The Top Challenges Facing Dentists Today

The Top Challenges Facing Dentists Today

To get in touch with Paul:

Dr. Paul Goodman
text ‘NACHOS’ on (215) 543-6454

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Chris Pistorius (00:01):

Hey, everyone. It’s Chris Pistorius again with the Dental And Orthodontic Marketing Podcast. We’re all about finding great ideas, unique ideas, and things to help dental practice owners. Today is going to be no different. I’ve got a great guest, Dr. Paul Goodman a.k.a Dr. Nacho is with us today.

Chris Pistorius (00:23):

Dr. Nacho, thanks so much for joining us today.

Dr. Paul Goodman (00:26):

Love being here. Thanks for having me on. I love you guys. Love when people do stuff like this, get more stories out there on how dentists can do you better. Honored to be here.

Chris Pistorius (00:33):

Absolutely. Awesome. Well, hey. You’re a busy guy. All right. We talked before we hit the record button here. You’re running this Dental Nachos that we’re going to talk about in a second. You’re a current dental practice owner. You’re practicing. You’re a practice broker as well. How do you find the time to do all of this, possibly and get sleep still?

Dr. Paul Goodman (00:55):

Thanks for sharing that. Well, you have to work your whole life to create unique opportunities, unique timing. I practice six to eight days a month. I do dental practice brokering, Dental Nachos speaking the other days of the month.

Dr. Paul Goodman (01:08):

I was practicing as a full-time dentist. I always wanted to have a collaborative dental office. What’s unique about us is we have two locations with nine dentists working there. So we can always have a musical chairs of dentists. Someone can cover for me.

Dr. Paul Goodman (01:20):

One of the challenging parts, which I talk about, is being a solo practice owner can have a lot of upside, but also can have a lot of restrictions on your time when you’re the only person doing it. So the first thing I did was to create ability to replace myself in the practice with associates and other dentists there.

Dr. Paul Goodman (01:36):

I sleep more than people think. I just am like a friendly tornado, operate on double speed when I’m awake. So it’s not always easy to be around me.

Chris Pistorius (01:44):

Yeah. Well, that’s incredible. Always stay busy. I think that’s a good thing, right?

Dr. Paul Goodman (01:49):

Yeah, for sure.

Chris Pistorius (01:50):

Tell me about this Dental Nacho stuff. Obviously, I know a little bit about what’s going on there, but somebody that’s never heard of it or doesn’t know what it’s all about, tell us all about it, please.

Dr. Paul Goodman (01:59):

It’s a common thing. You wear this shirt around, people will stop you. I was getting money at the ATM. Do they call it the ATM? The guy who is the security guard said, “What is Dental Nacho?” Really, it’s like a Mister Rogers’ Neighborhood for dentists, where dentists could come together, talk, share, discuss spicy topics.

Dr. Paul Goodman (02:16):

Mr. Rogers is one of my heroes. Mr. Rogers … I’m a kid of the ’80s. I’m 43. He was talking about gun control, racism, things that we’re talking about now 30 years ago. That show is not just for kids. If you watch Won’t You Be My Neighbor, an amazing show about him.

Dr. Paul Goodman (02:33):

I wanted to create an environment where dentists would feel safe sharing, but we also could discuss the challenges that are facing our industry, causing us to have problems with our morale, challenges with money.

Dr. Paul Goodman (02:44):

I think one of the popular term now, Chris, is gaslighting. I think the public says, “Oh, my dentist always seems happy.” I say, “Well, that’s just a fake face they put on for you when you’re there, because we’re doing full contact arts and crafts on people who don’t want to be there.” So it can be a much more stressful job than what the patients see.

Chris Pistorius (03:03):

Right. So it’s kind of a … Dental Nachos, you almost think of a safe place for dentists, right?

Dr. Paul Goodman (03:08):

Yeah. But we can have spicy conversations. We also do a lot of things, in-person events, live streamed events, CE courses. The pandemic has created an opportunity for us to do things like we’re doing now. Also a community for dentists to care just as much about each other as they do about their crown preps, which I think is important.

Chris Pistorius (03:28):

Yeah, absolutely. You just mentioned [inaudible 00:03:31], you talk about some of the top challenges in dentistry now. That certainly changes from month to month, as we’ve seen from the recent COVID stuff. Other than COVID, or maybe you could include COVID into this, what do you think are some of the top challenges facing dentists today?

Dr. Paul Goodman (03:46):

I talk about the Ds destroying the life of dentists. Dentistry’s great. Technology, great. Stuff we can do on patients, great. Working inside of our operatories has gotten more fun, probably a little bit easier, and we can do amazing things. When you step outside the operatory, morale and life of dentists, problems.

Dr. Paul Goodman (04:03):

Here’s one. Declining insurance reimbursement. I will use this example. Imagine if they said, “You’re going to exercise every day. You’re going to eat right. And every year, you’re going to gain five pounds.” That would hurt your morale. That’s what’s happening with insurance reimbursement for dentists. We’re being paid less than we were years ago, even though our business costs more to run.

Dr. Paul Goodman (04:21):

Our newest dentists, dental school costs has gone up two to three times as much without dentists making more money. So dental student debt affects the industry, not just the new dentists, it affects all of us. It affects decisions in where they work. It affects so many things. So both dental student debt and declining insurance reimbursement, I think, are two of the biggest challenges.

Dr. Paul Goodman (04:41):

Also, the pandemic has caused many hurdles for team members. Some of them couldn’t come back to work. We have to put together a whole football team to get our job done, right?

Dr. Paul Goodman (04:50):

I had a chiropractor as a patient. I said, “That must have been a relaxing job. It’s just you and the table. As long as the table shows up, you can do your job.” But I don’t know if you’ve been in a dental office. We’ve got assistants, hygienist, front desk. That can be fun. But if one person’s missing, I’m a big sports fan, we don’t always have a bench. That can really impact your ability to deliver care.

Chris Pistorius (05:11):

Yeah. That’s awesome. It’s kind of like the next man up philosophy of football perhaps, right?

Dr. Paul Goodman (05:15):

Yes. Yeah. But we have no next man or [crosstalk 00:05:18]. You turn back and we got nobody.

Chris Pistorius (05:21):


Dr. Paul Goodman (05:22):

That’s part of the challenges.

Chris Pistorius (05:23):

Yeah. Well, let’s dive into that a little bit. It seems like a hot topic. I ask this in almost every interview I do. It’s great to get different ideas here. But hiring and firing, and especially hiring and retaining employees, that next man up strategy we were talking about, in your opinion, you’ve been around, you know this stuff, what’s the best way to find great employees that are going to stick around?

Dr. Paul Goodman (05:48):

First thing I always share is always be looking for team members, even when you don’t need a team member. Always just be alert. I have a two children that live in my house. Apparently, it’s still illegal to leave them home alone. So we need baby sitters. So I’m always looking for extra babysitters.

Dr. Paul Goodman (06:04):

Life happens. Dental team members, it’s not an easy job. You’re working shoulder to shoulder with people who don’t want to be there, in a high stress environment. With the pandemic, sometimes people couldn’t come back to work because of their children. Sometimes people just get burnt out of the industry. So one strategy is always be looking, even when you don’t need anyone.

Dr. Paul Goodman (06:20):

Number two strategy is stay connected in your community, both dental and outside of dental, because there’s positions you can train people off the proverbial street.

Dr. Paul Goodman (06:28):

Three, stay connected with people who are connectors, like equipment reps, like marketing companies like you, so that you can leverage that. Oftentimes people shout out, “I need a hygienist,” but they don’t have any relationships at that time. There’s great services out there. Some of them are sponsors of our group. But they’re not magicians.

Dr. Paul Goodman (06:48):

Those are the three things I would say is always be looking, even when you don’t have a need in your office, for good team members.

Chris Pistorius (06:54):

Yeah. I think that’s great advice. In your experience, I’ve heard lately more of dental practice owners and managers really hiring people with no experience in dental. The thought behind that is, number one, there’s more of them available, right?

Dr. Paul Goodman (07:10):

For sure.

Chris Pistorius (07:10):

Number two is they’re finding that when they do that, yeah, there’s more training. They can teach them the dental side of it, but they’re finding that they’re not set in their ways, they’re totally coachable, and they wind up being better employees. Have you seen that? Do you have any experience with that?

Dr. Paul Goodman (07:25):

Oh yeah. We do that with a lot of things. There’s technical jobs that are hard to do that, some not legal, like hygiene. But sometimes your assistant team, depending on what they’re do, or your front desk team, and also just …

Dr. Paul Goodman (07:37):

This is an off topic, but why does somebody have to have the same career for 40 years? Is that a good thing? Meaning someone who’s a dental assistant, and an awesome dental assistant, aged 23 to 36, maybe they’re just burnt out, and they want to be a rep for a supply company. That’s totally cool.

Dr. Paul Goodman (07:53):

So I think we just need to be comfortable with this transitioning nature of the workforce, and be agile and flexible. You’ve said a good point. Get good training systems in your practice so that when you do bring somebody in, you’re not reinventing the wheel.

Dr. Paul Goodman (08:06):

Too often, dentists are held hostage in a way by this one team member who knows all these things. Also, I’ve had a great life, but I’ve also had some challenges. I’ve had unexpected events happen, illness, death, injury, or happy events. Somebody’s spouse has to move across the country because they got a great job as the VP of sales for something. Now, they’re gone. So I think dentists need to learn in school that putting your team together is something that’s never finished, and you should always be working on it.

Chris Pistorius (08:36):

Yeah. I’ve referenced this before, but are you familiar with a book called E-Myth Revisited?

Dr. Paul Goodman (08:42):

Oh, yeah. Am I familiar with it? It’s near me at all times. I have it right here.

Chris Pistorius (08:46):

Folks, this was not planned. I promise.

Dr. Paul Goodman (08:48):

Yeah, yeah.

Chris Pistorius (08:49):

I’m not promoting-

Dr. Paul Goodman (08:50):

These are my two favorite books. E-Myth and Checklist Manifesto. I have these at all times.

Chris Pistorius (08:55):

Perfect. This was not rehearsed. I promise. But you’ve said a couple of things that made me think you might be onto that. You talked about replacing yourself earlier, and then you talked a little bit just now about process, procedures.

Chris Pistorius (09:08):

Anybody watching or listening right now, this book, E-Myth Revisited, applies to you. It applies to almost any business. What it really talks about is what Dr. Nacho was just talking about, in the sense that you never know what’s going to happen, so you really need to have a really good book of process, procedures, something that somebody even off the street could come and just read the book and know how to do that job, right?

Dr. Paul Goodman (09:35):

[inaudible 00:09:35] paper still. We have ways for people to touch something and say, “These are the most eight important things from the Checklist Manifesto for each job.”

Dr. Paul Goodman (09:42):

I think management is repetition. One of my consultants told me that early on. It’s such a good point. I think dentists get frustrated where they need to learn to delegate tasks that they are able to give up. But some dentists will micromanage too many things and cause their stress level to rise.

Dr. Paul Goodman (09:58):

Really, it’s sitting down, going through the process of creating a system, creating supporting assets for it, whether it’s digital and paper, and then being patient enough [inaudible 00:10:09] to help people when they drop their nachos, or the nachos go off script.

Dr. Paul Goodman (10:14):

But what’s crazy, Chris, is, I say this all the time, dental school sets dentists up to be miserable, because they don’t talk about any of this. So they make you think that being technically competent is good.

Dr. Paul Goodman (10:26):

Everybody knows this experience. Everybody has in their background an amazing chef owned restaurant where the service stunk, the food took too long, you didn’t know if they’re open, but the food was amazing, but you stopped going there because the other stuff was a problem.

Dr. Paul Goodman (10:42):

Dentists are the people trying to make their pasta so well, while the other stuff they’re not planning. That’s part of the reason, I believe, why they’re so stressed out in private practice, because they don’t even know that this is a thing until they get there.

Chris Pistorius (10:53):

Right. Yeah. That all makes complete sense. I can’t say enough good things about that book, E-Myth Revisited.

Dr. Paul Goodman (11:01):


Chris Pistorius (11:01):

It talks about creating a business as a franchise. Even though you’re not going to be a franchise, there’s a lot of things that you can do to set your business up in that way. I totally see some parallels on how that could work, like you mentioned with dentistry.

Chris Pistorius (11:15):

I’m going to switch gears just a little bit here. You mentioned dental school. This was a topic I was talking with somebody the other day about, how in dental school, they teach you really well how to become a dentist, or in most cases, how to become a dentist, but they leave out a lot of the business aspect of this. Is that accurate?

Dr. Paul Goodman (11:34):

Yeah. It’s incredibly accurate, irresponsible, and maybe even borders on a scam, because here’s why. Dental school keeps raising their prices, they’re delivering less to the dental student, and they’re not training them to survive and thrive in the real world.

Dr. Paul Goodman (11:48):

Here’s an example. Dental school charges 500 or $600,000. That’s money, right? They charge it to the dental student. Yet when the dental student is in dental school, nobody teaches them how money works in dentistry, which is one of the most irresponsible things.

Dr. Paul Goodman (12:04):

I don’t know if I’m an economist, or I don’t know if I’m a business whiz, but I don’t think you can help anyone if your practice goes out of business. I don’t think you’d be doing dentistry on the streets.

Dr. Paul Goodman (12:13):

Keeping your dental office in business is more challenging than people think. They just give these cliches, “Dentists don’t fail.” “None of them go out of business.” But they have not looked to see what’s happening in our industry with declining insurance reimbursement, with challenges that people are having. So I just think we need to start to have these conversations in dental school, so they’re at least aware of these things.

Chris Pistorius (12:34):

Yeah. We see all it all the time too in marketing. Honestly, in all frankness, it’s probably helped our business, because these people come out of school, and they’re like, “All right. I know how to do dentistry, but how do I grow a practice?” Right?

Dr. Paul Goodman (12:48):


Chris Pistorius (12:48):

They don’t know much about marketing. Unfortunately, what happens, if they get in the wrong hands with the wrong people in terms of marketing, they can spend a ton of money and not get anything out of it. We see a lot of that, especially with some of the newer guys or girls coming out of school, and trying to figure out what they want to do with their practice.

