Scott Leune (00:00):

Forget for a second. This question, how many doctors do we need? Start with how many procedures do I need and I'm taking home $1 million a year, only working enough per week to do four or five cases.

Richard Low (00:11):

Dentists assume this is high risk, the risk is so low. Welcome to Shared Practices 2.0. This is part three in a series talking about the possibility of a million dollar take home with my co-host, Dr. Scott Loon. Leune, sorry, already screwing it up At the end of last episode, I was explicit in spelling your last name and pronouncing it correctly for our listeners, and then I botch it at the beginning of episode three. I love it.

Personal Anecdotes

Scott Leune (00:49):

No, I know listeners that have names that are always spelled weird or wrong or botched would appreciate this moment. It's a normal occurrence in my life. No problem. I was actually born and grew up in Amsterdam and didn't move to the US until I was 11, so I didn't learn English until I was 11. And so my last name is a Dutch last name spelled L-E-U-N-E, pronounced in Dutch Leune, but no one says that in that battle. Doesn't exist here. Yeah. So it's Leune and everyone thinks

Richard Low (01:19):

I'm Hispanic,

Scott Leune (01:20):

I'm not.

Richard Low (01:20):

I love it. And correct me if I'm wrong, were you in the temple, Texas area for a little while?

Scott Leune (01:28):

Yeah, that's where I went to high school for three years in Belton, right next to Temple. Yes, I did.

Richard Low (01:34):

I was at Fort Hood when shared practices was born living in Harker Heights, just down the road. And I feel like there was some seafood restaurant right on some water that was in the bein temple area that I was like, oh, this is the area that Scott's from. Yeah,

Scott Leune (01:51):

Yeah. And I used to be a professional musician, so I toured, I was gone. I was doing studio work a lot. So even in high school I wasn't really there a lot. I was constantly traveling. And so I was kind of like high school to me and living in Belton, to me it was a blur because I was doing all these cool, exciting things and playing music. Man, that was a lifetime

Richard Low (02:16):

Ago. Well, one last little tangent there. What instruments or instrument did you play?

Scott Leune (02:22):

I made most of my money and had most of my success playing keyboards and singing. However I was weirdly, I was like a little trumpet prodigy, so I had a full ride in college on trumpet. I studied with people from the Tonight Show and I traveled New Orleans to study on trumpet, but no trumpet, never paid the keyboards and singing is what my career was about.

Richard Low (02:45):

Love it. No, and our listeners know that we do a little bit of tangents on the podcast, but we're not the talk for 15 minutes about unrelated stuff and then get into the topic like, nah, this is why we're here. But I do think the audience really appreciates kind of these little, okay, over time they get to kind of connect and hear the details of our lives. So I'm actually on the side right now. I've got a list in my midlife crisis of unfinished business. So things that I started or enjoyed in high school or growing up that I never really got to fully explore or get good at. And piano is one of those things. So I'm about to start taking piano lessons from my mother-in-law who has a little studio and I'm just like, okay, I am a baby piano player at this point, but

The Part-Time Million Dollar Dentist

Scott Leune (03:39):

Well, don't do that. Just get the app. Simply piano the piano. I'm serious. Simply piano. My second youngest taught himself how to play piano when he was like, I dunno, four and a half or five on that app and my middle child as well. So it's straight out. But let's get to dentistry. Let's get to a million dollars, take home pay working.

Richard Low (04:02):

I reached Scott's limit. I now know that George and Scott have the same,

Scott Leune (04:06):

I've just ed it to the listener. I love to talk about music the whole time.

Richard Low (04:09):

Actually, no, George and Scott have the same tolerance for pre-show banter. So I am glad we found the limit. This is what you teased as something you are even more excited about, which is the idea of being a part-time dentist and having a million dollar take home pay, which can be a linear step from the last episode of being a full-time dentist with a small team and a small staff and having that take home pay. So describe for me like you did in the last episode, if you don't mind the anatomy of what this looks like, how this is possible so that our listeners can understand and see what this looks like. And I think it'll provide a lot of clarity right up front of what's possible.

