54: The Serial Dental Entrepreneur with Dr. Mark Costes

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Welcome everybody to a new episode of the Dental Boardroom podcast. I have a really cool and special guest today on the program, Dr. Mark Costas. Welcome to the program, Mark.

Hey Wes, how's it going today, my friend? Good to be here.

It's going great and it is such an honor to have you on. You've got probably one of the best known, if not the best known kind of business dental podcast out there, which I love. I've listened to a lot of it. You have great guests on there. And so I would was on your podcast not too long ago, earlier this month actually. And so here I am inviting you to be a guest on my podcast. Really excited today because your story is a very dynamic story. As a dentist and as really a businessman in many ways is the way that I view you first kind of a businessman and entrepreneur. And a dentist is sort of the trade that you had that supported that primary and career path of yours, just like mine has been sort of CPA work and financial planning work and. But a lot of my career I would define as starting up a business really with employees, with cash flow, with taxes, with debt, with all of that stuff that goes with being a business owner. And I would love to have from this podcast a few crisp takeaways for both pre practice owning doctors who are getting ready for ownership and secondly for existing practice owners on how they can be great practice owning business people while also being dentists. And I know you do a lot of seminars and teaching on this subject, the business side of dentistry. So this is going to be very rich with content. If you don't mind, Mark, can we just go back to the beginning a little bit? Where, where are you from and what motivated you to go into dental school?

Yeah, thanks man. I appreciate the question. I get asked this from time to time, but I'll try to give you the Cliff Notes version of kind of where I come from and the reason I got into dentistry in the first place. But I'm a first generation American, so my family is from the Philippines. Both my mom and dad grew up in the Philippines. My sister was born there. My dad's an electrical engineer and he was a math professor at the university there in the Philippines. Really, really smart guy. But when he transitioned to the professional world and went from education into the engineering world, they had a very special program happening in the United States at the time where they were trying to recruit, I guess, smart people from all over the world. And it was called Third preference. And they allowed engineers, doctors, nurses and other types of professionals to come in with relatively lax immigration standards. So he took advantage of that. In the late 60s, he came to Chicago and then New York, started working for IBM, and that bounced him around the country. I was born actually in New York. Then we went to Boulder, Colorado, then Tucson, Arizona, then Southern California. I kind of moved around a lot as a kid, Always kind of relying on athletics to equal the playing field. When I was at a new school, I was always involved with. I was a wrestler, I was a baseball player, I was a football player. I actually ended up playing some time in the collegiate ranks, playing football. But as I was growing up, I was more involved with athletics than academics. I was a kid that was. I had attention problems, I had comprehension problems. So I wasn't a good reader. And I was not the typical kid that you could sit in front of a teacher or a lecturer for eight hours a day. I don't know how they expect young boys and young girls to do that and actually thrive. But I was the kid that.

That.

They made some concessions for me. They allowed me to stand up in class. They allowed me to leave the classroom from time to time because I had a pretty bad case of what we would now call probably add. So that made it difficult for me during most of my educational experience. When I was 16 years old, I was playing in a baseball game, My very first varsity baseball game, actually. I lived in Southern California at the time. Some kid hit a home run in my direction, and I misjudged it badly. I was trying to play the ball off the fence, but I misjudged it badly, and I ended up smashing into the left field fence. There was no warning track, there was no padding, and I ended up breaking my jaw and losing a lot of my upper front teeth. So that ended up kind of being a trajectory moment for me, because as a profession, dentistry had never been on my radar. But I spent the next 16, 18 months in and out of dental offices, oral surgery offices, dental specialty offices. These incredible clinicians were able to put my face back together. In fact, my smile is much nicer now than it was before the accident because I got some dental implants and some beautiful veneers. And that sent me on a trajectory of being very, very interested in dentistry. I was inspired by what they were able to do to heal me. And that became my profession, my target profession. But the learning issues kind of persisted. And I had maybe an average GPA graduating from high school, and then got into. I played a couple years of college football. Then I transferred to UC San Diego Realizing that I was never going to get into the NFL. So it was time for me to focus on academics. But those kind of average test scores, my inability to take standardized tests really well, and my GPA was average, left me with like a very average gpa. So I was still in San Diego at the time, trying to get into dental school. It took me three years to actually get into dental school. 21 tries to get into dental school for a single acceptance. But during that time, I was fortunate enough to have a great experience. I applied for and got accepted into the executive MBA program at University of San Diego. And I bought my first business, which was a catering truck. A very simple business. We would drive this truck from construction site to construction site. I had two employees. One would pack my truck in the morning with supplies, and then I had a cook that would come along with me. And it was just like a glorified ice cream man. I'd drive around, honk the horn, construction workers would come out, they would buy carne asada burritos and cheeseburgers from me and Marlboro Lights, and I'd move on to the next construction site. And it taught me a lot about business in general. It taught me the marketing cycle. It taught me about overhead, taught me how to read profit and loss reports and the difference between a P and L, cash flow statement and balance sheet. Taught me the fact that the owner actually gets paid less and that how to manage employees, how to recruit employees, those sorts of things. And if I was going to hold up the business ownership experience up next to the executive MBA classes and what I learned there, I would say that it was the entrepreneurial venture that taught me the most about business in general. So I finally got into dental school, went to Marquette University, graduated in four years, and then started my journey into multiple practice ownership. Just because I had so much of the entrepreneurial bug, I wanted to take this health health care practice and see if I could scale it to a larger scale than the typical dentist. So that's kind of my. My backstory as far as how I got into dentistry in the first place.