Dr. Paul Goodman (13:07):

I agree with you, but I would encourage, and not really challenge … If a dentist is going to spend 5% on marketing, just as an example, and you took all the millions of dollars of revenue, it’s going to be like 0.6%. So your business has a huge pie that could grow for all companies if dentist says, “Hey. I’m at least going to spend $50,000 of my million on marketing,” because dentists are often very frugal, #dentistCheap, I’ve come up with that, on marketing. So I think, in the most positive way, there’s a huge pie for marketing companies to win if dentists get the message like, “Hey, I should be spending this money on marketing.”

Chris Pistorius (13:45):

Yeah. No, that totally makes sense. Especially, it’s so competitive now. Depending on the market you’re in, you’re getting a lot of pressure from corporate dentistry.

Dr. Paul Goodman (13:54):


Chris Pistorius (13:54):

So yeah, for sure. I want to talk a little bit more about new dentists. What’s your advice to somebody coming out of school, or maybe they’ve been an associate for a year or two, and they’re getting that itch to maybe have their own practice? Do you feel as though it’s smart right now go out and do your own thing?

Dr. Paul Goodman (14:11):

What they should do is go to someone who has a three-year-old, like me, [inaudible 00:14:15] and say, “I want to watch it for the next week, and see how I do,” because having a dental practice is like having a three-year-old that never grows up.

Dr. Paul Goodman (14:21):

But in all seriousness, I think that they need to develop their core with business leadership, team communication, nothing to do with crown preps, nothing to do with extracting teeth, and see if that’s the life that they want. I think one of the …

Dr. Paul Goodman (14:36):

If someone said to me, “Why are dentists have so many morale problems, stress problems, depression, death by suicide?” Here’s why. This is the answer. Dentistry is filled with conflict. You’re talking to people who don’t want to be there and don’t want to pay for it. You have team members who are challenging to deal with.

Dr. Paul Goodman (14:54):

If conflict is fighting fires, a firefighter knows they’ve signed up to fight fires. A dentist in the real world has no idea how much conflict they have to deal with. As a practice owner, you have to deal with quite a bit daily. It’s all personality driven. Are you the type of personality that will do this?

Dr. Paul Goodman (15:11):

Buying a practice can be the key to financial success, can be the key to making flexible decisions, but you know what? Here’s a problem, Chris. What’s your spouse’s job? Because if your spouse has a job where he or she might move across the country, you buy a practice, you’ve got a big problem. Because if she gets a promotion, or she has to live her dream, what are you going to do with your practice? Dentistry …

Dr. Paul Goodman (15:31):

I have two daughters. What this pandemic has taught me is I will encourage them to do what they want in life, but I will guide them. I will tell them that if they have a job where the only way they can make money is by physically being in front of somebody, it’s a very risky job. Dentistry, hairstylist, restaurant server. Because what this pandemic has taught us is dentistry’s not portable.

Dr. Paul Goodman (15:55):

There’s great points. Everyone’s going to need a dentist. Doesn’t mean it’s [inaudible 00:15:58] But just sharing that owning a dental practice can be an anchor to that geographic region, you just want to make sure that’s where you’re going to be.

Chris Pistorius (16:06):

Yeah. That’s a great point. COVID has definitely shown us that. We see the people, the businesses that have been impacted the most, dentistry, anything in person, entertainment, arts, things like that.

Dr. Paul Goodman (16:17):


Chris Pistorius (16:18):

That’s an excellent point, for sure.

Dr. Paul Goodman (16:20):


Chris Pistorius (16:21):

When we talk about somebody going to buy a new practice, or they’ve made the decision, “Yeah. I want to do this. I want to own a practice,” tell me … You did this. What was your thought process in terms of, do I start from scratch and build my own, or do I go out and look for a book of business and maybe buy one from somebody that’s retiring?

Dr. Paul Goodman (16:42):

It’s such a good question. Most of the time, buying a good acquisition is going to … You’re going to buy cash flow. You’re going to buy systems. So most of the time, that’s what dentists do.

Dr. Paul Goodman (16:52):

But startups, and we work with startup consultants, we respond to startup consultants, give you the opportunity to create your own brand from scratch, but it also means you likely will need to go where there’s a need for a dentist.

Dr. Paul Goodman (17:07):

In my area of New Jersey, we have a one dentist to every thousand people. Very competitive. If someone came into my town and wanted to do a startup, it would be very difficult for them to survive, not because they’re not a great dentist, not because I wouldn’t be nice to them, just because when there’s a free pizza, and there’s nine people, and there’s eight slices, there’s going to be a problem.

Dr. Paul Goodman (17:29):

There’s a really interesting thing happening where there’s massive opportunity, where you can be in a ratio of one to 3001, one to 4,000. But I say this in the most diplomatic way. They’re not often areas where people are clamoring to move to, and they might not be able to bring their spouse there. So I think …

Dr. Paul Goodman (17:48):

I don’t know. There was this movie, Doc Hollywood, back in the day, with Michael J. Fox. He got stranded [inaudible 00:17:53]. I believe that’s going to happen. There’s going to be towns that have no dentists. Dentists are shutting their doors, and no one’s replacing them, because up until about the 1990s, most dentists returned to where they lived to practice, me included. [inaudible 00:18:06].

Dr. Paul Goodman (18:07):

Now, we have all these cool people, 50/50 men and women, more women, people from other countries. It’s awesome for the field. But from a business perspective, are people going to go to the middle of Pennsylvania to buy a dental practice if they’re not from the middle of Pennsylvania? Spoiler alert, they are not.

Chris Pistorius (18:24):


Dr. Paul Goodman (18:25):

So it’s a very unique challenge. Some of it comes with massive opportunity, but some it comes with massive risk. The first thing I say to a dentist when they’re getting a job, which is what we help them do, “Are you geographically flexible?” If they say yes, I say, “You can earn twice what most dentists make, but you’re going to go to Omaha, Nebraska. You’re going to go to Fargo, North Dakota. Is that okay with you?”

Dr. Paul Goodman (18:46):

Nobody … This is what they should tell dental school applicants, Chris, because they’re really not being …. They’re not showing them the true picture of private practice dentistry before they go to school.

Chris Pistorius (18:58):

Right. Yeah. I think that’s a great point, and you’re right. People used to go to school, they’d come back, go to their hometown, set up shop, and they’d be there. That trend certainly is changing.

Dr. Paul Goodman (19:11):


Chris Pistorius (19:11):

That’s very interesting. We’re going to wrap it up here, but what kind of parting words or nuggets of wisdom could you share with folks that are watching right now?

Dr. Paul Goodman (19:22):

What I would say is if you’re a dentist watching, just do one thing to be kinder to a dentist near you. Call them up on the phone and do something that was normal when you were a teenager, but now I know you’re all weird. Say, “Hey, do you want to go get lunch and just talk?” I know it’s going to be weird. Just say, “I’d love to get to know you.” I believe dentists getting to know each other, being kinder, sharing more, is the key to a successful industry.

Dr. Paul Goodman (19:45):

I’m a huge Game of Thrones fan, so if someone’s listening to Game of Thrones, they’re going to get it, this is like when they didn’t think the White Walkers were coming, but they were coming. They were. I’m telling you, the White Walkers are coming for dentistry. Dental insurance reimbursement, dental student debt.

Dr. Paul Goodman (19:59):

I work with DSOs. DSOs a very interesting mix. That’s corporate dentistry. Corporate dentistry is doing things to push the field forward, but also doing things that limit opportunities for private practitioners, because a great practice will often be bought by a DSO before it gets on the open market. That’s something that’s been … Our dental ancestors have let them in, so now we have to deal with that.

Dr. Paul Goodman (20:22):

So I would encourage you, reach out to a dentist in your town, talk to them more, go to more in-person CE, be that kind of friend that you needed when you were in dental school. That’s what I hope people would do.

Chris Pistorius (20:33):

Yeah. That’s great. That’s a great analogy with the White Walkers. I like that.

Dr. Paul Goodman (20:37):

Yeah, right.

Chris Pistorius (20:37):

What if somebody’s watching this, and they’re like, “I need some help [crosstalk 00:20:42] Dr. Goodman’s talking about here,” what’s the best way to reach out to you guys and learn more about your program?

Dr. Paul Goodman (20:49):

Thanks so much for letting me share that. I’ve tried to create like an ESPN version of what we do, from buying practices, CE, events. You go to

Dr. Paul Goodman (20:59):

One of my best friends in life, I brought him. It’s my phone. You could just text nachos to (215) 543-6454. If you text nachos to (215) 543-6454, one of my idols is Gary Vaynerchuk, Gary V, and I got the same community text platform that he has. It’s been a great way to connect with people, because you text in, and you’re texting me. We can have a conversation. Ask me a question. I really love it.

Dr. Paul Goodman (21:24):

Thanks so much for letting me share that.

Chris Pistorius (21:25):

Nice. Yeah. I’ll make sure we put that information below the post and everywhere that this is going to be broadcast.

Dr. Paul Goodman (21:31):


Chris Pistorius (21:32):

Hey, Dr. Goodman, seriously, thanks so much for your time. I know how busy you are. This has been really fun and a lot of really good information. I appreciate you being with us today.

Dr. Paul Goodman (21:41):

Thanks, Chris. I really appreciate it.

Chris Pistorius (21:43):

Sure thing.

Chris Pistorius (21:43):

Thank you to everybody that’s watched this episode of the Dental And Orthodontic Marketing Podcast. Please be sure to check in with us next week for another great show. Thanks again.


Internal vs. External Marketing For Dental Practices

Internal vs. External Marketing For Dental Practices

To get in touch with Lee:

Lee Harris
(714) 293-2195  

View Full Transcript

Chris Pistorius (00:03):

Hey, everybody. It’s Chris Pistorius again with the Dental and Orthodontic Marketing podcast. We are busy today. This is our second live interview on Facebook for the day so we’re getting busy on Friday. But we’ve got a great guest with us this afternoon. We have Mr. Lee Harris.

Lee Harris (00:23):


Chris Pistorius (00:25):

Lee is a dental practice management consultant. He is with Harris Dental Solutions. He is coming to us today out of Southern California. Lee, thanks so much for being a part of the show today.

Lee Harris (00:39):

Glad to be here, Chris.

Chris Pistorius (00:41):

Great. Well, why don’t we start off as we usually do, and tell us a little bit about what you do, how you do it and why you do it.

Lee Harris (00:48):

Okay. Well, a little bit of background, I was a practicing dentist from 1974 till about 2004. And at that time I was starting to feel my way through consulting and I started my consulting practice in 2001 while I was still practicing. And now I’ve been a full-time consultant since about 2007 or ’08. All I do is consulting for dentists who need help, either startups or practices that have plateaued and doctors don’t know what to do to get their practice moving and I help them do that.

Lee Harris (01:24):

I do policies and procedures, set up efficient systems in their practice, and then we go ahead and do some marketing and get them growing. We want to make sure that patients don’t go in the front door and out the back door. So we don’t want to do any marketing until we make sure that every system in the office and the employees are well-trained and you take care of the patients in a compassionate and quality manner.

Chris Pistorius (01:50):

Awesome. That’s a lot there. And a couple of things that stand out for me. I’m going to hit you with first, plateau. I’m sure there’s a lot of dentists that are watching this that could be in that boat. And COVID probably spins that a little bit, too, but talk to me about what you would define as a plateau when it comes to this.

Lee Harris (02:09):

Okay. So, in normal businesses, I’ve been in the business community, worked for the insurance industry for about 18 years. And they look for 15, 16% growth a year. Yeah, if you get five to 10, 15, your shareholders or your investors are happy. So, I would look at plateau as anything where you’re not growing, growing two or 3% is just keeping up with inflation, but you’re really not growing. So if I’ve got a practice that’s coming to me and they’re doing $100,000 a month but they could be doing $200,000 a month and they just can’t seem to get over the hump, that’s when I shine, that’s when I can help them. And usually it’s back to basics because the offices are kind of confused. They don’t know where they are and we can help them out in putting them on the right path.

Chris Pistorius (03:01):

Yeah. Being a dental marketing agency owner, we get hit with some of these clients. They’re like, “Things were going great and we were growing and then all of a sudden, we’re just kind of staying the same.” And it’s interesting how that happens. And it happens in a lot of different things. So I think sometimes just some new creative ideas can really spark that so it’s interesting that you bring that up.

Chris Pistorius (03:28):

The other thing that you mentioned in your intro was making sure patients aren’t coming in the front and going out the back door, right?

Lee Harris (03:36):


Chris Pistorius (03:37):

And we see this a lot. Yeah. We see this a lot here at KickStart where everything’s focused around, “I need new patients. I need new patients.” And I’m like, “Yeah, you do, but first let’s talk about what’s going on with your current patients. Are they coming back? Are you doing anything to reengage inactive patients?”

Lee Harris (03:56):

Well, I’m glad you mentioned that Chris-

Chris Pistorius (03:57):

Right, right.

Lee Harris (03:59):

… because internal marketing comes first.

Chris Pistorius (04:01):

That’s right. You got it. And what’s crazy about it is that everybody’s focused in my industry on new patients and all my competition’s all about new patients, new patients, but there’s very few agencies and probably consultants like you that are like, “Wait a minute. You’ve got this whole group of people that already know you, like you, and trust you,” hopefully, “let’s focus some of this money on bringing those folks back in.” Is that kind of what you’re talking about with that?

Lee Harris (04:29):

Absolutely, Chris, you’re so right because, and that’s what I focus in right away. Because if your staff isn’t treating your patients warmly, if your back office is not doing things efficiently, if there’s not systems set up and customers are going to be, patients are going to be unhappy, then they’re not going to start referring their friends. Or you may not be taking advantage of the patient base, as you mentioned, that you already have. And so a lot of things that can be done.

Lee Harris (04:59):

Dentists don’t even know how to ask their patients to refer them, family members or friends or acquaintances and they just need to get help with that. And we help them with that. But first we focus on the systems. We focus on what they already have. And then, when the staff is trained and ready to go and primed and all the systems are working, and the internal marketing has stepped up a bit and you can see your patients rise.

Lee Harris (05:25):

I mean, I had a client just this past year, COVID hit, he was getting five, six new patients a month, really poor. We just fixed the systems. Didn’t do anything but talk about internal marketing and he’s doing 15 to 20 new patients a month now. And we’re almost ready to go to external marketing because he’s starting to get-

Chris Pistorius (05:45):

That’s awesome.

Lee Harris (05:47):

… his own patients to come in, the systems are better, the staff is retrained. We had to get rid of few people, but that’s what we do and that works. [inaudible 00:05:56]

Chris Pistorius (05:56):

Yeah. Maybe you could, just for the people listening that maybe aren’t quite so sure, could you explain what you’re talking about with the difference between internal marketing and external?

