Acquiring and Managing a High Quality Orthodontic Practice with Dr. Chad Foster

Hey, everybody.

My first podcast show I did was called Associates on Fire, part of my AssociatesOnFire.com program to educate associate dentists on all things financial as they step into ownership. And some of the great episodes I really enjoyed doing were on dentists journey into and out of dental practice ownership. And I've got a handful of these from a few years back that I just think are so valuable and relevant and, and because they were so early on, they didn't get a whole lot of attention. And I want to project them out there because I think they deserve some attention. The stories are so great, and we tend to learn a lot by hearing about our peers and their experiences and the challenges they faced and the opportunities they faced and all of that. I just think it will be super valuable.

So I'm going to rebroadcast these.

Hope you enjoy them.

All right, I'd like to welcome on our Associates on fire podcast today, Dr. Chad Foster. Dr. Foster, welcome to the program.

Hi, Wes. Thanks for having me.

We've been working together for, I think, about four or five years now. It's been a total great story to watch as you went into buying your practice. We connected up shortly, I think, before that time, right around the time you were acquiring your practice, and we did evaluation on it, and we sort of helped you assess the purchase price. And so I'm excited to hear your, your journey from there to here. Let me give you, let me give the listeners a quick a, a quick background story on you. So you're from, you're from Arizona, right?

Yep, from Tempe, Arizona, originally.

Tempe, Arizona. And that's where you're currently practicing, is in Phoenix Body Practice, 2016. And Dr. Foster is an orthodontist. So things we'll talk about today, they apply, I think, to any associate buying, but there will definitely be some perhaps unique comments to the orthodontists out there. So if you're an orthodontist, stay tuned for a great program. A little bit about your education background, Chad. It's actually very prestigious. So you got your Bachelor of Science in, in Biology at Chapman University, and then you spent a good number of years at USC University of Southern California, where you got your Doctorate of Dental Surgery and then a master's degree in craniofacial biology and then a graduate orthodontic residency. All of that at the University of Southern California. And in Dental School, Dr. Foster placed in the 99th percentile in the National Board of Dental exam, number one in his class at USC. And during his orthodontic residency. Dr. Foster was awarded top clinician at USC. So that speaks for itself in terms of the clinical. No question. I would send my kids to you if I was in Arizona.

Oh, thanks.

But we'll talk about how that may be dovetailed too, on the business side, because in the same way that I think you were successful in learning the ropes of the clinical side of orthodontics, you've definitely been, I believe, successful in learning the business side of running an orthodontic practice as well. Another cool thing that I like because I'm a big tennis fan is you were a state champion in tennis. Is that right, Dr. Foster?

Yeah, I was. That's funny, I forgot that you played tennis too. It was 2A Arizona, so it's kind of small school, so I was, I was a big fish in a small pond. But yeah, once, once upon a time, 1999, I was a double state champion.

It's a great sport. You learn a lot of good things that apply to life, particularly how you deal with failure, because everybody loses in the sport of tennis. Even if you win a tournament, you lost a game, you lost a set, et cetera.

Yeah, accountability, it's a individual sport, so it really, there's good things that come out of team sports and individual sports, but accountability and you, when you win, you win. When you lose, you lose. So kind of ends with that.

The mental side. I got a 15 year old who plays about five, six days a week, plays competitively.

Oh, wow.

And it's been a long road for him to.

And not throw his hat on the ground and kick it and throw his racket against the fence. But he's learning.

I remember those, man. I definitely remember.

There's a lot to talk about, father and son, how you deal with emotion and how you deal with loss. And I think you can get that in so many sports. But I particularly love that about tennis. Okay. Also, so you acquired your practice in 2016, early 2016. And the unique thing about acquiring a practice in orthodontics is valuing. It is different than valuing other GP practice and even other specialties because in orthodontics you have, you have long term contracts, you have contract receivables, they're called. And I want to pause just to educate the listeners on this a little bit. And for general dentists, you have accounts receivables, and accounts receivables are for treatment that has been done already, but you have not collected on it and you measure it by how long it's been outstanding, 30 days or less, 60 days or less, 90 days or less, 120 days or less and 120 days or more. And the longer it becomes outstanding, the less likely it is to be collected on. And so you're always trying to collect really quickly. Well, in orthodontics, you have accounts receivable for work that you've performed but maybe haven't collected on, but you typically have more of what's called contract receivable, which is money you will collect on that is committed, but you haven't performed the treatment yet. Because a lot of times you'll get prepays and orthodontics. And valuing the price of contracts when you're buying an orthodontic practice is a little bit tricky because you're buying the value of the contracts, but you're also going to be paying for all of the work and the supplies and the overhead to deliver on that orthodontic treatment. So you have to sort of take the gross value and subtract out what is the, what's the overhead to service that future orthodontic work, to arrive at what's sort of a net profit, and then you factor that into the valuation.

