82: Focus on Value Creation Not Multiples with CFO Jake Lewis

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 rad out of school, I never imagined I could own these many practices with this amount of support. So thank you.

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You have this natural talent, this unique ability. Happy day to you and welcome to another episode of DSO Secrets. I am Ken Kaufman, your host today, filling in for the illustrious Emmett Scott. I'm excited to introduce today's guest. His name is Jake Lewis. Accounting degree from byu, MBA from Carnegie Mellon. He was the CFO of a DSO in the Pacific Northwest. Many of you have probably heard of them Smiles Dental they sold a few years ago and he moved on to scaling a long term care pharmacy organization that grew to 130 million in sales that was shortly thereafter sold to CVS. Now, besides other projects that Jake's working on, he's dedicated part of his time to to being a part time or fractional CFO helping emerging DSOs to grow to the next level of sophistication from just having a bookkeeper who's leading the accounting and finance functions. Currently he is living in the state of Washington. Jake, thank you for joining me on today's show.

Thanks Ken. It's great to be with you.

Yeah, I'm actually really excited for this interview and I know there are quite a few people who will be interested amongst the DSO Secrets podcast listeners. So Jake, can you start out by telling us what is it that led you into this amazing and sometimes crazy and sometimes complex industry of the DSO industry and why is it that you just haven't been able to get away from it? It seems like you even tried when you went into the pharmacy side, but then you found yourself back here.

It's interesting, Ken. Originally I had a friend in grad school that kept coming up with all these different business ideas and kept he would call me up and say, hey, we should go do this or we should. And multiple times he'd reached out to me. At one point he reached out and said, hey, I have a friend who's a dentist. We should really look at forming a company and really growing a dental practice. And initially I kind of laughed at him and I thought, you know, this is another crazy idea. This, you know, my dentist was. I grew up with the dentist. I knew who he was. He just had one practice. That's what the industry was. And he had enough enthusiasm that I said, well, let me look at it. Let me. Let's look at it. So we talked to his friend who was a dentist who was interested at acquiring multiple practices, had at that point a partnership that had seven practices, and they were looking at continuing to scale. And all of a sudden it started. The light bulb went on for me, and I thought, you know, this is a business that has historically been exactly what I thought it was. But there's so much opportunity to apply business acumen that could improve the way that dentists are able to operate their business. And from that point on, it kind of just gets in your blood a little bit. And it's a little crazy how as an industry, you look at and you think this is, you know, it is. It may be the industry that made me lose my hair, I don't know. But it's at the same time, it's been a lot of fun and it's a challenging industry, but at the same time has so many opportunities that people, you know, to continue to grow and improve as a business and as individuals.

Yeah, that's. That's an amazing answer. Couldn't agree more. Especially around the opportunity side. You know, around every corner there's more opportunity, more complexity that goes with it. But for some reason, we just, we tend to go running toward that. And I really appreciate that about you and about the perspective you bring. So I want to go back to when you were the CFO of Smiles Dental. I'm going to ask you some questions and if you can answer from that context so that our listeners can get an idea of the scale and size and some of the tools you guys were using. Because part of the reason why we're doing this CFO interview series on the DSO Secrets podcast is because we want to build up a nice network of finance professionals who are dedicated to the DSO space. And amongst all of us, we've got answers to all the most difficult questions. Sometimes it's just hard to know who to go to. And so this gives our listeners a real quick way to kind of know and understand what your background is and perhaps if they could connect and you could help them in some way. So let's start out. First of all, what were the total number of locations? We grew to 26 outstanding and total

full time doctors, probably around 32.

Okay. And how many total states and which states were you in?

We were in Washington, Oregon and Alaska.

Okay, wow, that's a big distance to get up there to Alaska. Hopefully Alaska had its own dedicated regional.

Yeah, Alaska was a whole interesting problem of its own. And it's a great state. I mean, it's a great place to be, but it has its own challenges.