What part of Southern California were you living in when you were in your teenage years?

I was in Agora, California, which is a suburb of la, just past the San Fernando Valley. North of the San Fernando Valley on the border of Ventura county and Los Angeles County.

Yeah, very cool. I lived in Thousand Oaks for a while. I grew up in Valencia, which is probably 30 minutes away from you. Also kind of the distant north suburb of LA as well. That's Where I went to high school, played football as well and played some hockey. I wrestled as well. I'll tell you what, Mark. For me, sports was more defining in my development and my understanding of what kind of the input, output, relationship and life and kind of success. I had very average grades as well and couldn't get into a great university out of school. So I eventually I did a local junior college, and then I transferred as well. And now I have a son who's 18, and he did pretty well. He got a 1400 on his SAT, and he got, I think, like a 3, 85 with some. With some AP classes. But even then he really wanted to go to uc. Ucsd, your alma mater. He could get accepted there, tried to go to ucla, couldn't get accepted there. And so he just decided to stay local. And I said, hey, buddy, there's nothing wrong with that. I mean, look at the cost. You can do that. You can get some good grades. So he's taken like 19 credits right now, and then. And then he'll transfer. And I've been thinking about this subject. It's a bit of a tangent here, but, like, I'm listening to the Elon Musk audio book right now, and even Elon didn't have, like, the best grades. He was probably a little bit above average. But one thing about him was that if there was a subject he was interested in, it wasn't about getting grades, something on paper or checking boxes. He would go deep into that subject and learn everything he could about it for the sake of learning. And I think about that, how can I teach my son, even myself, but how do I teach my son to go deep into learning for the sake of learning and not grades, when our world is so structured around measuring people by their grades? And it's like, yes, I want you to go to college, but there's a bigger reason behind all of this, and that's so that you become educated and you have this hunger for knowledge. And so that's a tough lesson to teach these days. But anyways, yeah, thanks for that. Thanks for that story. That's a good backdrop to who you are. And I'm sure that's those sports as well, define a lot of, kind of the grit that you've had to put into your career to do what you've. You've done. So you go to dental school, you come out of dental school. Tell me about the first, I don't know, few years out of dental school before practice ownership. And how long was that before you.

