Building a Killer Cosmetic Dental Practice

Hey, dental associates and new practice owners. Welcome to the Associates on Fire podcast. Powered by Practice cfo. This is the podcast that teaches you what you never learned in dental school, the financial side of dentistry. We cover topics from planning for ownership, buying a practice, to student loans, taxes, and all things financial for the hungry to learn Dental Associate. So let's light it up.

Welcome back, everybody, to another episode of the Associates on Fire podcast. As always, I'm thrilled to have a great guest today in Dr. Todd Snyder. I'm going to introduce him in a minute, but as always, I just want to remind everybody about our Associates on Fire education platform. This is really designed for the early stage dentist who is yet to own or maybe is a new owner of a practice and even for the dental student. And we are teaching you all things of business, the stuff that you aren't taught in dental school. But man, I can't tell you how important it is as I've worked Now for about 13 years with dentists and seeing those dentists that are really successful financially and sort of own their career, they, you know, they speak that language of business enough to really manage their finances effectively. And on our Associates on Fire website, which is associatesonfire.com we have these podcasts which you can also download on your, on your phone. Just search for associatesonfire.com and then we have a lot of great videos on all sorts of financial subjects. Be sure to watch those, create an account, fill out your account profile and.

I promise you you'll get some really good content out of it because of the type of people that are presenting and sharing their knowledge. And on that note, Today we've got Dr. Todd Snyder, who is a practicing dentist. I'm going to give a quick intro to you, but welcome to the show, Dr. Snyder.

Hey, thank you, Wes. I appreciate it. It's good to be here.

So you've had a really heavy focus. Here's my intro about you. Tell me, correct me where I'm wrong, but you've had a really heavy focus over the years on cosmetic dentistry.

And you've been very successful at it. That is sort of a niche within your practice and you've been so successful at it that you've sort of wanted to reach out and just share the things that you've learned over the years with others. And so you, you are now a trainer as well as a practicing dentist and you have given trainings throughout the world. You focus a lot on what is a great business and life mindset, on communication, how to lead your team, how, how to talk to your patients, all these things that are invaluable to what is really a successful dental practice. How did I do in that intro?

You did pretty well. I mean, I could certainly throw a couple extra tidbits in, but, man, you nailed it.

Well, that's what I want to hear is a little bit of those tidbits. Give us a backdrop of yourself.

Yeah. So when I was in dental school, we. We probably all. For all those dentists that are out there, young guys, old guys, we all had someone that kind of we looked up to in dental school, that one professor that really we liked a lot. So I had one that I was very fortunate. He was an international lecturer, book publisher on cosmetic dentistry. And so we bonded together over water skiing and snow skiing. And so he basically took me in as, like, a second son. And so I was pretty fortunate to have this cosmetic guru just show me the ropes on everything. And so when I was leaving dental school, he's like, okay, why don't you. Why don't you come back here and let's create a graduate program in cosmetic dentistry? And I was like, that sounds great. I'd love to. I'd love to learn some stuff and put that on the map, because there is no graduate program in cosmetic dentistry. Everyone takes weekend courses. And so I went back, and for almost four years, we created and ran a graduate program that was five days a week, two years long on cosmetic restorative dentistry. And so that's where I got my start of publishing, you know, a book, writing articles for the dental journals, doing research and teaching. I'm an educator. I'm a teacher. And so from there, when that collapsed because of politics and universities, I got to then start teaching on the road. So I've been lecturing on cosmetic and restorative dentistry for, like, 26, seven years, something like that. So it's been a long time of teaching. It's only been in the last, like, five years that I said, you know what? People need to understand more about all the business aspects, the marketing, the communication, and all the things that go into it. Because, as Dennis, let's face it, we all want to get proficient and be the best at the dentistry. In my mind, dentistry is the last part of the equation. You can't get there if you can't market and you can't communicate. So you could be the best dentist on the planet. But if you have no patience or they don't move forward, you have nothing. And so that's kind of the last five years hence, doing my Online training programs and other things where I've had more fun, you know, helping people grow and do things they've never seen. Because most time as dentists, we have blinders on and we look at just how can I get really proficient at doing a certain procedure or buy the next tool. So there's a nutshell. There you go.

Great. Thanks for elaborating. Good detail there. Tell me, what are the credentials for those who specialize in cosmetic dentistry?

That's a good question. So obviously there are, what, five recognized specialties in dentistry? Cosmetic dentistry is not a recognized specialty. And.

So we were trying to put that on the map by saying, okay, we had a postgraduate program that was a certificate program, program through ucla. So it was not recognized by the ada, but it was a certificate.

And so there are groups or organizations out there right now trying to create cosmetic dentistry as a specialty that is recognized by the ADA or some other body. But as of right now, there are only, you could say, like academies that have their own credentialing process, which I will say are quite rigorous. And definitely for anyone that has that certificate, it says a lot about what they've achieved. It doesn't mean that someone that hasn't gone through it can't be as good, but it says a lot about their commitment and their skill set to have gone through it and passed.

Can you tell us what those are? The Academy of Dentistry.

Yeah, American Academy of Cosmetic Dentistry is probably the biggest, most well known. And then you have.

The American Society for Dental Aesthetics, which is asda. They have their own board exam as well, and both of them have board exams as well as you have to turn in cases documenting all the steps. And then for the aacd, you have to go in and actually do a dissertation verbally in front of them where they grill you. And you've got to prove your knowledge and your skill set. So very much like a graduate program as far as what they test you at, but you learn over your own kind of time, courses, et cetera, and try to achieve what they're asking for. There's one other cosmetic group called the American Academy of Aesthetic Dentistry, which for that one, they don't really have any kind of board or test, but it is literally the who's who of high end cosmetic dentistry. And to some extent, it's just a matter of knowing the right people and getting an invite.