And it's always, always a unique part of valuing orthodontic practices. It was a healthy practice. It was doing about 1.2 million or so per year in collections. It had an operating income after overhead of 34%. That's after your labor, labs, supplies, facility marketing and admin costs. Typically you're shooting for about 40. Well, you've raised that.

I forgot about that. The overhead was that high when it was.

Yeah, it was pretty high. And you've raised that substantially. Now you're well above even a 40%, which is considered healthy for orthodontic practices and GP practices. And you've also grown the collections. So it's been a real success story. But one thing I'll say about you, Dr. Foster, is this didn't just happen. It didn't just land in your email box, your bank account, or your lap, however you want to say it. It didn't just go automatic. And I've seen you working.

After hours. I've seen you doing all the extracurricular that a business owner has to be involved in, I believe, to be successful today in the world of dentistry. And so I want to hear about that.

Are you looking to sell a dental practice? If you're a seller, how do you find a strong list of potential buyers? There's no MLS or Zillow for Dental practice sales. In such a fragmented market, with transaction costs so high, many dentists selling their practice feel discouraged. That's why I built practiceOrbit.com practice orbit is modernizing how dental practices are sold through its online marketplace platform. It brings together buyers, sellers, and their professional teams directly. Sellers can easily and anonymously showcase their practice on the site for free. Practice Orbit offers two options to sell your practice or option one. For 2% of the sale price fee, you'll get access to all Practice Orbit tools to sell your practice, along with a dedicated human assistant to coordinate the sale. And you only pay that 2% if you sell through the Practice Orbit system. Option 2. Practice Orbit also offers a fully brokered option of 4 to 6% of the sale price. With our fully brokered option, you'll be assigned an experienced practice sales agent to help you determine a price, identify a buyer, and navigate the entire transaction. If you're thinking about selling your dental practice, create your free account today at www.practiceorbit.com.

So let me, let me jump into my first question for you, Chad. You ready?

I'm ready.

All right. So you bought your practice for 834,000. And.

When, by the way, when we valued the practice, that was pretty much right where we valued. So we felt that you bought it for the right price but backing up a little bit before that, how long had you associated and what. You probably knew you were always going to want to own a practice. So what did you do to prepare yourself for becoming an owner?

I was an associate for six years when I came back to Arizona after I graduated from usc, my residency came back and was an associate for a lot of different corporate practices. Western Dental, Pacific Dental.

And a number of other offices. I kind of was very. I knew I wanted to own my own practice, but I was very hesitant to jump in because I knew once it's a very big commitment. And I kind of just wanted the. I wanted to make sure that I found the right opportunity. And I was passively. I didn't, I didn't want to really own my first couple of years because I wanted to just get some experience practicing, which I think is a really good thing, which I would recommend to a lot of younger doctors coming out. And then I think it took six years just because I was very nervous about jumping into something. And I was kind of. I had what I would call paralysis by analysis. I would look at opportunities and I would say, oh, it's, you know, not quite good enough. And, you know, I was, I guess I was waiting for just an. A opportunity to drop in my lap. And it never really did. And even when I bought the practice that I own now.

I would. I would classify it as like a good opportunity. It wasn't a perfect opportunity. But by that point, I think timing wise, I was just very ready at that point. And I said, you know, even if it's just a good opportunity, even if it's not a perfect opportunity, I can work it into being what I want it to be. Even if it is, you know, a good opportunity or a B plus opportunity.

Do you feel that you could have been just as successful had you purchased three or four years out of school rather than six years out of school? Out of curiosity?

I think I would say yes, but I don't know.