Bought a practice yeah, awesome questions. I'll go back to your previous point though. Sports are. They were everything for me. My ability to work within a team. I found that most people that I have hired along the way, I've had probably, I don't know, hundreds and hundreds of employees at this point. Being in business for 22 years now, the people that I think are the most resilient and capable of adapting to constructive criticism and difficult situations are people that have been on sports teams. I mean, hands down, I think those are the most. Those are the most resilient people that I usually come across. So sports for me was really, really instrumental. And I will further to your point and what your son is experiencing right now and your little aside about Elon Musk. I personally think that GPA and formal academic records are a very poor predictor of entrepreneurial success and life success in general. It just means that you're able to be successful with a very, very narrow parameter of skills and attributes. Ability to memorize things and potentially purge those skills or those facts that you have crammed into your head after a very short period of time doesn't really serve you well in the real world. When in the real world you do better to work well with other people and collaborate and surround yourself with people that are better at certain things and kind of fill the gaps of what you're weak in. I think those are the people that do the best in business, not necessarily people that got 4.5s and 1600s on standardized tests. So that's what I personally found. So a perfect example is all the billionaires and some of the iconic business leaders of all time have been college dropouts. So Elon being one of them. So back to your secondary question, which was when did I start my entrepreneurial journey? I associated for a year and it was a really, really good situation for me. Just another one of those kind of transformational, lucky situations that has happened in my life. I've had many, many. I've been blessed in so many different ways. When I look back, things that seem like difficulty at the time ended up being huge blessings. But I worked at a really, really high paced Medicaid office in Phoenix. One of my good friends from dental school graduated three years before I did and he always said, hey man, when you graduate, I got a job waiting for you because I'm going to go into multiple practice ownership. So he started building these Medicaid practices around Phoenix and I graduated and he literally just threw in one, like no mentorship. There was nobody else that I was working with I was all by myself and I took it upon myself to build my clinical savviness, my clinical speed, and also I was a super dork about figuring out how the business ran. So I made good friends with the office manager and I would stay after every day and I'd watch her kind of do all of the billing, watched her work through the practice management software. I understood how the the practice worked from a number standpoint. So I took that first year on as my financial residency and my clinical residency. So that was a really, really instructive year for me. And it was after that year that I started building my own dental practices. About 13 months after graduation I owned my first one and then within the first year and a half after the first one I had three. And then we built that up to about 16 practices over probably a 12 year period of time. And I practiced dentistry until about six months ago when I sold my last.

Four practices Are you looking to buy.

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Sold.

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Sounds like you had an early immersion immersion into the operational side of dentistry outside of the operatory room. Because you didn't have there wasn't another dentist there. It sounds like you were curious yourself, took some extra credit. Time to go and sit and observe. How can do you think associates today get experience on the business aspects and the operational aspects of a dental practice when they're oftentimes coming out working for a large DSO like here in California? PDS is a big one. Is there a way to do that? And who knows, maybe actually going to a DSO can expose them to effective business processes more than a private practice. But can they get that exposure when it's such a well oiled assembly line and they're basically there to produce? What's the advice you have for those associates?

That's such an awesome question. I don't think I've ever been asked it in that way. I think there are huge benefits to working for a private practitioner, a non affiliated private practice, if you select the right one. Like I was lucky enough to find the right one where it was high volume. So I had to kind of hang in there and figure out how to be faster and maintain a high quality of clinical standards. But also they were open enough to let me learn within this small dental practice. So for me it was a perfect opportunity. Now you're right. The reality is that a lot of young dental students, emerging young baby docs, are going to be working for DSOs. But that doesn't necessarily mean that your learning has to be stunted because of the corporate nature. What you have to do is you have to self educate. You have to listen to podcasts like this. You have to surround yourself with people that are very entrepreneurial. There's nothing overly complex about the management and ownership of a dental practice and understanding the business of a dental practice. But people still don't give it enough credit and they don't give it enough focus. So even though it's not Overly complex. And anybody that's graduated from dental school should be able to figure this stuff out and should be able to understand it very, very quickly. But you still need somebody to help instruct you and kind of teach you how it all works. So if you're working for a large dso, what I would recommend is trying to get as much education as you can about the practice management and structure of a business. Sometimes that information is not readily available, so you just have to open your eyes and pay attention. Like what is their onboarding process from the moment that you accepted the position? What did that contract look like? What did negotiat feel like when you got in there? How did they get you up to speed as far as the onboarding process for the associates? How are all the auxiliaries within the dental practice trained? What is the scripting like? What do transitions look like in that particular office? What is the flow of prosthetics and lab work within the dental office? How do they break down and set up a room, how do they set up their meetings, and how often are performance reviews happening? All of that stuff you can learn from a DSO because they're doing this on a large scale and they figured out how to operationalize each of their practices. So each of them are very similar. And if you can learn just by the structure of what they're doing, that's a huge part that you could take into private practice yourself. But it's the looking at the P and ls, how the categorization works within the expenses, what overhead means, what EBITDA means, those sorts of things. You may need some advanced help and mentorship, but there's a lot to be learned about the structure that you can see inside a DSO while you're working within one.