Yeah, you know, I got a question for you on this and I asked about the credentials because obviously it goes without saying that a dentist needs to learn how to do this. Well before they introduce it in their practice, or at least at some level, and then they'll continue to improve their skill set. But, you know, some of my more successful, and I'll just define in this narrow sense successful as financially productive in their practice. Some of my doctors who are more financially productive in their practice have a strong cosmetic element to their practice. And I think because there's less pressure from reimbursement, meaning that it's a lot of fee for service. And so therefore your return on time, your return on hour is much better financially. So why don't more dentists do it then? That's my question for you to start.

You know, it's such a big topic right there, man. I just see it going a million ways. So to keep it simple, why don't more dentists try to do the cosmetic dentistry that is not impinged upon by insurance so they can make more money for their time? Well, I would say the first thing starts with fear.

And comfort. And so obviously it's comfortable when you have a lot of patience to just keep doing what you've been doing and making a decent income to change all that and say, okay, I'm going to try and do just primarily cosmetic dentistry and get the insurance out of the equation. Fear limits people from doing things. And so.

Majority of dentists, I forget what the number is, like 86% take insurance. And so if you're going to try and do cosmetic dentistry, you're still limited by the insurance carrier as far as what you can charge. And so for some of that, your time and capabilities and materials are still dictated by that, that fee. And so you can't provide potentially the higher level of service and product, et cetera, because of that fee unless you, you know, play games. So the alternative is, okay, well, then I'm going to drop insurance. Well, that scares most, Dennis, because they're going, well, then most of my patients are going to leave. And I can tell you, if you've got good communication skills and people value your product, you and your service, basically, they won't all leave. And for the handful that maybe do leave, I don't care if it's 10 or 20%, if you do the numbers and figure out how much you make when you're out of network, charging your UCR as opposed to being in network and having significantly reduced, reduced fees and what you write off, you'd realize that, hey, I can treat less people and make more than seeing all these people on insurance and making less. So it's the Pareto principle.

So that's where I see a lot of people just, they won't focus on doing one thing like I want to be just a cosmetic dentist and do just cosmetic dentistry. Most dentists try to do everything to try and become profitable. So a master of all trades or jack. Jack of all trades, master of none. Is that what it is?

So are you recommending that if somebody untethers from the insurance, from the PPOs and they go fee for service that. Let me rephrase this question. If a practice is going to go cosmetic heavily, are you recommending then that they detach completely or untether completely from insurance so that the insurance fee schedule isn't holding back the, the larger or the growing bulk of their production, which is cosmetic? And don't let the PPO tail wag, wag the dog, in other words.

You know what? I never tell anyone how to run a business. There's a lot of ways to do things. I'm telling you, for me, there's no way that I could do what I do and charge the fees that I charge and use the labs that I, that I implement. Like, you know, my lab, you know, if it's like a $900 veneer or crown and insurance reimburses at 786, let's say I'm just ballpark guessing on insurance. But it's like, okay, so I would go backwards. Like that makes no sense.

So how do you do like a single front tooth? You can't charge like 5 or $6,000 for a lab technician to make a $2,000 crown. So you have to decide what it is you're trying to do. Now, if you're not trying to do that level of cases, but you want to do just a lot veneers and bondings and crowns and things, you can do that with insurance. You're going to have to, again, volume. You're going to have to do more of them. But it doesn't mean you can't do them. You certainly can.

You're just going to be limited by that. You know that, that fee structure. And I know there's games that a lot of dentists play to get around some of those fee structures. But you know, if you're doing things right and legally and everything else, then you know you're bound by that contract. So you can't do certain cosmetic things and be very profitable. So you can do it either way. But I would say for me, I got to do it this way.

You had mentioned fear and comfort earlier. I want to talk about comfort for a sec. I think there is a comfort in knowing that you have the PPOs, without a doubt. And listeners to my podcast know that. I bring up this subject of ppo. My last podcast was with a, with a, a client of ours who, who went fee for service and talked about that experience and, and he ended up saying that there was more fear than was merited. The reality of, of definitely took a process and thought and it wasn't easy, but his practice is doing better now than before and from production standpoint and his return on time, which is one of my favorite terms. What, what's your return on your time? Dentists have such a valuable skill set. You have to, you can't underestimate what the return of time that you should be getting is for all the years that you've put into this. So, you know, so be willing to do that. But that comfort of knowing that, okay, I've got the insurance companies, it's very easy for a patient to say yes when they know that the insurance company is paying for a lot of it or most of it. Or also, if I'm cosmetic, isn't people coming in with pain? If somebody comes in with pain, they, that's. It's also easier there to get to a yes than doing a cosmetic work. So there's a comfort with your sort of traditional PPO restorative type dentistry, which is fine, which is fine for a lot of practices. And we're not saying, and I'm sure you would agree, we're not saying everybody needs to go full on cosmetic here, but there is a space for it. And for a lot of practice students coming out of school and associates, there's actually a really good opportunity for it. One of the big thoughts I have or questions is, is this something that is only doable in a. Well, with a, with a wealthier demographics or in a certain type of geography? Or could this be done pretty much, pretty much anywhere?

Let's start with the first thing. Fear. Yeah. False evidence appearing real.