It's hard to know. I think when I was thrown into ownership, it's just a lot of things change mentally and how you approach things, and there's kind of like this level of desperation that kicks in in the first few months that really just brings you to a new level of work capacity, I would say. And I experienced that when I bought my practice, and I think I probably still would have experienced it at year three or four. So I don't think it was. You know, when I say that there's a lot to be gained from being an associate and working for different practices, I think that that can be. I think those experiences are gained within a couple years and longer than that. I don't know if there's that much more to be gained. So I think at year three or four, you know, had I had an opportunity to come up that I wanted to jump into, I think it would have been. I think I would have. I would have approached it with the same level desire to make it work.

One of the struggles that associates have is simply finding opportunities because there's. There isn't a. You know, there's not an Amazon for dental practices. And so the field is. Has fragmented information. As I say, how did you find the practice that you eventually bought?

So what I did.

I basically called a few consultants, practice consultants, and I would check in with them every couple months, six months, whatever.

So I was communicating with maybe three or four different consultants that I would periodically call. One of them was Ken Alexander, who lives in San Diego. Do you know him? Wesley?

Yeah, a little bit.

Okay. So I. He was one guy that I was reaching out to, and Ken just, you know, he was the one that introduced me to the practice that I bought. He mentioned the practice of Clark Jones, who is the orthodontist that I bought the practice from. And he said it's a good opportunity. Older doctor practice that used to be, you know, very, very successful, but, but a practice that had kind of started aging and declining past 10 years or so. So just that he was, he was really the one that.

Connected me.

Is he an orthodontic broker?

Yes, he is. And he's. Well, he's, I guess he, he does practice sales, but he, he's more of a consultant for practice management. So I've had Ken come into my practice and do just scheduling type stuff and just things that a practice consultant does.

And how did you find out about him?

Boy, I'm trying to remember.

I think I just went. I'm not really sure, but I think I just went online and, and looked up orthodontic practice consultants. I might have found a couple that I was communicating with that way.

Maybe I heard his name from someone else, I'm not sure. But I think that's really important if an associate is looking for practices. I think just it was helpful for me to, even before I found this opportunity to be in touch with consultants and kind of explore certain, certain options superficially, to kind of get used to going through things. It gives you kind of a perspective of what's out there and.

It starts to get your mind working on the process of, do I want to buy a practice? Do I want to buy this practice? Just having different little scenarios of practices that are available.

Let's talk about now. You found the practice and you meet Dr. Jones. How did that relationship.

Start? Did he stay in the practice after you bought it? And really, just tell me about that experience of buying a dental practice that roughly, I don't know, two, three month experience of organizing your team and dealing with all of the legal stuff, the financing on the practice, the negotiations, stepping into, you know, literally stepping into the building and starting ownership. Tell me about your experience and what lessons perhaps did you learn?

Yeah, it was very stressful, which I guess is how it always is for someone when they go into that. Because when you're an associate, you don't have any, you don't have any knowledge of a lot of that stuff. And you kind of make it into a bigger deal than what it is like when you don't know any. For me, anyways, when I didn't know anything about practice ownership, it was all very kind of scary and new and I felt very, you know, intimidated and kind of underprepared, I guess. So when the day came and this was the opportunity, I thought I was moving forward with. I just tried to get really good help around me. So I hired. You know, I knew I wanted a good accountant, so I went with practice cfo, which I'm really happy with. You guys helped me analyze the practice. You gave me good feedback saying that this looks like a good opportunity. I also had another orthodontic specific.

Evaluator do the same and he gave me the green light. And then when I got into the practice, you know, there were, obviously there's a lot of things involved with.

Getting, getting bank of America or whoever your bank is to help and all that insurance wise and all that stuff. But I think that a lot of it, I would tell an associate not to be overly worried about needing to absolutely know everything as long as you are able to get good people on your side to help you evaluate, because there's no way that I was going to be able to do it all by myself. The real skill that you need to have, I think is being able to identify people who are good people to help you and people that you trust to walk through some of those things because you can't be an expert in all of it. And so that's what I leaned on in going through the actual purchase process.

And then when I bought the practice.

Again.

I leaned on you guys a lot, trying to understand how an orthodontic practice collects and what was being done in the practice before me. Because Dr. Jones was an older orthodontist and he was kind of by that time in his career, he was a little bit hands off with knowing how to run things. So I had to figure out how the practice was running kind of on the fly with some help from him because he definitely knew more than I did. But we were changing some systems and obviously changing accountants and payroll, and you guys were a great help in that. So.