Couple of thoughts to parlay off that. So much good content there, Mark. You know, my thought is that associate gets out of school and they've got to, they still got to cut their teeth on the clinical side of dentistry, right? So they're trying to do that. They got student loans, probably a little bit of anxiety around 4 or 5, $600,000 of student loans and all of that. It's a lot to ask, but at the same time it is very possible because there is time outside of the clinical to think about yourself as a professional, as human being who's continually, continually trying to develop themselves. And here are some thoughts that I have on this. I don't see any DSO or any private practice owner willing to pay an associate to get involved in the non clinical aspects of dentistry on the operational and business side. So you just have to say, I'm going to do like this informal intern, unpaid internship, and I'm going to learn wherever I can, whatever I can about how this business, this style of business operates outside of fixing teeth. So things in businesses, in all businesses is, and I always think about it this way, a dental practice, my business, other practices, 60, 70% of running that business is the same. It's the same. You have a lot of similarities on the P and L. You've got people who are paid, you have equipment, you have supplies, you have rent, you have to sell the service, you have to market the service, you have to collect on the service. These are, in, in any business you have these, these modules, these, these features that make the business the business. And then you have the business delivery or the product or service itself, which is just the smaller in many ways aspect of, of what is success in any given business. And it's like this is total tangible. It's like Elon Musk in the book I was listening to when he decided to build rockets. He didn't go to build rockets for the sake of business. He wanted to build rockets for the sake of what he felt humanity needed. And you know, Elon's crazy mind up there, he just felt this is what humanity needs is this interplanetary travel system. And then because he already had so much experience in business, then he backed into the business side of it and it had all of these same elements I'm talking about in a business. Now him, massive amounts of investor money is at play as well. But they're the same concepts. No matter if you're building rockets or if you're doing dentistry, it's the same thing. And you have. So in a business, you have workflows, you have processes, you have compensation models, you have reviews, you have organizational charts and you have courses that you can take. I think it's really important that dentists learn how to read a profit and loss statement, understand why a profit and loss statement tells you certain answers and doesn't answer other questions. Like it doesn't answer where did your money go? Because it's not a cash flow statement. And a lot of dentists don't fully understand that. So then you have other reports that say, where did my cash flow actually go? The P and L is primarily to create a K1 for your S Corp. Tax return, but it does have a lot of benefits if it's formatted the right way. And how is your practice doing relative to specific goals that you've set for yourself and how is it doing relative to the industry standards? For example, what is your labor cost as a percentage of your revenue? What are your supply costs? What would happen if, if you've got a CAD cam to your labor costs and after the tax effect, is this a good economic decision? There's so many aspects of the numbers that tell a story that could help you be a better business owner. And there's a lot of great conferences. I believe that young dentists should, in the first year or two, maybe wait their CE for the clinical. I get that. But pretty quickly you need to start infusing your CE or I won't even say CE your educational experience because a lot of non CE courses don't come with CE like a lot of mine have not qualified as ce. And yet I think a lot of dentists, if you want to be a good practice owner, you need to go to these business courses where they don't talk about teeth, they talk about numbers, they talk about P Ls, they talk about balance sheet, they talk about operational processes, they talk about leadership management which are not the same. Leadership and management, two different skill sets, those kinds things. I also believe that those things create a much more dynamic experience as a professional and just as a human being in managing this professional side of your life. And so you basically got to create your own sort of business plan. And I have this program called Associates on Fire. In fact, this podcast, the Dental Boardroom originated as the Associates on Fire website, which is a name I pulled from another podcast I listened to called Entrepreneurs on Fire.

I know John, I know Don Lee.

Oh, do you?

Yeah, he's a good friend of mine.

One of my favorite podcasts right there. And, and the Associates on Fire has these three fuel cells. The first one is igniting yourself as a, as an associate and the second one is basically buying into a practice, that whole phase. And then the third one is stepping into the shoes of ownership. And how do you do that successfully? And then I actually have a three part quiz for each of those fuel cells and if they pass it, then I even give, give doctors a certificate that you are Associates on Fire certified. And I've actually talked to the banks who would love to see their borrowers with that because that means that they've deliberately taken time to learn a lot of the language of the business aspects of dentistry. So I encourage any listeners to go to Associates on Fire. Create your free account. It's all free. Create your free account and learn a lot of at least from my side, the accounting and finance side of dental practice ownership, less on the operational side because I don't get into that. My, my, yeah. Any thoughts on that sort of internship that you have to almost self create as an associate to learn the business side?

