46: Fantasies Of A Dental Student w/ Dr. Chad Evans

Welcome to DSO Secrets. I know what it's like to be an entrepreneur in the dental industry. I've had my ups and downs, just like you. There's so much opportunity to be excited about, but so few resources to get answers. From here on DSO Secrets, we get you those answers so you can change the lives you're meant to bless and achieve your personal success.

When I was working as an associate rat at a school, I never imagined

I could own these many practices with

this amount of support. So thank you.

You have helped build my marketing mind to a whole new level.

You have this natural talent, this unique ability.

Hello, everyone, and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott, and I'm so excited to be here with you today. And I have Dr. Chad Evans, my business partner at Community Dental Partners, here again with me. Welcome, Chad.

Hey, thanks, Emmett.

Yeah, we got great feedback on our last podcast, and we got some questions that came in that really would be best for both of us. So I think I'm gonna title this one Fantasies of a Dental Student, because we've got a lot of dental students coming out of school asking questions a lot in specialty programs as well, and the questions seem to be pretty consistent, and they really center around their future and how they're thinking about their future. So I want to take you back, Chad, just a few years to graduating, and you, of course, get to talk to a lot of dental students as well. So take us to that mindset of being in school and what your focus is, where your time and energy is going into, and how you kind of shape or use that to shape how you think the future is going to be.

Yeah, no, and this is a great topic. I mean, this is really, really fun to think back and remember those times and, you know, just kind of going back to the very beginning of that whole dental adventure and setting off on going to dental school. I remember getting accepted to dental school and having conversations with other classmates of mine around their experience and getting accepted to dental school. I remember one in particular who shared with me the fact that he started crying when he got his acceptance. And it was. I mean, it was a very, very powerful moment. But for him, I mean, he literally tied acceptance to dental school with professional success for the rest of his life.

Like, he was done.

Like he was done. He won the lottery. He had just won the lottery by being accepted. And he was an interesting guy with an interesting story. This is, like, the third time applying to dental school, so there's a lot, lot that he was really looking for. But that was literally the way he looked at it. And I don't think that's too far off for most of us. Being honest, I felt the same way.

I mean, it is. Academically, it's a huge accomplishment. It's not like there's only 10 guys applying or whatever. Like, there's a lot of individuals trying to get in. And so getting in is meaningful, right?

Yeah. I mean, yes, academically, certainly, it's an accomplishment, but also professionally, there's just this expectation. And traditionally, in the business of dentistry, if you're going to be a dentist, that means you're now going to be wealthy, you're going to be successful, you're going to be a professional within your community that's looked up to. These were all givens.

Okay, so is it fair to say that it wasn't just an academic accomplishment, but it was almost, in some people's mind, the career tipping point, where everything else after that was going to be kind of downhill? Like, once I'm in now, I just need to kind of. I'm in the system. I just need to kind of follow the system, show up every day, and then success will naturally kind of flow my way.

Literally, this was that this is just the first domino. You just pushed over the first domino, which is the hardest part of the whole thing. Right. Every now, from now on, everything else just falls right into place. I personally, I mean, just. And it's not just. So that's kind of the mentality that you feel or that you sense before dental school. And then once you get in there, it's just reiterated over and over and over that if it was bad before you got in, it just gets worse.

And when you say bad, I mean, you got the other students, who are super excited that they got in a little bit, feeling like, hey, you know, my passport's been stamped and, you know, I'm in the best place. But since I didn't go through dental school, professors are also. I mean, are they giving any kind of reality checks of like, hey, this is just school guys. Like, real world's totally different?

No, no, that was not my experience. That was not my experience whatsoever. And quite frankly, the opposite was true for me personally. I remember one experience when I was in dental school as a little bit of an outlier. I was running my own business while I was in school. I was actually buying and selling cars. And as part of that, sometimes I miss class here and there. And one of the professors there really, really liked him myself. A lot of the folks thought he was pretty strict, but I liked him. He actually pulled me aside one day when he learned about the car business and me buying and selling cars. And he pulled me aside and said, chad, you've got to stop worrying about money. You're in dental school. As soon as you graduate, you won't have to worry about another thing for the rest of your life. I mean, that was literally. I mean, that's almost a direct quote. That was what my. And he was the head of the operative department, extremely well respected, well revered dentist in the community and at the school, even nationally. And that was the mentality. That was the mentality of these folks that were teaching us.

Do you think? I mean, I don't want to set it up like it's a big scam, because we know that we kind of know how the story ends, which. It gets harder, not easier. But do you think they really believe it? Do you think they have an ulterior motive? I mean, what is it about saying, hey, once you finish our schooling program, the rest of your life is easy, simple, and you'll have all the money you ever need. Indifference to your work ethic, indifference to your personality, indifference to your sales or influence capability, your leadership capability, which aren't getting addressed there. What do you think is their motive? Or did they come from a different time, or what is it?

Yeah, I thought a lot about that because my experience did not mirror what I was told, right. What I had been told, specifically, directly, indirectly. My experience has been the exact opposite of all that expectation. And I've wondered that, like, where did that all come from? Why was that? The mentality that was told was, were they intentionally trying to pull the wool over my eyes? Were they just ignorant? I mean, and I think it was a different time, and I think we still kind of have that hangover, quite frankly. But I think there was a long time when the dental industry was really in a league of its own. If you were to ask physicians or obstetricians or everybody else that was physicians in the medical field, there was a couple decades there where they said, go be a dentist, because they were getting hammered by a bunch of business innovations and things that were minimizing their importance. But dentistry was still very lucrative. Dentists could work fewer days a week, and they make great incomes. And I think that even the inadequacies that a lot of dentists had were getting covered up by just the lucrative nature of the industry.