Yeah.

What's one of the biggest decisions financially you make with when you buy a practice? It's a commitment. I mean, you took on what you take on $850,000 or so in debt at the time, and.

That doesn't get paid off easily. No, but the other thing too is you said earlier that it was a good opportunity, perhaps not a great opportunity. How many great opportunities are out there? There are some great opportunities, but not many. Yeah, and you're, you're a very, very lucky one. If you find a practice that you're able to maybe purch it at undervalued maybe. There's, there's a lot of work to be done. The team's already the culture is good and the team knows what they're doing and the transition just, just goes really smoothly. And next thing you know you've got a 1.3 or $4 million practice with the 40% operating income. It rarely does it happen that smoothly. And so sometimes I think of it actually, when you made that comment, I thought of it how a little bit with, you know, with marriage, you find somebody and the success of that marriage in some ways depends on what you do after. Of course, you want to find somebody you're compatible with and you know, you're attracted to and you're happy with and, and all of that stuff. But. But I think in the long run, it really matters what you do after buying that practice. And I remember after you bought your practice, are you looking to buy or.

Sell a dental practice? If you're a seller, how do you find a strong list of potential buyers? There's no MLS or Zillow for dental practice sales. In such a fragmented market, many dentists selling their practice feel discouraged. That's why I build practice. Practice Orbit is modernizing how dental practices are bought and sold. It's a platform technology. Y' all know them Zillow, Airbnb, Uber, and OpenTable, just to name a few. These technologies do two things. First, they help match buyers and sellers by centralizing the marketplace. Second, once the match between buyer and seller is made, these technologies help them navigate the sale to a successful close. Here are a few of the features inside a Practice Orbit users can determine a reasonable sale price for practice in just minutes. All they need is the most recent business tax return. Practice owners can use the directory to find important service providers like practice brokers, attorneys, accountants, and bankers. Practice owners and their brokers can invite those service providers into the platform so all parties are coordinating the sale together. Practice owners will have a beautiful digital listing of their practice like a home on Redfin. And importantly, the listing will be anonymous and personal information like your address, name and pictures are only released after an NDA is signed and approved by you or your broker. Practice buyers can create saved searches to be auto notified when new listings come on the platform that fit their desired specialty and location. And hey, dental practice brokers, you can list all the your practices on the site for free. By doing so, you'll get access to Practice Orbit's large pool of buyers, all of whom have created profiles and saved searches to be auto notified when new listings come for sale. You can use the platform to introduce your listings to a targeted set of buyers. Additionally, and optionally you can use the platform tools such as a built in NDA, a customizable LOI and a workflow tool to navigate the sale from LOI to Closing. In fact, you can manage all your listings on the system from listing the practice to NDA to LOI and finally.

To closing the deal.

Create your free account today at www.practiceorbit.com.

It was a little bit rare. I don't think we've ever had any other client of ours do this. You wanted to meet every month to go over the financials together and understand really every line that was on that set of financial statements. You remember that?

Yeah, I do.

Wes, One more month. I'll meet with Richard. He's somebody in our office. I want to meet with Richard one more month to make sure I understand this.

Yeah.

Now you said a minute ago that you'll never understand everything and that's, you know, none of us can understand everything and we rely on good people to help us through the important decision, these important decisions. And you know, sometimes that comes with a price tag. But if you do your due diligence on your team, I think it's really, really going to, going to pay off to have the right consultant and the right, maybe attorney and the right cpa, the right, the right financial advice around you as you make that commitment and sort of lock yourself self in. But at the same time, one thing that I think has worked so well for you is that you did dig in enough into the numbers and the finances to at least speak that language.

Yeah.

To be able to interpret these financial X rays that we, that we provide.

Yeah.

And you now, you know what an income statement is and how to read it, you know, what are healthy ratios, you know, what a balance sheet is and the nuances of debt and paying off debt. And you're always asking questions about what can I deduct, what can I deduct and you know, how do I maximize tax benefits and things like that. You're just inquisitive about that.

Yeah.

And I find that to be a common characteristic among those that are really strong on the business side as well as the clinical side.

And it's not, I didn't know anything beforehand and I knew that was, it was probably out of insecurity that I really wanted to make sure that I understood a lot, especially the first few months.

I can't imagine not having a dental accountant.