Yeah, dude, you're preaching to the choir here. Because I host what, 11 live events per year specifically on dentistry practice, management, culture, leadership, operational systemization. So I am in the trenches doing this. I will say this, I will say that there has never been more access to information in the history of mankind. So when I was on the come up, I graduated in 2002. I'm aging myself, but I graduated dental school in 2002 and there was nothing, man. There was like a few, a handful of business books on some very, very rudimentary business ideas. If you wanted to learn about the P and LS and the difference between a P and L, cash flow statement and balance sheet, you had to dig into some pretty dry stuff. It wasn't like it was readily available and easily digestible. Right now there really is so much information and so much access to it for dental students. I mean, podcasts like this, I have almost 1900 episodes specifically geared towards dental business ownership. Like you can plug into my podcast or any number of different podcasts like yours, the dental Boardroom, and really start just that high level understanding of the vocabulary and some of the key ideas that you have to, to go further and investigate further and research further on your own. But YouTube, Instagram, for goodness sake, podcasts, these are all free resources for people. And then What? You buy five or six key $20 books and there you have it. You literally have everything that you need for a mastership in dental practice ownership. Like I said, it's not rocket science, but you still have to give it credit where credit's due. And you have to take the time to educate yourself because just because you understand the Krebs cycle and biochemist and organic chemistry and endodontics and prosthodontics and operative dentistry does not mean that you're just going to be able to figure this stuff out on your own. You have to find the right instructors and the right information that you can plug into to become really educated. But it's really, really astounding to me how many banks will lend a million 750,000 to a million dollars with somebody with a year and a half of clinical experience, with zero business training. It's crazy to me, but that's the soapbox that I could talk about for, for hours.

There's a lot that you and I talk about Mark for hours. Let me say one final comment on this for the associates. And then I want to sort of jump into practice owners. I always tell associates and even, even early stage practice owners that when it comes to spending and your personal finance, so I'm a, I'm a financial planner as well, a CFP certified financial planner. And so I dig into the subject of money with my clients all the time and, and all of our advisors here, practice CFO do. So it's a very personal kind of relationship. When you come out of dental school, there is this pent up consumerism, I call it almost this desire to go buy that nice car, to get into the house as soon as you can, to, you know, just go to maybe the nicer restaurants. If you could restrain that so that you have the resources to invest in these trainings like your events, Mark, pay some money, go to Mark's events, go to other business management events and that will have, that will have the most dividends, the most ROI return on investment than any stock you could buy, invest in yourself. And that might mean that you still got to live like a dental student for five years out of dental school, I don't know, maybe longer. And then when you get into a practice and let's say the practice is doing 80, $90,000 a month, maybe it's doing $100,000 a month, you need a great team. I can't emphasize this enough that I think, think dentists need a great either a coach, a practice management consultant, whatever name you want to give it, but somebody who has a platform, not just, hey, let's talk about how you can have a conversation with your hygienist. Not just that I'm talking about they have a management platform that will create this organizational structure that talks about how you create processes and a cadence to your meeting. So I use one. It's called the EOS Entrepreneurial Operating System, which is kind of popular for a lot of small businesses these days. And it's a whole operating system. And so it was more than just how do I address one angle of business ownership and much more about how do you set in place a codified system of sort of DJing all aspects of your business? And I think dentists need some form of platform or framework wherever their source of consulting comes from, that consulting should come with a platform or framework. And then they plug that in, they adopt it. And it usually takes 18 months to two years for people to learn the language, for behavior to change. Sometimes you're going to lose Pretty much in every case, you're going to lose 20, 30, 40% of your team because they're not going to buy in. And you got to swap them out. You got to find people who are going to buy into this model and then that's how you can sort of start to extract yourself. To have the right team addressing these problems, who are independent enough to use their judgment and follow kind of this system and this theory. And your job is to be this sort of visionary to lead and motivate the team and create a great culture. I think in my opinion you need a great office. I don't even like to call them an office manager. I like to call them an operations manager. In this system that I have called the eos, you have the visionary, which is the owner, and then you have this key player called the integrator. And the integrator is like Walt Disney is the visionary and his brother, I think his name was Roy, is the integrator. Somebody who isn't as emotional, who maybe doesn't have the vision, but they're grounded, they can have hard conversations. They don't lead with their heart necessarily. They lead with a very practical approach to things and they're great executors. And for me, if you have to pay 50% more than the industry average for an operations person over, you know, a basic front office person, it's going to be worth it in the long run. I think you need that person. And then I also think you need your cfo. Obviously this is self serving practice. CFO plays that outsourced role where we meet every three to four months with clients and we look at their P and L or balance sheet. We do a cash flow projection, tax projection, we talk about their personal budget. We bring all that together so that we see what's happening with clarity on the financial side of their business. And with that team in place, I think that's how you can just scale much bigger than what you can do on your own. Now you did that. So Mark, tell me, what were some of the lessons learned as you went from one practice and you grew that and then you obviously you opened up many more doors after that. What were some of the inflection points and key lessons you learned for practice owners?

