[00:00:00] Hey everybody. Welcome to the No BS Dental Marketing Podcast. I am your host, Chris Pistorius, and on this show, as you probably already know, we talk about straight to the point, No BS tactics, tricks, and strategies to help you grow your practice.
Now, there’s no fluff here, just great information that you can start using immediately to help you grow your practice. And your bottom line. So if you’re a dental practice owner, a manager, a doctor, a front desk professional, or really whatever, be sure to click the subscribe button on this video so that you can keep up with all the latest tips and tactics.
Now, today we are talking to a special guest. We have Dr. Roy Krengel. Am I saying that right? Krengel?
You’re saying that correct. Krengel like, Chris.
I got a friend named last name Engel. You have a friend named Engel too, and I just can’t put those two together for some reason. But anyway, Dr. Roy Krengel, he owns two practices, two locations out in the St. Paul Minneapolis area, specifically in the Bloomington area, I believe in St. [00:01:00] Louis Park. Is that right?
That is correct. Yep.
I got that part right. Well, Dr. Krengel thanks so much for being a part of this show. Why don’t you just tell us a little bit about how you got started? How did you get started in this crazy industry of dentistry?
Thanks Chris. I appreciate you inviting me on the show. Looking forward to it. God, how did I get into it? Crazy. So I, yeah, I mean, all of us have some crazy story when we were younger and sitting in the dental chair all full of anxiety and stress and, you know, I spent a lot of time getting procedures done when I was younger and it kind of instilled this kind of, you know desire to wanna, you know, give back and maybe do it better.
Than when I was sitting in a chair going through it myself. So that was kind of the initial, I loved math, I loved science. And I just kind of fell into it. I started off really wanting to be a medical doctor or maybe my dad wanted me to be a medical doctor, right?
And but I got through all the classes and everything. And the interesting thing is, [00:02:00] you know, I shadowed a bunch of medical doctors and man, they were sad. They were crabby. They were mad at the world, you know? And then, but I was like, all right, I want to give back. So let’s do this. And I took the MCATs, didn’t do well.
And, you know, went through another year of preparing and somebody had mentioned you should talk to this dentist. He seems to be happy, see what that’s like. So I shadowed a dentist and the guy was tan, he was smiling, ready for his tea time, you know, and I was like, all right, I could see this.
So I decided to kind of pivot and man. Just crushed the dental related exams and just kind of followed my path that way and been happy ever since.
Yeah. That’s awesome. That’s a great story. I wonder how many dentists out there kind of took that path too. They kind of went down that, you know, medical doctor path and like, wait a minute, I don’t have to work 80 hours a week and, you know, do all this crazy stuff for years.
And then like the medical insurance is HMOs, hospitals, you know, [00:03:00] being on call and all the things that you know, again for the right reasons. You know, medical doctors, we need them. Right? And they’re really amazing at what they do.
But I don’t know. I just, I really like the meld of the healthcare give it back with the business side too. Running a small business together. That was really a big draw as well.
Yeah. So now you went, you did your undergraduate in Kansas, right?
Yep. So I grew up in Dallas, Texas, did my undergrad at the University of Kansas in Lawrence, and then went to dental school at the University of Minnesota.
Awesome. So when you started at Kansas, did you know right then and there, it’s gonna be doctor or dentist or somewhere in that direction?
Funny thing is like I said, you know, I was kind of pressed as a child, you know, who knows at 18 what they’re gonna to do in their life, you know?
Yeah.
And that’s, you know, they get me on a different soapbox of, you know, what, what we do with our kids, right?
In college. And you and I have spoken about that on the side, but essentially no, I knew that I wanted to be in healthcare and I loved [00:04:00] math and science. And freshman year I met with my advisor and I had couple Cs, you know, and wasn’t looking really good.
And the guy looked at me and he was like, I think you should look for an alternative career path buddy. And I feel like I know, right? And for me it, like, it kind of dug something, a lit a fire and I was like, I’m gonna prove it to you.
Yeah.