Yeah, no question. Well, I'm sure to whatever degree you were providing dental services there, there are many communities that are underserved. So I'm sure you guys were making a big difference in terms of delivering great care. What was your growth strategy? Was it de novo, was it acquisition? Or did you find you. You ended up doing some of both?

We did solely acquisition.

Okay, outstanding. What departments in the DSO were reporting to you, which functions?

Yeah, I had accounting, finance, hr and for part of the time I had revenue cycle as part of that.

Okay, very nice. It's fairly everything you described there, fairly common with what ends up sitting on the leader of finance. Can you tell us about the staffing in these departments? What did your accounting org look like? Your finance org, HR and even rev cycle to the degree you had some leadership responsibility there?

Yeah, the accounting team, we had a controller or an accounting manager and then a payroll person and two accounts payable people. We also had like a financial analyst or senior financial analyst on the finance side. From an HR perspective. We had an HR manager, a generalist and a recruiter that we had on that side. And then revenue cycle was a little bit more complicated. There was a whole team, so we had a manager or a director there. And then I think we probably had between 10 and 12 individuals who were processing payments. So we had tried to centralize or that was our process, was centralizing the billing process. And so we had a fairly sizable team on the revenue cycle side.

Okay, great. That's great context and helpful to understand. And from an accounting perspective, were you cash basis or accrual basis?

Accrual basis.

Okay, awesome. So you guys made the leap and jumped into that next level of complexity. I'm going to have another question for you here in a minute around that. So let's jump into practice management software. What software were you using?

We used a combination of Eaglesoft and Dentrix.

Okay, great. And did you find was it difficult to manage the complexity of two disparate systems?

It's definitely difficult. I think it's challenging from a training standpoint. You know, when you bring new people on, you have to have two systems. That what the reason we did that initially we had converted everyone to Eaglesoft and We thought that was the mode to go. But as we grew the offices that we were acquiring, a lot of them had Dentrix and it was much easier to let them stay on that than to systematically change them over and then have them start over from a learning curve in the clinic.

Okay, great. What about accounting software? What were you using?

We use Great Plains Dynamics.

Okay. Same as us. Very good. Which I think I mentioned this to you before, but we are in the process of making a change, but familiar with that software and its benefits as well, some of its limitations. I'm sure you guys started to bounce up against that. How about AP Automation? Were you guys pretty much manual in your AP process or did you have any automation software involved?

Yeah, we did not have automation. I've used automation in other industries, but we did not have automation in our system.

Okay, just out of curiosity, in your other industries, what do you have experience with?

Currently we're using, in the company that I'm working with, we're using bill.com and I've used a couple of others kind of scanning ocr softwares. But Bill.com seems to be working for us right now. And I know some DSOs that use bill.com and they've been able to kind of successfully implement that.

Okay, great. How about payroll, HRAs, LMS systems? What were you using on that payroll and HR side of the business?

Yeah, we did a conversion and we changed over to Paycom.

Okay, very good. Happy with that?

Yeah, I think so. I mean, obviously HR people seem to love it during the demo and then hate it afterwards. And that's whatever payroll system you're using. It seems like it's a love hate relationship. But in general, I think that it's about as good in terms of the modules talking to each other than from what I've seen.

That's great. Yeah. One of the biggest challenges we face right now, not just in our industry, but overall, is it seems like nobody really loves their payroll system. And it seems like there's an opportunity for somebody and to the degree they're acquiring different pieces to put together into that one stop shop from an HRIS payroll, LMS and everything else system, I call it Frankenware, where they pull all these different disparate pizzas together, jam them together, and then they sometimes don't talk to each other that well. So it sounds like paycom at least was solving some of that.

Well, paycom for sure had built it from the ground up. So they built everything as opposed to acquisition of the different modules. So that has its Advantages. There's obviously downsides to it as well in terms of functionality and what some other platforms have. But in general, I think that having one database and having it all interconnected from organically as opposed to through acquisition has, has some benefits for sure.

