Thinking of Selling Your Dental Practice? Here Are Some Things To Consider!

Thinking of Selling Your Dental Practice? Here Are Some Things To Consider!

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Chris Pistorius:                  00:05                     Hi everybody. This is Chris Pistorius again with Kickstart Dental Marketing. Today I’ve got a really special guest. We have the CEO of Lone Peak Dental Group with us. His name is Ray Caruso. Ray, I hope I pronounced that right. Is that correct?

Ray Caruso:                        00:21                     Yeah, absolutely. Thank you.

Chris Pistorius:                  00:23                     Okay. Awesome. Well, thanks so much for being with us. I appreciate it.

Ray Caruso:                        00:27                     Yeah. Thanks for having me. I appreciate it.

Chris Pistorius:                  00:29                     Yeah. So like I said, Ray is the CEO of Lone Peak Dental Group. They have 60 plus practices kind of in their umbrella. They cover 15 states all over the United States. They do most, I think, almost all pediatric and orthodontic practices. They do both new builds from scratch as well as acquisitions, of course. And I think probably you’re the expert on this Ray so I’ll let you maybe tell us a little bit more about the business and what got you involved.

Ray Caruso:                        00:59                     Yeah. So I’ve been in dentistry since I was 19. I actually started out as a dental assistant way back in the day and I’ve just stayed with dentistry my whole life. So I’ve loved it. Been a great part of it. I worked with a very large DSO as a youngster and got to watch them grow. Stayed with them for 11 years. Worked my way up into director role and then moved on to another dental service organization up in Chicago. Worked with them for another four or five years in a chief operating officer role and was recruited to come over here. The interesting thing about this group is all of our offices are owned in some capacity by the practicing doctor. And that’s where we look at it as our secret sauce and the two DSOs I was in before, while they had amazing, great things for their doctors and their team members, one thing they did not provide was ownership at that actual office level.

                                                                                So they got to-

Chris Pistorius:                  00:59                     Right.

Ray Caruso:                        02:06                     See the fruits of their hard labor. It wasn’t just at a HoldCo level or some kind of stock option or whatever. This was actual true ownership. And it’s really been a blessing because those doctors really, really care about it. It’s great for the team members, it’s great for the patients, great for the community. And it’s very similar to a locally owned mom and pop, if you will, practice. And for me, what that does is it brings in these local owners and their associates and it allows us to still provide best practices and good human resources and marketing and things like that so that they can be even more successful than maybe their counterparts that are trying to do it all on their own.

Chris Pistorius:                  02:55                     Great. Yeah. I know that can be very appealing for some dentists out there that kind of got one foot out the door of retirement, but they don’t really want to retire, but at the same time there’s a lot of stress that comes from owning a dental practice and just doing the day to day operations. And I know that we have several clients that have mentioned before that, “I love being a dentist, but I don’t necessarily having employees and running businesses and things like that.” So it-

Ray Caruso:                        03:23                     Yeah.

Chris Pistorius:                  03:24                     Definitely can be very appealing, right?

Ray Caruso:                        03:26                     Yeah. And even for our associate doctors because we do build two, three brand new dental offices where it makes sense for those communities. And we take our known docs. And if we’ve got a doctor that’s been working with us for two or three years and they’re phenomenal and they’re like, “Hey. How can I be an owner?” We start looking. And if it all lines up and matches up, every single new office has always had a current doctor become the owner of that practice.

Chris Pistorius:                  04:06                     Oh, that’s very cool. So you provide some opportunity on the other side of the spectrum where people are getting ready to buy a practice or should they spend millions to do it themselves. So that’s great.

Ray Caruso:                        04:17                     [inaudible 00:04:17] because-

Chris Pistorius:                  04:17                     Yeah.

Ray Caruso:                        04:19                     I wouldn’t have gone into so many of these communities and it’s a doctor who says, “This is where I want to get back to that area.” And so we’re like, “All right. Let’s do that.” And we’ll build out a pod in that area along with them. Yeah.

Chris Pistorius:                  04:29                     Yeah. That’s awesome. Okay. So when you look too, on the acquisition side of things, did you kind of have an ideal situation, like a particular type of market. I know you all pediatric and ortho, but when you go to acquire mode, what’s the best way to put it? Kind of [crosstalk 00:04:56] practice. Yeah. Yeah.

Ray Caruso:                        05:00                     [crosstalk 00:05:00] We have four main gates that we look at and really-

Chris Pistorius:                  05:04                     Okay.

Ray Caruso:                        05:05                     We won’t even cross into that yard unless we can get through these four gates. And the first one is we have to have that doctor. If we’re going to acquire that practice, they have to maintain some level of ownership. Whether it’s-

Chris Pistorius:                  05:05                     Okay.

Ray Caruso:                        05:18                     20%, 30%, even 40%. Some doctors don’t want to sell the whole thing, they want to hold on to a big piece of it. Our goal is though to have an owner doctor because that’s how we’re designed, that’s how we train, that’s how we work, and all of our training and all of our design is around how to support an owner, not how to tell an associate what to do. And so that’s-

Chris Pistorius:                  05:18                     Yeah.

Ray Caruso:                        05:46                     Number one, we have to have that. And then number two is a pediatric. It has to be a pediatric practice. We know what our lane is and we stay in it. If it has ortho, great. If it doesn’t have ortho, we’ll look to see, is this something that we can add, but that’s not a priority. It would be something down the road if it made sense. The third thing that we’d want is it in the geography that we’re currently in? Will we be able to support it with the people that we have? And then the fourth is, well there’s a fourth. I just can’t remember what it is off the top of my head. You put me on the spot.