And let's talk a little bit about that. I mean, you've really been in this industry. I'VE heard you say since you were 11, your dad was a lab tech. So you're around dentists and involved in that business really early on. And from what I've heard you say, dentists, as dentists were coming out of school, at least in Nevada, Texas, some of these other states, dentists would literally kind of give the new dentist patients and et cetera. Can you kind of explain? Yes, because we can't imagine that today.

Right, right. Well, so I grew up in southern Nevada, right outside of Vegas, in Henderson and that area. Southern Nevada was one of the most lucrative places to be a dentist in the nation. And a lot of it had to do with the dental board. And they would restrict the number of new dentists that they allowed into the state every year. It was only like 30 or 40. I mean, it was very, very limited. And they did that on purpose to limit supply. And so the dentists that actually got in just had an abundance of patients. And that was my experience growing up, working with all these dentists. And when I got out of school in 2005 and I moved back to Henderson, some of the laws had changed. They allowed reciprocity. There had been a massive flood of dentists that came into the southern Nevada. And so the whole environment was completely different from me than all these dentists that I had grown up around.

No one was handing you a big set of patients or anything? No.

So as I was struggling with my first practice, like with my head spinning, going, what the heck just happened? This is not the way it's supposed to go, I started seeking advice from all these different dentists who were great people. And I'd ask, when you started your practice, how did you get patients? And they said, oh, well, I just went around to all the dentists in the area and said, if you have people calling to schedule that you can't get to, can you refer them over to me? And they say, oh, yeah, no problem. And so then my response would be to them, well, oh, okay, well, I'm actually struggling. Can you do that? And they just kind of look at me and go, I'm sorry, I'm not as busy as I need to be. And so this whole environment had changed during those four years I was at dental school. And. And so the strategies that these particular dentists were telling me were completely non applicable.

What freaking whiplash for you? Cause, I mean, not only had you heard about it, you actually grew up around it, saw it with your own eyes. You get accepted to dental school, you have that moment experience, you've Got the professors telling you reinforcing what, what, frankly you saw with your own eyes. Right. And then you walk out of those doors and it's almost like someone removed that planet, replaced it with another planet. And you walked into, you know, what we would in the entrepreneur world call traditional capitalism, where instead of having limited supply and demand through regulatory components, you know, dentists were now doing normal supply and demand based on their capability to influence patients to say, hey, I am bringing this value. I'm doing these, you know, I'm opening like this, and I. And I can do these treatments or whatever it might be. But it was, man, you walked from one system into something totally different.

Yes. I mean, and to kind of even hammer that point home even further, when I got out of school in 2005, we really weren't that far removed from marketing being illegal. Okay. That prior, there was actually a time when you could not market, you could not advertise as a dentist.

Yeah. You hear stories of dentists who, the dental board or other competitors would come and measure the number of inches of their name on the door because it couldn't be more than 2 inches size and all of that stuff, right?

Yeah. What does that tell you about an industry that can literally pass rules and regulations that says nobody's allowed to advertise yet everybody still does?

Well, right, right.

That's remarkable. Yeah, that's remarkable. That's not playing by typical capitalism rules.

Yeah. That's limiting regulatory components for sure. Okay. So. So you've been given this extreme dose, both in life experience and then through schooling, of how the world's going to work for you. It has to create some level of. I don't know if entitlement is the right word, but you definitely, again, kind of feel like you got the golden ticket. And as far as the effort that you're gonna have to put in, maybe the longer hours, etc. That I would say is just typical even in the medical industry. Right. Like, you don't hear doctors go to school, and then they say, well, now that I'm working at the hospital, It's a great 9 to 5 job. Right. But you were given that kind of framework and that bubble, and then you walk out and you walk into the Las Vegas area in 2005 and walk right into the biggest recession we've had in a long time. And probably a state that was hammered, you know, similar to California and Arizona pretty heavily. So what was your real life experience once you walked through those doors?

What was my real life? It was the most painful experience I've ever had in my life. It was on a personal level, it was devastating to everything. I mean, quite my ego, to my, like my sense of self worth. It affected me. I mean, business wise, it was painful. You're accumulating debt. I remember actually calculating how much of my own dollars I was having to borrow every day to be able to do dentistry for other people. That was hard for me to the fact that. And I could not get that. I couldn't overcome that. After two and a half years, I still couldn't. I was still borrowing money from the bank just to keep doors open so I could do dentistry for other people. And that, yeah, that has an impact in every, you know, regard.

So I mean, financially, you've got your student loan debts and then you walk in and you bought a practice. Are you, how did that work? Are you working as an associate or what was your situation there?

All the above. I started my own practice utilizing leasing space from another dentist who had some extra chairs and operatories. And when that wasn't going well, then I started looking for associate ships to fill in some. So I'd open two or three days a week, do associate ships two or three other days a week. And then when that associateship wasn't as busy as it needed to be, then I take on another one. And I really was just doing everything in the world that I could think of to stay busy and generate revenue and just trying to get patients in the door or see somebody else's patients so I could have a paycheck.

It's interesting too, because when you mentioned the psychological component, you know, I work a lot with deaf people and deaf children oftentimes don't know the reality that they're deaf. And when they see their parents, especially hearing adults who can go and answer the door and there's somebody there and then they go to answer the door and there's nobody there, they don't realize or a fork drops off of the table and people know to go pick it up. Like, how did they know it dropped off? They don't connect the fact that, well, they live in a different world than what this deaf child is dealing with in some ways. And so what happens is the deaf child doesn't think, oh, I'm deaf. It takes them a long time actually to process that. They actually think they're stupid first, which is just interesting. That's a totally different discussion. But the psychological impact on you to say, oh, this is the world, and then walk out and have it be totally different. It would Take a while to process that that's not actually the real world. Instead, believe. Well, I just must be terrible. I mean, is that kind of what.