Just, it's, it's such an asset to work with a dental accountant who works with a lot of practices so they, that person can Tell me kind of what it. What's normal. Because it's just, I mean, everything. I'm blind to everything going into the purchase of the practice and how I'm spending money, how money's going out the door and coming in. So I just think that's one of the biggest things that I would say is that having a true dental accountant is super, super important. And then I still don't know a whole lot, but trying to know as much as I can just so I can understand a little bit about what's going on, because, you know, you can't, you can't. There's way too much going on in a practice to really be an expert and just know everything, know everything that's going on at every second. Because when I. When I bought the practice, I found my time was just so, so limited, and there were so many things that really needed attention, but my time was so limited, so I had to go through what stuff is stuff that only I can do or I need to do. And for me, when I bought the practice, it was more.

Trying to figure out clinical systems and trying to understand how new patients are coming in the door and, you know, to nurture those things that are getting new patients in the door and to build relationships with referring practices. How we're doing advertising, our website, our messaging to our current patients, a lot of that stuff was stuff that only I could really do. And the other stuff, I just wanted to get good people to help me and make sure that I could trust people that were helping me. And that was you guys for me. And that was a huge thing. And it's still that way today in the practice. Like, I don't have enough time to. There's so many things, and the practice has grown a lot, and there's so many things that really need attention. But I have good team members that I have that I trust that I can. You know, I understand what they're doing, but I'm having them do it. If we need a printer in the office, a printer goes down. I could spend four hours, like, researching the best printer and get the best cost, but I just don't do that. I'll have someone else do it. And at the end of the day, you know, worst case scenario, Maybe we spent $30 more on the printer, but I've spent those four hours doing something, you know, the things that I identify as the things that have to be done by me in the practice, and it works out, you know, I couldn't do. I couldn't do what I need to do for the practice. If I didn't trust my team, if I didn't have a good team, and if I didn't have people to help me.

Like practice CFO or like, you know, a consultant that I would use for stuff that is, you know, that I'm not an expert in, but I have a basic understanding in a lot.

Of really important stuff there. I want to just share my own thoughts as a practice owner. Yes, I'm a practice owner, not a dental practice owner, but I'm a CPA and financial planning practice owner here at practice cfo. And, and I've had to learn that myself, Chad. I remember when I started the company and I saw my savings dwindling and I lived in expensive Southern California with a wife, stay at home wife and three kids at home. And it was that same sort of anxiety that I gather you were feeling. You expressed a little bit of that. Early on, I was definitely feeling. And at the time, every penny mattered. So I Wore, I wore 50 hats. I did everything and. But as I sort of developed my understanding of what it means to be a leader, and maybe there's no way around being that initial 50 hat carrier person as you're starting something or new to something, but a good leader is going to learn how to take those hats off as fast as possible and put them on somebody else, train them adequately to do it, and then keep the hats on that only you can do. As you said, I think that's a really important comment. So at practice cfo, one thing I do is we came up with something we call the three to thrive. Our theme here is helping doctors thrive financially. And so our three to thrive is I meet with our head of accounting, our head of tax, our head of investments, and a few other people, and we just define every quarter. What are the three things, three things we're going to focus on right now to improve our processes and our system and our quality of service deliverable. And we just focus on that. And then every three months we meet and we see what's been accomplished and then we either redefine those items or we come up with a new three to thrive. And eventually you start to get to what I call the mo, your modus operandi, which is what's your pattern, what's your system that everybody is sort of following and they know their position and they know their plays. When you bought your practice, Chad, you had all of that issue of I need to sustain collections because everything depends on it. But at the same time, you have your practice Debt, you have all of your overhead expenses. You've got to structure your payroll, you've now got. Tax planning is a lot more involved as an S corporation. You have your personal budget. You want to start saving for a retirement plan at some point, probably dealing with student loans. So you've got this ecosystem of finances that's all sort of chipping away at your attention. And it creates this, this moment where you're just juggling a lot of things.

Yeah, definitely.

And you don't want to drop anything. And so that's where a good leader says, okay, these are the balls as I'm juggling, I just need to toss them over to somebody else, coordinate with them, let them handle it. And these are, you know, these are the balls I need to keep juggling myself. And eventually you sort of settle into a pattern, but you have to be very deliberate about doing that over time. And I've. A lot of times I meet with you and I, I see you, you're in sort of an office setting or I see all these books and all this paperwork and sometimes you look a bit tired. And I know it's because of the extracurricular, non clinical stuff that you're doing that's allowed you to get to a point where I know you say you still have a lot you're working on, but I think your M.O. is really getting, getting dialed in nicely.