So most people are afraid to do things because of their own mindset. Right. They haven't done it before, so they fear they can't do it. Or they listen to everyone else that says it can't be done. And yet everyone they listen to hasn't done it. So we're holding ourselves back versus saying, you know what, I can do something, I can do anything I want. The question is, when do I give up? Well, if you never give up, you never fail. And so what I would say is, you know, pushing yourself to be uncomfortable every day to me, is part of my life. Like, I want to be uncomfortable every day pushing for something bigger and better. Because when you're comfortable, you're complacent, you're not moving forward. And if the rest of the world's moving forward with inflation and everything else, you're actually going backwards. So when you sit there and say, okay, I'm in network and I'm getting paid, well, the insurance companies are decreasing your reimbursement every year, and yet products and overhead and everything else keep getting more expensive. And your lease is going up every year, too, right? Or your rent or whatnot. So you go, okay, I'm making less every year, and I have to work harder to make more. At what point do you want to get off that hamster wheel? Or what time or what point in time does your body break and let out because you've been working so hard, or you realize you missed out on parts of life that you'll never get back? You know, that's. That's a concept that you got to decide if you really want to be comfortable where you're at or if you want to push for something better or if you're tired of the status quo and you're willing to break the mold and do something that everyone else is afraid to do. And yet there is always a place for everything in this world. Let's face it, Lamborghini sells plenty of cars. Cars at a heavy price point, as opposed to, like, Honda and Kia. They both will get you from one place to another. But people are willing to pay for something. So with cosmetic dentistry, yeah, people are willing to pay. That's if you, you know, provide that. That marketing presence that they perceive a difference there, as well as communication to get them to understand why they should go with one business versus another. So. So, yeah, fear holds most people back. Can you do a cosmetic dental practice, you know, anywhere? Yeah, there's enough guys doing that that I know and have seen, you know, whether in rural New Mexico or, you know, someplace in Kentucky, whatever. There are guys that do primarily cosmetic dentistry. Now, some of them do just cosmetic dentistry, and others still will kind of sprinkle in other, you know, opportunities. So I don't like. For example, just because I do cosmetic dentistry doesn't mean I turn away someone that needs an exam and a filling and a cleaning. Right? I don't turn them away, but I don't market for that. So my niche is I am marketing, for one thing. I want that type of client that wants the smile makeover or the cosmetic dentistry or the jaw problems that relate oftentimes to looking at how the whole mouth needs to be rebuilt or modified. So I'm looking for big patients. And should someone come in that just needs a filling or crown, well, that's the little extra, so to speak. So my analogy would be like, I've got a glass, I'm filling it with giant ice cubes. Those are my big cases. And wherever someone happens to fit in and I have time, that's the smaller case. That's like a kidney bean. Let's say that I'm fitting some of those in between those big ice cubes. And those are my, some patients that want a couple crowns. And then between those I've got some little tiny peppercorns that I throw in and those are some fillings. And so the little stuff will fill in to help the cup be full. But I'm going after one big thing that's big game, big cosmetic dentistry, big treatments. And so I'll still do other stuff. And that's where anyone, whether on insurance or not, you know, you can do cosmetic dentistry, you might have some limitations, but you can do it and still fill in the other things. But as dentists, we tend to try and market to everybody for everything as opposed to saying, I'm fabulous at one thing, you want to come see me for that one thing. And then usually someone asks me like, well, can you do cleanings for me? And other stuff. That's what I want to hear. Because my message is so powerful. They're asking me, can they come into your world and have regular dentistry? And it's like, yeah, sure, you can come in.

So I'm interested in the evolution of a cosmetic practice and you're specifically yours. And I want to tell, I want you to tell us about that evolution a little bit. And I s in my mind right now I'm picturing it evolving in two ways to becoming a, a, a cosmetic based practice. Number one is people would come in, it was originally a standard restorative style dentistry practice. And you would, you became very effective at proposing and communicating cosmetic dentistry. And people started to say yes. Next thing you know, they're talking to their family members and friends and, and it evolves that way. Or the other option is you said, I want to really focus on cosmetic and I'm going to design this out in concept first and then I'm going to market my practice that way as a cosmetic practice. Even though I'm partly doing any cosmetic dentistry, at least in the beginning, because you got to start somewhere. Which one was it? Or was it a little bit of both?