Chris Pistorius:                  06:24                     No problem at all.

Ray Caruso:                        06:27                     Yeah. Oh, it’s [crosstalk 00:06:29] it’s the number of chairs cause pediatrics-

Chris Pistorius:                  06:33                     Ah.

Ray Caruso:                        06:33                     Based business. And if it’s a three chair practice in a four story of a professional building, it’s not going to work for us. We need to make sure that we’ve got the ability to treat a lot of kids because that’s really what we’re all about.

Chris Pistorius:                  06:51                     Right. Okay. Gotcha. I think it’s good to kind of stay in your lane, know-

Ray Caruso:                        06:51                     Mm-hmm (affirmative).

Chris Pistorius:                  06:55                     Know what you’re good at, maybe what you don’t know, and go there. I know with our business kickstart, kind of when we first started, we kind of said, “Hey. Anybody that can pay, come on in.” And then we realized very quickly that not everybody’s a great fit for us and that’s okay because we’re experts with specific types of marketing in dental and it’s just we learned pretty quickly that it’s good to find the right fit on both sides. So that makes sense.

Ray Caruso:                        07:25                     It’s very, very true. Very true.

Chris Pistorius:                  07:26                     Yeah. So of the practices, now they’re all individually branded, right? They’re not branded with your name.

Ray Caruso:                        07:33                     That’s correct. Yep.

Chris Pistorius:                  07:34                     Okay.

Ray Caruso:                        07:37                     Two or three of them might have the same name in the same town or the same community, but for the most part-

Chris Pistorius:                  07:42                     Okay.

Ray Caruso:                        07:42                     They’re all separate.

Chris Pistorius:                  07:44                     Okay. And then when you set these up, I’m assuming, I don’t know maybe you’ve read the book E-Myth Revisited. I don’t know if you’ve ever read that, but-

Ray Caruso:                        07:52                     I have not.

Chris Pistorius:                  07:53                     Okay. It’s a great book. And it talks a lot about like setting up your, and not just about dental practices, but business in general, it talks about kind of setting up your business as if it were a McDonald’s. So not that you’re ever going to do that, but just to set it up so you have like processes, procedures, just all documented and that anybody that you hire can kind of come in and they get this workbook, if you will and it details every part of their job that they need to do.

Ray Caruso:                        08:21                     Mm-hmm (affirmative).

Chris Pistorius:                  08:22                     And I can imagine that when you acquire a practice or even start from scratch, you probably have something like this that you know has worked in the past in successful practices and you probably, I don’t want to say cookie cutter, but you applied some of those winning strategies. Is that a fair way to look at it?

Ray Caruso:                        08:40                     Yeah. That’s a great way to look at it. We’ve got what we call processes or systems or whatever you want to call them, but-

Chris Pistorius:                  08:48                     Right.

Ray Caruso:                        08:48                     Processes for certain things. We also have policies and then we have guidelines because not everything is going to work in every community.

Chris Pistorius:                  08:57                     Yeah.

Ray Caruso:                        08:57                     A really small town in upstate Washington is going to run differently than an office in San Antonio.

Chris Pistorius:                  09:05                     Right.

Ray Caruso:                        09:05                     So there are some areas where it’s a guideline. This makes sense. But what we’ve put together is really a full service model that will encapsulate pretty much everything no matter where you go and we call it kid-sperience because we’re a pediatric practice and we’re looking at how can we improve the experience. I got with my team and we came up with this service model that will allow all of our practices to have one way to do many things, whether it’s how we answer the phone, how we confirm patients. This has nothing to do with scheduling.

                                                                                It’s all about how the customer service interaction with the team and the parents or the team and the patient. And all the way through to rescheduling their next visit and bringing them back in for re-care and things like that. So that is our best practices strategy, if you want to call it that, and it doesn’t matter if you’re in upstate Washington or if you’re in San Antonio. It works, everywhere.

Chris Pistorius:                  10:17                     Yeah.

Ray Caruso:                        10:18                     So that’s our like model, handbook for everybody. We’re still in the process of rolling it out. It has been adopted in many of our practices, but not everywhere. And in everything that we acquire, it’s a prerequisite. This is something that we speak to our doctors in advance of saying, “Hey. Here’s how we’re going to work together and this is what we believe and this is how we anticipate we will be training all of our offices. How do you feel about this?” So far no one’s ever looked at it and go, “Oh my God. This is ridiculous.” They’re all like-

Chris Pistorius:                  11:00                     Right.

Ray Caruso:                        11:01                     Amazing.

Chris Pistorius:                  11:02                     Yeah. Yeah. I know exactly what you mean. Part of what we do is we can help on the front desk training side of things. So our job for our clients is to generate new patient leads essentially.

Ray Caruso:                        11:17                     Mm-hmm (affirmative).

Chris Pistorius:                  11:17                     And the unfortunate part of it is sometimes we can generate those leads, but if we don’t have really a solid front desk staff with good training-

Ray Caruso:                        11:27                     Yep.

Chris Pistorius:                  11:27                     Sometimes those leads can kind of not close, if you will. So-

Ray Caruso:                        11:31                     Yeah.

Chris Pistorius:                  11:32                     About a year ago, we generated kind of an online training platform just to help people and front desk staff understand they’re not all referrals. Some people are just going to find you on the internet, not know anything about you or why you’re great, and you’ve got to know how to sell yourself a little bit to those folks and make them understand why you’re a special practice. So-

Ray Caruso:                        11:54                     Yep.