Okay, great. Yeah, really, really helpful context and perspective. Thank you for sharing that. How about forecasting and planning? Were you using any specific software there?

No, we used, we used Excel. I have used a system called Budget Maestro in other roles, but for the dso we were using Excel.

Great. Okay, and how about data visualization, data automation? Were you guys using anything specifically there?

No, I guess we did not have any specific automation software like doing consolidation or other things. The one thing we did use from a BI standpoint, we use practice analytics and that was, you know, in terms of, it does include some visualization from a operational KPI standpoint.

Okay, great, that's, that's really helpful to know. Were you using any specific project management software that you really liked and worked well with your teams or throughout your organization?

No.

Okay, what about team communication, chatting?

We used Skype and it might have been even Microsoft messenger at the time. I think since then there's some platforms that might be more effective, but we were just pretty basic in how we communicated.

Okay, and what are you using right now with the clients that you're helping? How do you generally connect with them and what do they use internally?

Yeah, I think that there's been a big movement, so there's a couple of tools. A lot of teams are using Slack and that is helpful for internal communication and partially as well from a project management standpoint. To take a step back, some of the clients are using Asana, which has been helpful from just team communication and management over various work streams.

Yeah, I've heard some really good things actually about Asana here. Several groups that I've talked to that, that get a lot of value out of that software. How about credit card and expense reimbursement where you're capturing the credit card expenses and employees are using some type of software to submit receipts and those sorts of things. Or were you guys a manual process?

Yeah, we use KeyBank's keycard and they provide a platform by which you can download that. The employees can go and submit receipts through there and you can have an approval process inside their system, which is, which is pretty robust from that standpoint.

Okay, awesome, great. Now can you tell us what did your monthly or quarterly financial statement package look like? Did you do some type of an MDA write up or was it a verbal Discussion. What did that process and what did that package look like?

Yeah, we did include an MDA written in the as a tab within the Excel workbook workbook and then would also include kind of standard financials as well as some of the KPI tracking that we used to share with our with not only the management team and our board.

Okay, great. How about your annual budgeting process? What was your philosophy? Top down, bottom up? And how did you approach that?

Yeah, it's more of a top down approach, but it was an iterative process between finance and operations and at the office. So typically we would start with inputs into revenue and try to create what we thought the buildup for revenue looked like and then go and sit down with the office manager or the regional manager and work through what that would look like or what they felt comfortable with in getting to a revenue number. And there was a bit of back and forth on that process. And then we would do the same thing on the expense side to get to a point where it was essentially finance providing the starting point and then having a discussion and working through what that ultimately would look like.

That's good to know. Okay, great. What about what challenges did you find trying to run consolidated financials in the DSO industry with the complexity of entities and different things that kind of connect and tie things together from a legal perspective and accounting perspective over some of the challenges you found and what were you guys doing to try to overcome those?

Yeah, it's definitely challenging from the DSO structure of having two legal entities operating within the same location to try to get a consolidated financial at that individual office level. And which from a management standpoint, obviously is what you need to know to run the business. And so, you know, like we did, we used classes within Great Plains and we had a consolidation kind of elimination out of that class within that system. So we had a separate elimination class that I think worked fairly well. The challenge was, and I think you can run into challenges depending on the check. You know, on ap, we ran a centralized AP that way and if, you know, we would, we would just make sure that the check was the right legal entity. But it's not super easy to manage that across within the same accounting system across legal entities.

Interesting. I like how you were using the class kind of capture that separate so you could go and find that detail, but then know that it was consolidated when you put everything together and eliminated.