Yeah. When I opened, I was literally. So I had practice in Los Angeles. I had practice in San Diego, and I said, I'm going to go right between into Orange county. And. So I found a building, literally built an office from scratch and put my shingle up. And from day one, I was known. I have the registered trademark of aesthetic dental designs. And so everything that I did had my brand. My brand said one thing. Aesthetic, right? It could be cosmetic. Dental designs could be aesthetic. But nonetheless, it was. I do cosmetics. And everything in my messaging, from my marketing to the actual verbiage in the ads, all talked about just cosmetics and what it could do and how we could fix things. Let's face it, we all want to look good and feel good. So I'm marketing towards that lifestyle. If you want to look good and feel good, I'm the guy you want to talk to. Now, opening an office from scratch, people would say, number one, you're crazy to open from scratch. Number two, to say you're opening in Orange county and there's what, seven dental schools in California, and you've got a ton of dentists already there. You're. You're going to go under, right? And then they're going to say, and you're not taking insurance. It's never going to work. You're going to fail. Well, these are all the people that have never tried it, right? So here we are, 21 years later, and it's worked great. Now, I'll say the first, like a year and a half to try and find patients was challenging, right? You know, you got to throw your marketing out there. It's the pebble in the lake, waiting for those ripples to eventually get to the side of the lake to build momentum. But it's all doable. You know, if you set up a business plan, if you factor in, you know, certain months that are probably going to be slow, that you have to have marketing dollars and dollars to pay for overhead and whatnot, you can make things happen. But then it becomes, okay, it's sink or swim. So I'm out there beating the pavements, trying to find people as well as doing marketing, because I'm not going to, you know, sink. I'm going to swim. One way or another, I will find the solution. And so it's not that hard to get people to come in and see you when you have the time to talk to people and share with them how you're different and unique and it resonates through your communication. So early on, it was all about me meeting people as well as some marketing out there. And the message was that I do something that no one else does. There are plenty of dentists that do the same thing I do, but that wasn't the perception by the public. And so the public was coming to me, for one thing, cosmetics. And once I got to the point of doing cosmetics, like, well, can I get my teeth clean here? Can you do a filling? It's like, yeah. So I didn't have a hygienist. It was me. It's like, yeah, I'll clean your teeth, no problem. But I'd give them the best darn cleaning they ever had, and I would tell them about things that I was doing that they hadn't heard of. So they had value built into it because of me communicating. And so I've communicated such that they get an appreciation for that value and the price point involved and that they didn't have it done in an insurance office. And it was slightly different with different technology, what have you, that they go, you know what? I'm happy to pay that difference of $20, $50, whatever it is, because I appreciate and value what you've done. And. And it resonates that it was. Was different. So hence I've got, again, going back to the analogy, I've got the big ice cubes coming in, but also the people go, can you help me with other stuff? And so I filled on the little aspects in that the ice cubes weren't positioned to take. And so that's the kidney bean, peppercorn, whatever you want to call it. So, yes, I ended up doing a lot of the regular stuff. So I would say you could build it from an existing practice and say, okay, I'm going to. I'm going to niche down and get rid of certain things. You could definitely do it that way and that ways. Probably a little more comfortable in some senses, but very fearful in other ways if you decide you're going to let go of some insurance along the way too. But it's doable. You know, anything is doable if you're committed and you have the right message and you have the right communication. And hence I talk about inside of Legion, my training program, the three things the trifecta is you have to attract, you have to convert, and you have to deliver. So that is your marketing, your communication or case acceptance, and delivering your product. And what do we as dentists focus on is delivering a product and we hope someone else can Help with the marketing and make that successful, or we hope that somehow someone else will close the case and get the patient to move forward. Usually the front office or financial person, what have you. It starts with you, the dentist, the person. If you want it to succeed, invest in yourself. That'll give you the biggest returns in life.

Yeah, a lot. A lot of good stuff in that, in all of that. And it makes me wonder, so you started from scratch and you knew from day one what you wanted to build.

What about those doctors who are buying an existing practice or they are already now owning an existing practice and it's your standard practice. Maybe pretty heavy ppo, but they really are interested in converting more to cosmetic. It sounds like when you started, you were literally on the streets talking to people and telling them about your cosmetic skill set. So you were attracting. And then they would come in and you would work on converting and then of course, you would deliver on that. What would you say for a lot of these dentists out there who aren't starting? Because you're right, that's like.

The bold, you know, the Fast and the furious. The ones who are starting their practices, I don't see that many. And the ones I do see, it's a little bit longer pathway to profitability because you don't have an existing income stream there. So a lot of people don't do it. Even though there are a lot of great perks to doing that. You get to design your, your, your. Everything about your career experience early on where you're practicing, the type of building, who you hire, what equipment you have, who you want to work with. There's so much great stuff in that. But it's hard when you've got $600,000 in student loans and these things are breathing down your back and, and you live in, you know, an expensive state like California or someplace else, and who knows, maybe you've got a family you're trying to support. It's just hard to, to go through that period of, of drought. So. So let's focus just for a sec on these people who own their practice or buying a standard practice. How do you convert it? What's your advice to them?

Yeah, let's come back to the kids and they're coming out of school. But when we get done with this, the. So if you're in a practice, or so you say, if you're going to buy a practice. I thought about this too, because you have two ways to go. You can either build or buy. The question is, when you're buying something what are you truly buying? You know, and so that's where, you know, companies come in to evaluate things and you have to decide how that's going to transition and is it just going to be a quick change or is a long term buyout? You know, there's a lot of different advantages there, both financially and patient wise. You know, if you're there for a long time, patients see you and they're happy to switch to you in the the older dentist finally retires. If it's just, hey, buy my practice and the older dentist is gone, then I think the math says there's something like 50 to 60% of patients potentially might leave, you know, and so now you have an older practice, potentially, you know, a lot of times it's an older practice being sold that you might have to modernize or buy new equipment. You've got a patient base that's not loyal to you that may leave you and you have employees that are used to working a certain way that now you're coming in and rocking the boat for them as well. And so I just saw a lot of headaches and me to retrofit and try to change the mindset of patients that said, well, the last doctor did it this way, I'm used to doing it that way. And you're saying, no, no, no, now we're out of insurance or we're out of network and we're not accepting insurance and you're paying the time of service and you're changing so many things that again, comfort and fear. Patient's like, well, I'm not beholden to you. You're someone new. I don't like the policies, I don't like things are changing. I don't like the fees going up, whatever it is. They're like, I'm gonna go somewhere else. So in my mind I was like, I'm gonna just, I'm gonna have to rebuild a whole office that I've just bought for X amount of money. So I'm better off for me and my just bullheaded mindset that I'm just gonna go build it right from the beginning and I'm gonna eat crow and sleep on the floor in my office for a year and a half until that money starts to come in. But long term, I saw it as a better benefit financially long term versus making money in the short term. So you can do it either way and decide for yourself which resonates more or less. But it can definitely be done from buying an office. I just don't know if it's financially really any that much better after a year and a half of buying it and changing things versus starting out from scratch. Be interesting to see how that could pencil out. But every office is going to be different. So it's anecdotal and I would think.