Yeah, I think that. So I think what I would say in regards to what you just said is when you come in, when an associate comes into ownership, I think that making sure that the people stuff is handled really well is super, super important.

Because the people stuff, the personal connection within your practice can't be, that can't be like, you know, delegated to someone else. When I came into the practice, I had to make sure in a transition the patients are going to be concerned and they're going to be confused. And I wanted to make sure I controlled exactly how they experienced this transition. And I wanted to make sure that I was proactive in my communications with them through letters and how we rebranded and my interaction with everybody that I met for the first time, that was super important. And then the team having a new team and.

Being the new leader of the team, because they're scared too. Your employees are. They don't know what's going to go on. They probably have assumptions about you coming in. And so you need to try to manage that. And then for me as a specialist, I have professional relationships that were existing with the office that I need to maintain. I need to make sure it's. There was so much involved in rebranding and introducing myself to the patients, the employees, the professional relationships. And that really took, like, all my time, because in my opinion, that's the most important thing. And even today in the practice, the thing that really makes us successful is I want the team to be happy. We have really happy team members. Because I put a lot of effort into.

Developing the culture within the office.

I want to have happy patients who can expect to be treated awesome by us. And I just want the professional relationships that we have to view us in a very special way, because I want our office to be the office that they think about when they think of orthodontics. So I want to make sure that I do a lot more. It's just a lot of effort put into it on my end, but it's. It's so worth it because the people stuff is the stuff that's going to define success. And. And that's the stuff that I feel like I could. I had to be intimately involved with, making sure that, you know, I was all over that part of it.

I think that's one of those balls you're juggling that you can't. You can't toss to somebody else.

No, is.

Is your culture and the energy that is in your office. I personally believe that when the doctor walks in the door every morning, the countenance of that doctor is going to reflect itself in the countenance of the team and the general environment there in the office.

Can I say something real quick? It's funny to mention that, because one feeling that I just remember that I had that was very foreign to me when I owned the practice is I felt like. I felt like everyone was always watching me in regards to all the other employees in the practice. I felt like it was just a different feeling from being an associate, where you're just one of the team. Kind of when you're an associate doctor, you're just. Yeah, you're the doctor in the practice, but you're one of a team when it's. When it's you and you're the owner. And that's just a very stark feeling that I had. And some days it was kind of overwhelming. I would come home at the end of the day and be like, I'm just sick of. I just feel like they're all watching me all the time and they're taking cues. Taking cues off my attitude or exactly what I'm saying. And it's a feeling, and it was a very strong feeling. And it's still there today, but it's like I kind of embrace it now and I kind of, you know, you grow to like it if you're a leader. And it actually being a leader and a practice owner has brought out.

It'S made me a better person in a lot of ways. It really has brought out, had made me a much, much better person. So I'm grateful in that. I'm hugely grateful in that regard. But that's just something funny that I noticed right away is that I just felt like I'm being watched by everybody all the time.

Yeah. Yeah. I think the things that we learn as practice owners can translate into other areas of your life. And as you raise children or other social groups that you're in or religious groups, there's just a lot you can learn about interacting with people. People. But I. I just believe that doctor. Doctor comes into the office and doctor needs to be on a mission. The doctor needs to have a sense of purpose that it. It isn't just about straightening teeth, although that is at sort of on the surface of what you do. But it's about giving. I don't know. It's. It's. It's about giving people an experience that just elevates their life a bit and makes. Makes their. Their existence a little bit happier. And however you define that, if you call it your true north, you come up with a mission statement, put it on the wall, whatever that is. But something that everybody sort of thinks about on a regular basis that indirectly but definitely drives a sense of purpose within the office. I think that's one incredibly valuable characteristic of a leader, is that they're just able to do that.

Let me ask you about just one or two more questions here. Chad is. The industry is undergoing a lot of change. And I bring this up in a lot of my podcasts, where you've got a lot of consolidation taking place, large group practices taking place, and yet when I asked dental students, do you want to own your own practice? Generally the answer is yes. Not always, but generally the answer is yes. And just as you had sort of felt some anxiety, maybe I'll even border and say perhaps some fear.