Lee Harris (06:06):

Sure. Internal marketing is you want to talk to the patients you currently have in your practice. Most of the practices that I go to, some not, have some kind of customer relationship management software, brand names Lighthouse, Practice Activator, Demandforce, there are a million of them out there. But you just got to use one of them and get it to work for you. That allows you to do newsletters. It allows you to do surveys. It allows you to contact your patients by email and text and allows you to communicate with your patients in a more proactive manner. So, that’s one thing you do.

Lee Harris (06:44):

The second thing is you reach out, you ask. If somebody walks out and they are happy with the treatment you just gave them, what’s wrong with asking?

Chris Pistorius (06:53):


Lee Harris (06:53):

Another thing is that we use what I call a comp card program, where you give some incentive for the employees in the office to give their card out and have them give it to a friend and have them bring in the patients. And in some practices, this works really well. And not only does the patient get a discount off their bill, but the new patient gets a credit toward their first exam. So it kind of works out and the dentist and the patient and the referral source are all working out and benefiting from this program.

Chris Pistorius (07:29):

Yeah, that’s awesome. And there’s a ton of creative ideas like that that if you can really get into, it can make a big difference. We talk all the time here about a dentist isn’t a dentist, right, meaning you’ve got to be different somehow.

Lee Harris (07:45):


Chris Pistorius (07:45):

You’ve got to show some sort of a unique selling proposition that distinguishes you from the competition because, Lee, there’s some markets we go into with a client, there’s 50 dentists within two or three square miles, and they’ve got to be able to distinguish themselves differently than the others. So, I think those are some great, great creative ideas. So I want to [crosstalk 00:08:07]-

Lee Harris (08:07):

Well, the other thing is that leads me to the external marketing.

Chris Pistorius (08:09):


Lee Harris (08:09):

Because in the external you have to have a uniqueness proposition, as you mentioned, Chris. So you’ve got to find something that’s going to attract patients to pick you rather than the 49 other dentists in the area that are your competitors.

Chris Pistorius (08:23):


Lee Harris (08:23):

What’s unique about you and tell them about yourself in the external marketing. And the external is people like KickStart Marketing or any of the many marketing firms out there. One thing I have to say and add is that some of these firms are not as good as others. You got to get one that’s going to stick with you. And most of them are great for the first two or three months and then they kind of drop the ball.

Chris Pistorius (08:47):


Lee Harris (08:47):

So you have to find one that you rely upon and one that you trust and that you can feel pretty assured that they’re going to take you through soup to nuts of building your web presence, your other presence in the market of Facebook, Instagram, whatever you choose to use, Google Ads, whatever it is, you need to establish a consistency with that and make sure that that unique message gets out there.

Chris Pistorius (09:16):

Yeah, absolutely. There’s no question. And it’s a beautiful thing when you can get the internal marketing and the external marketing working at the same time. We talk about not putting all your eggs in one basket. We try to, when we do external marketing for clients, we talk about creating seven or 10 different baskets and putting an egg in each one of those, right?

Lee Harris (09:37):


Chris Pistorius (09:37):

Because the buzzword these days in marketing is search engine optimization. Get your website to rank and no doubt that that’s an important strategy, but guess what? We don’t control that, the client doesn’t control that, Google controls that. So just because we get somebody ranked on top of Google in a certain city for dentists near me, Google can change their algorithm-

Lee Harris (10:01):


Chris Pistorius (10:01):

… or the rules that they use to rank and one day you’re number one and the next day you’re page five, right?

Lee Harris (10:07):

Right. And the other thing is, yeah.

Chris Pistorius (10:09):

Yeah. So, if that’s all you’re relying on for your new patient leads, then you’re in a world of trouble. So I think it’s best to build a strategy that’s got multi places to get new patients. I’m sorry, what were you going to say?

Lee Harris (10:21):

Oh, no, I’m sorry for interrupting. So I think that’s very true. And that’s why I say that there’s no one strategy that works for every dentist.

Chris Pistorius (10:31):


Lee Harris (10:31):

Every dentist is different. Every dental office is different. I can have a dentist on this street that’s doing great on Google and in the same city, just a couple of miles away, Google doesn’t work for them at all, but Yelp does, or Facebook does, or Instagram does. And I find that getting employees involved with posting Instagram pictures of actually having patients in the chair, this has worked great for practices that I know of, especially when it involves kids or a great result, and you can get it out there to a network of people that will see it. It’s fantastic.

Lee Harris (11:09):

But just as you say, not any one solution is going to work for every dentist. It’s got to be [crosstalk 00:11:16] and you don’t want to spend all your money on external marketing, but you got to have a strategy. So you find out what’s going to stick to the wall and then go with that and the only way to find out what’s going to stick is to do a lot of things.

Chris Pistorius (11:31):

Yeah. And 15 to 20 years ago, or maybe even less, the marketing mix, you go buy a Yellow Page ad, you maybe do some direct mail and it worked and you’re kind of set. And what we’re seeing now in this environment is another level of complexity with the internet. And now there’s 500 places that a dentist could potentially spend money and they’re getting calls from people, “Spend here, spend here.” And what, unfortunately, what I see that leads to sometimes is a dentist, or really any professional can just kind of say, “This is overwhelming. I’m going to put my head in the sand and do nothing.”

Chris Pistorius (12:07):

And that’s the worst thing that you can do right now, because you’re going to get passed up by your competition who is trying to figure it out. So I think it’s important for dentists sometimes to get help from people like you, people like me, get some opinions, come up with some ideas that can strategically get them ahead. Would you agree with that?

Lee Harris (12:30):

I definitely would agree with that. Seek professionals that you can trust and you know. And the other thing I might say is that COVID really has impacted the dental industry big time. And maybe what worked before COVID doesn’t work now.

Chris Pistorius (12:44):


Lee Harris (12:44):

That’s because the market’s changed. One of your unique things might be to explain, especially here in Southern California, Los Angeles was hit pretty hard with COVID, so part of that uniqueness formula is saying, “Well, what did you do in your office that sets you apart for protecting the safety of the patient and the employee from the spread of this infection,” may be a good way to go right now because dental offices are severely hurt. The best one I know of is down 15, 10, 15, 20%. So you’ve got to get out there and do something different now. And that’s a challenge for every dentist to be able to figure out what do I do now that times have changed. And so everybody has to be thinking about new ideas or strategies to get the more concerned patient out there.

Chris Pistorius (13:42):

Right. Yep. So what would you say to somebody that’s kind of, they might be watching this, or they may have been thinking about this for a while, they’ve plateaued, or maybe they’re just starting out and they’re really ready to take their practice to the next level. Obviously, reaching out to somebody like you is helpful, but what else can they do to kind of prepare for this type of growth?

Lee Harris (14:02):

Well, as I said in the beginning, get your house in order first. So that would be, to me, the first thing is make sure you got a good friendly staff. Your front office person has to have a lot of bubble. I used to use the term brain dead and non-dental because if you just want a bubbly personality that can engage that customer, that patient on the telephone and just be bright and smiley and cheery so you can see the smile through the phone. And so you have to have good and there’s a lot of AI going around in dentistry right now to listen to calls and to see exactly what your front office is saying because if you’re back in the chair, you’re not going to know what’s going on.

Chris Pistorius (14:46):


Lee Harris (14:47):

Somebody like me, a consultant, a lot of consultants give you a workbook and say, “Do this,” or, “Do that.” I’m in the office with the dentist, with the staff, working with them and getting them to understand what’s important. So, once you have all that in place, then you need to find a reliable and trustworthy marketing firm that has good and talented people that can research your specific area and recommend strategies that might work for you. And the dentist needs to understand that, “Oh, we’re going to try two or three strategies or four strategies for the first three months and if that doesn’t work, we’re going to go to two to three more.” So you have [crosstalk 00:15:28]-

Chris Pistorius (15:28):


Lee Harris (15:29):

… flexible and adjustable to figure out what’s going to work for you for each individual dental practice. There are no two alike.

Chris Pistorius (15:36):

Yeah. I really like your idea of hiring a marketing professional. I really like that idea.

Lee Harris (15:41):

Well, and I know you do. And the other thing is that me as a consultant, I don’t pretend to be a marketing guru. What I tell my clients is, “If I can’t do something, I’m going to bring in somebody I know is reliable and can do it for you.”

Chris Pistorius (15:57):


Lee Harris (15:59):

I don’t pretend to be a marketing person. I wouldn’t pretend to do what you do, nor would you pretend to do what I do.

Chris Pistorius (16:05):


Lee Harris (16:06):

So I would recommend marketing professionals to get out there and recommend a strategy once they learn about your practice and what your growth opportunities are and what the dentist’s vision for his future is.

Chris Pistorius (16:20):

Yeah. So, when somebody calls us for the first time, we kind of go through this needs analysis call, right, where I’ve got a list. And everybody that comes into our company, client wise, I talk to first, because I want to kind of interview them a little bit and make sure that what their goals are kind of align with what we do here. And so we ask questions. I ask questions to them about things like, “How much is each new patient worth to you over a year, over a lifetime? How many referrals on average does a new patient bring to you over the lifetime of being a patient,” big questions like that. And a lot of times I get kind of that deer in the headlights look like, “Uh.”

Lee Harris (17:03):

[crosstalk 00:17:03] they don’t know the answers to that.

Chris Pistorius (17:04):


Lee Harris (17:04):

And it’s because they can’t get information from their system because they have not studied it.

Chris Pistorius (17:10):


Lee Harris (17:10):

They could get that information. You can print up a referral report from any of these systems that will tell you every one of your patients and how many people they’ve referred to you. They can tell you how many patients you’ve had. They can tell you how much the average spend per year is per patient.

Chris Pistorius (17:23):


Lee Harris (17:23):

They can tell you all that stuff. You just got to look at it and you have to know what to look for.

Chris Pistorius (17:28):

Yeah. And what I find almost scary is that they’re ready to grow. They’re ready to spend a bunch of money. And I’m probably just one of a few marketing companies that they’re interviewing, right?

Lee Harris (17:38):


Chris Pistorius (17:38):

But they don’t know these numbers. And I’m like, “Wait a second. We’ve got to figure some of this out before we start going throwing thousands of dollars in the market trying to find you new patients.” Because you don’t know who the new patient is you’re trying to bring in, what they look like, how much money they spend. Do they own a car? Own a home? Things like that.

Lee Harris (17:56):


Chris Pistorius (17:57):

They don’t necessarily know where those people are. If they don’t know their numbers of their business, I guess, and they don’t understand who they’re marketing to, and they don’t understand what their unique selling proposition is, then marketing is going to be more difficult for them. It’s likely not to be as effective and it’s going to be very expensive. You know what I mean?

Lee Harris (18:17):

Absolutely. And you said one thing there that really peaked my interest in, and that’s a lot of things that dentists don’t do is they need to know who their target market is.

Chris Pistorius (18:25):


Lee Harris (18:26):

And I think a lot of times they don’t. I even get dentists who come to me and say, “I’m going to buy a practice over here.” I say, “Well, wait a minute. Before you decide to buy a practice, what kind of dentistry do you want to do?” Because many, many dentists buy practices, find out, “Oh, that’s not the kind of dentistry I want to do. That’s dentures and fillings and I want to do implants and overdentures.” And so you have to find out what your practice is going to be and what you want to do and kind of marry the two together. And it has to be congruent or else you’re just barking up the wrong tree.

Chris Pistorius (19:02):


Lee Harris (19:02):

So I think it’s important to know who your market is at and where are they, and is this kind of practice, is the location in a good spot to be able to capitalize on that target market because if it isn’t, then it’s not going to work either.

Chris Pistorius (19:17):

That’s true. Yep. So let’s shift gears a little bit and I want to get into a problem that I’ve been hearing a lot lately, and I’m not sure if it’s COVID related or not, really, but I think this was going on prior to COVID, but it’s with hiring. I have a lot of practices that are reaching out to me saying, “Chris, it seems like we hire somebody, train them, they leave. We hire somebody, we train them, they leave.” And they’re in this constant churn of hiring, firing, and they can’t find good quality people that are doing a good job. Do you help in any capacity with that? And if so, what kind of advice do you have?

Lee Harris (19:54):

Well, I’m glad you brought this up because this is a real problem right now. It’s been exacerbated by COVID because there’s a lot of women now that are no longer in the workforce because they have kids and they don’t have childcare. And so they can’t come back to work. So you lost a lot of dental assistants that are out there. The other problem is, is that the dentist’s biggest challenge is managing human resources. They don’t know how to do that. And so that causes some of the churn. You’ve got a [inaudible 00:20:25] and there’s a lot of books out there and one of the quotes I get from one of these books, I read, Traction, I think it’s called, is people in the right seats.

Chris Pistorius (20:34):


Lee Harris (20:35):

You have to have good people. And just like I was telling you to put that brain dead, not bubble person at the front desk, that’s what you want. You want a person at the receptionist desk who’s going to be outgoing and friendly.

Lee Harris (20:49):

You don’t want somebody who’s you can’t see a smile through the phone, so you have to have the right people and then you got to pay them right.

Chris Pistorius (20:57):


Lee Harris (20:58):

You’ve got to treat them right. And the other thing I find is a problem with dental offices losing people is chaos in the office. You might have one bad apple in the office that causes a whole lot of drama-

Chris Pistorius (21:12):

Drama, yes.

Lee Harris (21:13):

You don’t need the drama, right? So it’s better to act early, get rid of that loose cannon and get somebody else in the office even if you have to struggle for a little bit until you get the right person in the right seat.

Chris Pistorius (21:27):

Yeah. I agree. And you know what I’ve found on that, and I’m just talking with dental professionals, certainly no scientific evidence, but I’ve found that some people are having really good success with hiring people with no experience. And the reason for that is, is that they’re very coachable, right? Versus bringing somebody in with a ton of experience, you may not be able to coach them up the way that you want to do things. There could be some resistance or friction there, right? And these people are coming in and they have to do more training with people that don’t know the industry and don’t know dental, but they’re finding longer term success with that. Have you had any experience with that?

Lee Harris (22:06):

Absolutely true. Couldn’t agree more.

Chris Pistorius (22:08):


Lee Harris (22:10):

I find that even dental assistants, you hire somebody that doesn’t know a whole lot, but they don’t have any bad habits. And you’re talking about the people that have been in the industry 15, 20 years, they’ve got all those bad habits and they only want to do it their way and their way might not work for your office.