That somebody who owns their own practice and they have a, they have, they, they have foot traffic already from long standing goodwill of whoever the previous owner was that they bought it from, that they have, and they're wanting to now convert this to more of a cosmetic practice. They can go out and find brand new patients and market themselves as cosmetic and bring in sort of a, a new style of patient. Or they can communicate really effectively, propose cosmetic treatment plans to existing patients and build it that way. Let's talk about communication, which you and I spoke last week and we got to know each other a little bit. Communication was a major theme in the way you view owning a dental practice, both from a patient communication view and also staff communication and just on life, how valuable communication is. What kind of lesson would you give to associates about the value of education and specifically what can they do to be an effective communicator as a dentist?

Well, I'd say the first thing for me is honesty.

So if you're honest with yourself and you're honest with everyone around you, you won't have problems in life. But the majority of us lie.

You know, someone walks up to you and says, hey, how's your day going? It's going good. That's what everyone responds with, it's going good. No one wants to tell you all the bad stuff going on in their world. Everyone has something going on in their world, let's face it, it's just the way reality is. So if you're honest with yourself, you're honest with your patients, you're honest with your family, and you're honest in your marketing. It's nothing but up, right? And so communication becomes very interesting when everyone's being real and honest. But also the communication capabilities with someone to give them a message or to allow them to think differently is extremely powerful. And I learned that early in my career that I went and took Dale Carnegie's training programs to literally teach you how to think differently and speak differently and to do it quickly at a moment's notice. And I would say that was probably the most valuable training that I ever got in my dental business. And yet it has nothing to do with dentistry. One would say it's not dentistry. But I will tell you as a business owner, because let's Face it, if you're a dentist, you are a business owner, you're in the business of helping people with oral health and appearance, but the function of as well, but ultimately you have to be good at communicating and so communicating with your patients, communicating in your marketing, communicating with your employees that they want to stay with you and they want to work with you and protect and, you know, raise you up. You know, all of these things are communication. But yet I'm going to generalize. As dentists, we oftentimes get again, focused on the dentist or we got our blinders on. We're just running in and treating the patient and then it's off to the next room to treat the next patient because we're on a time schedule and we're, we're overbooked or we're seeing a lot to try and make up for again, that insurance thing. And so we're trying to treat a lot of people and we don't have time, or we choose not to make the time to sit and talk to those patients more, or we choose not to take the time to sit and talk with our employees more. You know, the number one thing we don't do with employees is train them. 98% of the problems in our offices are based on employer employee issues. And that's usually, this is all ADA research is because we don't train them, we don't have time to train them. We're too busy trying to see patients, trying to make money. And so my mind says, hey, step back, slow down and let's think about this. Spending a little more time with everyone could yield more money, but also could yield healthier patients, more accepting patients. You know, there's a lot of value to that. But somehow in dental school that's not taught that way. It's like we need to treat things and just keep looking at the dentistry. They never go into like the business and how it evolves and how it works. And then you come out and you go work, typically in insurance office or most people in a DSO nowadays, and you're just running room to room, trying to move as fast as you can. And hence you miss out on other aspects of business if you're going to be a business owner. And so again, communication is the key to success for me. And I can tell you I've seen plenty of dentists and trained plenty of dentists that for them, they may not be the best dentist by any means. I mean, like, not really a great.

Procedural person, I guess you could say, just to keep it simple and Nice. But man, they have fabulous marketing and they just bring this emotion, this love, this communication that everybody loves them, even though the dentistry is not that great. And so people are coming back with stuff falling out or in pain, and they still love this dentist. And you're like, how is it this person can do such poor dentistry and have all these patients coming to them? They never get bad reviews and everyone keeps paying them and they keep coming back for more. Like, makes you wonder that maybe doing the best dentistry out there and taking all the CE programs isn't the answer to being successful. Now, I'm not saying be a bad dentist either, but you can take away something from that to learn that, hey, this person is fabulous at communicating.

There's something to be said about being likable. Yeah, Plain likable and contagious in your likability.

And think about that. Any dentist knows this. If you're at a cocktail party or anywhere and someone comes up to you and you say you're a dentist, they go, oh, I have a great dentist. You're like, really? Tell me, why are they so great? And they're like, they're so nice. There you go. Well, if you're the nicest dentist, you're profitable. You know, they can't judge anything else. Right?

Yeah. I do want to, I do want to make a comment too, about training and training the team and educating the team and creating your team to be excited so that they're communicating well too. I always find that you can take people who don't have naturally good communication skills and just get them pumped up about your culture, about what you're doing. Give them something to come into work for. Give them, as I've heard it called at times, a true north or just a mission statement of values, whatever that is in your practice. Give them something to feel like they're working for a purpose, not just a paycheck. And then suddenly their communication style becomes more, the tone is more positive, they're more optimistic, they're kinder, they're more eager to do good. And I've, I've found that some of my, my clients who have just a great team and great team culture, they will pay some good money for this. They will ship their whole team out to some training in some other state and get them all pumped up and, you know, set, set, set goals as a team. They'll take, they'll, they'll do out, you know, an outing or they'll do some team building events. Just stuff like that that isn't producing anything immediately but man, does it just per, just pervade the culture and the excitement. And then that translates into daily experience, really positive experiences from patients coming in. And they feel it from the day, from the moment they walk in the door at the front desk to, to the assistant, to the doctor. And, and then that's what tells them at that cocktail party, I have just an amazing dentist because they're thinking about that experience even though their tooth might be hurting at that very moment. And, and I've, I've always found that to, to be the, the case that there is such an investment in team and, and with that investment in, in the way that they communicate across, across the team and, and to the patient. And that honesty is, is really important. One person I'm thinking of, I even had him on a podcast a while ago. His name is Dr. Landon Libby. It's one of my favorite people. And you know, and he's had moments with, with, with his team where they're very direct conversations and, but, but that honesty is sort of embedded in this broader sense of. But I, but I, I care for you. I love who you are. I love that you're here with our team and I, and I love what you're contributing here. And it just leads to such a great culture. And then the culture almost does so much of the work itself, this sort of intangible concept of culture. And it's hard to explain what that is, but you know it when it's there in your practice. You know, you know it, you feel it, and the patients feel it as well. Let's talk about the new dentist for a minute. Could we talk about the new dentist? So, new dentist coming out of school and have a lot of student loans and feeling a little bit nervous. Got a lot of offers for work at some, some big DSOs in town. And what, what's your advice for them? What, what should be the top priority for a newly minted graduate entering the dental field today?