Oh, yeah, that's a great. Yeah, that's a great explanation. And that's exactly what I felt because I was in an industry where no one failed. I'd already gotten the lottery ticket. I mean, who messes up after you get the lottery ticket, right? And so my experience was in complete contrast to everything that I thought I knew, everything I believe, believed, everything that I had heard or been told. And so it had to be me. It had to be something I was doing wrong. And, yes, that's exactly how I perceived it, and that's how I internalized it. And that was tough. That was really hard.

Yeah, yeah. Just hammering on, I mean, your clinical capability, your interaction with patients.

Can I.

Can I think a piece?

Just talking about it? I feel like you just peeled back a scab and you're, like, scratching it right now. Some stuff is so raw, it almost like it never goes away. But, yeah, that was the experience. And it's tough. It is brutal.

It's brutal. Well, and I think. And I appreciate you sharing because I think one of the things we want out of this podcast is, is if there's others that one are in dental school right now kind of getting that rhetoric. It's a little bit buyer beware here. Right? But the other part is we're not trying to be so much doom and gloom as if, you know, reality, you can get ahead of it so much faster.

Right?

Like the cycle of worrying that it's you and instead saying, okay, if this is the real game out there, if this is the reality of the challenges, what's the protection and support I need to get around myself as quickly as possible is a totally different approach than just like floundering out in the middle of the ocean by yourself.

Oh, yeah, absolutely. And by no means would I want to paint the picture that this is a duty doom and gloom industry without opportunity has tremendous opportunity, and you and I get to live it every day, and we love it, and we get to see our associates and our other doctors living it and enjoying it and benefiting from it. So by no means is this a doom and gloom message. Right. There is tremendous opportunity. What the message is is that the fantasies that you have in dental school, the fantasies of a dental student, don't align with the reality of the world that we actually live in.

Yeah, well, let's. Let's do a couple of those frameworks because we hear Them often. So I'll let you start off. But what are the typical things you hear from a second year or third year student around? If you said to them, tell me about your timeline once you graduate. You've heard it so many times. What's the timeline once I graduate, what's going to happen? So.

And yeah, I've interviewed many as more dentists, more dental students than I can count. I've had associates that I heard. I mean, this is. And I gotta be honest, I was one of them. Right. This is, this is not like I'm not making fun of anybody because I have to be making fun of myself, but it's the same story every time. Yeah. Within one to two years, I plan to have my office up and running. Year number two, I'm going to hire an associate, I'm going to open my second office, and then I'm going to get that one kind of rolling. Year number three, I'm going to open offices four and five, and within five years, I plan to have 10 to 15 offices, all of them up and running. You know, rock and enrollment. And it's as simple as that.

I mean, there's almost like someone gives them the script because you hear that so consistently.

You know what I would you dollars to donuts that there's a lot of dentists, as they listen to this, will be laughing at this point because they have said that themselves. They've heard their classmates or colleagues say it. It's the same thing over and over.

Yes. We might have to start a Facebook support group. Things I was lied to about. And now I'm dealing with the realities. I think we heard one, it was a little more dramatic. I've heard some variations. We heard one the other day where they said they're moving to a new state. And then I think the third year they're gonna start opening 10 a year. Was that right?

Yeah.

So there's definitely some variations on this. I've had ones where, hey, I'll have 60 within the next five years, you know, so some people think bigger.

Yeah, no, and I hope I'm not. Nobody takes this the wrong way. I'm certainly not making again. I've been there, I've lived. I. I've been in that mindset. And when these doctors and dental students or young dentists are like communicating, they're saying it like they believe it. It's part of their. It's coming from a place of complete sincerity. And they believe that. And I'm not gonna. Maybe somebody did it somewhere, but that's what I always hear from dentists as well is that they know about somebody who did something like this. I'm still trying to track that person down and I would love to meet them because you and I know that oftentimes we'll hear those stories and then we will track down supposedly the source or whoever this was and maybe we'll do an assessment or an evaluation or maybe for an acquisition. And when we start peeling back the layers, we find that the story is nowhere near what this legend has become. They're usually dealing with far more business complexity. They've usually, if they've managed to open multiple practices, they usually have one or two that are performing decent, that's supplementing the other three or four or five just to keep them open. And they're trying to figure out how to get the performance going. And they're getting pulled in every direction. And oftentimes those are the ones that these young students are pointing at saying, oh, look, so and so did this or that. And it's usually not quite what it seems on the surface, you know, and

this isn't unique to the dental industry. I've been in lots of different industries. We all love to look at the, you know, 25 year overnight successes. They hit the front page of Success magazine or whatever it might be. You know, it looks like a young CEO or whatever. But the reality is there, there is always a bigger story and a lot more heartache and pain and almost losing everything along the way. And frankly, 9 out of 10, 99 out of 100 did lose it along the way. And then you get, of course there's a reason this person made it in the magazine is because they actually made it. But a little bit of luck, a lot harder work than they let on to. So that's probably true in any industry. We're just not immune to it in dentistry. All right, so now I've walked out that door and reality's hitting me. You know, one thing as I was talking to this was a pediatric dentist. So I want to talk a little bit on the specialty side because I think even more painful in some ways for them, because not only did you get into dental school, but now you got into specialty and academically, you really did have to be at this other echelon. And even there they're saying, well, now you really don't have to worry about the capitalistic parts of a business. What you need to worry about is utilizing this type of supply material, etc. Make sure you're using this equipment, whatever it might be. But as I was talking recently, it was a pediatric dentist. And I said, you know, you've been in school now for a lot of your life. What do you think are the most important things once you step out? And he started talking through procedural components to. And clinical components which are absolutely necessary to understand and know. And I said, one of the. And he was asking for advice. He was going to buy a practice. He was trying to judge between them. I was happy to just support him. Nothing really in it for me or us in any way. And I said, I think the biggest surprise that you're going to have is that so much of your education, schooling and debt that you've accumulated is going to represent about 5 to 10% of the activity you'll be doing once you walk out those doors. And I said, especially if you're going to walk in and you're going to buy a practice, when you get into the HR conversations you're going to need to be having when you get into the IT because your computer doesn't magically work for some reason. When you get into all the vendors you're communicating with, oh, yeah, I need to know how to get patients in this store and compliance and so forth and so on. It's going to consume so much of your conversation. Oh, and this practice manager, how do I lead and inspire them? And this X ray tech who's not naturally creating, you know, taking great X rays, how do I train them? And what should I be expecting from this assistant sitting next to me, Right? And how do I get them up to the right level? I said, it's gonna just be so weird because you're gonna think to yourself, what the heck was schooling for? Because it's not a large portion of what I'm dealing with now.