So then I was able to kind of push through and, you know, follow my path. But no, I did not know that I wanted to be a dentist right away.
All right, cool. Interesting. So, you know, a lot of doctors that I interview and a lot of the audience that we have are obviously dentists or peep kids getting ready to come outta school and either start their own practice or you know, jump on as an associate.
When you got outta school, did you go the associate route or did you go right into private practice on your own?
Yeah. So I actually went to private practice on my own. I had the same name idea, as most people, I wanted to associate somewhere, learn, get a mentorship, couple years, buy in, kind of do the traditional path.
[00:05:00] But when I graduated it was 2009 and so 2008, obviously there’s a financial crisis and something that nobody would’ve expected. I had it all set up my father-in-law’s best friend, right? Like in the St. Louis Park community, which is where I was actually living at the time.
So everything was set up perfectly. I was gonna go right in and that crisis happened in 08 and he’s like, Sorry, I can’t hire you. And yeah, that’s what most of the Doctor’s were doing because their financial advisors were not ready. You know, you can’t hire somebody right now. Just doesn’t make sense.
So I was pretty scared and worried, like, okay. And they had a lot of classmates that were looking for work in, you know, rural communities, going out to Montana to Wyoming, you know, and somebody through some divine intervention in one of our labs reached out to me and said, listen, one of my classmates, she said, I went and talked to this doctor in Bloomington at the time, and it’s a great opportunity and I just don’t wanna buy a [00:06:00] practice right now, but would you be interested in meeting with him.
And I was like, yes, please. And not knowing that I was, I mean, I had no idea how to run and practice, you know, or buy a practice or what have you. I met with the guy and after an hour’s worth of like at a Starbucks, he was all in. I was all in and I bought my first practice right outta school.
That’s incredible. That’s a pretty small percentage that do that. So I mean, I guess you have to learn pretty quickly when that happens, right?
Yes. And I had a severe advantage, I think for multiple reasons. My father-in-law was an accountant and he worked with small medical practices. So on the financial side and those things, that was cool.
And the practice that I bought was actually in a, like a professional building. So I had a specialist everywhere. So next door was a endodontist, upstairs was an orthodontist and a periodontist. There was another GP. So I felt like, you know, if I ever got in a pickle, I had a lot of help. And it was fantastic. Yeah, it was cool. So I was very fantastic and very lucky.
You had [00:07:00] a little bit of a support network there for sure.
Definitely couldn’t have done it without it. For sure.
Let me ask, maybe somebody’s kind of thinking about doing the same thing here. What’s maybe the biggest or best piece of advice you’d give them if they wanted to come right outta school, not be an associate, go right into pro owning their own practice.
I think the right fit makes, I think the idea is having the right practice philosophy, I think. As, the doc that you are looking to buy out, right? Or the practice that you’re trying to do. There are a lot of different ways and styles of practicing, and especially right at a dental school, you don’t really know anything, you know, I mean, really they give you the basics, right?
And then you go out and so. Well, especially with business for sure. And that’s a whole other beast. But I’m talking just even on the dentistry side. Cause without the dentistry, you don’t have the business. Right? So, understanding that, you know whatever that philosophy is that you’re on board and have a [00:08:00] really good relationship with that doc.
The worst thing, and I’ve done this now three or four times where I’ve either bought another practice and added them into our current practice or, you know, another location. But essentially, you know, the biggest advocate for those patients hanging around is that previous doctor.
Yeah.
So yeah, so I would advise having a really good relationship with that doctor. Making sure that they’re hanging around, they’re talking you up. They’re able to, you know, build that rapport for you initially at least, cause especially getting out of school, you look young, you’re green as can be, and it can be scary. So having that person there would be, super helpful.
Yep. I’ve seen that go sour before. We represented a dentist that they were an associate first though, but they bought a practice and right before closing there was a little bit of a conflict there between the previous owner and if you guys are thinking about buying a practice, it’s not all candy canes and rainbows all the time.