Chris Pistorius (22:26):


Lee Harris (22:26):

So somebody who’s fresh and new that might be just out of school or have minimal training is a good way for the dentist to get them to do it their way. And if you take good care of those people and you train them and educate them about the industry and about them, they’re going to be with you for a long time.

Chris Pistorius (22:45):


Lee Harris (22:46):

That’s what you want. First of all, you want your patients to see the same people, the same dental assistants, the same hygienists, the same receptionist every time they come in, because they know them by their first name. And the people who talk more to the patients than the dentist are the staff, the hygienist, the front office. Those are the people that bring the patient back into the office. Yes, the dentist has to be good at what he does. He’s not the one that really has a relationship with the patient unless the patient’s been coming for 15, 20 years or so.

Chris Pistorius (23:18):

Right. Yeah. Well said. Well, we’re going to start wrapping up here, but I wanted to ask you any additional nuggets of wisdom, and I know you’re coming from insurance experience, dental, you’ve come from all sides of this. So I’m sure you’ve got a ton of these, but what’s one piece of advice you’d like to share with everybody right now?

Lee Harris (23:38):

Well, I’m talking to the dentist now, okay?

Chris Pistorius (23:42):


Lee Harris (23:42):

You can’t be everything to everybody, okay? You’ve got to focus on your niche in the industry. You’ve got to focus on what you do best and what you like to do. If you’re going to be in practice for a long time and be successful, you’ve got to be happy in what you’re doing every day. And if you spread that happiness and that warmth to your staff, then it will rub off on your patients. They will be able to see it and they’ll be glad to come into your office. So that homogenicity of getting people of the same wavelength and having consensus. And if you’re building a new policy, get your staff’s input. Say, “Look,” and here’s what I tell my folks, I say, “Look, I’m going to write this policy, but I’m not here to do the work. You are.”

Chris Pistorius (24:28):


Lee Harris (24:28):

“So, the policy’s dynamic. Make a recommendation to change it, we’ll change it.” It’s all about efficiency and making the staff a part of the solution.

Chris Pistorius (24:38):

Right, right. I think that’s great. Well, Lee, if somebody sees this and there’s going to be a lot of people viewing it, but what’s the best way to reach out to you if they want to kind of start the process of maybe getting some help professionally from a consulting perspective?

Lee Harris (24:53):

There’s the two best ways to get ahold of me are my email or you can phone me at (714) 293-2195. You can also visit my website at

Chris Pistorius (25:10):

Awesome. I’ll make sure that we put all of that in the post, on the podcast and everywhere else that this is broadcasted as well. Lee, I know you’re busy and I appreciate all the time that you’ve spent here. Maybe in a few months, we can catch up with you and see how thing’s going and hopefully we’re getting past COVID at that point and we can see what the future holds, if that’s okay.

Lee Harris (25:31):

Sounds good with me. It’s been my pleasure, Chris. Thanks for helping.

Chris Pistorius (25:34):

And thank you to everybody for watching today. I hope you got a lot of great information from Lee. He’s got tons of experience in the industry and can definitely help your practice get to the next level. Thanks again for watching and be sure to check out our next episode in about a week. Thanks and talk to you soon.


Starting a Dental Practice: Tips on Financing

Starting a Dental Practice: Tips on Financing

To get in touch with Gabe:

Gabe Vlahos

View Full Transcript

Chris Pistorius (00:03):

Hi, everybody. This is Chris Pistorius again with the Dentist & Orthodontist Marketing Podcast. Thanks for joining us today however you’re viewing us, live on Facebook or on the podcast channel, we appreciate you taking the time. So, today I’ve got an excellent guest for us. We are honored to be joined with Gabe Vlahos. Gabe is with Wells Fargo and he is a business development officer there, and he does an excellent job helping people in a lot of industries, but specifically the healthcare industry in securing loans for acquisitions or remodeling, lots of other stuff. But I’m going to go ahead and let Gabe explain all of that. Gabe, thanks so much for joining the show today.

Gabe Vlahos (00:54):

Thank you, Chris. I’m glad to be here.

Chris Pistorius (00:57):

Awesome. Well, hey, why don’t you tell us, Wells Fargo, obviously a huge organization, why don’t you tell us a little bit more specifically about what you do and how you help dental practice owners for instance?

Gabe Vlahos (01:10):

Yeah, absolutely. So just to give you an idea, a little bit about my background and how I came about this current position. I was actually born and raised in Brazil and moved out here in the US about 12 years ago to actually go to business school and play college tennis. Got a full ride scholarship, played number one, did all of that good stuff, graduating 2014 and then Wells Fargo became my first employer fresh out of college. So, I did a customer sales representative position for a year, step aside and opened my own business to put myself through an MBA in marketing program. And I was essentially coaching tennis to high-level high school kids here in Colorado. And did a little bit of consulting for startups and small businesses and came back to Wells three years ago.

Gabe Vlahos (02:05):

I was in a very analytical position in my previous role and have been recently joined the small business development group about four months ago. So we’re heavily involved in the healthcare space. We have a full division here called Practice Finance and essentially what we do, we help essentially dental labs, care homes, mobile nursing, private surgery centers, private practices. We really specialize, guiding and really be supportive for the practice owners in the dental, veterinarian, optometrists and medical fields in every stage of their career from start to finish, even recent college graduates, helping them start their own practice up until retirement mode. And I’m happy to explore more about that too, with you.

Chris Pistorius (03:01):

Awesome. What school did you play tennis for?

Gabe Vlahos (03:04):

Metro State, here in Downtown.

Chris Pistorius (03:07):


Gabe Vlahos (03:07):

Denver, Downtown.

Chris Pistorius (03:09):

… That’s awesome. So do you still play quite a bit?

Gabe Vlahos (03:12):

I do. I do. I actually still coach a little bit on the side here and there. Sometimes I get some requests from high school kids that want to go to the park and hit some balls. So I try to keep in shape that way too.

Chris Pistorius (03:25):

Right. Yeah. That’s awesome. That’s a great story. Awesome.

Gabe Vlahos (03:29):

Thank you.

Chris Pistorius (03:29):

So specifically, obviously we work with dentists and a lot of what we do is around dentistry, but it can really be modeled in all of healthcare. But talk to me a little bit specifically what the market looks like right now in terms of lending? Has COVID had any sort of an impact towards lending right now?

Gabe Vlahos (03:50):

Yeah, absolutely. So, with COVID, what I like the most about what we do is the relationship aspect of things. We’re not just a lender that looks at numbers, provides you with an interest rate, the term sheets and that good stuff and we would tell you what the monthly payments are going to look like, there’s the vision, was created 30 years ago and what we do, we put a team of consultants behind the doctors to really make sure that every step of the way in their career, they’re set up for success. So we have consultants that have been doing this for decades, and they actually have the best resources for say, HR questions or marketing, or they know the best vendors, the best attorneys to help you out, best CPAs, and all that good stuff.

Gabe Vlahos (04:41):

So, having that extra cushion and layer of security has really helped our dentists throughout COVID, knowing that they’re not alone. They have resources to help them out in every step of the way. The fact that interest rates have been so low recently as you might know, we are taking care of a lot of people that want to either refinance or start their own practice as we offer up to 100% financing. So literally doctors have that availability, which is something that a lot of other banks don’t offer up to 10 years fixed rate, which is pretty incredible too.

Chris Pistorius (05:24):

Wow. So, I like what you said there. It’s not all about right now, this second, it sounds like when you establish a relationship with a dentist, for instance, it’s all about growing with them and you’re there all along the whole journey, if you will. And if they need something five, 10, whatever years down the road, it sounds like that relationship is good as long as they’re in business, right?

Gabe Vlahos (05:51):

Exactly. Exactly. In fact, when they start banking with us and we helped them out with any lending opportunity, they automatically get a group of certified consultants, if you will. So year one, we want to make sure that they’re successful when everything’s working well for their practice. So, we actually have reports in the industry and we can kind of compare similar dental practices and kind of compare the numbers to make sure that they’re set up for success. And if the numbers are not looking that great, we have resources to help them out. So we’re definitely not just a lender that are providing the working capital, we’re actually supporting them in many, many different ways.

Chris Pistorius (06:39):

I see. Would you say, based on… I remember I asked this a little bit from new practice owners, is it harder right now for instance a dental practice to be approved for financing because of COVID or is that not the case?

Gabe Vlahos (06:54):

No. Absolutely not. We actually have an awesome relationship with the best Dental schools nationwide. And what we like to do actually is we have resources in those schools and we actually get in touch hands-on with students that are about to graduate. And what we’d like to do is really understand where their aspirations are, maybe they don’t really want to become their own boss, but a lot of them do. So we prepare them from day one. A lot of them don’t have that financial background. So we actually even help them with business planning. Sometimes they have some sort of business plan going on, but most of the times they don’t. So we help in literally every step of the way. And knowing that they’re going to graduate fresh out of school with a lot of debt-

Chris Pistorius (07:46):


Gabe Vlahos (07:47):

… we don’t really look at that as a negative factor because we expect that to be a thing already. And for that reason, we provide up to 100% financing, which is very unique. So, it has not been a negative impact COVID at all for us. In fact, we’ve been helping quite a bit of startups get started.

Chris Pistorius (08:08):

I see. And before we went on air when we were kind of discussing what you do and how you do it, something I hadn’t really thought about in terms of funding is that you do loans, not just for buying a practice or starting a practice from scratch, but you can use that money for other things like remodeling an office. Is that right?

Gabe Vlahos (08:29):

Exactly. Exactly. So some of the things that we do besides startups, we do acquisitions. That’s probably one of the most popular ones, equipment financing, remodeling, relocating. Sometimes dentists want to get out of the rental space, if you will, and actually acquired their own space. So, commercial real estate purchase, we do a lot of that, buy-ins, buyouts, refinancing. And remember, the products that we have within our Practice Finance group were created based on the industry. So, every single service that we offer, were created thinking about setting doctors up for success. So it’s different than the regular lenders that already have a set of products and services that they offer from a variety of different industries. Ours is very, very specialized. And like I mentioned, we can serve a variety of different purposes with lending.

Chris Pistorius (09:31):

Sure. That’s awesome. Tell me a little bit about somebody that’s watching this and they’re thinking about qualifications, like would I qualify for instance for alone? What do you guys look at in terms of a dental practice, for instance? What things are you really looking at and studying and what are the most important things to be able to qualify for a loan?

Gabe Vlahos (09:51):

Yeah, that’s a good question. I would say cash cash flow is king, right? So obviously having a decent credit, typically over 700 is what we like to see. That’s very critical and having a decent source of income. And again, for startups, we provide up to 100% financing, but depending on where they are right now, if they’re dentists, we want to see the income coming in. We typically, don’t prefer seeing a whole lot of outstanding debt with big balances, that kind of stuff. So, knowing that they’ve been good creditors and really paying out their debt, it’s really what matters the most for us. So we want to see good cash flow, and we want to see that they have been doing a good job paying off their current debt.

Chris Pistorius (10:44):

Sure. Okay. That makes sense. So tell me a little bit, I ask everybody this no matter what industry you’re in, but there’s a lot of other lenders out there, right? You’re competing certainly. And I always ask people, what’s your unique selling proposition. And I think you touched on a little bit of this, but what makes you different? Why should somebody choose you as a bank versus maybe somebody else?

Gabe Vlahos (11:08):

Yeah, Chris, this is a good question. When I say that we supported doctors in every stage of their career, I mean just that. It starts with our involvement with several large dental schools in the nation. We have business partners that work with colleges to help doctors understand the availability of financing and options that are there for them when they emerge into the market, where we have a team of private consumer bankers that help the doctors while they’re in school and doing personal financial planning as well. Then once the doctor has decided to enter the practice ownership space, then we have a specialty team of lenders and relationship managers to kind of navigate the world of practice ownership and business banking.

Gabe Vlahos (11:57):

We also have a practice consulting team that helps the doctors with marketing, HR questions, attracting and hiring the right staff, recommendations for the best vendors, the best architects, the best contractors, best manufacturers out there, which is just a complimentary add-on to the business that they do with us. There’s no other bank that is offering that specialized of a plan in industry.

Chris Pistorius (12:23):

Yeah. That’s awesome. There’s a lot of support services that you can offer that a lot of other folks can’t. When you do a loan for a dental practice, can some of that money be put aside for marketing purposes too, or is that something that you don’t really want to lend for?

Gabe Vlahos (12:43):

That’s a good question. So, typically with business planning, what we want to see is a proper allocation of the capital. So, we want to see where the money is going exactly. Whether it’s going to equipment finance, whether that’s going to HR purposes, merchant services, building a website or marketing purposes. Yes, we definitely want to make sure that part of the money that’s being lend to them is being allocated properly and marketing is so important, that’s why our consultants tend to make recommendations quite often in marketing say, COVID was a big hit. So, a lot of small businesses had to make sure their website was more user-friendly and had capabilities and features that they didn’t have before. So definitely.

Chris Pistorius (13:32):

Yeah, I think you’re right in all of those aspects. Let me ask, where do you see the lending industry specifically in health care, where do you see that growing or expanding over the next five years as it comes to your business?

Gabe Vlahos (13:47):

Sure, sure. Good question. Wells Fargo Practice Finance, our focus on healthcare is really a top priority for our small business banking group, to be honest. So, this concept of having doctors being surrounded by a team of experts in the field started just a couple of years ago, and now we’re still growing the model and through multiple footprints and within our bank. So, it’s exciting to watch the impact that we have had in the past, especially in our own communities here in Colorado, watching new practices open in developing areas, helping the doctor grow their dream practice, or even being that support system that a doctor really needs when transitioning out of practice and help facilitating the sale so their legacy can live on their practice. So ultimately, we will and we currently aspire to be the best resource for dentists, for specialized lending and guidance.

Chris Pistorius (14:50):

Awesome. Okay. So, talking about the process, how does this even get started? So let’s say somebody reaches out to you, they’re interested in maybe acquiring a new practice. What does that initial process look like? And then how long does the process take from start to finish typically for a loan?

Gabe Vlahos (15:11):

Yeah, no, that’s a great question. So, I’m in the business [inaudible 00:15:14] of connecting people, I’m in the business of making dreams come true. I’m the first point of contact here within the bank in our small business banking group. So, if they are interested, they can definitely reach out to me. And what I do, I like to have a meaningful conversation to really understand what their goals are. If they have a current practice, I want to understand, is their main goal to reduce costs? Is it to grow and expand the business? Do they want to retire anytime soon? There are many different ways and different solutions. So my goal is to really understand, and I’m the connector. My goal is to connect that specific person to the right team of individuals that will then really take that relationship to the next level.