Well, it depends on where they want to go, but you know what their long term goal is. And let's face it, how many people figure out their long term goals? Like what are you planning on being 10 years from now, 20 years from now, or five years from now? Where do you want to be? What do you want to do? And so at least giving that some thought, not that it can't change, but thinking about that and see, okay, yeah, the majority of students coming out are going to DSOs. Why? Yeah, because they have student debt. And so you're basically told you get, you know, A nice big salary and all this wonderful things. And then once you get there, you realize reality sets in, that it isn't as great as you thought it was. For most, there's some that love it, but majority stories I get from people, and maybe I have people that just resonate out of that. And that's why I hear their stories.

That you're going to work real hard and you might not like dentistry or the business at that point, but that's not how dentistry needs to be either. But for the same token, you may learn some bad habits there based on diagnosis and treatments and whatnot. So I would say take it. Knowing that there's potentially some good things and bad things, like anything in life, I would take the good of. I'm going to get really fast and proficient at my craft, and I'm going to stay to a certain level of expertise or quality, regardless of where anyone pushes me or takes me. My integrity and my license is more important than money. From there, I would also maybe learn some of the business things. DSOs are phenomenal at marketing and getting people to move forward and do treatment right. So there are things to learn there as well, but there's also some bad things there that you're going to want to recognize and steer clear of. So. So I think there's some value there. But I would. I look at it as if I was going to DSO is I would try to learn something and crank for like a year or two, pay down some of my debt or a little bit of the debt, you know, depending on how you want to see it. And then I would jump out and either go buy something or go build something. Now, I know some people, the mentality is, well, I want to stay in the DSO and buy multiple DSO offices and kind of be the overseer of things, and that's fine, too. You're a businessman or woman overseeing multiple businesses, so there's multiple ways to go. But for me, it's all about, you know, the dentistry being done. Well, because I. I got into this to help people. And so to help people feel better, to look better, to change their emotion, their. Their mindset, to do more in life because of me helping them. That's kind of what I got into it for. It wasn't about the money. The money comes when you do right by people. So I would say decide where you want to go and what that is and decide if that's going to work for you long term or short term, and take the good from anything and use that where you go next.

I'm curious, in the, in the DSO space, I want to talk about that. Just a sec. You've been, you've been around for a little while. You've seen, you've seen these things emerge and they come in different forms. If I distill them down into two forms, there's the DSO and the dpo. Now, I've heard many other titles for, for them, but the, the DSO is more of a, I'll call it the corporate structure. And the DPO is one where your, your practice is almost partnering with other practices and you're combining forces with a centralized management arm, which is a little bit different than really being completely owned from the top as kind of your standard DSO structure is.

My, my question to you is.

Do you let me, let me tie it into cosmetic. In, in these types of organizations, do you see a place for cosmetic dentistry or does cosmetic dentistry still reside primarily at the private practice level and it's more standard definition?

No, I think everyone does cosmetic dentistry. You could be in a DSO or DPO anything and do lots of cosmetic dentistry. It's all just in how you're attracting people or how you're converting people. Let's face it, 50% of your patient base wants to change something in their smile. There's research on this. So if you have a thousand patients, 500 want to change something in their smile. They just don't know what it is and don't know that you can do it and you haven't talked to them about it. Now, out of the 500, the half of your patients that want something done, 300 out of that, 500 willing to pay you money for it. And so if you're not asking, you're not getting. And that's the same as McDonald's asking if you want to supersize your, you know, Coke and fries. They asked and a lot of people did. It was a very powerful campaign, made them a lot of money. So if you're not asking people if they're happy with their smile, do they want to make the teeth whiter? Do they want to change out fillings? They want to straighten things. If you're not having the conversations, you can't get these things. If you just walk in and look at an X ray and look at the teeth and go, you need three fillings, one crown, and we'll see you next time. You created no value there. You didn't even discuss what is possible and how you might be able to help them with things. And so that's again, going back to Communication. You have cosmetic patients that you can treat. You don't need to go find anything. It's in your practice now. Use that as a springboard to do more cosmetic, to take photographs so you can market it more and show people what you've done, and then parlay that into doing more cosmetics and still continue to do traditional DSO DPO private practice the way you have been, but you've just changed a little bit more of the messaging and it's more visible to people. So, yeah, you can do it in any model.

What is your take, generally speaking, on the, on the deep DSO DPO space? And are those one and the same to you? Do you feel that they're a, a threat to, to dentistry in any negative way? Or do you feel like it's a natural, just a natural evolution of dentistry as, as a, as a field of business in, in our economy?

Well, you know, again, just personal opinion. Everyone's got their own take on things. I see DSOs as a good thing because they've continued to grow and get bigger and bigger, and I continue to get more patients from them. So I see it as a good thing because. And not that I'm generalizing, not that they're all horrible or bad or anything else. I'm sure there's great ones out there. I just hear certain stories, and the only time ever anyone ever does anything is they tell you bad. You know, know it's rare that someone gives you praise. It's always like, negativity. So all I'm hearing probably is the negativity. I'm sure they do great work for people.