Chris Pistorius:                  11:54                     I think just having that kind of stuff in place can help a ton and I can tell you most dentists don’t have stuff like that in place. So it totally makes sense when you say that where they’re like, “Oh, wow. This is great,” because they probably always wanted something like that, but they just not had the resources or time to do it.

Ray Caruso:                        12:10                     Mm-hmm (affirmative).

Chris Pistorius:                  12:13                     Okay, great. What would you say to a dental practice owner that maybe is considering selling or maybe partnering up with an organization like yours? What is some advice that you would give them on evaluating offers and kind of getting into this process?

Ray Caruso:                        12:31                     Yeah. Well, I think that it’s good for anybody who’s thinking about doing a sell to talk to people who have sold, whether it’s to a larger group or to a smaller group or even to another partner because you want to hear what’s the truth and you want to know, “Well, how did it go a year from now? How did it go two years from now?” And when you are, let’s say, somebody out there wants to talk to me. Don’t just talk to me. Talk to the doctors that are in my company that have sold their practices to me or to our company. I shouldn’t say is to me. I’m not [inaudible 00:13:17] And talk to some of these doctors who we’ve built new practices for and see how’s their experience been.

                                                                                Because that’s an important piece. A lot of times people are talking about EBITDA and valuations and how much money can I get and if that’s it, great. Good for you. Make as much money as you can. Right now the industry’s hot and brokers will tell you anything you want to hear. But the reality is, is you want to hear from people that you trust, not to say a broker you can’t trust, you can trust them, but they’re-

Chris Pistorius:                  12:31                     Sure.

Ray Caruso:                        13:49                     Also making money off of the money in which you sell the practice for. So they’re going to want to tell you why it’s worth so much and they may want to push you towards somebody who’s going to be willing to pay that much. And it’s, hopefully I don’t get blacklisted from all the brokers, but just because you’re willing to pay that much doesn’t necessarily mean you’re the right fit. So look at who’s the right fit for your organization. If I’m out there buying general practices, I may not be the right fit for you because we do all of our marketing and all of our training and everything is geared around pediatrics and ortho.

                                                                                So are you going to get the right fit there? Find out about the organization. Yelp them. Look them up and see what Glassdoor says. Find out what their employees are saying about them. And by the way, I’m not perfect. You can look us up. There’s all kinds of stuff out there, but the reality is, is know who you’re going to get into. You’re basically walking down the aisle. Who are you going to be with?

Chris Pistorius:                  15:04                     Yeah. Yeah. No, I think that’s great advice. And maybe just not your experience here, but you’ve been in the industry a long time and a common question that we get that doesn’t really relate to marketing and what we do, but a lot of practices are having issues right now with hiring staff, finding qualified people, getting people to stay sometimes, and it seems like some of these practice owners are getting into these cycles of they hire somebody and then for a few months they leave and then they’ve got to rehire and retrain and it’s like they never stopped training. What’s-

Ray Caruso:                        15:41                     Yeah.

Chris Pistorius:                  15:42                     Some advice you could give an owner on hiring and firing and do you hire typically with dental experience or without? What’s your advice on that?

Ray Caruso:                        15:51                     Oh, man. We’re going through that too.

Chris Pistorius:                  15:51                     Really?

Ray Caruso:                        15:57                     Well we can blame it on the wake of COVID, but the reality is, is just look at your leaders. If your leaders aren’t training well and holding people accountable and ensuring that they’re taken good care of, then they’re going to leave you.

Chris Pistorius:                  16:15                     Yeah.

Ray Caruso:                        16:16                     The number one reason for people leaving is not pay. The number one reason is their direct supervisor. So keep that in mind. All right. Secondly, so for hiring, do you look for dental experience? Yeah. I mean, if you want a dental assistant it’s better-

Chris Pistorius:                  16:16                     Yeah.

Ray Caruso:                        16:35                     Two or three years experience, but keep in mind-

Chris Pistorius:                  16:37                     Yeah.

Ray Caruso:                        16:38                     You hire one and you get them for 13 bucks an hour or something, I’m just making up a number, and then you train them for a year, immediately they’re worth $17 an hour. So make sure that you make that adjustment because they’ll know after six months or a year that they have experience, they can go right across the street and get paid three to four to $5 an hour and you’re the one who trained them. So keep that in mind. Be looking at market rate and adjust for-

Chris Pistorius:                  17:04                     Yeah.

Ray Caruso:                        17:05                     Too. The other thing that we do because I started noticing that we had a lot of turnover in our office manager. We call them team leaders, but in that office manager role and I started to recognize, “Well, why did we have so much turnover in this role?” And it all came down to accountability. We were working towards bringing more accountability to that role and they just weren’t ready for it, they didn’t want it, they weren’t used to it. And so we might’ve gone too soon, too fast. I don’t think so, but it could have also been that we set the expectation and then we kind of forgot about it and didn’t train them and keep going back to helping them and helping them and helping them and supporting them and supporting them and supporting them. So then when it came to like, “Hey,” they felt like they weren’t being able to do a good job.

Chris Pistorius:                  17:05                     Yeah.

Ray Caruso:                        18:03                     Yeah.

Chris Pistorius:                  18:03                     Yeah.

Ray Caruso:                        18:04                     [inaudible 00:18:04].

Chris Pistorius:                  18:03                     That’s [inaudible 00:18:05].