Fear.

And to that experience of owning a practice.

Do you think that associates still have the same great opportunity to be successful in private ownership?

I think so.

I do. And I was really nervous coming out because I practiced for a lot of corporate offices and saw how successful they were in Arizona, where I practiced, I think is the most saturated state with corporate dentistry.

So I was very intimidated in that regard, but I think they're. I think I'm really big on, like, what you mentioned, the doctor being the central part of the practice and in our. All of our communications with patients, in our, in our advertising and everything, it's very Dr. Centric. And I think there's an advantage that private practices have compared to big DSOs and corporate offices, and that it becomes very. It's just not. I don't know, it's not the same. It's the doctor.

When I, When I pick a doctor that I want to go to.

For me, if I pick a dermatologist or whatever it is, it's a lot more about, you know, the doctor that's there. It's not, it's not the name of the practice in some big group. And I think there's a big opportunity for doctors who, who do it right to.

To do very well in a private practice setting. I think, I think there's just some advantages. There's. There's. In a corporate setting, those doctors, they don't have the same ability to market in that way. So I think it's an advantage for doctors who own their own practice to do that.

Yeah, I think so, too. And if I'm, you know, if I'm honest, as I worked with a lot of associates and doctors, not. I mean, a lot of them feel that pressure, and they economically have been disadvantaged because of some of that pressure, along with reducing reimbursement rates from the insurance carriers. But those are some of the pressures. But at the same time, you said if they do it right and that, that, that, that is it right there. If doctors do it right and they put in, I think, the energy and the effort, the discipline, the extra time to do it, and they lead right, they can still have an incredibly enjoyable and financially successful career as a clinician.

Yeah.

Running their own practice, managing their own schedule, owning their own professional experience. There are just so many great things that come with practice ownership that I've been able to enjoy myself as a practice owner. And so, yeah, if they do it right. So how do you do it right? Well, a lot of what we're talking about is being deliberate about your decision making, being willing to overcome that anxiety and perhaps that fear and pull that trigger, or organizing your team, being involved in the details with your. The culture and coming to your financial M.O. and just, you know, just working really hard. All right, Dr. Foster, last question for you before we break is what other career advice, if any, do you have for associates aspiring to be a practice owner?

What career Advice would I have for.

Them if I were an associate and I came to you and I'm right out of dental school, I'm an orthodontist. And I said, Dr. Foster, what are the top one or two things I should be focusing on right now to get to where you are?

I would say working for someone else for a couple years is a great way to get experience under your belt as an orthodontist. It doesn't matter if it's general dentistry or orthodontics. You're going to be inheriting cases, those situations. So you learn a lot. I learned how to take over a case that wasn't going so well and bring it back into good shape. So there was huge.

Not just a steady paycheck, but huge clinical gains for me in doing that. And then I would say, while you're doing that, just keep your mind open, stay in touch with consultants, have conversations, assess opportunities as they come along, even if they're not the right opportunity. Just going through the process of assessing them is a great experience in learning how to do that. And then once you find the right opportunity, just, it's like burn your bridge time. And it doesn't matter if it was the perfect opportunity or not. Once you've committed, just, you know, it's time to be all in. And I think that. I think that if you have the intention to be a good doctor, and if you have the intention to be good to your patients and to be good to your team.

Then you'll be successful.

If you come into your practice every day. I try to be very vulnerable and be very honest. And.

Being an owner makes me a better person because I have to be honest. I can't BS the people in my practice, whether it's the patients or whether it's my team. I have to be my best self with them. And my intention is to do right by all of them. I just. I try to be vulnerable and be honest and lead from the heart and encourage my team to do the same.

And you can do it. And I would say that, you know, it's always looking from the outside in. It's always. You make it much, much harder from looking outside. And like, oh, I could never. I could never come in and own a practice or, you know, be competitive with other practices in this environment. And I think it's. It's very easy to do that, to make it harder than it is. But the reality is, once you're in and once you're fully. You've burned your bridge and it's full steam ahead, you start to realize that you're much more capable. And you start to realize that maybe the competing practices, maybe they don't know as much as you thought they did.

Great words of wisdom to end on. Dr. Foster. Thanks for being on our Associates on Five podcast.

Thanks, Wesley. I appreciate it.