Yeah, and I think one of the things, Ken, that is just on top of the consolidation, one of the challenges within the DSO industry, I think, and as I look at more and more states changing the way that they charge taxes and that they is that, you know, we had in Washington state, for example, there's a revenue, they call it B and O tax, but it's essentially a revenue generated tax. And a DSO structure is not very tax efficient from that standpoint because the same money that's flowing through to the DSO is essentially the same revenue that was generated or a portion of that revenue that was generated. So you're double taxed in that structure. So we spent a lot of time up front trying to optimize the taxation and minimize the double taxation. But it is something for DSOs and those who are working in finance to try to get their arms around is how do you manage the local state level taxes, not income taxes, but more of the other types of taxes that states. And Oregon is now starting to charge a revenue based tax. I know more and more states are starting to add that to the way that they tax businesses.

Yeah, that's a, that's a great point and probably worthy of its own, you know, completely separate podcast episode. And I appreciate you bringing light to it here for our listeners. So I wanted to step back to a little bit bigger picture now and appreciate you kind of going through those questions in a rapid fire so people could kind of hear and understand your perspective and what, you know, some of the tools and things that you guys used to, to solve some of the complexity of this industry in your mind. Jake, knowing what you know and having been in the industry and now working with others on this part time or fractional CFO basis, what is one of the biggest oversights or mistakes that you see being made by some of the smaller emerging DSO groups today?

You know, it's interesting because there's been so many, so much focus and so much growth in the DSO space. I think that with the attraction that private equity has brought and the focus that they've brought in terms of what they're doing with the business, the one thing I find is that some smaller DSOs are getting focused and they care more about the multiples and they're so focused, just maniacally focused on what the multiples are and what can I get for my, for my dso or what's it worth. And I mean, there's two things that, that I see as problematic with that. One is that a multiple is, is a tricky thing because you'd say like a multiple of what the definition of EBITDA is not always the same and there's add backs and there's add tos and depending on the state of your dso, if you don't have centralized team and the leadership in order to scale it, then a private equity company is going to add that as a deduction from your EBITDA to get on a multiple. So they may pay more or less, but you hear within the industry, oh, so and so got this multiple or this multiple happen and people get so focused on it that sometimes they don't understand it or. And really, if you think about what the value of a DSO is, it's about creating value from both a business perspective as well as a clinical perspective, and allowing dentists to focus on just providing great care. And the distraction of a multiple can get in the way of that actual value creation.

Yeah, it's such an interesting. You almost could ask the question this way. What comes first? An amazing DSO that's adding tremendous value to its clinicians and in turn empowering them and the supporting staff to deliver amazing care to patients. Does that come first or does the focus on the multiple come first? And the real interesting answer to this is the one feeds the other. If you're cobbling things together and your DSO isn't really consistent in the way that it's supports doctors and doesn't create sort of predictability throughout the entire platform, it's generally speaking, it means that fewer turns on multiples. Now, five years ago, that wasn't the case, but I think private equity over the last five years has gotten smarter and smarter to understand that a platform that truly has processes and systems that are repeatable, scalable, predictable, you know, can create the predictable results. And the powerful thing is the multiple goes to those who are building out a platform as a DSO that is doing so much to empower those dentists to be as successful as possible with the patient, including helping them with CES and learn new skill sets and move up the food chain as far as they'd like to in terms of capability. The more that that's happening, really, the more valuable the DSO is versus the one who's cobbling some things together and trying to nip and tuck around some corners and say, hey, we get our supplies for 2% less than this other DSO. This does not tend to be where the real value is. Do you have any reaction to that, Jake, or any additional comments?

You know, I think that, look, investors are investors and they are. Private equity is just a form of investor, right? And they are looking across industries. Investors want. They want value, right? They're trying to find companies that provide value. When I was at American Express before I kind of left and came into private equity backed companies and ended up in the DSO at Smiles. Our CFO had told me one time, he said, there's three things, and this is a publicly traded company. There's three things that create value for us as a company. It's growth, it's margins, and it's stability. And those three things are what investors want and they're willing to pay a certain premium if you have more of that. And so that's the same whether you're a publicly traded company like American Express Express or if you're a DSO that is attracting PE money, Those three things really become critical. And so if you're so focused on the multiple, if you focus on those three things creating growth opportunity, which to me is a scalable platform, if you're managing your margins effectively and if you're creating stability, those three things are going to garner a higher multiple than if you don't have those three things. And so I think that's the value. That's value creation in and of itself is focusing on that pyramid of growth, margins and stability and finding ways that you can improve each of those kind of simultaneously. Right. You can't have growth at the expense of stability because it's too much volatility. And nobody wants to invest in a business that's super volatile.