Ray Caruso:                        18:06                     You brought out a book that you appreciate. I’ll tell you the best book that I could tell you about is from Patrick Lencioni. It’s called the Ideal Team Player. And he goes into the three virtues that you look for when you’re hiring people. And it’s something that you really can’t train on and that’s humble or humility, hungry or what you might call work ethic, and then he calls it smart, but really it’s the emotional quotient, the ability to interact well with people. And-

Chris Pistorius:                  18:06                     Right.

Ray Caruso:                        18:42                     And then the opposite of that is ego, lazy, and disrespectful to people. So if you could just find those people that are hungry, humble, and smart, you’re always going to win.

Chris Pistorius:                  18:56                     I’m just curious. Do you ever use personality tests when hiring?

Ray Caruso:                        19:00                     No. No we don’t. As far as like our smile center, that’s what we call our corporate office. I like to be pretty cheesy. Our smile center, we did assessments to help us interact with each other better, but from-

Chris Pistorius:                  19:00                     Yeah.

Ray Caruso:                        19:18                     The office level, no. We haven’t done that, but I do like the disc profile. I think that’s super helpful.

Chris Pistorius:                  19:24                     Yeah.

Ray Caruso:                        19:25                     I’ve been in-

Chris Pistorius:                  19:25                     Yeah. When we hire, we use the Colby test, I think, or something like that. There’s several out there, but my advice there is that don’t let it be the end all, be all. Just use it as a guide-

Ray Caruso:                        19:42                     Yeah.

Chris Pistorius:                  19:42                     Versus saying, “Oh, well, this test doesn’t line up with what we want. So no way.” Go with your-

Ray Caruso:                        19:42                     Right.

Chris Pistorius:                  19:48                     Gut, but just use the personality test as kind of a guideline. Those are great insights. I think that can definitely help a lot of people. So I’m going to start wrapping up here, but I think you guys are still in acquisition mode out there looking for practices in both startup and acquisition. Where do you see your business over the next five years? How big do you guys want to get?

Ray Caruso:                        20:12                     You know, I would love to just go by the results or what I look back in my rear view mirror and say, “Hey. We should be at 300 practices,” or whatever.

Chris Pistorius:                  20:22                     Yeah.

Ray Caruso:                        20:23                     But the reality is I look at it as how are we influencing the industry? So five years from now, have we influenced the industry to where people see that the ownership doctor model is better than other models because we are better for the community, we’re better for the doctors, we have longer-term relationships with our doctors, we typically have low turnover, typically, and we’re better for our patient base in our patient population.

                                                                                And so for us to be able to influence, we have to get bigger. We must get bigger because otherwise a company with 60 practices doesn’t have the same influence as say a company with a thousand practices. And-

Chris Pistorius:                  21:16                     Right.

Ray Caruso:                        21:16                     Us to be at that table for us to be able to treat more patients, for us to be able to influence more doctors we have to grow. And so-

Chris Pistorius:                  21:24                     Right.

Ray Caruso:                        21:26                     If that’s a 150 practices after five years and we’ve got 150 amazing practices that we’re doing what we believe, so be it. I think we’ll be a lot further along than that.

Chris Pistorius:                  21:39                     Right. That’s exciting. That’s great to have goals and whether you hit them or not, at least you have something you’re trying to achieve for. And I don’t think it’s always all about growth either. I mean, we talk about our annual goals here and a lot of it’s around what you mentioned, making sure we’re doing the right things for our clients, making sure we’re not going too fast.

Ray Caruso:                        22:00                     Mm-hmm (affirmative).

Chris Pistorius:                  22:01                     Grow responsibly type stuff. I’ve been part of companies in the corporate world in my past where it just exploded growth, which is fun, but once the growth slows down, you look back and you’re like, “Oh my gosh. What did we do?” And you can ruin a business that way too. So I always-

Ray Caruso:                        22:18                     Yeah.

Chris Pistorius:                  22:18                     I always say, “Grow responsibly and the better your process and procedures are is going to dictate how fast you can do that.” So-

Ray Caruso:                        22:25                     Yeah.

Chris Pistorius:                  22:26                     Well, awesome. Right. Thanks so much for being a part of the show. If somebody happens to maybe want some more information about your organization, if they’re looking to maybe make a move, what’s the best way to maybe reach out to you?

Ray Caruso:                        22:39                     Yeah. Just email me directly. My email is so easy. Ray@. Ray at Ray. No,

Chris Pistorius:                  22:50                     Okay. And that’s L-O-N-E, right?

Ray Caruso:                        22:53                     Yep. L-O-N-E, yes. Yeah.

Chris Pistorius:                  22:53                     Okay.

Ray Caruso:                        22:56                     Not loan like, yeah.

Chris Pistorius:                  22:56                     Yeah. What are you getting into here?

Ray Caruso:                        23:02                     Yeah, right? Yeah.

Chris Pistorius:                  23:03                     Yeah.

Ray Caruso:                        23:03                     Well Chris, it’s been a pleasure. I really appreciate you doing this.

Chris Pistorius:                  23:07                     Yeah. I appreciate you taking the time. I know how busy you are and I’ve learned a lot, I know, and I know a lot of our listeners have too and maybe we’ll check in with you in a few months and see how you’re doing. Okay?

Ray Caruso:                        23:18                     Yeah. Do that. I’d love to hear from you again. Thanks Chris.

Chris Pistorius:                  23:21                     All right. Thanks Ray. We’ll talk to you-

Ray Caruso:                        23:23                     Great weekend. Bye-bye.