Yeah, if I could like just kind of boil it down. I love what you said about eos. Gino Wickman is a very, very popular author in my particular coaching group. I also like four Disciplines of Execution by Sean Covey. But the Entrepreneurial operating system, it's all right there in that word, operating system. So if you look at the number of franchises that are available throughout the world, it is a huge, huge trillion dollar industry. Franchises throughout the world, not just the United States, but millions and millions of people are involved with franchises because of the operating system that comes along with that particular franchise. So if you want to buy a Jiffy Lube or a Burger King or a Starbucks coffee shop, there's a certain way that they do things. And that's exactly what Gino Wickman is talking about. From operations to cash flow to marketing, et cetera, there's a built in operating system. People don't want to take the time to do that. So they purchase this thing that literally is a business in a box. They know how to construct the thing, they know how to lay it out, they know how to attract customers, they know where to buy their supplies. And that is an operating system. That is the level of sophistication that you had to have as a private business owner. So using something like Gina Wichman and that framework that you're talking about is very, very important in our particular organization. I've come to believe in frameworks and assessments and all of that stuff a lot. So our frameworks are many. So we have six pillars, six main pillars that we believe in that I've kind of come across as the main things to focus on throughout your dental practice life. We call that the elite practice blueprint. And then we have four pillars about your own personal life. We call those the four. So those are the frameworks that we lean on more than anything else. But we also have assessments so you always know where you are. We have assessments for leadership, for operational systemization, we have assessments for culture within your dental practice. So we're often working to take things that are very subjective in nature, like leadership and culture, and we're able to objectively measure those and your progress as things get more sophisticated and more complex within your organization. And then what? We have belt classifications. Like we do white belt, blue belt, brown belt and black belt. So we always know where you are according to certain characterizations and profitability and gross revenue. And then we have phase assessments for overhead and EBITDA as well. So over the years, I've made just about every mistake you could possibly make when it comes to business ownership. I've done everything wrong in all of those rounds. Systemization, leadership, culture. I've done everything wrong. But over the years I've been able to figure it out through adjustment and refinement and realizing when I made a mistake and pulling out the important things that I could learn from that particular mistake in that particular situation. And then now I've had the opportunity to work with thousands of dentists all over the world in the last 12 years that I've owned the consultancy. And certain themes float to the top. So we are able to kind of work through using our frameworks and assessments to make sure that people really, really get a sophisticated view of how to run a business.

This is a good moment really quickly for me to clarify to our listeners, many of whom are our practice CFO clients. We're going to send this out to all of our clients and our newsletter coming up in a week or two. All right. So are you out of dentistry right now and you're exclusively in the consulting side?

Yes, yes, I ran the consultancy for the last 12 years in parallel with my multiple practices and I was still a practicing dentist. So yes, five months ago I sold my last four dental practices and hung up the handpiece. So I am strictly working non clinical. But it's not just the consultancy. I have several other businesses including a surgical institute where we do hands on training for implant placement and advanced surgical procedures and IV sedation, et cetera. So I got my hands on a lot of things.

Very cool. Well that's one of the things that you, if you, you I think become a good business owner, one of the things you learn how to do very effectively is delegate and elevate, which is a term from this EOS system that I have. And the better you can delegate and elevate and let go of the vine, which is another term and let go. And the more you can lead the system, the people, the more you can actually do as a business or multiple business owner. So very cool to see that in action with you. Mark. Do you have then a set of, of consultants with your organization? What is the name of your organization for my clients and would they be working with your various consultants who you've kind of trained to adopt this system inside of your clients practices?