Yeah, getting out ahead of their skis. Right? That's the phrase that's often used, growing too fast, get out ahead of your skis and things, get out of control and create some volatility and are going to hurt earnings and hurt the business. I've ranted about this on this podcast before, but ultimately what investors are looking at to invest in is cash flow. And the more that they see the ability to drive cash flow, not just maintain, but drive and create. That's why they take that multiple or the EBITDA number, which is again the lazy finance person's shortcut to free cash flow. And the higher multiple is because they see growth. They see not just the stability, but and the predictability. But they see growth, they see a large acquisition funnel, they see a history of successfully onboarding acquisitions or successfully loading up de novos in some type of cadence and consistent performance amongst those. And the more that's there, the more value is perceived. Again, because it all comes down to what is the free cash flow that ultimately the business and the model can drive. And it even means that to some degree, if we're running a little bit inefficiently, to the degree an investor can see how those inefficiencies are going to work themselves out within six months or a year or two years, to some degree, they even will start to count that cash flow into how they think about the future at a current valuation today. So we won't beat this dead horse anymore. I've talked about it enough and Jake and I could pontificate for quite a while. But Jake, I wanted to ask you another question. What advice do you have for those emerging DSOs out there, group practices, who haven't really formally gone into the process of forming a dso? What advice do you have for them about how to think about that and how to start preparing themselves? Because ultimately if they want to take outside money, or I should say non clinical investment money, that's going to be an inevitable outcome anyway, or have anyone participate that's non clinician. What advice do you have for them as they're thinking about how to start preparing themselves for that?

I think that the, you know, I have a group that I work with that is in this boat. It's owned by, owned by a doctor, you know. And in fact, you know, even DSOs, a lot of times they haven't taken outside money, but they form themselves into that with the intention that maybe one day I will. I think what's important for every business owner to think about is what is your long term plan? Like, what are you trying to accomplish? In many cases you don't need to form a DSO to just continue to grow your group. Right? I mean that's not necessarily equivalent. So the term DSO has, has come in vogue because it's leading towards outside money potentially and it's a route to faster growth because you can access capital from outside sources. But depending on what your goal is, you don't necessarily have to form a DSO to accomplish that goal. But if you have decided like, look, this is the path that I'm going down and I want to form a dso, then what is the end goal? Are you forming it to get outside capital? What is the culture of your company? Are you going to grow through acquisition, through de novo? Having a strategy as you think about that lets you start positioning yourself for the formation of a dso. That makes sense. And in some cases you may need to have the term they call sub dso and in some cases you may not. So it's important to kind of begin with the end in mind, think about what you're forming that for and then you can go down the path and there's groups that can give you guidance on the legal ramifications and how to structure it legally and how to accomplish what you want. But if you don't know what you want, then you'll end up with a cookie cutter approach that they might use with someone else, and it may not accomplish what you want. So you kind of need to think personally first, plan that out and then go get the experts to help you execute on what you are trying to accomplish.

I really like that advice, and it's interesting. I've seen a couple of waves since I've been in the industry where everybody says, yes, everybody needs to be a dso, and then it's no, everybody just needs to be a group practice. And the reality is you've got to stop and figure out the why, and you've got to understand your vision and then get your mindset around that. And then ultimately the structure can be developed to help you accomplish whatever it is you want. And so I think what I'm hearing you say is before you decide you want to go down that road, really be thoughtful about who you want to be, how you want to grow, what you want your organization to be like, and then move forward. And the DSO formation isn't necessarily the hardest or most complex thing in the world, but it's more about making sure it's right for you and right for your organization and ultimately your overall mission and what you want to accomplish.