How to Expand Your Dental Practice with Julie Rentz

How to Expand Your Dental Practice with Julie Rentz

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Chris Pistorius (00:05):

Hi, everybody. This is Chris Pistorius with KickStart Dental Marketing. Today, I’ve got a special guest, a great client of ours, Julie Rentz. She is the business administrator for two practices that they own, Stonegate Dental in Parker and Deer Run Dentistry. We’re going to talk to Julie today about just some overall things that have made her and her husband, Dr. Rentz, successful, and the recent addition Deer Run Dentistry to their family. They just bought that not too long ago.

Chris Pistorius (00:40):

Julie, thank you so much for coming on and being a part of the show today.

Julie Rentz (00:45):

Yeah, but thank you for having me.

Chris Pistorius (00:46):

Of course. Why don’t you just start off by telling us a little bit about your practices, how long you guys have been in dentistry and things like that?

Julie Rentz (00:58):

Yeah. Our practice, we’ve been in dentistry, we bought our practice back in 2013. My husband’s been practicing since 2011. Got a couple of years under our belt before, under his belt, before we went into that ownership market, but we’re a general practice in Parker … We have a general practice in Parker. We just purchased a second general practice in Greenwood Village, and it’s been a wild ride.

Julie Rentz (01:34):

We started with three employees when we purchased the practice, it was really part-time. I don’t know, maybe 600 active patients when we bought it, and now we’re at, at Stonegate, we’re at 11 employees and we’re at roughly about 2,600 active patients. It’s grown a lot.

Chris Pistorius (02:00):


Julie Rentz (02:01):

Dr. Rentz is what’s referred to as a super GP. He does a lot of his own work here in our office. I think when we originally started, he did a lot of his own procedures out of necessity. You know, dental school is not cheap. We had to look for ways, we didn’t have a big patient count, we had to look for ways to really keep what we could in-house.

Julie Rentz (02:26):

But I think keeping things in house out of necessity has transformed into this intentional business model for us. I think it’s worked really well, and we’re able to do a lot of our patients’ care just here without having to send them out all of the time. We do sometimes, but …

Chris Pistorius (02:51):

Yeah. Well, that’s great. In both practices, do you offer some services in one practice versus the other, or is it pretty much the same services in both practices?

Julie Rentz (03:06):

Yeah, we try to keep it uniform, same services in both practices. When we were looking for an associate for this new practice, that was one of the areas that was important in our selecting a candidate, was we wanted somebody who could step into that super GP role, because I think when you’re in a saturated area, there’s a lot of other doctors, a lot of competition and you’re dealing with insurance and insurance reimbursements. It’s almost a necessity.

Chris Pistorius (03:41):

Yeah, yeah.

Julie Rentz (03:42):

And I think patients really prefer not to have to travel to other offices. there’s always cases where you have to send them out to specialists, but it eliminates a lot of hassle for the patients.

Chris Pistorius (03:59):

Yeah, absolutely, and we find that too. As you know, when we do your marketing, most of the times, unless you’re a specialist, most of the times in a densely populated area, most of your patients are going to come from a five mile radius, depending on the market. It’s out of convenience, and it’s out of convenience from their home or from their work. Yeah, I think you’re spot on there.

Chris Pistorius (04:25):

Talk to me about when you grew enough, and you decided to go ahead and purchase a second practice. Did you come up with maybe writing out, “All right, this is how we run Stonegate. This is our standard operating procedures. Let’s duplicate what we’re doing here, and then bring that over to Deer Run, and just set it up how we have the current one set up.” Does that make sense of that? Is that kind of how you approached it?

Julie Rentz (04:53):

Yeah. Ultimately, yes. Once we got into the practice and you start to get a feel for the patient demographic, and how things had been done, you start looking at ways to either modify some of those procedures to be individualized for that practice, or sometimes I say, “No, that’s not how it should be done at all,” and we just scrap it and put our procedure in place.

Julie Rentz (05:23):

But yeah, I think especially in private dental practices, I know there’s a lot of really great private offices, very successful, but so common the administrative side that the standard operating procedures … I think clinically, they all get special training for that, and so those are all to some degree pretty standard protocols, right?

Julie Rentz (05:47):

But administratively, somebody has to put those in place. Somebody has to work to put those together and train everybody. I guess I’m always surprised at how many offices don’t take the time to do that, because I feel like that in and of itself is … It makes bringing on employees that much easier, it makes knowing how to handle situations kind of a step-by-step guide.

Julie Rentz (06:18):

Yeah, those are really, I think, vital to the operation of the office, and then being able to just change the logo and take it to the next office has been a huge advantage.

Chris Pistorius (06:34):

Yeah. There’s a book out there, I don’t know if you guys have read it, but it’s called The E-Myth Revisited, and it’s [crosstalk 00:06:41]-

Julie Rentz (06:41):

Yeah, I have.

Chris Pistorius (06:41):

Yeah, it talks a lot about, not just about dentistry, but it talks about how to scale a business, and it talks about you got to really have a map of standard operating procedures, and instead of working in the business, you should be working on it at a high level. It talks a lot about processes and procedures.

Chris Pistorius (07:02):

I think if you’re looking at growing a dental practice and buying one or even more practices, I think what you did is exactly right. You’ve got to have those standard operating procedures. We know what works, we know what doesn’t from our years of experience, and then we’re going to, I don’t want to say cookie cutter, that’s probably the wrong word, but it’s that mind frame of I think it will just help you expand the business quicker, and get up and running as fast as possible.