So I get patients all the time that are disappointed with the care or the diagnosis or whatever or something that hurts. And so I get a fair amount of patients coming in that just had a problem. And so it's like, great. You know, you guys keep doing your thing, I'll keep doing mine. Again, there's a. There's a business to fit everyone out there. So if everyone's trying to run to the DSOs, well, great. I'll have an even smaller niche of being an independent dentist that you see one guy every time it's the same guy. And you can create a relationship and you can get a certain type of work or comfort in going to that one person versus the turnover and things where it's like, well, last week Dr. Bob saw me, this week, Dr. Smith saw me. The week before it was Dr. James, like, can I just get one person to do my work? You know, like, so there's some of that that some people just don't want. And so again, having different business models is valuable. As far as the dpo, multiple different dental office, I guess that kind of are aligned together under the guise of hey, we're going to work together as a team even though we're independent offices that like my oral surgeon and I have combined together and I refer to him and he's supposed to refer to me, that could work. I don't know enough about them, haven't seen enough of them out there. I guess the only question for me is as a specialist, specialists get the referrals from all the gps that if.

Like the GPS that have been referring to the specialist, that the specialist somehow is now in this private group, if that gets out to the dentist that have been referring to them, they may fear that their patients may go inside this group and never come back to them. So I guess there's got to be some very unique ways of setting that up or not letting the public know or something so that the specialists can continue to derive their patient pool from all the people in the area. So that would be interesting to know how that works. I don't claim to know enough about it, so I can't really give much of my opinion since I don't know.

There'S some natural economic forces in that direction of banding together to get real benefits that you can never get otherwise in how you negotiate with the ppo, with the insurance companies or with your vendors or whatnot. And, and then also having kind of a built in referral if you go kind of a multi specialty program. I think it will be interesting to see how that evolves over time. I, I, I've become much more, almost supportive of the concept of a DPO structure where private practices are partnering for the purpose of purposes of maintaining the private practice environment in a way which I still view different than say a corporate structure. And so I view the DPO and the DSO quite, quite differently. But as it relates to cosmetic, there sounds like there's a place for all of that in, in cosmetic, cosmetic dentistry. I did want to ask you, do general dentists refer to you as a cosmetic dentist? Yes. Did I pick up on that? Right.

Specialists send me too. And I made cards that I dropped off in offices saying refer to me. Here's my referral card. The same as all the oral surgeons, orthodontist, everyone else has a referral card. Here's my referral cards. So yes, I get referrals. And you know what, it's funny, I was thinking a DPO was something different. So I may be again not understanding it but. So I was with one company called Stratus out of, I think it was Oregon. And then there was another one out of Texas that I was in where it was a bunch of dentists that are all under kind of this parent company that can help with your marketing at a lower price point and helping with supplies and all that stuff. So if that's the what's considered the DPO now the acronym on it, then yeah, I had been in two of those at one point. I think each one of my lasted about a month or two.

There are shades of these things. There's a lot, I've seen a lot of these things come across my, my desk over the years. And there's group purchasing organizations which one could say we are partnering together and therefore sort of a dental partnership organization.

But I think what that is more happening. What's happening in a DPO is there's still a sale happening of the practice, but it's an indirect sale where that doctor will still own their corporation 100% but the profits end up getting sifted out to the management entity via a management agreement, via a management fee. But the, but the partnership arrangement there is that usually there's an equity swap where when that doctor sells their practice, they're going to convert some of the equity of their own practice into the equity of this DPO organization itself. And the goal, the purpose of that is you might swap $500,000 of equity in your practice into $500,000 of the DPO, but your practice is in limited and how much it's going to grow in value. Where the DPO might have a, what's called an EBITDA multiple of six at the time that you roll your equity into it and then that over the next five years becomes 10. And so the value of your equity swap just went way up. And when you did that equity swap, when you sold your practice, there was no tax on it. Where if you sold it externally to a buyer, most of that's going to be goodwill. You're going to pay long term capital gains on that. So you're going to pay taxes where the equity swap you don't. But then if that DPO goes under, well, you just basically lost that portion of the value of your practice. So there's a risk and return. There's. But I'm seeing a lot of interest in it for a couple reasons that I could probably condone, which is number one, somebody wants to be a part of something bigger than their own office. They want to be a part of a group. They want to go to an annual conference, they want to go to ski, they want to go skiing together as, you know, as a group. And they want to, you know, they want to be a part of something outside of that. And that's number one. And then number two, of course, are the economic benefits of the fact that you could reduce your overhead structure by say, 20% when you team up with, or I'll say sell to a dpo. It's just the equity structure is different because now it's. Now you're no longer, you no longer have the equity of your practice, at least not 100%. You have the part equity of this sort of bigger thing going on, which you have less control over, but it has a higher return potential at the same time. And in a lot of, a lot of times, you'll get paid out, say, 50% of the value of your practice. So maybe you. They pay you 500,000 now and you can then go invest in real estate or heck, you could go and invest that back into the central organization or you can diversify it in stocks and bonds. And so there's a lot of movement there in that transaction. But there are some things where I'm finding myself being much more supportive sort of the DPO concept than I am, say your traditional DSO concept, where really you're sort of dictated what to do, when to do it, when to show up, what tools to use, and you don't really control much a dpo. I think there's still a lot of control left in the hands of the clinician while getting some, some of the benefit there.

Yeah, the DPO sounds a lot better than the DSO model.

Yeah, I think that that trend is going to continue, and it's probably one I throw my weight behind here at practice cfo. We're even considering developing an institutional arm to service specifically that type, because there's a lot of requests for this, and I'm even talking to some individuals who are forming one of these as well. So I don't want to be like Blockbuster. I need to look ahead and see what's happening and have a few toes in that water to understand it. And I'll probably end up doing a podcast just on this subject alone since it's, it's, it's becoming an increasing part of my.