Gabe Vlahos (16:02):

In terms of getting the financials from them and helping them out, a lot of people are very organized with their financials and they can get those to us fairly quickly. Some people, they have their CPAs that they work with. Some people don’t even have a CPA. So, it can take a little bit longer, but things can get moving fairly quickly, maybe within 45 days. We’ve seen things moving fairly fast here.

Chris Pistorius (16:32):

That’s awesome. Great. So tell me, what are your additional nuggets of wisdom, if you will? Maybe somebody that’s watching this and they’re thinking about, “I kind of want to buy a practice.” Or, “Maybe I want to buy another practice.” Or maybe a student that’s coming out of school and trying to decide if they want to become an associate or if they want to buy their own practice, what would you say to them? What do they need to really get together and be organized with in terms of making that decision?

Gabe Vlahos (17:03):

Gosh, that’s a good question. I would say if you are a doctor and you have been working for another practice or corporation and you are interested in a roadmap to ownership, we are the best starting place and you’re not going to pay consulting fees with us. It’s all complimentary service. We create a team that surrounds you to really achieve your goals. So, it doesn’t really get much better than that to have that specialized team with that amount of experience behind you.

Chris Pistorius (17:36):

Right. So with you, it’s not all about just lending the money, it’s also about connecting them with people that can help them with a multitude of things from construction, to remodeling contractors, to marketing people, whatever it may be, right?

Gabe Vlahos (17:51):

Exactly, exactly.

Chris Pistorius (17:52):


Gabe Vlahos (17:53):

We’re all about the customer experience. So with us, there will be no 1-800 numbers. They’re not going to be bouncing between calls when they call the 1-800 numbers. They will have a team of experts that will be there for them whenever they need, looking now for their business and proactively calling them to make sure everything’s running smoothly.

Chris Pistorius (18:13):

Awesome. Awesome. So Gabe, tell me if somebody is watching this and they’re interested, I know you’re stationed here in Colorado, but you can help people from all over the country, right?

Gabe Vlahos (18:25):

Yes, absolutely. So, we are nationwide. So, if they want to reach out to me, they don’t need to be in Colorado specifically. They’re welcome to reach out to me. I don’t know if we’re going to leave a phone number-

Chris Pistorius (18:38):


Gabe Vlahos (18:38):

… somewhere here, but there will be my phone number. They can reach out to my phone number or my email, and I’ll be sure to get the ball rolling as soon as possible.

Chris Pistorius (18:49):

Awesome. Yeah. Why don’t you… If you could maybe, and I certainly will put it in the post too, but maybe just tell people right now best way to reach out to you and get the ball rolling?

Gabe Vlahos (18:59):

Sure. So my number is 303-335-5735. Again, 303-335-5735. And email gets a little tricky because my last name gets funny to pronounce sometimes, but it’s essentially gabriel.t.vlahos,

Chris Pistorius (19:24):

You’ve got the same problem I do. My last name is Pistorius and I can’t even put it in my email address. People get lost, but I’ll be sure to post that in the Facebook post and on the podcast so people can easily reach out. So, hey, Gabe, I really appreciate your time. I know how busy you are. I think this is very helpful to anybody in the dental industry that is looking to maybe make that next move. So, thanks so much for your time today.

Gabe Vlahos (19:51):

Thank you, Chris. Very honored to be here and we’ll sure to be in touch with you.

Chris Pistorius (19:55):

Absolutely. And thanks to everybody watching. This was another episode of the Dentist & Orthodontist Marketing Podcast. Please reply with the comments of what you thought of the episode. Subscribe, do whatever you need to do, but make sure you watch our next episode that should be coming out in about a week. Thanks so much and we’ll talk to you soon.


Dental Staffing – How To Hire & Retain The Best Employees For Your Practice

Dental Staffing – How To Hire & Retain The Best Employees For Your Practice

To get in touch with Roy:

Roy Barker 

View Full Transcript

Chris Pistorius (00:03):

Hi everybody. This is Chris Pistorius again with The Dental and Orthodontic Marketing Podcast. Thanks for coming back for another episode. We’ve got another great guest for you today, we’ve got, Roy Barker. Roy, is a Consultant and he’s here to talk about one of the biggest hot issues right now, I think in dentistry anyway, and that’s how to retain employees. I’ve heard from many of you out there that watch the show are current clients of us, how we’re having such a hard time getting, finding, keeping employees and you feel like you’re in this churn of hiring and then training and then hiring and then training and you’re never really getting forward. Roy, thanks so much for being on the show today.

Roy Barker (00:51):

You bet, Chris, thanks a lot for having me, I appreciate it.

Chris Pistorius (00:54):

Absolutely. Well, first of all, why don’t you just tell us a little bit about what you do, your background and we’ll go from there.

Roy Barker (00:59):

Well, I’ve been consulting for about the last 25 years, a lot of strategy financial and then I fell into the retention side. I worked in the senior living industry and actually I did some graduate studies in that and I was reading a book and it said that some of these communities can have up to 300% turnover. I actually had to go back and read this again and be like, “Okay, so you got 100 people or so and you’re turning over 300 times every year.” What is the cost to the organization? Because there’s not only a true physical money outlay for that but there’s also humongous risk that we run by churning that many people through any kind of a business every year. So it just really got me interested in this part of business and believe me, it reaches out to a lot of industries and hurts a lot of people, but it’s the five most dangerous words in business is that, well, it’s always been this way.

But my message is it really doesn’t always have to be that way, there are things that can be done in order to help reduce that turnover. It’s not going to be instantaneous, you’re not going to flip a switch, but if you can get yourself in the right mindset and in the right process and the right role, I think any business can bring that way down.

Chris Pistorius (02:28):

Awesome. You’re definitely hitting a hot topic here. I know it’s not just in dentistry but it’s what we hear all the time. So why don’t you tell everybody a little bit about, what does proper employee retention look like? Is it going out and buying ping pong tables or is it getting a soda machine maybe in there? I mean, how do you do it? What are the tricks here?

Roy Barker (02:54):

Those are the easy things that everybody wants to focus on because they’re really cool but you know my message is that’s at the bottom. I actually created an employee retention funnel, typically like a sales funnel just starting at the top, how we feed things through and what comes out at the bottom. And so while those are important things to have to retain good employees, the operative word there is good employee. We have to make sure that we’re actually hiring people that are compatible with our work situation, good attitudes. And especially in professional services, people that can handle the customers in a way that doesn’t run your business of because unfortunately, you make some bad hires, they chase off some clients and then you’ve got other problems as well.

But one of my big messages is I think that we need to think about marketing for talent, like we think about marketing for clients or prospects is that we can’t be reactive. And recruiting today unfortunately, is placing an ad on Indeed or some other service and that’s not recruiting. That’s placing an ad and sending it out. We’ve got to take the time to recruit and get ahead of this so we can be proactive not reactive. And when somebody leaves, we need to have three or four candidates that we can think, “Okay, I know these three people I need to reach out to, because I’ve seen their social media and what they say, they’re not doing anything outrageous.”

The last year has been difficult because we’ve been under quarantine so we can’t go out to events, but when you can get to events, collect people’s names, cards, think about that always, who would fit into my office well? Who would I want the way that we interact at a conference or even at a restaurant, if you get somebody that gives you good service, we could teach them to use the tools, the computer put stuff in it’s that attitude and how they handle your customers. Those are the main things and that they’re compatible with you and your staff, your whole process.

Chris Pistorius (05:10):

There is a whole science behind this and sometimes we do this, but have you ever heard of or have any experience or any opinion on using some of these employee personality tests? I think one’s like a Kolbe index where you take them through an exam and it takes out some numbers that it’s supposed to show their personalities. Have you done that before?

Roy Barker (05:31):

Yeah. Actually in the senior living industry, there is a company that focuses on care and caregivers because unfortunately over in that section, they get so far behind in hiring that it’s just more of a cattle call. They just bring as many people in and we used to joke that the litmus test for getting hired was first, do you have a pulse? And secondly, do you like the elderly and everybody’s like, “Yeah, I do.” But the reality is taking care of my grandmother for me is a lot different than taking care of yours. And so there were not only skills but aptitude tests to find, are people tempered with it. A couple other things that they would actually screen for not really hidden, but out in the open would be substance abuse and predisposition to file workers comp claims.

At first, when I heard that I actually called the guy that designed it, a psychologist and called him and said like, “Are you sneaking the question in the back door, are you twisting something around?” He’s like, “Nope.” He’s like, “We come right out and ask, have you ever, would you ever, have you ever considered.” Because he said those types of people live in a different world. He’s like, “They are very open.” That’s they talk to their friends about it, so the best way is just ask the question. On the drug side, it’s could you pass a screen today and if they can or can’t, then there’s your answer.

But it’s also about getting out there for that recruiting part to have people in mind but then also that assessment, that’s a huge second step before I even want to see anybody for an interview. Is we need to have industry specific if we can or position specific assessment to run them through, prior to even bringing them in for an interview. That’s going to give you a lot of clues about their aptitude, how they can interact and like I said, it’s not about, I know how to run the computer programs at the office. It’s as much, can I learn it, am I willing to learn it? Those are the types of things that you should be looking for.

Chris Pistorius (07:51):

That makes sense. We use these personality tests more as a guide, it comes back and okay, yeah, that aligns but we’re not going to eliminate somebody just because your personality test didn’t… Because some people can get squirrely taking tests. I mean, I just don’t think it can be an end all be all, when you’re talking about hiring.

Roy Barker (08:14):

Right, right. And I like those too, because they’re more positional, is if you’re applying for a sales role, do you have that sales aptitude versus would you rather be behind a computer? Just leave me alone, let me punch in my numbers every day. So a lot can be gained from that but a couple more things is not only… The other nice thing about the assessment that I was talking about, is they would actually generate questions for you to ask in an interview. And so we need to really think about, what kind of questions and not the typical ones that we used to hear about, do you want to be a big fish in a little pond or a little fish in a big pond and those kinds of things. Because people learn how to talk around those so we need to ask very important thing, if it’s a customer facing position, what would you do in this position, have you ever been in?

Run through some of these real life challenges but then the next thing is the onboarding and I always suggest setting up some kind of a mentorship. Because I mean, Chris, if you just hired me tomorrow and I know computers pretty well but I come to your work and I’m not that proficient with whatever you’ve got going on. Well, I don’t want to come to Chris and say, “Hey, I’m the guy you just hired yesterday and I don’t really know what to do here.” If I had a peer, somebody I could say, “Hey, I’m having a little trouble.” They could provide that guidance because I’ll tell you what, a lot of times the new employee will get frustrated and say, “I’m out of here.”

And then you get the no call, no show and here you go again hiring and so the onboarding process it’s key. And when I say onboarding, it’s not laying a three ring binder on somebody’s desk and give them a couple hours to read through it and say we’re done. It needs to be spread out over a period of time dependent upon how heavy it is. But I mean, it could take two to three weeks not eight hours a day, but little bits and pieces to get the important stuff out of the way, follow up. And then also have follow-up guides for, maybe what these are the tasks that you need to complete every day. This is a task that maybe you need to look at once a week or keep your eye on, just a little reminder where they can walk through that, which gets back to the importance of documentation of workflow and documentation of positions.

Because somebody at your company knows what this guy does, not everybody and so if the right person isn’t there, then it’s like, “I don’t even know what this position does.” So have everything documented and these are living, breathing documents that change. I mean, just because we out in this position today, when I get in it we may need to tweak it for what I’m doing. Maybe we’ve added, maybe we’ve subtracted but it’s going to change over time. But you need to sit down every six months to a year, really look at all of your positions to make sure that you have them documented what they are really doing.

Chris Pistorius (11:18):

Yeah, I totally agree. And having a problem of writing down some points as you speak, this is great stuff. I read a book years ago and I’ve actually read it a couple of times, maybe you have to, it’s called E-Myth Revisited.

Roy Barker (11:31):


Chris Pistorius (11:31):

And it talks about, no matter if you’re a dentist or you’re a McDonald’s, the author uses the example of a McDonald’s in most of the book and how it’s set up, how a franchise is set up. Where they basically a franchise is the machine, the process and procedures really are the machine. And then you plug people in that have well-documented process and procedures to run that machine. And then he says, you can apply it, you don’t have to be a franchise to apply that. He talks about how everything that you do in your business should have a manual to it, a process, a procedure, so that if somebody got hit by a bus for instance, a new person could almost just walk in and read that and be able to do that job. Again, that’s not the end all be all but I think it’s critically important to have that. And I think a dental practices is not immune to that. I think that’s something that they could use as well, would you agree to that?

Roy Barker (12:30):

Yeah. Certainly it needs to be documented and nowadays we have access to things like Teams and Zoom and there’s another called, Loom. I love it because it’s a screen capture and so all these, even if it’s a complex set of going here in a computer system, you can document it and have it there. Maybe you told me about it on Monday when I came in I forgot, the next week I can revisit this video to figure that out. So we’ve got so many tools that there’s really no excuse, it’s just taking the time and people think it’s a waste but it’s not because the next part is, as we grow, we need to know when we need to trigger that next hire. Because typically what I see is people come in and they’re like, “My gosh, we needed to hire an extra person a month ago and now we’re already behind, so we’re scrambling.” But that way you can look at your processes, procedures and what’s going to be the trigger to add that next person. So it really helps in growth as well as what’s going on right now.

Chris Pistorius (13:33):

Yeah, that’s perfect. People talk about hiring and training and it’s laughable type subject but there is a pretty big risk, I think in doing this too. And I know that from my own business, we have client success managers and they’re really the ones with the day to day communication with our clients and they forge relationships and rely on each other. And so that’s a very important hire for us and we find that if by whatever reason we lose one of those client success managers and we bring somebody new in and there are some clients that raised our hands and say, “Hey, I don’t know about a new person here.” I knew Sally or whoever it was. So I’m thinking with dentistry, it’s similar, that if you do a lot of that churn, do you think that there’s a potential of losing some patients from that type of activity?