Yeah, yeah, No, I think I've shared this with you before, but there was this point that I came to and I. I can't recall exactly when it happened, but I had this realization. Everything that I was doing that I was doing in dental school that was around oral health and restorations and all the things that I was learning about in dental school for that same amount of time and at that same level of intensity, somebody else was learning about business, and somebody else was learning about marketing, and somebody else was learning about human resources, and somebody else was learning about on and on and on, Right? And so this idea that somehow by learning about teeth and the oral cavity somehow made me an expert in all these other areas. I mean, I don't know where that comes from. I don't know why that is, but there's something about going to dental school where we actually get out of there thinking, or maybe you don't have appreciation for it, but we get out thinking that we now are experts in all of these other things because we learned about teeth.

And.

And I came to this realization, this personal realization that these other people that had learned so much and had spent so much time. I mean, you, for example, I mean, you've told me before and I don't know how many books on business that you've read, like an encyclopedia of business. I could never scratch the surface around entrepreneurship and business that, you know, but at the same time, you couldn't touch, even scratch the surface on what I know about dentistry. Right. And so to partner with people like that and to be able to open your mind and realize, I need a team, I need help, and we need to know all of these things. We need experts in all of these things. I can't be the expert in all of it. That's when you're going to start to actually enjoy some of the success.

Interesting. So the first real gateway to kind of break out of this. This bubble and to get out of the, I don't know, the spiral, you know, emotional spin that could happen when you walk out is really just a humility factor. And, you know, as you were talking, I thought I kind of get why it could happen. Because, you know, if you look out in the world, you say, well, there's a lot of marketing people and there's a lot of different business, and there's even a lot of these accounting IT guys and so forth. And so that must be easier to learn maybe, you know, because there's a lot of them. And clinical, you know, is a complicated field. And so is it the hardest one to learn. And so maybe it marketing, hr, maybe it's easier, you know, maybe. Maybe those are simpler. So if I've. If I've already mastered quantum physics, you know, so to speak, then coming over here and learning something about colors isn't really that hard or something. But sadly, it doesn't quite stack that way. Right. It's a totally different industry. It's a totally different field of education and different capabilities altogether. You can know a lot about how to take great X rays. Knowing how to communicate that to somebody is like its own world, right? It's its own skill set and capability and to have it stick. And for them to do that on a consistent basis or to create a system and process. So anyway, I guess on one side, I could see how that mindset or that trap could be fallen into on the other side. Obviously, it's not really logical.

Yeah, no. And so, yeah, you said, like, kind of first step. And I think the first step is gaining an appreciation for all these things that we are not learning about that we don't know, and then give them the value that they deserve. Don't discount it, don't discredit. I mean, that's what I hear all the time is, oh, it's super simple. I'll just figure that one out. And I think that speaks to what you were just saying for some reason, because we went through dental school, somehow we think, oh, we'll just be able to figure marketing out. That'll be a piece of cake.

It would also be tough, if you're sitting in dental school, to think learning 5 to 10% of what I'm gonna. I'm accumulating a lot of debt for that 5 or 10%. So I think there is some mindset there and some reality of it's an important 5 to 10%. I haven't figured out how to open dental practices without trained dentists that are licensed, etc. So that they're critical to the process. But that would be a pretty big job. And maybe there'd be a little uprising in dental school, too, to say, hey, if I'm putting half a million into this thing, I need you to teach me a little bit beyond the clinical components, because I'm walking into something that's a lot more complex.

Yeah, no, I think everyone would be well served if that was. If there actually was a focus in dental school outside of. I'd be a little bit scared about who they get to come teach those classes. But let me tell you where you actually did win the lottery ticket by going to dental school, getting in. And where I actually think that massive tuition and that massive student loan debt actually is worth it is because you just gained access to this industry at a level and in a way that nobody else can. For me, that has been just incredibly beneficial. It's been a tremendous blessing for me to have gained access to this industry at the level and in a way that I. That I have access to it because there are laws, and I actually think those laws should be in place around who can actually do dentistry, around who can actually participate in dental offices, you know, at certain levels and do certain things. And so by just gaining access to this industry, they're actually. That's a huge win. It really is.

You hold the keys to the doorway.

You do.

Right. And then you get to decide who gets to come in.

That's true.

Or who doesn't.

Right?

Yeah. And so it's using those keys wisely and building. I think the end of the story is building a team around you to maximize the opportunity that you got access to.

Yes. Yes.

Yeah. Okay. So now I'm out of dental school, and I'm facing these realities. Like, how did that experience change how you see patients and how you see the marketplace in general? Because after that experience, you went and worked as an associate, Right, Full time?

Yes. Yeah.

And did you. I mean, what was the employee mindset you had? Or did you keep your owner mindset? Or how did you go into that associateship?