Julie Rentz (07:29):

Yeah. Yeah.

Chris Pistorius (07:30):

Well, awesome. Talk to me about, obviously with marketing, what do you think is your unique selling proposition at your practices? This is like, obviously we all know that there’s a lot of competition in dentistry.

Julie Rentz (07:46):


Chris Pistorius (07:49):

Yeah, why should people go and visit your practices versus maybe somebody else’s?

Julie Rentz (07:56):

Well, I think ultimately it’s that comprehensive model. I think that what sets us apart, and the feedback we get from patients so often is that they build a relationship with Dr. Rentz, they trust him, and so they want him to do their work. They don’t want to have to go to a specialist. Sometimes patients will be saying, “No, can you just try? Can you just try?” Instead of sending them, and puts him in a difficult spot, but I think that that model …

Julie Rentz (08:35):

And to be honest, I didn’t realize that it was a model until we started interviewing other dentists, and realizing other dentists don’t do all of this stuff. They either don’t like it, or they just don’t feel confident, they don’t get the continuing education in it.

Julie Rentz (08:58):

I guess I didn’t really realize that this was fairly unique for us, but I think that’s ultimately what sets us apart. That the patient can come in and get their endo, they can get their oral surgery, they can get their hybrid, they can get whatever process they’re doing here.

Chris Pistorius (09:19):

Yeah. No, that’s awesome. Again, I don’t want to bad words again, but kind of a one-stop shop, but people are looking for convenience, and trying to get most of their needs from one place.

Julie Rentz (09:32):


Chris Pistorius (09:33):

That totally makes sense.

Julie Rentz (09:33):

Well, and I think another piece to that is maybe instead of one-stop shop, Dr. Rentz ends up quarterbacking, maybe is a better word, that care, right?

Chris Pistorius (09:46):


Julie Rentz (09:46):

If that patient has to go see a specialist, we’re not just sending them. He is involved and he is … Which I think is common, right? I think doctors do tend to be aware of where their patients are going and when, but it’s a little different when he’s actively involved in that case.

Chris Pistorius (10:07):

Right, and going back to … Because I know that we’ve got … Several clients right now are actually looking to potentially expand and buy another practice, and go through what you’ve just gone through. I guess overall, what are some major tips or advice that you would give somebody that’s looking to maybe add on to their practice? What are some of the big things that you went through?

Julie Rentz (10:40):

Well, I think we had … In some ways it was a huge disadvantage and in some ways it was an advantage. We bought our practice literally on the day we all had to close down for COVID. We closed the practice on March 18th, and March 19th was when they all said everyone shut down.

Julie Rentz (11:02):

Of course that was not ideal at all, buying a new private practice and then having zero income for the next … I think it ended up being about a month and a half, two months, but at the same time, it also gave me a lot of opportunity to really dive into their office systems, seeing their billing, and how they were scheduling things, and how they had things set up in the system.

Julie Rentz (11:31):

For me, I think I thought it was going to be as easy as taking my processes from this office and transferring it over to that other office, and that definitely was a huge advantage and helped a ton. But I think there’s also the employee side, for me, having to try and be in two places when both offices need me, that’s the challenge.

Julie Rentz (11:59):

I would say, make sure that you have an office manager in place before you buy that practice. If you buy the practice and it comes with one, great, but you need someone who can be you, basically-

Chris Pistorius (12:24):


Julie Rentz (12:24):

You need someone who can … Yes, and is keeping a very watchful eye over especially those first few weeks. They’re very crucial in transitioning the patients to a new provider. I had to do a lot of phone conversations with patients who just weren’t sure that they wanted to try the new doctor [inaudible 00:12:43]. I think having the availability to be present.

Chris Pistorius (12:52):

Yeah, yeah. That totally makes sense, and I think it is very, very important to have a very strong office manager in any practice, but especially when you’re expanding and adding practices. You’ve just got to make sure you’ve got somebody there that can take accountability, can take charge, can handle the smaller stuff, and then that’s really what puts you in multiple places at one time, right?

Julie Rentz (13:21):


Chris Pistorius (13:24):

I think that’s incredibly important.

Julie Rentz (13:26):

Yeah, and I think for me, that has been the number one struggle, is just personnel and having someone there. If I were to give somebody advice for going into this type of buying a second practice, it would be to have that person that you really know and trust, knows how you like it done, knows how to get things set up right, and get the ball rolling.

Chris Pistorius (13:53):

Yeah, and I think it’s a good segue into many, many practice owners and managers talk to us about staffing, and how it’s difficult to find people and quality people, and get them to stay. They want to avoid this cycle of hiring somebody, then they leave, and they got to rehire and start all over. I think when you expand the practices, you have to look at probably the existing staff that they have. Did you put them through an interview process, or how did that work, and what are some tips that you have on hiring and firing?

Julie Rentz (14:27):

Yeah. Yeah, so our situation was unique, because we were closing, we actually did not rehire their office. Some doctors may not know this, but when you buy a practice, those employees essentially become brand new employees on the day you buy the practice. Their employment is not an automatic through the purchase. It’s very common. It’s highly suggested that you keep the current staff, but for us, we knew we were going to be closed for a month and a half.

Julie Rentz (15:03):

I had done some due diligence on the practice and seen some of the way that things were being handled clinically. I went back and forth. Do I keep them and try to retrain them? I think that that’s difficult, or we’re going to be closed for the next two months. Do I just not rehire them and build my own team? Because now I’ve got the time, right? I don’t have any patients that I have to see.