Roy Barker (14:26):

Yeah. Definitely and from my own experience if it’s a company I deal with regularly, if I see that it’s somebody new every time I’m calling or going in it raises a red flag, because I’m like, “What is going on?” Because it generally it’s a amplification of other things that are going on in the business. It’s not just something that siloed over here all by itself typically. And one thing I was going to mention is the cost, there’s the risk factor. I mean, nowadays with data the HIPAA laws and how we got to protect data. But also, people getting into your bank accounts and doing all this other stuff, there’s also that worker’s comp issue but the true cash cost is depending, but usually between about five to $7,500 to replace a $10 an hour employee. And as we climb up-

Chris Pistorius (15:22):

There’s not many $10 an hour employees anymore, either.

Roy Barker (15:26):

Exactly. And there’s been some studies of your McDonald’s workers that some experts have put that at up to $10,000 to turn them over. And so another message is let’s take some of that money and invest in our people that we have to help them and make them want to stay. The reality is too that people and this isn’t my study, there’s a lot of empirical evidence that employees are not going to walk across the street for another dime or for 25 cents more an hour, it just doesn’t happen. Now on an exit interview, I’m going to tell you, Chris, I found more money over here because I don’t want to tell you that I don’t like you or I don’t like your manager or that there’s some turmoil in your business. And there’s just an old saying that people leave managers, they don’t leave companies.

And so that’s what we have to get to the root of, is what is that management issue? If we have multiple departments, we can look at when we look at employee turnover numbers, we can see it’s skewed to this one department versus another. Maybe we need to do a little work with that manager over there. It can be a costly proposition and that’s just on the front end and like you were saying, the risk on the back end there’s really no dollar limit, because they can hurt your business, they can put you out of business.

Chris Pistorius (16:46):

That’s right. That’s for sure. Yeah, it’s a serious deal. You mentioned earlier about marketing for talent and I’ll tell you what’s happening now in the dental industry, as you probably already know is that we do marketing for dentists. Our job is supposed to be bring in new patients, help you keep the ones you have and then help you bring back in the ones that you’ve already had. And so what we’re seeing is we want to get the funnel full and get the new patients and make sure the back door is locked so that you’re not losing patients, essentially. But what we’re seeing now is that we are now starting to do some of our marketing campaigns on the hiring.

Trying to find people for these dental practices, like Facebook ads, for instance, LinkedIn ads, we sometimes even manage Indeed for people. Are you seeing more of that happening now? And do you have some experience in managing that process or what do you think of all that?

Roy Barker (17:50):

That’s pretty forward thinking and it’s a good thing to do that but the other thing I like to focus on is the practice itself, is talk about why you’re different. What sets you apart than being any other place like on LinkedIn or Facebook, if you have pictures of, we’ve got modern equipment. Have pictures of your happy workers that are still working there. You know, those are all the kind of things to make me when I’m scrolling through and be like, “Hey, you know what? That looks like a great place to work.” And maybe I’ll put in there or even if I’m a client, we can’t overlook that even some of the clients that come through maybe may make good employees.

It’s something that you always have to be looking for and one thing I have heard a lot is that people be out at restaurants and they get very good customer service and they just asked the waitress, “Hey, have you ever thought about being in the dental industry?” Depending upon the position but if they’re going to be a customer facing, if they’ve got a good attitude. Those are the things that we always have to be keeping our eye, you go to, if you’re at some kind of conference event, always be looking around for the intelligent top people that you feel that could work well in your organization. Write it down and say, look, maybe you say, “I don’t have a position right now, would you be open to, if something opens up in the next six months, would you be interested in coming?”

Have those conversations, you can watch them on Facebook or social media in general, because I’ll tell you, I’ve had some people that I thought made great candidates, they said all the right things. And then I found some, “My gosh, moments on Facebook.” And luckily I checked it before, hiring but those are things that, if you know this person and you think that they might make a good employee, it’s things that you can always be looking at over time not have to make a split second decision. Like I looked at this one page, this is what it says today or it gives you time to think about, things like that.

Chris Pistorius (19:54):

Yeah. Yeah. I agree. And notice I’m going to switch gears a little bit in terms of retention. You don’t necessarily hear about this in dentistry a lot but what’s your thoughts on maybe including bonus plans for retention? Is that something that you think could help or is money not the only object here?

Roy Barker (20:16):

Typically money is not the object, I think that you always want to bonus those good people that you have and keep them. But I think we get back to what we talked about in the beginning, is that if I’ve got somebody with the sour attitude, I don’t want them staying around for six months. We want to get that good hire that has the good attitude, but yeah, bonuses and things like that. And also two we talk a lot about, not necessarily money maybe you give them a trip. People like events or like things that they can experience, so if there’s something in your geographical area that would be cool to send somebody for a day, it’s well worth it to give them a day off work, spend a couple $100 to let them go take the… If you close early on let’s say a Friday afternoon, send the women if they want to go down and do the manicure, pedicure, pay for that.

I’m huge about off site events, I need to know you outside of work, I need to know our family, your kids. I need to know what’s going on in your life so when you come in and have a bad day, we can have a conversation. And I know, maybe if your husband’s going through some illness or something, we can talk about that. But so many times everybody it’s just work but go out and have a meal, cook them lunch, bring in lunch, do something. But you can’t do that and lock yourself in your office, you have to be a part of the group, the comradery but really get to know the people.

Chris Pistorius (21:51):

Yeah. Yeah. That’s great advice. I wonder about, sometimes when you’re hiring, that’s certainly part of retention there’s a debate going on right now with dentistry and probably other industries. When you hire somebody for the long haul and you want to have that retention, should you bring somebody in with a ton of experience or should you bring somebody in with no experience? And the reason I say that you tipped on this, is that my thought is with my business is I can bring somebody in and I can teach them what we do. I can teach them marketing and how we do things in the process and procedures but what I can’t teach sometimes, is if I bringing somebody in and they just have a bad attitude. They’re not easy to coach. That’s something that I would struggle with in the longterm.

So the debate is, do you bring somebody in with no experience that maybe you could mold a little bit more or do you take that chance on somebody that’s got a ton of experience? What are your thoughts with that?

Roy Barker (22:53):

If I have to go with experience over attitude, I will take the attitude because I’m like you, I can train them to do what I need them to do. It may take me a little longer but I’ll tell you a bad attitude is like a virus and it will spread throughout your entire organization.

Chris Pistorius (23:09):

And they can hide it. They can hide it during the interview process.

Roy Barker (23:13):

Yeah. And they’ll come in and smile at you and tell you everything you want to hear and then when they get there, it’s just complain, complain, till it sours everybody. And what happens then unfortunately, they ended up staying but your other good people get to leave and because they’re tired of hearing it. So it can have an adverse effect. I have a Venn diagram almost it’s skill, education and grit. And I think we have to have grit because people aren’t going to always know every answer but what I want somebody to do is know when to go find it. I don’t want somebody just to sit there and say, “I don’t know.” I want them to say, “You know what, don’t know it, but I can find out for you.” That’s the kind of people that we really need to have. And I think that comes from a grit factor is that, it’s okay to say we don’t know stuff but we have to follow that up with, I will find out and get back to you. Whether it’s for the customer or whether it’s for the professional themself.

Chris Pistorius (24:16):

Yeah. Yeah. I think that’s so critical, it really is. I’m going to my last big question here is, I come from corporate America and some of this has been drilled into me, but I’ve always wondered if it is effective. It seems to work for us but it’s the quarterly review, stuff where you sit down in one-on-one with somebody and you talk to them about their performance, about where they see themselves and how they want to grow within your company. Is that something that’s still effective or are there any new twists to this? Is this something that you would recommend?

Roy Barker (24:52):

I would recommend sooner rather than later because it’s whatever your start date was, if it’s June 1st. So we’re sitting down in May the next year and I’m like, “You remember back on June, the third, you did this.” And the employee is like, “Well, gosh, that’s been a whole year now. I’m just getting in trouble for it.” I think we need evaluations, we need to write things down and document it just in case we have to get rid of somebody, we have it. Because that’s a bad thing if you don’t do it, it’s really hard to get rid of undesirable employee. But I think we need to do it in real time, it’s just stop by the desk, have these casual conversations about this is my expectations. “Hey, I would like for you to pick up a little bit more on this.” But yeah, the more throughout the year we can have them, because the old days was, it was at once a year.

Chris Pistorius (25:44):

And in [inaudible 00:25:44].

Roy Barker (25:44):

Yeah. And it’s lost on everybody because it’s been like, how are you remembering back a year have you been taking notes? If you have, then why haven’t we talked? Why didn’t you try to correct my behavior back when you thought it was a problem, instead of waiting now, give me a bad review and not giving me a chance. Because I don’t think people ever want to come in and do the wrong thing, sometimes they just don’t know. And so again, I can’t stress communication it’s an open communication that when they start the job, this is what I need you to do. Clear process and procedures that they can refer to but then having those conversations and quarterly is good, but I mean, even monthly, it doesn’t have to be formal, but it can just be, “Hey, here are some things I want to talk to you about.”

Chris Pistorius (26:34):

Right. Right. Yeah, that’s awesome, that’s awesome. Roy, I know you’ve been so busy and we’ve had to reschedule a couple of times for both of our schedules but I really appreciate you taking the time today. Any leaving words of advice or nuggets of wisdom, you can provide to dental industry on retaining employees?

Roy Barker (26:54):

Yeah. Just one more thing. I appreciate you having me, it’s been great being here, but you know what? I would challenge everybody to do it’s to be an employer of choice, not to be an employer of last resort. Which is sometimes what we do is where the like, “I didn’t get that other job I really wanted, so you’re hiring, I’ll just take that.” Really get out there and market and have people that really want to come to work for you not feel like, they don’t have another choice but to work for you.

Chris Pistorius (27:22):

Right. And Roy, if somebody wants to reach out that sees this or listens to this and they want some more help from somebody like you, what’s the best way to reach out and contact you?

Roy Barker (27:33):

Just shoot me an email, it’s, Yeah, just email me, I’ll be glad to chat, even if somebody just wants to talk through something, I’ll be glad to have a conversation.

Chris Pistorius (27:49):

Awesome. Well, thanks again for your time and I want to thank you everybody that tuned in to this episode. I know this is going to be a popular and just because of the importance it has in the dental industry. And please join us next time we’ve got more great guests coming up in the next four to six episodes and really appreciate everybody taking the time to watch. So for, Roy and myself, thanks again. And we’ll talk to you very soon. Thank you.

Roy Barker (28:12):

Thanks, Chris.


How To Determine The Selling Price Of Your Practice

How To Determine The Selling Price Of Your Practice

To get in touch with Megan:

Megan Urban
Omni Practice Group
(503) 830-5765

View Full Transcript

Chris Pistorius (00:03):

Hi everybody. It’s Chris Pistorius again, with the Dental and Orthodontic Marketing Podcast.

Chris Pistorius (00:08):

I got a great guest for us this week. We have Megan Urban with OMNI Practice Group. She specifically is a dental practice broker, so she helps dentists buy practices, sell practices, and kind of everything in between. She’s based in Salem, Oregon, but her and her group can work in a lot of the United States. Megan specifically has really spent her whole life in dentistry. I think we’re in for a treat here today. Megan thanks so much for joining the program.

Megan Urban (00:44):

Thank you.

Chris Pistorius (00:45):

Why don’t you start off Megan, by telling us a little bit about what you do, what OMNI is all about and we’ll kind of go from there?

Megan Urban (00:53):

Well, with OMNI, we’ve been a group helping dentists in all the specialties, so orthodontist, periodontist, all the different specialties since gosh, 2004. And like you said, we’re in most every state almost. We do help dentists of all specialties buy and sell practices, even help because of our background and our experience, we can help even if somebody is looking to add an associate and how does work. We do a lot of consulting around dentistry in general, but we certainly help with the buying and selling of dental practices. All of us have our real estate licenses too, so that makes it nice because then we can help if there is any kind of real estate involved, whether it’s a condo or a freestanding building or whatever.

Chris Pistorius (01:40):

Cool. Nice.

Chris Pistorius (01:41):

How do you see the market right now as a whole? Is it a hot market? Is it kind of a stagnant market? Where is it?

Megan Urban (01:49):

It’s a seller’s market. We had a few years, after 2008, I realize that’s a little while back, where I think dentists ended up having to work longer than they thought they would. It’s definitely a seller’s market and banks are lending, so it’s a great market right now. I know a lot of us and a lot of the population always are concerned with the big corporate practices and the direction that’s going, but we still see a lot of dentists that want their own thing. So we’re busy.

Chris Pistorius (02:23):

Yeah, well that’s great. That’s good news.

Chris Pistorius (02:26):

I definitely want to get into to the broker and selling and buying and that kind of stuff. Do you also help? I assume you could help a dentist that maybe has one practice and is looking to expand into additional practices too.

Megan Urban (02:41):

Absolutely. It’s a big deal to add an associate or to add another location. It really is a big deal. We like to help with that so that it has a better result than winging it. It’s a big deal.

Chris Pistorius (02:58):

Yeah. Yeah.

Chris Pistorius (02:59):

Talk a little bit about banks and lending. I know that’s certainly part of it. Have you seen any banks be a little tighter now because of COVID or are we starting to see that kind of expand out now?

Megan Urban (03:12):

A little bit. I think from my perspective, I feel like they do sometimes change their processes and things that they like. Sometimes they like startups, sometimes they don’t. Sometimes they like multiple locations, sometimes they don’t. During the height of COVID I was still selling practices and getting lending for people, but it was a little bit of a different process. We definitely have done all specific lenders that help our dentists. They understand dentistry, so they hear the story; it’s not just the numbers. It is the numbers, but they also hear the story. We have a lot of great banks that we work with.

Chris Pistorius (03:56):

Gotcha. Okay.

Chris Pistorius (03:57):

I’m going to kind of put you into two situations here. Let’s say first of all, I’m coming out of school or maybe I’ve been an associate for a while and I’m ready to buy my own practice. What are some tips or tricks if you will, or what do I need to do to get ready to do that?

Megan Urban (04:13):

I think you need to ask yourself if you’re ready to do it, and then I think you do need to find the right broker that can help you understand the practice that you’re looking at. No practice is perfect. There’s always areas of opportunity, but going in with your eyes wide open, I think is good. So anytime you can work with a broker that does come like I do, like we do from a dental background that truly understands what’s happening and how to make that smooth transition.

Megan Urban (04:48):

I think it’s also time to get your financial information together for the bank. They’re going to usually want maybe the last two or three years of your tax returns. They’re going to want to know what debt you have. And they expect every new dentist to have 200, $500,000 in student debt. Then they’re going to also want to know how much other debt do you have in credit card or that type of thing. Just to be able to get those things together. The other half to their loan is what is the practice cash flow? But if you have your stuff together and you’re ready to roll, that’s a good piece.