Scott Leune (04:56):

Well, how about this? How about I describe some aspects of it, but you and the listeners tell me how big of a practice this is, how's it made up? We'll see if we can get there. So see if the listeners can figure this out too. So here's something very interesting. When you look at the business side of dentistry, if you have, let's just say an associate dentist and their production, their collections are enough that all of your expenses are paid for the business. You're not picking up a handpiece at all. They're the ones picking up the handpiece. And when the dust settles, there's profit. And as we know from a dsso style model, that profit could be 10 to 20% or even more, but there's profit there. But what if in that practice where all the expenses are paid by the associate, there's empty chair time and we go insert an owner only into the empty chair time.

We haven't had pay for new rent, we haven't had to pay for new utilities, have not had to pay for new marketing. We still have the same office manager, we still have the same hygienist. We have not had to increase any of those expenses. The owner is going to use the capacity that's open that already exists without adding any of those more fixed expenses. What expenses do go up? Materials. Materials go up. What would the overhead be of if we were to call the owner's two hands, this kind of virtual practice, what would the owner's overhead be in this scenario? What would you think it

The Pseudo Specialist Model

Richard Low (06:37):

Would be? So based on what we were talking about last episode, if we assume that there was openings not only in chair time, but also staff team capacity and we're not having to add team members to the overhead, then lab and supplies nine to 10% for that extra dentistry that was done when no dentistry would've been done. And other than that, I don't really see a lot.

Scott Leune (07:08):

You're exactly right. So let me tell you a quick story here. I'm a first year dentist. I have a booming startup. I break my back in four places. It crushes all the nerves that go to my lower body. And then for the next 11 years, I'm in excruciating pain, suicidal levels of pain. I have to be in and out of a wheelchair. My wife has to bathe me, drag me on a towel on the floor of a specially made shower every day. I can't hold a baby, I can't dance, I can't walk in roam. I am constantly thinking about pain every second. And I couldn't be a dentist, but I still wanted to be a dentist. And in year two, from in and out of a wheelchair from this back problem, from the pit of this moment, I still found a way to do dentistry.

And what kind of dentistry maybe could I do with major back problems? Something that required me to bend over for short amount of time, not very often. That was ortho. So I learned how to do comprehensive ortho. I thought this has the only chance of me being a dentist if I could do ortho. Now, my practice at that point, year two had grown a lot and I had already had now associates. And those associates did well enough that we were profitable without my ortho. And I just used the empty chair time we had and I used an assistant or two here or there, and I used the same front office team and I did 1.1 million in ortho starts that year. In addition to the 1.1 million in ortho starts, there might've been another a hundred, $200,000 of profit that the practice had without me. My take home pay was over a million dollars.

And if you see, how did that happen? I did it on accident. How did that happen? I've called this being like a pseudo specialist as an owner, but you don't have to be. But it's easy when you are, meaning I know how to do a specialty procedure or a few maybe, and I'm going to have a virtual specialty practice that is going to just kind of hover over my existing practice. My overhead as a pseudo orthodontist may have been only 10%. The overhead of the orthodontist I refer to, I guarantee you was way higher than 10%. And if we think about, now let's use another theoretical. What if I'm a periodontist, an actual specialist, I will likely make way more money with my two hands having a virtual perial practice float over one or two GP practices I own. I might have 90% take home pay on my own two hands.

Then if I did the same amount of perio in a standalone facility, I would call my perio practice. So now how do we make a million take home pay as a part-time owner, we have to have our practice paid for without us. And then all the dentistry we do, 90% of our own two hands is going to go in our pocket. So how big of a practice is that? What are we collecting? Let's literally get a calculator out. Actually, before we do that, I guess should we explain more about what I just said or do you think everyone's

Calculating the Practice Size and Production Needs

Richard Low (10:34):

Getting, getting it? So here's the assumptions that go into this. We've got our overhead paid for by hygiene and associates with some amount of profit left over. We've talked about a hundred to 200 K leftover and we've got about 10% on our additional procedures that we're doing, even if they're maybe some specialty procedures that have different requirements, implants or ortho, not that much variable expenses associated with this. So the math should be fairly straightforward and my brain has been working in the background, but I need the calculator. I need to write it down. I'm not good enough to break this all out. And the question mark I have is how big does the associate driven portion need to be to cover expenses and generate 100, 200 K? And then it becomes very easy to calculate how much dentistry I need to do with my own two hands to make up the difference and get to a million dollars.