Absolutely.

All right, one last question in this area. And I want you to focus on all of the other finance leaders and professionals that have committed themselves into this industry, especially those that are say, bookkeeper level, controller level, VP of finance, director of finance, finance, CFO level folks. What advice do you have for them about how they should. What mindset they should take on to continuing to figure out how to add value to their organizations? And again, I gave you a wide range of people to talk to, but what mindset would you advise them to really start thinking about and trying to put on that will help them just add more and more value and help their DSOs be more and more successful?

I think every role within an organization has a part of creating value. And if you look back to those three areas that I mentioned earlier, growth, margins, and stability, each of those roles may influence multiple facets of that. So you could have a bookkeeper or a controller that or a staff account level into the accounting department somebody is focused on. And part of their job is to make sure that we have controls around cash management, that we don't have fraud, that we have controls around our expenses, and that expense reports are approved. And there's simple Things like that, that increase value because you're overall increasing the stability of the company and the controls within that, within that company. Moving to accrual based accounting adds value. Investors look at that more preferable and you can get a reviewer, an audit as opposed to, you know, an external, just as opposed to internally created financials. So that creates value for a dso. So when you're a bookkeeper or you're an accounting person, finding those ways and it may have nothing to do with the underlying business, those things create value. Having said that, I think that if you can change your perspective, accountants, and this is not, this is true of any industry, accountants can get a bad rap for being been counters or just reporting on past numbers. But real value creation figures out, okay, I see these numbers. How do I influence the future? And as an accountant, you can look at things like variable and fixed costs and figure out what I can do to manage my cost structure better. I can forecast and provide data around what the cash flow will look like in six months from now or 12 months from now. I can evaluate as we're reopening from COVID and figure out, okay, how do I manage this reopen process and provide data to the business owner or the business leader, whoever that may be, that can help them make decisions that will optimize the future for the business. Those things and those levers all create value and all help the business perform at a higher level.

Good question. And you know, from my perspective, just to layer something on to what you've said in the finance world, people who are outside of your organization, they look at your entire organization through a very tiny lens called your financial statements. And to the degree you're able to get yourself organized to an accrual basis and you are able to get a review or an audit completed on your financial statements. The amount of trust and confidence that outside financial parties have when they're looking in and considering either loaning money or making investment, not only can it make all the difference in the world, it can make difference in terms of turns on multiple or in terms of what funded debt to EBITDA covenant ratio that you need to live within and so on. And so I really like that you talked about that. I think there's huge value there. And then everything else you talked about with forecasting and modeling and figuring out how to reopen again, those are things that actually add value to the outside parties as well. And the more they're adding value to outside parties, it's obviously doing something and adding tremendous value internally. So that was the thing that really struck in my mind, Jake, as you were talking, is there's this connection that the finance leader in the business has the ability to increase confidence and increase value creation, both internally and externally, all for the betterment of the business, short term and long term. So I think I really appreciated how you said that. Thank you. Now we're jumping into our lightning round. Jake, these are just a few questions we like to ask all of our guests, just to get to know you a little better, and then we'll go ahead and wrap up. So the first one is, what are you currently working on?

I have a project ongoing right now that's. This is a personal. This is just me and my family. We have two Mongolian yurts that we just built on our property. And we. I just, you know, we put them on Airbnb and we've been renting them, and it gives the kids something to clean and earn some money. Where we live, we live out, away from people. So I realized the kids don't have an easy way to mow lawns or babysit or anything like that. So we've got these yurts, and we're trying it out to see how well we can do it. Kind of the Airbnb world on these with yurts.

Wow. That's incredible. That is definitely a project well done. What are you most proud of, Jake?