The whole negotiation and, you know, it’s kind of can be a nightmare. But anyway, this [00:09:00] particular practice, they had a little bit of a conflict and it led to, the new dentist saying, you know what? I don’t want you a part of any of this transition. Just go and leave. And this was a pretty well established practice, and they lost.
About 60% of those active patients because what the person did was, and against my advice, but you know, I don’t know everything, but they changed the name immediately. They had no association with the old doc and they didn’t do a very good job of communicating any part of the transition. They just kind of assumed that they could go in, take over and everything would just be fine, and it wasn’t.
And it hurt them pretty badly. I don’t know if they’re still around or not, but I think that advice that you just gave is huge if you are taking over an existing practice, I think that relationship with that transition period is huge.
And let me make another quick comment, if that’s okay, but at least like today speaking to my banker based on interest rates, right?
So if you’re buying a practice, you’re most likely taking a loan. [00:10:00] And back in the day when the interest rates were kind of fun, right? 2-3%. You know, the margins in dentistry were enough that maybe you lose 20, 30, 40% of patients. It sucks. You’re not happy about it, but you can still make due and kind of grow this new practice.
Now, I think those margins have gotten a lot smaller, really hard to, you know, the attrition of those patients. I mean, sounds like 60% leaving does not sound like it’d be manageable with these interest rates right now. So yeah, do everything you can to try to keep those existing patients.
Yeah, and a lot of times what we’re seeing right now is this kind of turnover of, you know, kind of the, I guess kind of the baby boomer dental practices are starting to sell to, you know, the younger crowd.
And what we’re finding is that the older dentist really for the last few years, just kind of put things on autopilot. Because they knew they were gonna sell and they didn’t wanna invest in like a cerec machine and you know, keeping up on the latest stuff. And so you go and buy that existing practice and then you’ve gotta start thinking about [00:11:00] buying the cerec machine, digital x-ray, you know, whatever it may be. And that’s just other stuff that’s gonna have to be financed and it can get pretty expensive, you know, once the final bill’s there.
Definitely. I don’t wanna scare anybody away. Because it is been the best, I mean, the best investment is in yourself. And doing, you know, buying a practice is still gonna be ideal if you, if you are looking for something, you know, in ownership. Right?
And in dentistry. But yeah. No, I think all those things will come through if you just do your best. Right? And try to connect with that previous doctor and just make sure you’re there for the patients.
Yeah, I totally agree. Now, shifting gears a few years, I guess you know, I know that you do or you like to do a lot of implant work.
Correct.
You do a wide variety. In fact, we have a mutual friend who does training and education for GPs to be able to do implants Dr. Todd Engel. And I’ve sat through a few of his courses, and I’m not a dentist, but I’d like to give it a shot to do an implant, but I think I’m that [00:12:00] close to being able to do it. But,
Yeah.
You know, obviously I think you were trained through him as well. How long ago was that and what’s that experience been for you since?
Well, I mean, I definitely consider him one of my biggest mentors in dentistry. I started in 2009 practicing and then started placing implants probably a couple years after.
Okay. That’s pretty quick.
And yeah, pretty quick. Yeah, and to be honest, you know, I mean, there are so many courses now available to go out and get training on dental and anything, right? I mean, you can do things online now and then jump right in.
That’s kinda scary, really.
It was scary. It is, it is however, you know, Dr. Engel was at a North Carolina he has different courses. You know, starting off with just placing a single implant all the way to doing the all on x fixed hybrid procedures.
Gone through all those I highly, highly recommend it because of the way he, basically, probably made you feel so [00:13:00] comfortable, Chris, that you could place an implant, right? I mean, it becomes. Yeah. I mean, I think a lot of the courses taught by specialists primarily make you feel. Like you’re not good enough to be able to.
They talk down to you sometimes, almost it doesn’t should be.
They do.
And not to interrupt, this isn’t a plug for Dr. Engel, but you know, I sat through probably two of his courses and he just has this talent of just putting complex things into layman’s terms so well that even, you know, dummy like me feels like, oh yeah, that makes sense, you know?