So, you know, it's. It's. Yeah. So I've always had an entrepreneurial streak. I mean, like I just said, I was running my own used car sales business while in dental school. So I've always had this entrepreneurial drive, and that's always been important to me. And when I opened my own dental practice and I had it for two and a half years, and it was just excruciating pain day after day after day, I finally threw my hands up and I said, I'm out. Okay. I'm not cut out for this. I thought I was. I mean, it really kind of took the fight out of me, and I said, I'm just gonna go be an associate. That mindset lasted for maybe six weeks, and then. But that was just something that was so internal to me. And as I went to work as an associate, and I went to work somewhere that actually had business practices and had teams and had systems and processes, and I actually got to see business acumen applied to a dental business that started some light bulbs for me. And I think it was probably you that had maybe recommended some books to me that I, you know, I wasn't gonna. I always had this arrogance around, oh, I'm a dentist now. I'm gonna be successful. And so I actually started reading some books, and I started actually reading some of the stuff that you had recommended around entrepreneurial development and business development and systemizing and processes. And that's when I started to get the right mindset around this dental business. Not just, oh, I got a dental degree, so I'm going to be successful. But, okay, so I'm a dentist in a dental industry, but this is what it's going to take to be successful. So. So I moved back into that kind of that business owner, entrepreneur mindset pretty quick.

Yeah, the glasses went back on. So to speak. And instead of just seeing the clinical piece, you started to see, it was almost like someone ripped it off and goes, oh, all of this stuff is behind the curtain of successful practices.

Right? Yeah.

And then from a patient perspective, had your mindset around patience? I mean, what was your mindset around patience?

Well, we could talk specifically about patience, and I think that's probably good to talk about, but it was much broader and bigger than that. My mindset went from this idea that I've already done the hardest part. Right. That was my mindset, okay, I've got my dental degree. I did the hardest part, Success, here I come. Like, it was waiting for me. And then my mindset changed to, okay, the keys and the process to success in dentistry are the same as everywhere else, and there are no shortcuts. And so if I'm going to be successful in dentistry, I'm going to have to do the things that it takes to be successful, period. And then that's what started changing the way I looked at patients and how I interacted with patients and how I took care of my staff and all of those things. So I had to get that mindset first.

So it was almost like it didn't matter if I was going to go do a tech startup or a dental startup. I needed to go into this with an entrepreneur mindset that there is an effort that I'm going to need to put into this. That's way different than what I've been sold up to that point.

Absolutely, yes.

And like any other person you know, I see in a lot of entrepreneur blogs, they always have these sayings of, I'm going to work the next 10 years like no one else, so that I can work the next 10 years after that like no one else. Right. Like that. That first 10 years, there's just an effort that has to go into it because you are going up this hill. That's extreme. It's extreme. Like, you're still learning a bunch of clinical stuff, but now you've got a whole other set of education that you got to start consuming as well. And you're in an environment that is competitive, and customers are making choices on value offerings. And whether you like it or not, they're not super excited about the fact that you know how to do fillings. They're not like, you know, walking in and go, wait, you know how to do fillings? Oh, my goodness. I've been looking for you my. My whole life. In fact, every clinical procedure, you know, probably isn't what excites them. It's probably some layer of value offering you're able to put within that.

No. And quite frankly, it's the opposite because they get disappointed when there's a particular procedure that you can't do. So it's not even that there's an expectation that I have a dental problem and you are going to fix it. And when you say, oh, well, I don't do that particular type of root canal, I can't do that kind of, that's. They actually get disappointed and upset. So, so the customer actually has this fundamental expectation that anything dental related that you're going to be able to figure out, figure that out and do it for them.

There's some interesting statistics and now big studies around this, but as dentists aren't able to do certain procedures, it's funny, but patients will actually tell their friends, oh, they can't service you there, right? Not that the patient knows anything about the clinical needs of their friend, but because that dentist couldn't do some procedure and heaven knows what it could have been, right. But that they say, okay, well, if you can't do that procedure, then you must not be able to do X, Y and Z. Which is. That's daunting.

Yeah, no, it's a lot of pressure. But again, if you're dealing with marketing issues and HR issues and making sure these two people are getting trained properly and these folks over here getting along and payrolls getting submitted and you're dealing with all this other, how in the world are you going to develop those clinical skills that the patient actually expects you to have? So, I mean, that's where getting the right support, having an appreciation for all those other things and then getting the right support so that you can actually now focus on the thing that your patient expects you to be able to do is just absolutely critical.

So, I mean, bringing it back to the patient. Tell me about how you think about patients today. I mean, what, what's your mindset? Has it changed? I mean, it sounds like you started off with kind of the world centered around you. And I know enough now that the world centers around patients for you. So what changed that or how, you know, explain it. Explain how you think about it now?

Yeah, so first thing I do, I don't even call them. I don't call them patients. I mean, in some settings I do, but I call them customers because patient makes it feel like they're my patient, like they belong to me and they're not. They're customers and they go where they find the most value. And that's Kind of the first thing, I don't even like to have that mindset of them being a patient of record. I think that's the silliest idea because these are customers that are going to go where the value is and they're going to change from me as easy as going to Target instead of Walmart. And so that's how I view them. And so when they come in and they sit in my chair, they really do get my, they get my empathy, they get my concentration, they get my focus, they get my intellect. I do actually like to engage them on a human personal level and figure out, I mean, the first thing I ask them is, what brings you in today? I want them to set the terms for our relationship. I want them to let me know what they came to me for because I want to satisfy their needs. I see so often dentists dictate to their patients. I mean they, they'll get after them for their brushing or hygiene habits. They will start telling them what they need to be doing and they'll start setting the. I just, I don't believe any in any of that. I am, I'm trying to think of

an example of that in another retail environment. Like you walk into Target, you know, and you pick out some clothing and they're like, really? Are you sure you want that clothing? Yeah, you know, yeah.

And who picked those clothes out for you today?

Yeah, that's right. Yeah. I don't know if you want to buy those when you're wearing those kind of clothes. Yeah. So starting off, I mean, that's a pretty low standard, but it is, it's a challenge in this industry is don't demean the person that's sitting in the chair. But you know, I think docs sometimes think they're educated.

