or joining a private practice like how do you diligence the opportunity the answer is always the same i would say you know call the doctor or the doctor that's there the doctor that was there and asked them about their experience i think that's great advice no matter how big you get so for your listeners um i would offer any of our doctors up as a as a data point in your decision making and if obviously this makes sense to you and this interests you um feel free to reach out to us yeah and tell um so um is Daniel Blair is he the in kind of charge of Arizona uh no they're once again if they're all different they're all different private practitioners but yeah i'd like to uh i'd like to podcast an mb2 if you can think of a good mb2 dentist uh who's not afraid i know a lot of people are i know public speaking is the biggest fear everybody says it's the biggest fear but I’ve never been to a funeral and someone said well i'd rather him be dead than public speaking so I’m glad grandpa's in a casket but yeah if you got a uh if you got someone who uh is not afraid of uh um public speaking uh an mb2 dentist in Arizona i'd love to talk more because like say these uh these are big forces in dentistry um Arizona is number one it's 18.6 percent of all the dentists are working for a dso and um in these hard times um you know like say i love them because when i got out of school um the only people that would have hired a dentist straight out of school was the army navy air force marines public health Indian public health service and if it wasn't for especially mike i seemed like the navy was the biggest employer of uh new kids well now they come out of school and the only people the only people um hiring new dentists are the dsos because they're already back up to pre-pandemic levels because it's operations and logistics it's having a plan it's execution and uh so thanks for all you do for dentistry and um it was just an honor to podcast you chris thanks so much for coming on thank you thank you Howard!
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