Totally. And I, that’s exactly what I was gonna say. I mean, still the words are firing off, he makes everything so simple, even though it’s complicated and he spends a ton of time, you know, figuring out how to translate that message. But when you’ leave that class, number one, you’ve already done a handful of implants.
Right.
Live. On live patients, right? Who are volunteering to be there under the supervision of mentors, and other classmates that are going through it, it’s [00:14:00] great, you know, and then you go home on Monday and you get going and you can place your first one right away. A lot of courses, you know, you get a lot of that, you know, didactic.
You sit and then you listen and you get in enthusiastic about it. You spend the 20 grand on the implant supplies and everything, and then you get back and you’re like, oh my gosh, nobody’s here to watch me. What am I doing?
Yeah.
So, yeah. So that’s been great. And like I said, I started that a couple years outta practice, you know, about 11 and 12.
And then Maybe 2019 I started, I went all the way to the final one where we did the full on all on x cases.
Interesting man, right?
Yeah, man, it is seriously the most revolutionary thing you know, procedure in dentistry, in my opinion. It changes someone’s life over overnight of, you know.
And it’s great. It’s been amazing. So to have the confidence to be able to do that took years, of course.
Sure.
Of training and practice and such. But it’s been fantastic.
Yeah. And I know Dr. Engel thought teaches, you know, especially in the early stages, [00:15:00] he’s like, don’t ever take on something you’re not comfortable with.
You know, like if it’s too complex of a case, you know, early on, send him off. Right? But sounds like over the years you don’t turn down much, do you? I mean, you can do full on everything, right?
I was just telling somebody or my other associates at the office today that I get more anxious and afraid when I see a big filling that I need to do in my schedule than if I see the surgeries or even like the, hard root canals and things like that.
I think again, the repetitive nature, right? When you’re doing something enough, you have a little bit more confidence. Don’t get me wrong. I make mistakes, and you know, it’s just part of the process. But yeah, I feel comfortable with a lot of things that originally. Right? Like I never did. I never thought to be able to.
Yeah. That’s, it’s just human nature, I think. And I think that, you know, and he talks about this too. He is like, whatever you do, don’t come away from the training and just not do many implants, you know, [00:16:00] do them. Right? Just keep practicing cause it’s like anything else.
If you’re trained on something and you do a couple of them and you stop doing them for several months, you’re gonna lose your skill. Would you agree with that?
I would agree that wholeheartedly. Yeah. And the way we run our practice, which is kind of part of why I wanted it to be this way, is we have different doctors who are really good at doing different things.
I don’t wanna call them. We don’t all specialize, but we just have our favorite procedures that we like to do. And we work as a group. You know, it’s very hard. I wanna say it’s impossible. Like the doctors of the olden days, right? Who kind of either did everything right? And then you conclude business in that too.
I mean, it’s impossible to be able, one person to be able to do all of that alone.
Right.
So yeah, so being able to pick and choose what procedures we’re really good at and do them all the time and keep them within the practice. That’s been great.
Yeah. And can you talk to us a little bit about what it’s done for your business in terms of financials?
I mean, a lot of the dentists we [00:17:00] work with, you know, they like to do those types of procedures, but they’ve told me that it’s a very profitable aspect of their practice and it kind of helped them go from, you know, maybe that $500,000 practice. Doing as much as a million now. What’s your take on that and did it help your financial stuff as well?
A hundred percent. You know, I think there are games you can play in terms of what procedures and then what type of materials and type of implants and systems and things like that, and discounts. But at the end of the day, the profit margins on these procedures are a lot higher than, you know, the bread and butter type of dentistry. Right?
You know, I’m trying to think of like, what’s a good example. You know, like the crown and bridge and the operative, they take a long time to do, you know, and then there’s the lab fees and things like that that come along with the surgeries. They’re really, I mean, you have the initial investment of the materials.
You have an initial investment of the, you know the implants or what have you, but the procedures [00:18:00] don’t take as long and so, you can definitely charge more and definitely increase the profitability of your practice pretty quick.
Yep. No question. I’m gonna kinda do rapid fire a little bit here and put you on the spot.