Megan Urban (05:31):

They have to look at information about the practice too. If the practice is doing surgical implants and this dentist, like you just said, is new out of school and they don’t do surgical implants yet, what’s the plan? Is the seller going to stay on and do them, or maybe it’s not a big part of the practice so it’s not a concern. Just a lot of details to look at.

Chris Pistorius (05:52):


Chris Pistorius (05:54):

Over the years, I know you’ve been in dentistry a long time and I want hit on that too, but do you see dentists that are more successful just starting a brand new from scratch practice or one’s more successful typically when they buy an existing book of business or an existing practice?

Megan Urban (06:09):

I think it takes a really special person or a unique person that can do a startup. You have to be pretty outgoing. You can’t just sit down in the chair and continue the process. You really have to get out there. That’s where, especially you guys come in handy because it’s not like the old days where you just put your shingle out front with your name and people walk in. So super critical that you think you have the personality and the wherewithal emotionally and financially to do a startup, but then be willing to understand that there’s a cost they’re going to need to put forward to with a great marketing plan. A lot of the banks understand that too, and so they’re going to potentially include that financial piece for marketing.

Chris Pistorius (07:01):

Gotcha. When we talk about starting something from scratch or even buying an existing practice, I think you’re probably right, banks realize that they’re going to need some money to start this up and get their own stuff going, and they’ll include some of those monies for marketing and things like that, right?

Megan Urban (07:23):

Yep. I always tell the young dentists because they’re concerned about the finances and I understand that, but sometimes you really have to keep the big picture in mind. $10,000, 30, $50,000 I realize is a lot of money, but in the life of your career it’s not that much for 30, 40 whatever years.

Chris Pistorius (07:46):

Yeah. We talk a lot about that with dentists. A lot of them, when we get some practices in to do our marketing services, they’re very focused on, “Okay, what are you going to do for me next month,” type thinking, and I totally get that. But they also have to sit back and realize, “Okay, what is a new patient worth to me for the lifetime of them being a patient,” and really knowing their numbers and understanding what each new patient’s worth. And if I do send them 10 brand new patients, how many of those will come back for regular treatment for the rest of their lives potentially? They’ve got to really start thinking about that big picture, not just next month, but next six months, next year, next five years, next 10 years. So I think that’s an excellent point.

Megan Urban (08:31):

Yeah. Which is why I always encourage them too is it is important your new patient count, but let’s look at your re-care. How many did come for their regular cleanings and perio-maintenance? Where all those people going?

Chris Pistorius (08:43):

Yeah, you’re exactly right. I’ve seen it too many times where a dentist will focus on new patients, new patients, new patients, certainly are a huge part of it, but there’s also usually a big pocket of patients that are not active anymore and they’re not coming back in and they’re not spending enough time, or focus on trying to get those patients that potentially already know you, like you and trust you to come back in, and those shouldn’t be the easiest ones to bring back in. That’s why I like to when I approach marketing, I talk about not just new patients, but a holistic approach that’s going to bring patients in from all over the place. I think that’s an awesome point that you made.

Megan Urban (09:21):

Oh, so important. When I talk to dentist and they say, “Well I just have one hygienist. We couldn’t keep another one full.” And I’m like, “Why not? [inaudible 00:09:32]. You’ve been practicing for X number of years and you’ve had X number of new patients per year or per month, whatever, where is everybody?

Chris Pistorius (09:41):

Right. Yeah. You’re totally right.

Chris Pistorius (09:43):

Well let me go to my other scenario here where I’m an existing dentist, and I’ve done it for 20 or 30 years and I don’t want to do it anymore. I’m ready to sell. How long a lead way do you typically get to start thinking about that process and what do you need to have in place? What’s the process with that?

Megan Urban (10:03):

There’s no right answer. I think sometimes dentists are lucky enough to say, hey I have a five-year plan. And that’s where the trusted advisors work together like you and me, the accountant, all that type of stuff to say, how do we make this work in a way that makes sense and we have five years. But if you don’t have five years and you’re ready to sell that still fine too. Either way, we just are going to need to know what your plan is. In fact, I always recommend, it’s not my business and you don’t have to, but I always say, “Yeah, talk to your financial planner. Are you ready? Can you financially retire? And if you can’t maybe you still need to get out because of a health problem or whatever anyway, but what are you going to do with this money in a way that makes sense tax-wise? You still pay your taxes, but what are you going to do with these funds?”

Megan Urban (10:55):

Really the next best thing is just to know, “Hey, I have my CPA that’s going to electronically send you my tax returns, and here’s the reports that we need from your software.” And then we do evaluation, come up with what we think is the reasonable price and then we recruit and find the right fit. Sometimes sellers are lucky enough to have several options and pick the buyer that they think is going to be the best one in their shoes, sometimes they don’t, just depends. And then it’s time to start thinking about a non-compete. Does the seller … Sometimes all of a sudden the day of closing they’re like, “Well, I really think I kind of want to work a couple of days a week.” And it’s like, “Oh my gosh, hold on. That’s not part of the plan.” The new dentist has to eat. The food now is theirs, and they have to pay the bills and pay the bank.

Megan Urban (11:52):

So it’s really good to think ahead. I think for most of them is what am I going to do? Do I want to have in my non-compete that I have the right to help these five friends of mine for one or two weeks at a time to cover vacation? All those details need to be in the contract. So that’s stuff that you need to think about before.

Chris Pistorius (12:12):


Chris Pistorius (12:15):

I get asked this a little bit too in marketing is how do you evaluate a dental practice? Is it how much income? Is it how many patients? Is there a basic scenario or a formula on how to evaluate a dental practice?

Megan Urban (12:32):

Yeah. Yeah, there is. It’s actually a fairly complex evaluation that we go through. There is a certain huge part; that’s the last three years of financials. We do look at adjusted cashflow. When you look at somebody’s tax returns, they may have three kids on payroll for tax and retirement benefits. We take that piece out so that we can see what amount of cash would truly be available to a buyer. We do look at the last three years numbers of how much did you collect and how much did you put in your pocket? That’s a big part of it.

Megan Urban (13:15):

And then we do look at what’s the new patient count? I think every new dentist, that’s a huge question for them. What website do they have? We look at the location. Is it urban or rural? Does it look like 1975 in there? We don’t need it to look like the Taj Mahal, but those things do definitely play a piece in it too. Once we have the financial piece, then we say, “Okay what is this other piece?”

Chris Pistorius (13:51):

Right. Okay.

Chris Pistorius (13:53):

I guess if you own your own building, that’s one thing, but I think most dental practices are in some sort of a lease situation. Does it matter how far along they are in their lease and what those terms look like. I guess my question would be, I’m three years from retirement potentially, should I worry about a longer lease to renew with, or a shorter one? What’s your advice for that?

Megan Urban (14:18):

Yeah. That’s very important. I’m glad you said that. It’s super important. A lot of times I noticed when I talk to dentists that have a lease, they don’t even remember. It’s time to dig that out. Find that lease and see how much longer you have and what the details are. Even if you’ve got 20 years left on your lease or something can this new person take it over? So yeah, lease is super important. And I think you definitely need to know what you have available because the bank isn’t going to give the buyer money if they don’t have that building and that space to practice in.

Chris Pistorius (14:55):

Yeah. Yeah. That totally makes sense.

Chris Pistorius (14:58):

Kind of bringing modern world into this … Does marketing a practice and being able to show that you’ve marketed a practice over the last few years, and you can show physically that new patients come in from your marketing efforts, does that help with the value of a practice?

Megan Urban (15:15):

It does. It definitely does. We have plenty of practices that we work with that don’t have a website, that don’t have business cards, that don’t do advertising, or that still do yellow pages, but the new dentists are a little more savvy to all the ways to market and social media and the SEO and all that. So I think that definitely plays a big part in what a buyer looks at for a practice.

Chris Pistorius (15:43):

Okay. What about employees? You’ve got hygienists, you got front desk staff, you’ve got all kinds of employees. Is there anything that you should do prior to selling to get these folks ready? How does that work?

Megan Urban (15:58):

Not really. Typically, we don’t recommend that your staff or your team has any knowledge of you ready to leave. Now that being said, though, I’ve got multiple dentists that I’ve worked with that say, “But this team has been with me 30 years. They’re my friends. They’re my family. I have to tell them.” “Well that’s up to you. Here’s why we’re concerned. We don’t want them to get panicked and nervous and leave because they are a part of the goodwill too. The patients like the team as well.”

Megan Urban (16:35):

But it’s just human nature to get really freaked out and nervous about this kind of stuff. And so we don’t typically recommend that they talk to them or tell them about it until we have a new buyer and it’s pretty tied up. I guess if you really have somebody awful on your team that you’ve been nursing for a while, maybe it’s time to move on. But otherwise there’s not a lot you can typically do there.

Chris Pistorius (17:01):

Yeah. Yeah.

Chris Pistorius (17:02):

I know this is across the board, but if you brought on a dentist who’s looking to sell right now, how long does that process take on average?

Megan Urban (17:12):

It definitely depends. I guess maybe six months, maybe less. I’ve seen some happen in a month and a half, but I’d say they’re typically usually around six maybe. And that’s allowing for time to find the right buyer and they contact their advisors too, their CPA and their lenders and attorney and get all that straightened out. Again, it goes much quicker if you have dental specific lenders and dental specific attorneys that are involved and know what they’re doing and can wrap it up pretty quickly.

Chris Pistorius (17:49):

Right. Okay. Okay.

Chris Pistorius (17:51):

Now I know OMNI can … Maybe you can talk a little bit about between yourself and your company, who can you service? Where can you help dentists?

Megan Urban (18:01):

Depending on what we’re doing to some degree any state. On our team we have, gosh, I don’t know, probably four dentists that are also brokers. We have a CPA. We have MBAs. We have several of us that have been in the dental industry forever. We’re definitely licensed, especially with our real estate license in I’ll say Oregon, Washington, Alaska, Idaho, Nevada, Arizona, California, Colorado, Ohio. I hope I didn’t miss any there.

Chris Pistorius (18:44):

All over the place.

Chris Pistorius (18:46):

Let’s say somebody is ready to buy their practice or they’re ready to sell their practice. What is typically a first step when they contact somebody like you? What do you do first?

Megan Urban (18:57):

Just ask a lot of questions honestly, to find out what they want to do, what their goal is, if they want to stay on and work some or they don’t. Just in general is we just literally talk about what the process is. “Yeah, here’s how this works. Here’s how we advertise and market your practice. We have hundreds of dentists looking for practice. Well, I do, so as a team, we would have thousands and thousands that I can reach out to. I need to know about your practice and what we’re selling. Who we’re looking for to take over for you.”

Megan Urban (19:37):

That’s really just a simple start. It’s just literally to talk and talk about the practice and what the process is. Yes, we get evaluation and they come and look at your practice and they get lending, and literally just to share that knowledge and guide them.

Chris Pistorius (19:53):

Yeah. Yeah. And in hiring somebody like you with this much experience, over the years I’m sure you’ve got tons of contacts and lending and all other expertise in selling and buying practices, right?

Megan Urban (20:07):

Yep. Yeah. We have all the dental specific attorneys and accountants and lenders that all know how to come together and make it as stress free as possible to the transition.

Chris Pistorius (20:22):

Sure. Yeah. I think that’s the thing. We’ve had experiences here at our agency where practices have grown and they need to expand. It’s a very stressful process a lot of the times. You think about yourself when you buy a home; it’s one of the most stressful times of your life. So I think if you can find the right person to partner with to help you through that process and they know the ins and outs, any less stress that can be involved the better, right?

Megan Urban (20:52):

Yeah. Absolutely. And then that’s what I even find out too is how often they want to communicate with me. Maybe they don’t know yet, but as we go along, they’ll decide. I have some people if I don’t talk to them every day, they wonder what’s going on. But others are like, “I don’t need to know who asked for my information. Just tell me when you have something.” I’m like, “Okay, you got it.”

Chris Pistorius (21:17):

Well Megan, if somebody is watching this and they may be in that process or thought pattern of sell or buy or something in between, what’s the best way to reach out and get a hold of you?

Megan Urban (21:26):

You can call me, email me, whatever you want. Our website is omni-pg, as in It will have my phone number and my email. I’m available. This is what we do.

Chris Pistorius (21:45):

Awesome. I’ll make sure that on the video wherever you’re watching this or listening to this, your details will be attached to that as well. Somebody can easily reach out and get a hold of you if they have questions or just need advice.

Megan Urban (22:00):

Yeah. Sometimes it’s just talking through something. I have all these years of experience and when you’re in your own little office by yourself, maybe you have a couple of golf buddies that are dentists, but you just don’t know. So sometimes talking through a few things.

Chris Pistorius (22:19):

Yeah, for sure.

Chris Pistorius (22:20):

Well Megan, I appreciate you taking the time to be with us today. I know you’re very busy. Maybe we can follow up in a few months and just see how the market is and go from there. Thanks so much for taking the time to be with us today.

Megan Urban (22:34):

Thank you so much.

Chris Pistorius (22:35):

All right. Awesome.

Chris Pistorius (22:37):

Well, thanks everybody for watching. I hope you got a lot out of this. Some great information that Megan just unpacked for us; buying and selling and everything in between, how to get ready for it, how to prepare, what questions sometimes to ask, things like that.

Chris Pistorius (22:53):

Please join us in our next episode and thanks again for joining us today.


What Dental & Orthodontic Practices Need To Know About HIPAA

What Dental & Orthodontic Practices Need To Know About HIPAA

To get in touch with Debi:

Debi Carr
DK Carr & Associates
(844) 352-2771

View Full Transcript

Chris Pistorius (00:04):

Hello everybody. This is Chris Pistorius, the CEO and Founder of KickStart Dental Marketing. Thanks for joining us today. We have the distinguished Debi Carr of DK Carr and Associates with us today. And Debi is a consultant really in technology and security. Debi has over 22 years of private practice management experience, and she’s got over 30 years of experience in technology and security.

Chris Pistorius (00:34):

Now, she helps dentists in obtaining and maintaining a HIPAA HITECH compliance, which I know is top of the page to a lot of you guys out there listening. That includes performing risk analysis and team security training. And a lot of my interview today with Debi will be around that. Debi holds several certifications which is too many for me to list. And we’ll ask her about that in just a minute. But Debi, I want to thank you for being on our show today.