Scott Leune (11:40):

Yeah, great. Great comments here. So we've got several things we need talk about. So first of all, what whether we had one associate or 10, what if it only broke even to then take home million? I'd have to take home 90% of something that equals a million,

Richard Low (11:59):

Right? 1.11.

Scott Leune (12:01):

So that means I have to produce 1.1. Okay, how can I produce 1.1? And this is one extreme. Extreme says my practice makes no money. All of my take home pay is just going to come from my two hands in this virtual model. I got to produce 1.1 in this virtual model. Okay, well, in this virtual model, if I am a pseudo specialist, that means that every time I use my hands, it might be something like a 5,000 case, it could be more, but I think 5,000 would be a reasonable assumption for learning purposes. Do you agree?

Richard Low (12:35):

Absolutely.

Scott Leune (12:36):

Okay. So $5,000 case. So if I have to do 1.1, that means that per year I got to do 222 cases. So that means per month I got to do 18 cases a month of whatever this is. So that means I have to do approximately four or five cases a week. Alright? So four or five cases a week. If I'm only showing up to work two days a week, I could do four or five cases of just about anything a week. Would you agree with that?

Leveraging Specialty Procedures

Richard Low (13:06):

Hundred percent. Two days doing two to three procedures a day seems reasonable.

Scott Leune (13:14):

Well, it's, yeah, two to three procedures a day. And I don't have to do any hygiene exams. So in other words, if I want to take a vacation for a month, no problem. I'll just put those five procedures in the next month. We'll do 10 in the next month instead of five, right? Or you know what I mean? So what we're saying is if I make zero profit on my practice, my own two hands, I need to do four or five cases a week of these $5,000 cases. Obviously if I know how to do bigger than five, I need to do less. So the question starts here with, okay, on one extreme where my practice doesn't make money without me, the most cases I'll have to do in this extreme is four or five a week. How can I get four or five a week?

If I can get four or five through just marketing and plucking from the recall base, that's great. If I'm really effective with it, I don't need as many associates as, I don't need a huge patient base to give it to me. If I can't get any through marketing and I'm not effective at getting it from the recall base, I might need more and more recall patients to fill me. So there's some levers there. If I market better, if I'm good at conversion from the recall base, I need a smaller practice to achieve this. Now that's whole one category of thoughts, of levers of decision-making. The other category says, well, I need to use open time in my facility. And if all I have is a five operatory facility that's only enough for one dentist, I could expand the hours. And now I've got two dentists up to two, of course I'm expanding my staff, but I could expand the hours.

So I would say in this model, a five op facility is likely the smallest. That's feasible. It would have to be expanded hours where I would have maybe one and a half dentists. If I can't get enough cases from one and a half dentists of a recall base, I would need more dentists. And that's common. So I might need seven ops. Seven ops could get me two full-time dentists with some expanded hours and open capacity. Seven ops is probably the sweet spot where this model is simple. Now let me make it even more confusing. Four or five cases a week is harder to get. If all I do is invisalign, four or five cases is easy to get. If I do Invisalign and wisdom teeth extraction with sedation and sleep apnea therapy and I do a bunch of Botox, I don't know. You know what I mean?

So the more specialty procedures I actually can do the less patient base I even need to get my four or five cases a week. The reason why once all this sinks in, I think will be a shocking aha moment for people is that we tend to not take this path when we are a dentist that has a full practice and and we start daydreaming about only working part-time. We start daydreaming about can I find the right associate? They can take part of my days, they can help me when I'm off a vacation. I can help them when they're on vacation. We don't think, oh no, no, no, no, no, no. We just need regular dentists that are going to do decent work and have us at least break even. And I need to be building my specialty skill and my specialty marketing and my specialty conversion.