They do. And yeah, you just don't demean them. Bet most of dentists that I'm actually thinking of where I've watched this happen don't realize that they are, they think they're being helpful. They think they're actually providing some value to the patient and instead they're like crushing a human spirit. It's so, so I, that's how, so that's how I look at them. That's, that's how I think about and I perceive these customers that are coming to see me. How am I going to bring value to this person?

I'm probably pretty self aware too. I mean, I know for myself and most people I talk to, walking into the dentist has a lot of shame built in. They know they haven't been in in a while. They really don't want to hear the whole preaching. What have you been doing? You know, So, I mean, just you having the mindset that knowing that walking in probably changes a lot.

Oh, it is. And even the subtleties, right? Like, we see a lot of pediatrics, a lot of pediatric patients. And so I have to train our dentist not to do this, but I'll be watching, and there'll be a child, maybe 6 years old, sitting in the chair and mom sitting off to the side. And the doctor says, so, are you brushing your teeth? How many times a day are you brushing? And the mom immediately answers for the child, oh, they're brushing two times a day. Two times a day. Like, they just. They feel so much guilt and shame. And the doctor's just trying to get information. Right? The doctor's just trying to find out what's the kind of the hygiene level and status of this patient and what are their habits. So I get it. I know what the dentist is doing. That's what they teach us in dental school.

But the mom buttons you're pushing on are so big, you might as well just be running them out of the.

Yeah, just escort them out the door and bid them farewell. Because that is. I mean, those are just subtleties that nobody even realizes that they're doing. But they have such an impact.

Okay, this is a hot topic. You know, we talk about dentists being entitled, but I know that patients. Sometimes the dentists feel like the patient's entitled. How do you feel about patients who come in late or they want dental practices to be open late? You know, have you ever had a moment where you're getting ready to leave and then a patient comes in and, you know, what's your take on that?

Yeah. No. And I think. I bet Apple thinks all of their iPhone users are entitled as well. And I'm sure that, you know, Ford Motor Company thinks that their customers, you know, because our customers have an expectation, doesn't make them entitled. It makes them customers. And customers are going to come in the door with certain expectations, and if it's unreasonable, it's unreasonable. But the question becomes, is it reasonable or not?

For me, how far are you willing to go to do the Ritz Carlton, hey, do whatever you need to for this person? I mean. Yeah, it's kind of up to you to decide how broad you want to go.

Right. And as you. I mean, to kind of play off of that. Different businesses have different levels of customer service that they're going to offer different levels of accommodation that they're going to make, right? And so you have to develop a business model that's going to match with what you want to offer the world and what kind of value you want to bring. But if you want to do a budget, you know, minimal investment, minimal value offering, don't be upset when that's what you get in return, right? And so for me personally, I like taking care of people. I like taking care of patients. I like seeing how far I can go. If it is on the edge of my skill set, if it's on the edge, on the edge of what I can do, I let them know. I let them know. I say, hey, this is about as far as I can go. And I wish I could go further for you, but this is the best that I can offer. And so I'm realistic with them, but I'm willing to stretch myself. I'm willing to constantly stretch myself and do it for them.

Are you surprised at how attached patients are to you and to wanting you to do procedures versus being referred out to somebody else?

Well, so, absolutely. And yeah, absolutely. Patients know if you're actually stretching yourself for them, they know it. I mean, when you get out of school, you're gonna be limited on what you actually can do. But patients know if you are really, really genuinely concerned about them, are doing your best to satisfy what they need, they'll know it. And if you are hitting a limitation, they'll be fine with it as long as they know there are certain things that anybody can do, right, that are outside this technical world. There are certain things like how late you're willing to stay for them if they come in midday and they got a toothache and you're willing to do anything it takes to work them back in to get them out of pain. Anybody can do that, right? So there are certain things that, regardless of your skill set or how many years you've been out of school or what you technically can and can't do, that patients can absolutely feel from you. That being said, as far as what are patients willing to tolerate as far as you stretching yourself? It never ceases to amaze me how far patients want you to go for them and how far they're willing to let you go. They don't want to be referred out. And I know the specialists listening to this probably don't want to hear that, and I'm sorry it's the case, but they don't. They just don't. They don't like the run around, they don't like the referral they don't like going here, they don't like going there. I share this with my young doctors, and this is. This is true. I can't tell you how many times I've done this. Maybe it's dozens of times at this point where I've been stretched like I'm working with a patient and there's something going on that I just. It's nothing. I've. It's something I've never done before. It's outside. I've seen so many tens of thousands of patients at this point, and I will literally look at these patients in the eye and I will tell them I have never done this before. This is what you need done. Here's a list of specialists. They're experts at this. They've done it many, many, many times. And I know they can do a great job for you. But if you want and if you're willing, I will go in my office, I will turn on YouTube, and I will watch a tutorial video on what procedure you actually need at this moment, and I'll come back and do it for you to the best of my ability. And I have never been turned down.

Wow.

Every single time it's happened probably a couple dozen times at this point, I've had the level of procedure and trust that these patients will put in me. It just blows my mind. But I've done that. I've done it. And you know what? Most of them, almost every one, has turned out pretty well. I've been actually pretty pleased with how they've turned out. There've been a couple times when it just ended up being a hopeless situation. We had to pull the tooth or something like that. But for the most part, it goes pretty well.

Yeah. So, I mean, what I'm hearing is know your skill set, but then be willing to stretch. Right. And be willing to learn and get educated. Take ce. The patients want it. They want you to have as broad a capability as you want, and you hit on something else, which is availability. Yeah, Right. So capability is one thing, and then availability, you know, what kind of availability are you willing to stretch yourself for?

Personally? Yeah, I'm pretty extreme. I'm pretty extreme. And, you know, even at this point in my career, if I'm in a dental office and I'm covering for a doctor, nobody walks out of my dental office in pain. That's like. That is fundamentally nobody. If I have the ability to alleviate pain and discomfort, I absolutely do it. Even that being said, if I can make somebody's day a little bit Nicer, a little bit better, a little bit more convenient. I do it. I absolutely do it. I've been known to stay in the dental office until, I think my record's probably about midnight. I've stayed till probably midnight just working on people because they didn't want to have to come back another day. And I was. I was willing to do that for them.