Yeah, at the moment of this recording we have 21 what we call black belt coaches. They've all been practice owners, they're all either practicing dentists or recently retired from practice ownership. Very, very young group of dentists. Most of them are still practice owners and still sitting at the chair. So these are not CPAs, these are not non dental people that have come into dentistry. These are actual practicing dentists, all license holding dentists that have gone through our curriculum and now coach for us on the side as well. So 21 coaches, we have 220 private clients right now. We work on a waiting list and interview potential members. Clients. They have to fit our culture. They have to have kind of the right type of practice in order for us to consider working with them. We guard our culture inside this very boutique consulting firm very, very carefully, as if we were hiring for a very boutique like organization. We hire or we accept clients based on a certain number of parameters. You just have to have a great positive attitude, be willing to work. And you have to have either an integrator or you are an integrator. Your that is kind of our main coaching group. Our boutique coaching group is called Dental Success Institute. Then we have a large community which is almost 1400 licensed dentists that are members of a different organization called the Dental Success Network. The Dental Success Network actually has one of the largest buying groups in all of dentistry because you get 1400 dentists in a room and you have a lot of leverage to work with vendors and negotiate with vendors for them to give us the best prices that they can possibly give to our members. We have about 650 hours of continuing education that's available via video format. And then we have 20 chat rooms within our closed community with 20 faculty members that are manning each chat room. Anything clinical you could possibly imagine, implants, IV sedation, restorative dentistry, pediatric dentistry, and then also things on practice management, leadership, et cetera, etc, inside those chat rooms. So that's Dental Success Network. That's a much lower barrier of entry, which is why we have many more clients inside there. And then we have the private coaching, which is Dental Success Institute.

And where does Mark go from here? You look younger than me. Your hair's great. I don't see any grays. You're physically strong, you're mentally at your peak. Where does Mark go from here over the next five or ten years?

Yeah. You know, it's funny, when I speak at large conferences, I usually request a whiteboard and I start with this image that I dry up in the middle is dsi Dental Success Institute. And these little bubbles that pop off from the main mothership are so many of our coaches and affiliates that are super entrepreneurial and ask me to be part of their fledgling organizations. That's how I got involved with the Surgical Institute, which has just exploded over the last two years. That's how I got involved with tpl, which is our startup coaching. That's how I got involved with a lot of the new businesses that we have created. So my role in all of these is not for me to sit there and pretend that I'm going to operationally help in what is close to 16 businesses now that are all growing rapidly. Really what I'm doing now is acting as an advisor kind of in a, like a, I guess you could call me like a board member for each of these, helping them to grow and then lending, providing my either financial support or exposure. The different outlets that I have the privilege of speaking at, particularly my podcast, which is the biggest business podcast in dentistry as you alluded to. So those are some of the projects that I'm working on right now. We do have. I don't know if you even knew this Wes, but we have formed what we call Dental Success Partners which is a group of very curated dental practices that are extremely successful and we are building our own, own unique type of DSO that is super focused on the patient experience and on really, really predictable and advanced level clinical outcomes and recruitment of only the best types of associates. So we have about 24 practices together now in our organization called Dental Success Partners. I'm the CEO of that group as well and we're constantly on the lookout for other groups like unicorn type practices. We intend to be well over 70 practices in the next five years. So we are, we are working hard to assemble that organization as well.

Lot going on. I think the word serial applies to you, Mark, Serial entrepreneur.

And you know what, the lessons you can take from one to the next sort of venture are significant. And so if you find a passion in creating, I think there's an artist within Mark Costas for sure. Because every new business comes, comes with this element of artistry and creation and building and innovating that is very exciting. I think one of the things for practice owners to try to learn to be comfortable with is, is uncertainty, unpredictability. Because when you're trying to build something, you just don't know. You don't know if that dollar of investment is going to have a return on it or if it's just going to be money down the toilet. You don't know what the ultimate solution is. This is why grades aren't the best metric at the end of the day for teaching success is because they have a very definitive of target. But the reality is in life and in business and as a dental practice owner or as you know, a practice management consultant sort of company, or for me, you know, the CPA financial planning firm, I have Practice Orbit, which I've talked about, which is more of a technology for practice transitions. I don't know what the exact solution is. I don't know the right model for it. And so you have to go through this testing where you try something and it fails. You try something and it fails and then something starts to catch and then you build up on that. And there's just a whole school of learning that comes from experiential life that you can't learn in any other way. And so it's just awesome to see what you've done and where you're going. It's a total honor to have you on the show. I guess I'll end with this. So your parents are from the Philippines. Have you gone back to the Philippines and seen what life is like economically back there? And how do you compare that to here and what you've been able to do here? Here?