And what this is actually going to look like is I'm never going to have to do a hygiene exam again. Now I have full schedule freedom. I don't need a super associate, I just need a practice without me. That at least breaks even. And one last thing before I shut up, this four or five cases a week assumes the practice only breaks even if the practice makes money. We're not talking about four or five a week, we're talking about whatever, two or three a week. And if I know how to do several things, oh my lord, I'll have, sorry, I think my computer froze. Oh my lord. I'll have two or three cases a week every single week without much trouble. All right, so lemme pause. I said a whole lot there. I'll pause for

Transitioning to a Part-Time Model

Richard Low (17:41):

No, that was great. I love the levels of assumptions here because that allows us to find opportunity at each level of, okay, can we find a practice that we can break even with two associates, seven ops? Can we do that? That's very reasonable. Okay, can we find an extra 100 to 200, maybe even 300 K of EBITDA of profit that is coming out of what's going on in the practice by going back to yesterday's episode or last time's episode by tweaking a lot of these dials and building a really good system and building a really good practice that operates well. And then on top of that, we're making assumptions about the dollar amount of the procedures we're doing, the numbers of procedures, we're doing the numbers of days required. And each layer here has options for us to play with the freedom and the configurations that go into this.

Whether you're loving all on four or whether it's like I love full band and bracket ortho and I love printing my own aligners, and so I've got great margins on those. I'm all into that. Or I love pediatric dentistry and my associates don't. Or I have a scope and I like to do root canals, whatever version of this, whatever configuration of a combination of procedures that you love. And I think that's probably my favorite part of all of this is you get to build whatever really fills you up. And maybe you made the choice to do comprehensive ortho because of the situation you were in. Maybe you didn't really like ortho, it was just like, I need to make this work. But maybe you loved it and maybe as you dove in, you were like, I actually really, really enjoy doing this part of dentistry and this gives birth to another phase in someone's career of like, okay, I can really lean in to something new. Because I think a lot of dentists feel bored at a certain point or they feel trapped. They feel like this is my only option to keep doing what I'm doing. I've got this cash cow, I can't walk away. So those are all of the thoughts that I love to what you just threw out, all of these layers of assumption. And I'll let you respond before we finally dive back into the math and really kind of look at this with some numbers.

Scott Leune (20:23):

Yeah, so you mentioned something really cool that made me think of something. You said, well, a new phase. I focus on my next clinical passion. Here's what's important to understand about this model. Most people that find the next phase their clinical passion where it's facial aesthetics or implant-based restorative or whatever it might be, they desire to change their practice to that model. Well, the problem with doing it that way is that you are still handcuffed to your exam schedule and you've got 50, 60% overhead on the dentistry you do, and you better have enough of it to fill your day. A whole lot of cases. What I'm describing here, just make sure we understand the truth behind this model, the truths behind it. Say I've got a GP practice that pays all the bills for me, that domino, that falls in that way for our favor, it pays the bills for me, creates a whole effect that says that means I don't have to do exams.

That means I don't even have to do a whole lot of cases to make a bunch of money because I've got only 10% variable overhead. And if I don't have to do a bunch of exams, I can take time when I need to take time for myself, for my family, or to work on the practice or whatever it might be. If I don't have to do that many cases because my overhead's so low on those cases, I don't actually need that many cases. So I don't need a mega practice, a mega group. I don't need a mega group. It could just be a group. It could just be one associate maybe. And it also means the more of those types of procedures I do, again, my patient base doesn't have to be as big. I don't have to be a supersized practice. I don't have to have super case acceptance around this stuff.

I don't have to spend super money on marketing. I don't have to do a super ton of it. I can just be modest in all of those things because my competitive advantage is that my overhead's only 10%. That's my competitive advantage. So it starts with that foundation. Can I have a practice that has open capacity and no bills left over? That's the foundation of this and we can't break that. So as we build this out, we have to say no to adding more ops. Say no to adding more staff is tempting as it can look. Those sirens calling us into those waters are not helping us. We have to be steadfast and say, I'm right now in my career wanting to master the part-time million dollar take home pay formula right now. I'm not going for lots of associates and lots of practices and everything that comes with that. I'm only going to take home a million dollars in a very modest, healthy way. It's done through being thoughtful about the business

The Importance of Planning and Vision

Richard Low (23:19):

This episode. And I guess so far, all three of them reaffirms to me why a month and a half ago, two months ago as we moved into this partnership that I was like, you know what? We just kind of need to burn down the old podcast. We just need to put the whole thing on an archive. And we've talked about this in our framework as an option as, hey, once you're at this group level, you've got options. If you've got enough margin, you could step back completely. You could step back part-time, you could do more specialty work. But we haven't articulated it as clearly as this is the defined option and I only need enough to then fuel the type of production that I want and no more. And those little tweaks, I'm worried. I am honestly worried at how many of our listeners and how many of our clients are going to be pissed after this episode.