Julie Rentz (15:32):

For us, that’s what we opted to do. We didn’t rehire their staff, and we built our own staff.

Chris Pistorius (15:42):

I see, okay.

Julie Rentz (15:43):

Yeah, yeah. I think finding the right employee varies by owner, right? What I find value in and what another owner finds value in could be different, but for me, the three things I first look for in a candidate is their personality. Then I look to see, are they trainable? And then I looked to see, do they want to grow? Because I feel like so often dental employees …

Julie Rentz (16:17):

Well, okay. First I think dental employees, because of their experience, tend to get cycled through offices, but aren’t necessarily good employees, but they get hired. They constantly get rehired because they have experience. I think that it’s almost like a set up to fail, if you just hire somebody because they have experience.

Julie Rentz (16:42):

I think one, personality you can’t train, so I think that has to be there. Two, when I say I need that person to be trainable, I need them to be trainable whether they’ve had 10 years of experience or whether they have no experience, because the reality is that every employee that you hire requires training, whether it’s to your specific processes or just determining …

Julie Rentz (17:07):

In interviews, every candidate is going to tell you they know how to read an EOB. Every candidate is going to tell you they know how to talk to patients about insurance, how to present a treatment plan. They’re going to tell you they know how to multitask.

Chris Pistorius (17:20):


Julie Rentz (17:20):

I’m exaggerating, but … In their minds, they really do think they know these things, but you get them on the job, and you realize they only know what they’ve been taught in the past or trained in the past. If that’s either incorrect or not your way, every employee you ever hire is going to require training. If that candidate seems like, “I know what I’m doing, and I’m not open to feedback or training,” it’s like a no-go for me from the start.

Julie Rentz (17:56):

Then lastly, I think so often these dental jobs, not necessarily for clinical employees … I still think all of these things apply for clinical employees, but I want an employee who views this position as a career, not just a job. I think viewing the position as a career means that they’re constantly looking for ways to grow in that position. They’re constantly looking for what they don’t know, and how to get better, and how to move up.

Julie Rentz (18:30):

That only benefits my practice. If I’ve got somebody who has the drive to want to be good and do better, that’s my ideal employee. Those three things, and I feel like everything else is trainable.

Chris Pistorius (18:46):

Yeah. I think that’s a great plan, and that’s great advice. I think this whole COVID thing has maybe increased the talent pool a little bit. Maybe there’s more qualified people available.

Chris Pistorius (19:01):

But I’m hearing more and more about dental practices hiring, not necessarily with no experience, like you were addressing. Some practices like to hire people with no dental experience, because they feel as though then they can train somebody just the way to their customs and their procedures, and there isn’t this already-set-in-their-way type attitude. But I think that the thing is that you have to be coachable, and they have to be trainable, and they have to be willing to learn.

Julie Rentz (19:35):

Yeah, and on the employer side, the employer has to have systems set up to train that employee. A lot of times they just stick them in the front and train them as they go, but the reality is, especially in dental, and healthcare in general, there’s so much you have to know. From insurance, how to code, dental terminology, insurance, how different plans apply, billing, you have to know accounting. There’s just such a wide range of information that you have to know, that if an employer hires somebody without experience and doesn’t have a system in place to adequately train that employee, you’re going to get out of it what you put into it.

Chris Pistorius (20:19):

Yeah, I think that’s great, yeah. Okay. Well, I’m going to start wrapping up here, but I’m curious, you just brought on the additional practice. Where do you see your practices in the next five years? What are some of the goals that you want to accomplish?

Julie Rentz (20:35):

Yeah, the Deer Run office that we bought actually is in a very similar situation to where Stonegate was when we initially bought Stonegate. In a way, I think Dr. Rentz and I are hoping that we can replicate that success, which I think is every doctor who buys a second practice, I think that’s their goal, right? They want to replicate their success at their existing practice. In five years, I’m hoping that Deer Run will be seeing the same type of growth that we’ve been able to see here at at Stonegate.

Julie Rentz (21:13):

For Stonegate, we’re definitely going to have to be in a new building. We’ve taken off, our growth has taken off over the last several years, and we’ve just outgrown the space we’re in now. I think the next step for us is getting into a bigger building, so that we can continue that growth.

Chris Pistorius (21:36):


Julie Rentz (21:37):

Honestly, I think just continuing to improve our patient experience. I don’t see any changes necessarily to our model, or things like that. Just what we can offer to the patients and the experience we can offer to the patients.

Chris Pistorius (21:58):

Yeah, yeah. Well, that’s awesome. I know that Deer Run’s going to be as just a biggest success, because you have such a great internal organization. Dr. Rentz is awesome, I know his patients love him, and with you running the show behind the scenes, I think that’s just a recipe for success.

Julie Rentz (22:16):

Thank you.

Chris Pistorius (22:18):

I think what you talked about … And maybe once you move into the new building, that’ll be our next segment. You can teach everybody what the best practices for moving are.

Julie Rentz (22:28):

Yeah. Oh, I was just going to say, luckily, I’ve got a good group of other dental spouses behind me who have all been through this, and they give great advice and great checklists.

Chris Pistorius (22:42):

Yeah, yeah. Well, awesome. Well, Julie, I appreciate you taking the time. I know how busy you are, and I really appreciate you coming on. I know anybody that’s going to watch this will get a lot of value out of it just from your experiences. Thanks [inaudible 00:22:56] so much for being with us today.