Yeah. Great question. Thank you. I have been back a handful of times, not as many times as I would have liked. I think I've been back six times in my lifetime. My kids have not been back yet. I still have a grandmother that's still alive. She is 97 years old. I would love to take them back there within the next 12 months or so to meet her. Yeah, it is a stark difference in what we experience on an everyday basis. One of my other pet projects is Smile Outreach International have this very, very strong backing for building these charitable clinics throughout the third world. This year we're going to Tanzania, to the Dominican Republic and then to Fiji. In 2024, my next year, I intend to get back to the Philippines and build a clinic out there in the Philippines. But our first one, because just for logistical purposes, because it's close by where I live, we're going to build our first standalone clinic in Mexico. Mexico. Once we have ironed out all the details to that, then we're going to work on other areas. But we already have fixed clinics that we're utilizing. Like I said in Africa, in the Dr. And in the South Pacific. So. So, yes, we take so much for granted here in the United States and, and the things that we worry about that other people could never even imagine, like our problems to them would be their best day. I, I recently got back from summiting Kilimanjaro in Tanzania and just the remarkable people there that work for seven to ten bucks a day doing the hardest work that I could ever imagine with big smiles on their faces. It's just there's a lot to learn about what we take for granted and how fortunate and blessed we are to live here in a first world country.

I'm going to end off on this Thought I did a podcast probably a year ago with somebody named Chuck Blakeman. Not sure if you know Chuck Blakeman.

But Chuck, he's been on my podcast. Yes, indeed.

Have you? Awesome. You know, he's, he, he thinks big picture on, on life. And he says the question, and this is my question, my, not my question, this is my, my sort of parting thought is what we should be asking ourselves is not why are we in business? But why are we in life? And if you start with that question, which sounds sort of fuzzy, but in reality it's probably the most important question is why life? And then from there you work back into, okay, why am I in business? Well, it's to support that bigger why and what level of energy and what level of output do I need to accomplish that bigger purpose? Because once you get to a certain level of income, happiness doesn't go up because of that income. It's like Maslow's hierarchy. Once you get to that certain point, if you don't use that extra dollar above that point, whether that, that's 150,000 as sort of the research says, if you're in California, it might be closer to 250,000. But whatever that point is, anything above that, if it's not applied toward a purpose that gives you a sense of fulfillment and meaning, then it's not necessarily going to produce any extra units of happiness in your life. In fact, it could do the opposite if you're not careful. And so think about your life, think about why, then go back and start say, what do I need to do? And I look at you, Mark, and you've got this thing in Mexico and you've got these other things going on. And I see this bigger why that's sort of driving the smaller whys. And that's just a great pattern to develop in the way we approach our, our life, big picture, medium, sort of short term. And so I love to see what, what you're doing, Mark.

Thanks, Wes. I really appreciate it. And you as a financial planner, you're probably talking all the time about this target number where people could just do whatever they want once they approach or achieve this number where the dividends are going to spin off enough either interest or dividends from the performance of their investments so as they can now live a lifestyle with cash flow and they don't have to do anything anymore. I will tell you that I've seen people achieve that number without a plan and without a plan for legacy and purpose. And it's a very, very empty, hollow feeling when you're no longer contributing to anything in the world anymore. I think we have to spend a lot of our time really contemplating what Chuck would say is, why are you in this life? I think that's a huge, huge, great distinction and a great question to answer before you actually get there. Because it was probably what, eight years ago now when I hit my freedom number and I don't have to work anymore. And I found myself working harder than ever because now I have Smile Outreach International, and every excess dollar that I have goes towards this organization that's helping people that really, really need the help. It's interesting that you talked about me going back to the Philippines and the difference in their standard of living compared to ours. That is my new purpose. And if I didn't have that purpose, I wouldn't have to work anymore, but I sure wouldn't have a whole lot of fulfillment in my life. So I think that's a huge distinction. I'm glad you brought it up.

Mark, thank you for being on the show. Maybe in the future I'll come back to you and say, hey, I've got this subject, Mark. I would love to pick your mind on it. I could definitely see that. Love the interaction with you. Thanks again for being on the dental board room.

Thank you, my friend. I really appreciate it and hope to meet you in person soon. I was just in in your hometown, but hopefully I'll get there soon and we can have a cup of coffee. Be great.

Door is always open. Be an honor. Sam.