Last episode, my wife was pissed because she's like, why haven't we earned a million dollars a year with you having a reasonable schedule? And instead we've been stressed and made less. Now there's going to be clients and listeners who are like, oh, I didn't have to keep going. I could have gotten to the sweet spot and doubled down on this specialty model if this was something they wanted. So I am very excited for the clarity that this provides people and it requires threading that needle of the right amount, but not too much and growth to a point, but not infinite.

Scott Leune (25:06):

Well, it's wonderful you say that. What you've been doing and what I've been doing and all the past things we've tried and all that, that always culminates into today being the best advice we have, the best system we know, and whether I'm the dentist or I'm the podcaster, I am in the position I am today with the knowledge I have and the focus I have based on all the things I've done. And maybe had I not done things a harder way, I wouldn't even give time to this podcast. This wouldn't even impact me. I'd be so far off from seeing this vision because I had never experienced the pain of a different vision. I don't recognize these valuable attributes of this new model. So we should definitely not be negative about the things that have gotten us here. Those are parts of our story and they've made us into the person that's thoughtful and mature enough today to keep on going.

Now this model, I just want to make sure that I'm clear here. The reason why I can be so concise on describing things and not distracted by all these components in dental practice is because I've got this very clear vision of what we're trying to accomplish. This vision says I want a million dollars take home pay at the minimum, and I want to do it part-time. No exams clear as day. And when we have clarity like that, if we could stick to that vision, we can now start to put the building blocks together that result in that. And it's really hard to get a million dollars take home pay without hygiene exams. For example, if the way we get there is becoming an all on four dentist, we can get there. We can only do consults for all in four and not have any sort of recurring recall base and have a 50% overhead.

We could definitely get there, but it's harder. It's even more hard if we're trying to do something else like wisdom team. Basically we've become an oral surgeon and we've got higher overhead. We've got to have a whole lot of those cases. So the reason why it's so concise again is because I've been very defined on the vision in this particular phase. We want part-time million dollars take home pay complete freedom from the schedule. That's different than the last phase. Here's the other thing that's important to realize. If we did on the last episode, we talked about a million dollars as a solo office, solo dentist working five days a week. If we accomplish that, we have turned our knobs of operations, our case acceptance, our diagnosis, the systems, the day-to-day of the practice, how we spend money, all those things. We've managed the business good enough to have success there. Now, when we start backing out and bringing on associate or two, as we become a part-time specialist, those knobs have been tweaked well enough that now this model is less risky. And sometimes people don't do that in that order sometimes instead of perfecting the practice they have with the owner first, they don't. They just add associates first.

And what you do is not just about compounding your problems. What you're doing when you add associates is you're expanding your current model. If your current model is low fees, low profit margin, lots of errors, you're expanding that model. So what I love about this linear path, this linear approach, it says we are going to have a modestly healthy practice first that will generate a million take home pay before we expand that model so that it dramatically lowers our risks and expansion. And we of course are benefiting now from this kind of 10% overhead virtual practice that we've now built on top of it.

Overcoming Misconceptions and Risks

Richard Low (29:09):

I appreciate the reframe you gave me because I think any of our clients, any of our listeners who have scaled to the point where they have multiple doctors, whether it's two or three, they are in, we've done what you just said, which is we have worked all along at using metrics to tweak the key systems and build what really matters in retention, in case acceptance, in sustainability in these systems. And now if this is the direction they want to go, they've got the foundation of, they've got the space, they've got the systems, they have the associates, they have the team, and now it's relatively simple to hone into this clear picture of what they want. So I've got about 11 minutes left. I want to hit the numbers. I want to go into an example or two that is reasonable, probably like we did last time, we kind of made some negative assumptions and did the numbers.

I think we should do it both ways. Let's do some like a break even associate driven practice where you're not doing any exams, I guess we've already done that. You've made $0 if you want to make a million, you got to do 1.1 million and the practice wasn't producing anything. I think the question I want in that practice is what is a reasonable set of assumptions that leads to a non-profitable practice with probably two doctors and therefore enough patient flow for you to do that 1.1 million or would it be reasonable to think that requires three doctors to do that much production? So yeah, I just want to look at, before we go onto a more favorable example, I want to look at some assumptions around the non-profitable associate side.