What about patients who come in just as you're closing the doors?

I stay. I mean, short answer, I stay. And if they actually have pain and discomfort, I will reopen the office, we'll fire things back up and we will take care of them. If, And I will tell you this, it happens without fail, every single Friday evening at 5:30, whatever time you're closing that day, somebody will come in as you are. You know, you've got everything cleaned up, you've got all the instruments and the sterile, you've got all the chairs lifted and all the floors mopped, and somebody will always come in Friday evening as you're trying to walk out the door.

Do you think that's tough? I mean, I would think it is for somebody who, who. They were supposed to have their ticket punched once they came out of dental school and now they're pandering to the needs of these patients.

Well, it's. I mean, there are those that look at it that way, they really are. But I would actually just challenge all of these dentists coming out of dental school to actually live up to, to the admissions letter that we all wrote, because, you know, we all write the same letter, right? We all go into.

Tell me about this.

Well, on the application, there's a part to write your little letter. And every single person going to dental school talks about how they want to help people. They want to, you know, alleviate pain and discomfort and serve people and give them good smiles and all those things. I would just say, let's live up to. Up to that mantra, because I know everybody that's listening to this wrote that same letter. And the reality is, if you actually want to be successful in this, and I wish it were the other story, I wish I could tell you, yes, you already won the lottery. Yes, all of that was true. It was amazing. I got out of school and success was waiting for me. There's a red carpet right there. I just walked down it and I got everything I ever hoped for and everybody. And that's just not true. The reality is there is a certain process and a certain amount of sacrifice that has to be followed if you want success. And there just aren't shortcuts. There's ways to make the path more predictable. There's ways to make the path more efficient. But there is a ton of work between here and success, and that also depends on what is success for you. So when you say pandering to these patients, you can have that mentality, and there's going to be a certain career attached to that mentality. There's going to be a certain level of success attached to that mentality. And if that's what you're okay with, then fine. But most the dentists I talk to have a totally different expectation. They have a completely different expectation for what they consider success to be, and it just requires this formula.

Yeah, okay. I know we've gone long. I really appreciate your time. I'm going to hit on just one more topic because this has been so good, because you've talked about capability, and I think it's really clear that when you come out of dental school, the reality is use that to leverage into more and more and more capability. Right? Like what I heard is the capability learning just started. And even for you today, the patients are saying, do you mind learning a little bit more capability? It's an unending hunger for customer service to continue to enhance your skills. The next thing I heard was availability. The more willing you are to be available, the greater your chances of success. And the formula goes up from there. This last one I want to hit on is maybe staff expectations, because a place that I see a lot of dentists struggle, and I don't know, there's a shortcut for this, either is they're not sure how to interact or what to expect from staff. And can you kind of talk through that? Because that seems like its own education that has to happen as well.

It is, and it's extremely challenging. That one took me years. And I'm still, you know, figuring that I'm still still figuring all this out. Right. But that one is really tough, because anytime that you're going to provide criticism, critique, expectation of other people, that's just a hard thing to communicate. And that is a hard thing to successfully do without creating hard feelings, creating embarrassment, creating just a negative response from this other person that you're trying to get, you need them to act a certain way or do a certain thing or perform a certain way. And how do you get them to do that and do it in a way that you're still lifting their spirit, you're making them better. And really, the most fundamental place that you have to start is actually caring about that other Person, Right. I care about this person. I don't care that they get better so much that it makes my life easier. I want them to get better because I like them as a person and I want them to get better for themselves. And I have a way and I know some things that can actually get them there. And so as you're developing these people, I'm going to, I would start with, so for what purpose? Like, is this all self serving? Is this completely because you want your day to be better? Or is this because you actually care about that person that you're trying to elevate and make better? I know that's, that's probably not what anybody wants to hear because it's, there's not a formula to that. Right, right.

But that's what leadership is. I mean, the reason that category is so different difficult is because instead of being a technical skill or even just a willingness mindset that's just enveloped in you. Right. I mean, capability, there's a lot you can just personally get on and it's a ton of work, but it's like you going to the gym type work. Right. And availability is a mindset for you to change, to interact with patients at a different level, but to really influence and train another human being to inspire them. Now we're getting into the age old questions around leadership and how does leadership really happen? Right. And you and I both have like mutual books that we love around this. Leadership and self deception is incredible. Crucial conversations is incredible. And we've loved extreme ownership recently. Right. But I think those are foundational for listeners. Start off with leadership and self deception, go to crucial conversations and then extreme ownership. But all of this, I think those three categories ten times harder if you're trying to do it all by yourself while you're doing payroll that night.

Right. But what's really interesting to me, and I haven't been in a whole lot of other industries, so I don't know how it goes down in other places. But what always strikes me is how frustrated dentists get with this. Well, I told them, like I told them to do this thing and they didn't do it. So, like, what's the problem? Like, like somehow in dentistry we're not supposed to have hr. Stuff is not supposed to exist. Right? Because you said it suddenly that person should be able to do it. And if it doesn't happen now, you're entitled to get upset and throw something across a room. I mean, there's so many stories about dentists kicking their assistant under the chair, dropping or throwing an instrument because they got upset. I wish that weren't the case, but it's true. And this idea, again, going back to this idea that once you get out of dental school, everything's just supposed to fall into place. This particular area doesn't escape that fantasy. There's just this belief that everybody in the dental office that's there to support you automatically knows how to support you and does a great job doing it, and that's just not true. So you actually, you have to learn how to develop the path, people around you, how to communicate what you actually need them to do, and what's the right process for that? What's the right training cadence and protocol for doing these different procedures and these different things that you need help with or scheduling patients or dismissing patients and making sure they get rescheduled and that the dental claims get processed and all these different. Just different things around training and personnel development.