Experience in working with dentists, of what's just naturally coming to my desk and what I'm being, what I'm being pulled into these days.

That sounds great. I look forward to hearing it.

Well, let me. Let's finish off by. By asking you about Legion. I'd like you just to tell us a little bit about Legion. We've got to know you a little bit today. I know your practice is. Is remarkable. I have a client, client who just can't stop singing your praises. We have a couple clients who. Same thing. And so I'm like, who's. Who's Dr. Snyder? I want to get to know this guy. Well, tell us a little bit about your program you created called Legion, and how people can learn about it.

So again, we all take continuing education on dentistry. And so I've been teaching dentistry for years. What I found was for dentists to truly become happier, more profitable, and to be able to live, you know, a fuller life and have more freedoms to do what they want. I started talking more about business because, let's face it, Dennis, just don't have a lot of business coming out of dental school. And some, you know, gravitate and do well in business. But I'd say that on the whole, a lot of dentists struggle, and you can see that in the numbers. So I said, you know what? I want to share kind of a lot of the stuff that I've been doing, as I've learned from many other people over the years in business, not in dentistry, but in business aspects that I want to share so other people can be profitable. Where I used to think of it as my secret sauce, that I never want anyone to know what I do, it's now it's like, no, no, I'm. I'm going to share with everyone, give back. Because I don't see any competition now. Whereas earlier it was like, well, I got competition. I'm going to keep these things to myself. It's like, no, let me share everything that I do. And if you want to use that, not that you have to be a cosmetic dentist, but the marketing, the communication, everything else is for any business, whether it could be even, like, you know, an auto mechanic or something. It doesn't have to be. Dentistry is to learn how to truly market yourself differently and to communicate. And so that's two of the programs that I built out. One was called Inception. Like, how can we have communications that are powerful, that resonate, that get people to do things, not to do things that are like a sleazy salesman type things, but to get them to move forward? Because, let's face it, most of the time, we hold ourselves back. And so to communicate in such a fashion that gets people to move forward with what they want in life, to get what they want, as opposed to saying, I can't have that. That's what it's all about. It's a very powerful communication. And then the other program with singularity is how can we create a unique singular, meaning you, a marketing program around you and what you want to do with your dentistry, with your life and everything else. And so none of these programs are a dogmatic, like do it my way. It's all of here's some very powerful tools now let's figure out how they will work for you and how you can implement them with your business and where you want to go and be in life and the type of dentistry and business you want to run. And so most time we take programs and we try to be someone else and we can't. And so these were set up specifically that anyone can do well with these from there. The other program we had was known as pride. It's 90 days long. The other two are 30 days. 90 days of changing habits, changing mindset, fixing various aspects of our world. And so we think of it as like, you know, power being your body, the health of yourself. Because, because let's face it, if you don't take care of yourself, you may not be here as long. Your purpose, what is your purpose in life? Where are you going? What are you doing, your passion with those people around you, whether it be your personal one on one family members or your employees, how you treat them, how you interact with them, how you build them up in value and communicate. And then the last thing is production. What are you building in this world? What do you plan on building in this world? How are you going to get there? How are you going to get paid? You know, all of those aspects. And so we change people's mindset and habits and create goals and patterns that you would have never learned in the dental industry. And I can tell you it instantly changes people's worlds that they become more successful, more happy and just overall a totally different person. So it's been a lot of fun to watch people change and transform from these three unique programs. And yet I still will have dental programs on there coming up. They're not there yet, but people still ask me like, well, I want to learn your dentistry. Can you teach me your dentistry? Like, okay, sure, we'll put that up next.

One thing I love about that is it resonates with, with me and, and my approach as a, as a dental cpa. You're probably wondering how in the world does this relate to a CPA bean counter. But believe it or not, there's some relationship there because we, the way we look at dentistry is dentistry is just a means to an end of meeting your life goals. And I'm a certified financial planner as well as a cpa. And really I got into dentistry not necessarily because I love the fact that dentists fixed teeth. It was really because I wanted to help this group of people. I wanted to learn all about them and then help them reach their life goals, particularly as it relates to the financial aspects of those goals. Things with a price tag on them throughout their life. And all of the clinical work of what we do on the CPA side is really just. It's just to sort of help them get there. And it sounds like that's what Legion does. And your focus is, let me help you think about life in a different way, in a bigger picture, and start with the end in mind. You don't want to climb up a ladder and then realize when you get to the top that you climbed up the wrong building. And how do we avoid that? How do we avoid going after our success so aggressively that we fail in other areas that ended up being more critical than in the area of focus? And it overshadows that success. So defining, I sometimes call it defining your, your success by the elements of loss. What are those areas of loss that if, that if you did lose those, it would overshadow any success you have in your business. And, and you know, I think about that a lot. I think about that when I talk with my, with my clients is where. Talking about their life and their, their, their children and what they, what they want to accomplish, and then you go back to the dentistry. Great. Well, what do we need to do in your dental practice today in order to set aside the, the financial capital to meet those goals that you've set for yourself? So I love, I love what you're doing. The website is called www.legion.doist and just for clarification, there's no.com there. This is. You're. You're. You're one of the innovators here, one of the early adopters of the non.com websites, which is awesome. Www.legionlegion.detentist and go there. You can check it out. Anything else, Dr. Snada, you want to share about that program?

You know, you hit it all pretty much very well that we have kindred spirits, that we're trying to help people do something different. You know, we're here today. We're not guaranteed a tomorrow. And the hardest day was yesterday. So if I can get people to think and do more in life versus waiting till hopefully later in life when they have money and time, start enjoying things now.

Couldn't agree with you more. Dr. SN, thanks for being on the program.

My pleasure. Thank you.