Scott Leune (31:05):

Okay, so this is going to sound really weird maybe, but put that thought on the shelf for a second. Forget for a second this question. How many doctors do we need? Start with how many procedures do I need per week? And we already said that was four to five a week. Okay, now how big of a practice do we need to get four or five of those procedures a week? That is really the riddle that you will never truly solve, but you will get very good at estimating. So if I need four or five procedures a week, do I only do Invisalign? Man, that means I need 20 cases a month of Invisalign. That's a lot. That means I'm doing heavy marketing. I need a big recall base. That is hard. But what if I do Invisalign and bracketed ortho and I do sleep apnea therapy and wisdom teeth.

I'm just making things up suddenly. I might only need one Invisalign case a week max because I could I get another ortho case once a week max? I could do some sleep apnea therapy. Suddenly the patient base I need is much smaller. So I look at, the way I try to figure this out is, okay, if I'm the dentist, if I'm the only dentist in the practice, about how many of these cases per week am I getting naturally if I'm the only dentist, if I need four or five a week, but naturally I'm getting two or three today, then without changing anything else, I'm going to need two associates. I'm going to need two doctors worth of a patient base without changing anything else. That is how I would look at it to try to estimate the size I'm going to need. So if I need four or five cases a week, I already as a full-time dentist get two or three.

I'm going to need probably two full-time associates before I get four or five on a very predictable basis without getting better at marketing, without getting better at cases, without getting better at anything, I'm going to need two doctors. Well, if I need two doctors, how many ops do I need? If I'm willing to expand my hours, I'm going to need five to seven ops. And maybe if I get better at things, I don't need two doctors, I need a doctor and a half willing to expand my hours. That means I only need five ops. So we're not talking about megas size practices, and again, we're assuming we're making no profit on those doctors. So we're assuming zero profit margin without my four or five cases a week, I'm going to need, in this example, about one and a half to two docs, five to seven ops with expanded hours. And I'm taking home a million dollars a year without a hygiene exam, only working enough per week to do four or five cases. Does that make sense? Absolutely.

Richard Low (34:01):

And it underscores the importance of the last episode and this linear approach of if you don't have a good idea of the frequency and the case acceptance of these procedures and what you can do and the rates that you can charge in your area, it is much more of a stab in the dark to just try and go straight into this to say, okay, I'm going to buy a practice that I quickly am evolving into this and I never am the primary producer and I never have figured this base rate out because this is more dependent on these two pieces, the combination of the profitability of your practice and the types of procedures, the fee of those procedures and how many you're getting. Those are the pieces that solve the formula. And if you haven't lived in the practice and optimized it and systematized it, you don't know the data, you're making a lot of assumptions. And even if maybe you knew this data at a previous practice and you're going in and you're acquiring another practice somewhere else, the demographics, the fee schedules, the acceptance rates, that part of town, all of those things will play into it. So that's what I'm getting out of your pushback.

Preparing for the Next Phase

Scott Leune (35:24):

Okay. I understand where you're coming from for sure. I don't think it's as hard as what you just made it sound. So we don't need to be good and necessarily anything. We don't need to be optimized on case acceptance. It's just the better we are at those things, the less of a patient base we need to accomplish. We just need to know, even in our broken selves of running a broken practice, that's a freaking mess and chaos every day that we feel. How many cases are we doing per week of these types of things? Oh, two or three. Okay, well, if we don't fix any of that brokenness, this model will still happen. We'll still have that take home pay with these compromises in our business when we switch to the setup. So the reason why I'm making this a point is that I don't want someone thinking this can only be accomplished when I've mastered practice management.

No, it's just as you master components of practice management, this gets even easier and you need even less patience to do it. But you could also be bad at practice management and have bad metrics, but you have enough patients or you know how to do enough procedures or your fees are high enough that you end up in the same place. So this isn't about becoming a master. That also another thing I want to point out. Imagine you're the only dentist working a full schedule and you've got more take home pay than you need. Transitioning to this model is relatively low risk. You're going to replace your days with an associate that's not going to do as well as you, but you're now going to also float in specialty procedures and you had more take home pay than you needed to begin with that when the dust settles, this is a pretty low risk transition that you could always undo if you ever wanted to undo it.