What's so hard, Chad, is the day you walk out of dental school, you don't even know for yourself what needs to be on that tray, you know, and yet you're supposed to set the expectation for everybody else but you. I mean, it's blind leading the blind, right? I mean, the only way I know how to get around blind leading the blind is just total and complete transparency and humility.

Right? Well, number one, recognizing and acknowledging you're blind and then having an appreciation for the fact that there's somebody else that isn't blind in that area.

Yeah, that's true. That's true.

But I always. I don't know, stuff never ceases to surprise me. Right. But I still get surprised at the level of expectation that so many dentists have around what their staff should know how to do or should just be able to do without them having to provide the proper leadership, guidance and training to get those. Those folks to that level. It's just supposed to be there because they want it to be. I guess. I don't. I don't know. But that's.

I think the argument is they just don't have any bandwidth themselves. Right. They're, like, so overwhelmed that the bandwidth, the thought that there's five other people, 10, 12 other people in that office that need more from them is probably quite overwhelming, especially if they're trying to do all the other components. What's the. I mean, if I think we're somewhat hitting on it, but to kind of close this out, what's the benefit then of coming into a good DSO environment? What do you get? And then what do you not avoid.

Okay.

Because what we don't want to walk into is from one entitlement into the next. Right? Okay, well, maybe if dental school didn't get me there, then maybe the DSO gets me everything without having to do any effort as well. So what am I getting out of a DSO environment? And again, I'm going to qualify it as dso, as I think of it, Supportive Clinical leads, Not dictating all of that stuff. Stuff. But what's the main benefit you've seen?

So the main benefit that I've seen is when you don't have the dso, when you don't have that support, all of your energy and time is being expended on a bunch of things that you're never going to be really good at or probably not get very, very good at. And honestly, a lot of things you probably don't even care about or you don't. You wouldn't be getting even doing them unless you absolutely had to. And so as the DSO takes that off your plate, it really allows you to focus on the things that allow you to really bring value, to bring value to your patients, to bring value to your dental team, to bring value to your practice. And so as the DSO takes all that other stuff, all that noise, you still have to spend the energy. Like, it's not like, oh, the DSO took all that away. I get to go sit on a beach in Hawaii. No, the DSO took that all out of the way. So now you get to actually focus that time, energy and attention. You just get to redirect it onto the areas that it should be focused on anyways, for me as the clinician, that patient engagement, my staff development,

capability, availability. Right. And then staff development.

Absolutely. So now. So now I'm free to put that time and energy where it needs to, to where I do see dentists falling short.

Still,

is that idea that success is just supposed to come, that it's waiting for them, like, it's this amazing thing that they just have to walk down the road and get. There's a lot of work. And again, it also depends on your level of success. There's a tremendous amount of work and sacrifice that's going to go in achieving the success you want to achieve. And this is also hard for people to hear, but it's not just you, it's your spouse, it's your children. And again, it's all relative to what you want to achieve. But I just always encourage people, make sure your expectation or what you want to accomplish is in line with what you're willing to sacrifice and work for. If you have this idea that you're just going to achieve tremendous amounts of success financially, professionally, in every regard, but only be at the office 15, 20 hours a week, it's just not going to happen.

It's a good point, too, that I hadn't thought of, is you weren't the only one getting fed that information. Your spouse, your significant other, and they made tremendous sacrifice while you were in dental school. And, you know, if you're like us, probably having kids along the way and everything else, and so they're kind of hoping they're done too, Right?

Yeah.

And so there is. There is some realignment to say, hey, the sacrifice isn't over. Right, Right. There is still a lot of work to be done, and we're gonna need to figure out how to make all this happen. Yeah.

That's probably a whole other episode, interacting with it. But you're right. My wife and I had three kids in dental school, and I have seven kids now. So they've all paid the price, and they didn't choose it. You know, my wife and I chose it, and then the kids just kind of have to live with it. But this is something the whole family, you know, is a part of. But again, it all boils down to what you want to accomplish.

And frankly, for everyone else who's in health care, they kind of know it going in. I don't know why, but the facade of every other healthcare professional is not, you get through medical school and then the sacrifice is over. I mean, ask any cardiologist or emergency room doc. They didn't say, hey, the easiest part, you know, was after I got out of. Out of school. So I do think having the right expectations and mindset sets you up for the right success.

It does. I recently saw this meme with everybody graduating these, you know, here recently, all high school grads. And the meme said something like, congratulations, you just finished the easiest part of your life. And unfortunately, I think that we need a meme for the dental school experience. Congratulations. You just completed the easiest part of your career, and that would be dental school, so.

Well, Chad, you've been really generous with your time. I appreciate you being vulnerable, too, and sharing your personal story. I mean, there's. There's nothing quite like hearing the realities from somebody who's been there, done that. And I know that there's listeners who, you know, they've been through those same experiences, or they're in the thick of it right now. And hopefully a podcast like this gives them the tools to realize that maybe the issue really isn't them, and maybe this is just challenging and this is hard, and there's a certain mindset that they're going to have to adopt and there are certain resources that they are going to need to surround themselves with. And, you know, no one expects them to be Superman, but it is going to be a lot of hard work, you know, in front of them to get there. But you'd say it's all worth it after all that?

I would. And I would say if you and I can do it, anybody can do it.

That's right. That's right. Well, guys, it's been awesome to be able to walk through this. So if you have any further questions for Dr. Evans, here he is over on our Facebook site at DSO Secrets. And until next time, keep smiling. Thank you for listening to DSO Secrets. Join our community on Facebook at DSO Secrets and get answers and resources to some of your most challenging questions. If you want to get a copy of the seven secrets of any DSO, go to our website at dsosecrets.com and we will get that emailed to you. Remember, don't go at this alone. Let us be your team while you build your team.