Julie Rentz (22:58):

Yeah. Thanks for inviting me, I appreciate it.

Chris Pistorius (23:01):

Of course. That’s it. Thanks, everybody, and be sure to tune in to our next segment. Thank you.

A Very Exciting Week So Far!

A Very Exciting Week So Far!

Hey guys, it’s Chris Pistorius with dental marketing company, KickStart. I want to give you a quick update on what I’ve been up to this week. I’m actually in Miami, Florida, I am with about, I don’t know, 50 other agency owners. We all get together every three or four months or so. We go over the latest in local marketing. And these are other agencies that are in all kinds of industries, not just dental. We go over what’s working well, what’s not working well. What the latest marketing technologies are, the latest cool things in terms of website, design, and development, and really what’s out there on the horizon in terms of marketing for local businesses. So I want to share you share this with you because I’m so excited about what I’ve learned so far. I’m on day two, tomorrow will be our last day meeting and I’ve just learned a ton about things that I can bring in immediately to our clients to help them and us kind of zoom in if you will, to 2021.

So learning some great stuff here, I’m really excited. I’m going to unpack this for you when I get back. So you’ll see some more videos of me soon talking about the details of things that I’m learning and if you’re a client of ours now, you’ll definitely be hearing from me soon because we want to start, using some of this, some of these new learnings in our campaigns and just to drive even better results for you guys in 2021. So all good here in Miami and looking forward to unpacking this and talking to you soon. Thanks.

Also, if you would like to see how your practice is faring compared to others during the COVID pandemic, please check out the latest study from the ADA.


How Does Your Dental Practice Compare To Others During The COVID Pandemic?

How Does Your Dental Practice Compare To Others During The COVID Pandemic?

Some great data from the ADA on the current state of affairs (data as of 10/5/20) in the dental industry during the COVID-19 pandemic. KickStart Dental Marketing is proud to share this kind of important data with our visitors.

  • Recovery: As of the week of October 5th, 99% of dental offices in the U.S. were open and patient volume was estimated
    at 80% of pre-COVID-19 levels. Staffing was at 93% of pre-COVID-19 levels. These values have been roughly unchanged
    for several weeks and suggest we have reached a “steady state” of economic activity in dental offices.
  • Dentists are hiring: Roughly one-third of dental practices are recruiting dental assistants and one quarter are recruiting
    hygienists. DSO-affiliated practices and large groups are recruiting more heavily than non-DSO and solo practices.
  • Recruitment is a challenge: Recruiting dental team members is challenging. Among dentists hiring for any position (i.e.,
    hygienists, assistants, administrative staff, or dentists), the majority report that it has been extremely or very challenging
    compared to before the COVID-19 pandemic. Nearly 80% reported it was extremely or very challenging to recruit
    hygienists, and roughly 70% said the same for assistants.
  • Patients are willing to get vaccinated at the dental office: Consumers are open to the idea of vaccination at the dental
    office as part of their dental visit. If an annual flu shot could be incorporated into a routine dental visit, the majority of
    consumers report they would be interested in that option. If a COVID-19 vaccine were available and patients could get the vaccine at their dentist’s office during their appointment, the majority would be interested.

As of the week of October 5th, 99% of dental practices in the U.S. were open. Less than half of the open practices reported “business as usual” in terms of patient volume. This has declined over the past month.


Patient volume in dental practices is at 80% of pre-COVID-19 levels as of the week of October 5th.


Staffing in dental practices was at roughly 93% of pre-COVID-19 levels the week of October 5th. This has been stable for several weeks.


79% of people are either “recently active” or “ready to go” in terms of visiting a dentist’s office. 


Consumers are open to the idea of vaccination at the dental office as part of their dental visit. If an annual flu shot could be incorporated into a routine dental visit, the majority of consumers report they would be interested in that option. If a COVID-19 vaccine were available and patients could get the vaccine at their dentist’s office during their appointment, the majority would be interested.

Also, don’t forget to check out Chris’ latest blog post on how to hire dental front desk staff to enhance your dental marketing efforts!


A Quick Thought On Hiring Front Desk Staff

A Quick Thought On Hiring Front Desk Staff

Hey guys, it’s Chris with the top rated dental marketing agency, KickStart Dental Marketing. I just got off the phone with the dentist of a potential brand new practice. And we talked about front desk staff and what they should do when they’re looking to hire a front desk staff. And I thought, “Why not shoot a minute or two video on my thoughts on this. And it might help somebody else in our community?”

So, I wanted to talk about that really quickly in the sense that most dental practices, what we’ve found over the last 10, 11 years that we’ve been doing dental marketing is that, a lot of dental practices will hire front desk people, but they won’t think about these front desk folks as having sales skills. And I think that’s a mistake because truth be known, if you’re doing marketing or if you’re on insurance lists, things like that, you should be getting a good influx of phone calls and inquiries into your practice from people that don’t know who you are. And you need somebody that’s very skilled at that front desk position in sales to help portray your value, schedule those appointments and get them into your chairs.

So, you may want to think about the next time you’re hiring a front desk staff person in that, do they have sales skills? And if they don’t, that’s okay. But are they coachable? Will they be willing to learn new skills and get better at their jobs? So, it can be literally a make or break for a dental practice that is looking to grow of having somebody that’s answering the phones that has some skills in terms of turning cold leads into new patients. So, just some thoughts on that. I hope it helps you. And let me know if you have any questions.

Be sure to check out my interview with Jordan Armstrong with Sky 5 Cleaning on how to keep your office “COVID clean”.