Debi Carr (01:04):

Thank you for having me.

Chris Pistorius (01:06):

Did I mess up the intro at all? Is that just pretty much cover what-

Debi Carr (01:08):


Chris Pistorius (01:10):

Okay, good.

Debi Carr (01:10):

That’s pretty much summed up.

Chris Pistorius (01:12):

Well, that’s good. So, Debi it’s obviously you’ve got tons of experience with this stuff and you’re consulting in an area that I know that a lot of my clients ask about with HIPAA and security and website security, and all kinds of stuff. And why don’t you just tell us a little bit more about how you got started in this business?

Debi Carr (01:33):

Well, I 30 years ago married a wonderful man who was very involved with technology. He would rebuild computers at our home and he also was a computer programmer, and he still is a computer programmer and he doesn’t build computers anymore, but he is a computer programmer for a defense contractor. I went into the dental industry as a practice manager, but we always had our doctor to be state-of-the-art with technology, because I was a techie. So, anything new that came out, I wanted my doctor to have it.

Debi Carr (02:11):

When you have technology, there comes security. And because my husband works for department of defense, I was always having to adhere to that standards. In 2013, I realized that the law had changed. I was consulting, helping dentists go paperless and implement a paperless office, and realized that the law changed in September of 2013, which gave the office of civil rights, more bite in levy penalties and fines against them. And with technology you need security, and the way the law is structured, it can assist dentist and in implementing a security office, a secure office, while meeting compliance.

Chris Pistorius (03:06):

That totally makes sense. And it’s an interesting way to get a start in this crazy HIPPA security world. So that’s very interesting. Why don’t you tell me a little bit more about your business as it exists today and really what you’re specializing in and what really your passion is?

Debi Carr (03:26):

Well, one of the first things that my passion is, is to help dentists to become compliant. And we want them to secure their practice against the data breach. Because if they implement good security protocols, they will be compliant. Compliance doesn’t always bring security, but security will bring compliance.

Debi Carr (03:49):

So, the first thing that we do, is we do a random objective review of their current status, their current situation, we call it a risk analysis. It is the first letter the law mandates. And it’s the first protocol that you should always do in any security management program.

Debi Carr (04:16):

So, we’re going to do a risk analysis and we’re going to see what they have in place, and what they need to have in place. And what we’re looking at is, what is the likelihood of an event happening? What can we do to maybe stop or mitigate that? And most importantly, what is the financial impact that will have on that practice if this risk comes to fruition?

Chris Pistorius (04:42):

I think it’s certainly not over simplifying it, but I think you put it in a way that everybody understands. And I think with anything, I know with marketing on my side of it, it’s the same kind of thing. We put things into kind of an action plan step by step, and that’s how you overcome a lot of stuff that’s going on with the practice. So, I think that’s a great way to put that.

Chris Pistorius (05:05):

Now, obviously you’re not the only consultant that talks about things like this, and there’s several choices that dentists have. And that’s the other problem that I see, is that dentists don’t really know who to trust. Especially with consulting and especially with HIPAA related stuff when it comes to dentistry. There’s a lot of information out there from a lot of different sources, and who knows sometimes if it’s accurate or not.

Chris Pistorius (05:29):

So, what would you say is the biggest difference between you and maybe other consultants, and people that are in this arena, and why should dentists, really trust what you have to say in your authority?

Debi Carr (05:44):

Well, first of all, one of my certifications that I have is a healthcare information security privacy practitioner through (ISC)2. (ISC)2 is the certification organization that is recognized on an international basis for security. So, I am (ISC)2 certified. I’m also HIMSS certified.

Debi Carr (06:12):

The other thing that I think sets me apart is that, because one, I’ve worked in the healthcare industry IN the dental industry for 23 years. I know how practices work. I’ve been in the trenches and I know what it’s like to be in an operatory versus someone just coming in that’s never seen a operatory or understands.

Debi Carr (06:37):

For instance, one of the protocols in security is that, you should go to a screensaver after 90 seconds. I don’t want the dentist going to a screensaver after 90 seconds because he needs to look at that X-ray when he’s doing a surgery. So, because I’ve been there, I know how to overcome and how to do some work around while still securing.

Debi Carr (07:00):

I also have been in technology for 30 years. And so, I understand how technology and how vital and crucial technology is to dental practice, because whether it’s true or it’s not true, but this is how patient perception is. Patients perceive their doctor’s ability based on the technology in their practice.

Debi Carr (07:24):

So, the more technology that they have in the practice, the better reputation they have in the community, but the more they have to secure that technology.

Debi Carr (07:36):

So, there’s three legs to securing a practice. You want to have administrative, you want to have physical, and you also want to have technical. And because of my background, I’m able to look at all three. I work with your existing IT company. I don’t try to replace your IT company. I work with your existing IT company to make sure that they’re providing the service that you think that they’re providing for you, as well as helping you to implement policies and just securing your practice, using administrative, technical, as well as physical guidelines.

Chris Pistorius (08:22):

Yeah. I think that would be a good reason for me to use you for sure. But one thing that stood out from there is that, you make sure that IT companies are doing what they say that they’re doing, right? Or they’re doing what you think they’re doing. And I think that’s really important because the dentists that we work with, they don’t have time to check out and make sure that everybody that they’ve hired and every company that they use are really doing the things that they say. And I think having somebody in place like yourself overseeing some of that, is a very valuable service. So, I think that’s a great approach to it.

Debi Carr (08:57):

And the thing to remember is that ultimately when there’s a data breach, it’s not the IT company that’s held to the highest responsibility, it’s the doctor. It’s the doctor that’s going to be [inaudible 00:09:09] to facing the fines and penalties, not the IT company. Although now there are some fines and penalties that’s going against the business associates, but ultimately it’s still the doctor.

Chris Pistorius (09:22):

Yeah. I mean, it’s the IT company isn’t going to be one shelling out the box. It’s going to be the doc. That’s a very good point. So, just because you’re paying somebody, doesn’t necessarily mean that you’re passing on that liability as well, right?

Debi Carr (09:38):


Chris Pistorius (09:39):

Okay. I think that’s great. Now, talk to me, do you service the entire country or do you just service a specific area, or are you even international?

Debi Carr (09:50):

We try to stay on the Eastern Seaboard. I’ve gone as far West of Texas. But when you specialize in the risk assessments and incident response. Incident response is when you’ve had a data attack or you turn on computers and you’ve got ransomware, or you walk in Monday morning and your computers are gone. Because that involves over 500 patients and any time over 500 patients are involved, you have to A, notify the office of civil rights. Chances are you have to notify your state department of justice, but you also have to notify the local media, and you have to notify your patients. And you have to have an incident response investigation.

Debi Carr (10:44):

So, we’re there to guide you through and help you to know what to do when you have to make that call. But our goal is to make it so that you’re proactive, and that when that happens, you’re ready to handle it. You just go right into what we call a coop mode or a disaster mode. And you’ve got a plan and you’re ready to deal with it. And everybody knows what to do. And they go to step one, step two, to step three.

Chris Pistorius (11:15):

Wow. I think that would be pretty important to have a resource like you, because there is no way that I would know, if I were a dentist I would have no idea where to go to first. And I can promise you that many out there don’t know that they need to do state filings, maybe national filings, contact the patients, and what’s the best way to contact the patients. And I just can’t even imagine how you would navigate through that without somebody like you.

Chris Pistorius (11:44):

Now, one thing you said in there Debi was ransomware, and that’s been on the news lately, right? I mean, that’s where somebody will hack into your computer, lock up the data that you own, encrypt it, and then try to sell you the password to your own data. Is that accurate? And then-

Debi Carr (12:02):

That is very accurate.

Chris Pistorius (12:05):

… to attach on to that, I can see some dentists out there listening to this right now, kind of shaking their heads like, “Yeah, right. That’s really going to happen to a dentist?” So, could you tell us number one, does it happen to dentists and am I accurate with my statement on-

Debi Carr (12:18):

Absolutely. It absolutely happens to dentists because they are a soft target. Because they don’t see security as a priority. Protecting their data. Their data is the most expensive piece of technology or equipment that they have in their practice, but they don’t put the emphasis on it.

Debi Carr (12:43):

And what happens is that they get a ransomware attack, and yes, it is exactly what you described. They’re holding your data ransom. And the FBI tells you not to pay the Bitcoin, because if you do there’s no guarantee that you’re going to receive your data back. These are bad actors that are holding your data. So, they may or may not give you your data back. But because you’re a small office, you are prime target because they are able to get into your network very easily if you’re not protecting and securing it correctly.

Debi Carr (13:23):

So yes, it absolutely is happening to dentists on a daily basis. And a lot of times what I’m seeing is that they will just restore their backup, which is a good thing to do. That’s part of their disaster plan. That’s what they should do. But they still have to do those other parts, and we still have to report it. It is a reportable offense. And you want to be proactive with the office of civil rights versus on the defensive, because you don’t want the FBI and the office of civil rights knocking at your door because they found your data on the dark web.

Chris Pistorius (14:02):

Well, that’s intriguing. And it’s also very scary, but you’re right. I think most, especially the smaller practices out there don’t have tons of security on their network. And it’s a scary thing that, I think potentially, and I hope I’m not overdramatizing things here, but I think that could potentially put a dentist out of business if somebody did this to them. Have you seen that in the past? I mean, is it-

Debi Carr (14:30):

It could be financially devastating. I mean, I’ve seen fines as low as 12,000. I’ve seen fines at 750,000. So, none of us want to pay the government anything. So, to have any penalties or fines coming at us, whether they’re 12,000 or 750,000, that’s a lot. And 750,000 could financially devastate a practice. Not to mention the reputation damage.

Chris Pistorius (15:05):

Yeah. And that’s a biggie with dental practices. I mean, one of the services we offer is online reputation marketing, and we talk to dentists how important their reputation is. And especially as competitive as dentistry is getting now. So that’s a biggie that you want to keep intact.

Debi Carr (15:24):

But imagine if you have to put on your website that you’ve been hacked.

Chris Pistorius (15:27):

Yeah. That wouldn’t help.

Debi Carr (15:29):

On the front page.

Chris Pistorius (15:31):

Yeah. A potential new patient would skip right over your website and go right to the next in line for sure. Debi, how would you describe your ideal client? Who would be your ideal practice that you would work with?

Debi Carr (15:44):

Private practice, usually one to five doctors in the practice. That’s pretty much who we concentrate on. There are a lot of consultants that will deal with the bigger practices, but it’s the singular practices that are the most vulnerable.

Chris Pistorius (16:03):

Okay. What’s the favorite thing about what you do?

Debi Carr (16:10):

Oh, I think the favorite thing is just teaching and training them how important it is to be very vigilant on protecting their data. And just getting through to them that this is something that they have to take on a daily basis take seriously daily.

Chris Pistorius (16:33):

Yep. I think that’s an awesome way to look at it. And there’s no doubt that you’re providing a service that can really help dental practices. Now, one of the services that we provide are website design. And we’ll build a website from scratch, or we’ll take over an existing website and just make it better.

Chris Pistorius (16:52):

And I get lots of questions from practices about HIPAA, all kinds of HIPAA related stuff. But you and I were actually talking about this offline, and I was hoping you could maybe talk to our listeners a little bit. And you were talking about making sure that you have a notice of privacy on the website. Can you just tell our listeners a little bit more about that?

Debi Carr (17:13):

Correct. Yes. Notice of privacy practices is the contract you have with your patients. A notice of privacy practices is required by the law, and it’s how you’re going to handle the data. And when I see a lot of times is that a dentist will download one from somewhere, and they never read it. But that contract has been held up in Supreme Court, inside state as a contract between the doctor and the patient. And that has allowed these patients to sue the doctor.

Debi Carr (17:50):

So, on top of the fines, and on top of the penalties, and on top of the other expenses, now you’ve got a patient suing you because you’ve breached it. The law says that your notice of privacy practice must be conspicuously displayed in your waiting room, and on your website, and must be available to hand out to your patients.

Debi Carr (18:14):

Most dentists are really good at handing it to their patients, but they’re not really good at posting it conspicuously in their waiting room and on their website. And there’s these paid people that work for our government, the office of civil rights has them, the FBI has them, the auditors have them, they troll websites to see if you have that information posted. And if you don’t, that’s a door to allow for a random audit because you’re already in violation.

Chris Pistorius (18:52):

Wow. And there are people paying attention dentists, don’t fool yourselves.

Debi Carr (18:58):


Chris Pistorius (18:59):

There’s all kinds of trolls out there. This is one of them. We have one common in our business, where these people will actually troll dental websites and make sure that the images that they’re using on their website are not copyrighted from somebody else-

Debi Carr (19:12):


Chris Pistorius (19:12):

… and if they find one of those, they send you in the mail is a letter demanding a bill, and sometimes it’s a couple of hundred dollars and I’ve seen them, like you said earlier with the fines, several thousand dollars. So, it’s a lot to think about, but it’s very important to protect yourself.

Chris Pistorius (19:30):

So, that’s great information to have. And we’re out of time today Debi, is there anything else you would like? And actually I think it might be a good idea, could you tell people practices out there. What’s the best way to reach you if they have questions or if they want to potentially hire you, how can they get ahold of you?

Debi Carr (19:50):

They can email me at Debi and that’s D-E-B as in boy, And they can reach me at (844) 352-2771 or DK Carr1.

Chris Pistorius (20:08):

Awesome. Now, will you offer like if somebody called you say off of this program or something, would you be able to talk with them over the phone for a little bit, kind of as a free consult or do you offer anything like that?

Debi Carr (20:20):

Yes. Absolutely.

Chris Pistorius (20:22):

Well, that’s awesome.

Debi Carr (20:23):

My passion is helping them to avoid a data breach and avoid the negative connotations that come with a data breach.

Chris Pistorius (20:33):

Okay. Well, great. And is there anything else you’d like to add Debi before we wrap up?

Debi Carr (20:37):

I think that covers it.

Chris Pistorius (20:42):

Okay. All right. Well, awesome. Well, I really appreciate your time. I know how busy you are. But dentists out, if you are listening and you have more questions about this, Debi’s awesome. She’s part of our network, people that we trust and that we recommend out to our consultants. So, feel free to give her a call if you have questions regarding security, HIPAA, things like that. She’s just an awesome resource to have, and she’s very easy to work with. So, with that being said, thanks again Debi, and thanks for listening dentist.