And let's say you now live in this moment where you're the part-time virtual specialist in this practice taking home really good pay and you've added another associate over time, it's pretty low risk to transition from this to never picking up a handpiece because you've already established the size, the profit, the systems to support multiple dentists backing yourself out those four or five procedures a week is not this shock to the system. You can replace yourself with other people that can do those procedures. And you've basically gone through this journey from solo dentist full-time to part-time, never picking up a handpiece. And that whole journey, you cashed in a million every year or more. And you did so in a very non-disruptive way. You've transitioned in a non-disruptive environment, in a low risk environment, low cost base, low number of practices, low number of team members to employ and manage simple focus and systems management. So much more simple than I graduate, I'm entrepreneurial, I'm going to go buy four practices and try to not pick up a handpiece. Does that make sense? A

Richard Low (38:33):

Hundred percent. And the pushback you just gave me, and by the way, you just did the next episode and we don't even have to do it now, but we still will, the next version of not picking up the handpiece, I understand that. It's like, okay, we don't need to make this scary because this is not a high risk proposition. This is a very reasonable path all along the way and does not ironically need to be rocket science. This is just clarity and focus and knowing where you're going and how to pull it off. And this is accessible. So that's the pushback that I'm getting. But the moment that you're like, you don't even have to be good at practice management, but in my head I'm screaming, but why wouldn't you be? It's like the obvious side of yeah, but if you can do all the things or if you can do at least some of them, well then this just gets even better. But your point is you don't have to, and therefore the risk is so low and the ability to do this is so in reach, and that's what dentists assume is the opposite. They assume this is high risk, this is out of reach. I can't do that. This is not for me.

Scott Leune (39:57):

I'm curious, you've done yourself, you've done all on X kind of dentistry, is that correct? Correct. And I'm assuming you had to go through some serious training to get that right? Yep. And when you've got a patient in front of you that's got a complete failure of their oral health and that's what they're going to need, and they want not only a wonderful result medically, but a wonderful result emotionally from the experience and aesthetically from the experience, I would imagine there's a lot of planning that has to happen,

Richard Low (40:29):

Correct?

Scott Leune (40:30):

Is that correct? Yeah. And it's so interesting how we will plan, spend more time planning and being deliberate about one all on X case than we will on our entire freaking career, that we are just going to be blown to the left and the white and the right with the wind of our practice and be kind of the victim of what happens to happen. Yet we're so thoughtful and prepared on our craft. And so when I look at these models, I know it's kind of cliche, but I really feel the biggest risk is the owner controlling the vision and strategy is actually the risk point. It's not the mechanics of making these transitions. Those can be de-risked tremendously. It's the fact that the owner is busy mentally and physically cutting teeth and cutting bone and not crafting out their career with preparation and focus. And again, that's why, at least in my life, having a group to remind me of that constantly having a coach to hold me accountable and guide me, having something like a podcast to become a habit of mine every morning or every day, those are the types of things that help me block the distractions, the loud distractions of our day, and help me just hear and see very clearly what I'm trying to accomplish.

That is not rocket science, it's not super, it's just deliberate. That's all. It's deliberate. It's actually easier, in my opinion, than most of the clinical procedures we've learned how to do. It just doesn't feel that way because we've never been thoughtful about it in this way.

Richard Low (42:22):

I love it. So I jokingly said we've already done the next episode of putting the handpiece down, but I do think our listeners are going to want to hear a little bit more of this transition, a little bit more of that. So

Scott Leune (42:36):

There's so much, actually, we need the math. We need to know how big we got to be. How many dentists can we not pick up a handpiece? How do we even manage those dentists? Where do we find 'em? What's the hygiene department? There's so much to talk about. I don't know if we can get it done in one episode, but having a million dollars take home pay without a handpiece is kind of a lot of people's ultimate goal and vision. And if it's not, it's definitely something that they might love listening to. I think this next episode is going to be super cool for a lot of people.

Richard Low (43:08):

I love it. Thank you, Scott, and we will talk to you next time on the Shared Practices Podcast.