Just we get questions that people send in actually wanting us to ask, you know, people that are experienced and, you know, have done just about everything, but what time of day do you get your best work done? Are you more of a morning person, afternoon or evening?
I am more of an evening person, but I get everything done in the morning. I don’t know why. I just, right? It’s a weird dynamic. And I did this in dental school too. You know, I take all those hard classes at 7:00 AM right in college where, you know, people are going out the night before and yeah, but for whatever it’s worth, once you get your butt out of bed and get moving, you just are definitely more productive and you get more out of the day. For sure.
Yeah, totally agree with that. I’m kinda the same way. I do best stuff at night, but if I don’t get outta bed fairly early, I kind of feel like I’ve missed something, you know? And [00:19:00] so I think you’re right.
Just gotta get up, get the day started, for sure. So if you weren’t a dentist, what do you think you would be?
I would probably be a fishing guide in The Bahamas.
Oh, that actually sounds pretty good now.
Doesn’t it?
Yeah.
I know, right? I know. Yeah, that’s what I would be, I don’t know too much about it, but I feel like that would be heavenly.
Now you did some soccer too, right? Growing up.
Yeah. I play soccer and my kids play soccer for sure.
Dad is a soccer player too, right?
Yeah. My dad is a soccer player. Yeah, yeah good memory.
That’s a lot.
Yeah.
I can’t remember my name some days, but I can remember things like that. What’s you biggest pet peeve in dentistry? What annoys you with the industry right now?
I would say, you know, the hardest thing is I feel like there’s a lot of competition within our group, I think we’re all type A’s we all wanna be the best.
Yeah.
And there’s too much of, you know, trying to take from others [00:20:00] because you feel this sense of lack.
But I feel like I wish there was a little bit more of the thought of abundance because there’s so much out there and there’s so many people out there that we can all help and work together. So yeah, that’s a big pet peeve of mine.
That is a good one. So, in your opinion, what do you think is the most important, like personality trait, I guess, or strength that you need to be a dentist. What makes you successful on that side of it?
Empathy. Not a doubt. Empathy. I think, you can use this in as an owner, business owner or as the dentist itself, working on patients when you can relate and kind of see things from the other person’s perspective.
It opens up your eyes to so much, you know, and most if you look at healthcare in general, medical doctors primarily, again, not to their fault because of, you know, what we talked about earlier, but just, you know, not having the time to sit and actually listen. You know it makes that industry really challenging.
And dentistry, I think we are able to sit down. Have these [00:21:00] relationships be empathetic to what they’re going through and help. And so I think that’s been super, super important.
Yeah. That’s awesome. Well, Dr. Krengel, I thank you so much for your time. I know you’re busy, you got a couple kids running around and a couple conferences to run.
I really appreciate you taking the time, and if you don’t mind, maybe in a few months, we could catch up with you again and just see what’s going on. One final question I do have for you though that I know some people are gonna wanna know. You went from one practice to two practices in the current landscape we’re in.
You know, I don’t think it’s a 2008 situation. Are you looking for another opportunity as well to continue to increase or are you good where you are or what’s your future plans?
I think if you’re not growing, you’re dying. And that doesn’t mean that you need to rule the world. It just means that opportunities are there.
And my vision and my goal is to be able to, you know, help as many patients as I can. And I can only do so much with my own two hands. So as opportunities come up and I have [00:22:00] brokers that I speak with, the bankers and, you know, the relationships that we have in the community. When things come up, I’m definitely open to continued growth.
That’s awesome. Great answer.
Yeah, yeah.
Okay. Well thanks again for being here. I appreciate it. Maybe we’ll catch up with you in six months and just see what’s going on, if that’s cool. That sounds great.
Thank you so much, Chris. I appreciate it.
Yep. Well, thanks so much also for everybody listening today. I appreciate it. And if you like today’s episode, please do hit that subscribe button. It will just help you when we launch one of these usually every week. You’ll get a proactive notice that a new episode has been launched and really appreciate it and we’ll see you next Wednesday on the next show. Thanks everyone.