I am most proud of my family. I think that I have four kids, and my wife and I love every bit of. My oldest is a senior, so she's headed off to college this fall. Hopefully, if it opens. And we're, you know, that's a big part of my life.

That's amazing. Thank you for sharing that. Favorite sports team?

Atlanta Braves.

Really? You're a West Coaster and you love the Atlanta Braves, huh?

Yeah. You know, I grew up in the TBS era, and so Del Murphy was my hero as a kid, and same here.

No question. That guy was and still is a stud.

Yeah, no, it's. That's. That's where it comes from.

By the way, do you know. Did you know that Dale Murphy, he's doing speaking engagements and gigs and doing corporate consulting and stuff now?

I had heard that, yeah.

At some point, we need to get all the amazing finance leaders in the DSO space together for a little conference and see if Dale Murphy will come and do our. How does that sound?

They should get one of these conferences to invite him for if conferences ever are a thing again.

Yeah, that's right. That's right. Favorite hobby?

I am a runner.

All right. Marathon or Shorter distances.

I've done marathons. I used to be quite fast. As I've gotten old, I feel like I'm not as fast. And I. So I haven't done a marathon in recently, but I was. Prior to Covid, I was training for a half Ironman, but the pool is closed, so I. And it's been postponed till next year, so that's kind of where I'm at.

Oh, wow. Okay. That's. That's an intense hobby, for sure. Favorite app on your phone.

Calm.

Tell us about that. I love asking this question because every time I hear apps that I've never

heard of before, it's a meditation app. So I find that it gives me 10 minutes in the morning of peace and quiet and kind of leads you through kind of a self meditation.

That's really. That's amazing. I've heard of several. I haven't heard of that one, so thank you for sharing that. Your favorite spreadsheet function.

Oh, good question. Probably sumif.

Okay. I love it. All right, Jake, we're gonna wrap up. Parting advice that you have for these emerging group practices.

Yeah. The DSO space is so amazing, and there is so much opportunity that people are looking at, obviously right now with COVID and everyone's kind of battling back and trying to figure out what do I do? And I know how tough it can be for somebody to go from one location to two to three, you know, like each incremental location, because you're sitting there thinking, how do I have enough cash flow that I can get out of the chair if I'm a dentist? And that's absolutely a challenge. And I see that happen with a lot of these small DSOs. And I would just say you're in a great place. You're doing. As long as you love what you're doing, then keep doing it and win the little battles. If you can find ways to make incremental improvements and create that incremental level of growth or stability in your practice and put systems in place, you're on the path. All of us are on the path somewhere, and we're developing and growing and trying to do that. And both that's, you know, both personally and professionally. And I think you're in the game, you're on the path, and you're doing something that, you know is amazing at the end of the day.

I love that. Jake, thank you for that perspective. That's so helpful and helpful to get our mindset around now for our listeners that have been listening in that would like to get ahold of Jake or have a conversation or follow up on any of the things he talked about or some of his expertise. Expertise. Jake is part of the DSO Secrets Facebook group, so we'd encourage you to come over there and you can start a discussion there and just call him out and he'll respond. Jake, are there any other ways folks could reach out to get ahold of you?

Yeah, other than other than on Facebook. I can also be reached on my email is jakelewisahoo.com outstanding.

So Jake, I have gotten a lot of value from this. I know our listeners are going to to get a lot of value from this as well. I really see kind of the main theme coming out of this is focus on creating value, not on multiples. Or maybe it's create value and the multiples will take care of themselves. Maybe that's even the better way to say it. Would you agree with that?

Yeah, I mean, I think another way to say that, Ken, is create the multiple by creating the value first. I mean, I definitely think the multiples will follow if you've created value.

Outstanding. Well, many, many thanks to all who've joined in to listen to this episode today. This is a wrap for episode on focusing on creating value and not on multiples with CFO Jake Lewis. Happy day.

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