Profitable Endo Sells to DPO – Dr. Young’s Story

Want to welcome everybody to another episode of the Dental Practice Sale podcast. I have one of my friends and clients on the program today as our guest. This is Dr. Jeremy Young. Welcome to the show, Dr. Young.

Happy to be here.

We've got a cool history together. I think we started working together around 2014. And you are in grass or were no longer. We'll go through some of your story in Grass Valley, California. Correct, Dr. Young?

That's right. Yep. It's, it's been a while, but yeah, I feel like we've lived a lot of life together, Wes, so I'm yeah, happy to, happy to be your friend.

That's one of the cool things about being a personal financial planner as well as a CPA is just there's more personal context to the relationships that I thoroughly enjoy. Let me give all of our listeners just a quick intro to again this style of a podcast. For those who are following our podcast, they know that we really have two objectives. One is to educate those who are considering a sale on the process of a sale, the differences and nuances between a private sale and an institutional sale to say a DSO or dpo. And also just what are some things, some of the technical sides to it, the legal, the tax side, so that sellers go into that sale filling educated about the process and what it's going to look like. That's our goal number one. Goal number two is to have dentists who have sold in the past come on the show and just share their story. What were some of the lessons they learned? What was that experience like? What was the motive to sell and what's it been like post sale? Anything that you feel comfortable sharing, you are free to do. So when it comes to numbers, you can share if you would like. You don't have to share specific numbers around the sale. It's totally your call on that one. Dr. Young, why don't we just start off and give me a little profile of your practice, which was an endo practice. How did you find it? When did you buy it? A little bit about the profile, help the listeners know what kind of practice you, you were running.

Yeah, yeah, no, happy, happy to do that. Yeah. So I, I practiced in a, a pretty small town in Grass Valley. Before moving to Grass Valley, I was an associate actually in Folsom, which is a little bit larger town. It's a suburb of Sacramento and that's really where my wife and I wanted to land, I'd say throughout residency we had kind of pinpointed Folsom as the spot we wanted to be. And I was fortunate enough to find a practice who had an opening for an associate and great guy. We worked out the details and pretty much right out of residency and right into that associateship. And it lasted for about one year. And this is one of those where I feel like there wasn't a fault per se. The senior doctor, I really do think he did everything he could to try to make it work. I tried to do everything I could, but there just wasn't enough patience for the both of us. And so I was moonlighting, you know, I think four or five different offices at one point. And so I just knew I need to find something else. So we widened our search to try and see what other opportunities were around. And there was this practice in Grass Valley that had been on the market for like two years or more. I think I'd seen it when I was a resident and I kind of knew, okay, that's in the general neighborhood of Sacramento, which is where my family was. But it was really tiny, small town, wasn't really where I wanted to live. But because of my circumstances, my student loans were coming due pretty soon. And, you know, that was a big burden, you know, on me to make those payments. So we said, well, let's take a look at it and see what that looks like. And so my wife and I drove up to Grass Valley and met the doctor. And long story short, we decided that was going to be our spot. So when I stepped into that practice, I think it was producing around 500,000, so fairly small. And this is around 2005, I think 2004, kind of in that ballpark. So I was looking to grow. And so over the course of time, I ended up kind of buying out the other endodontists in town as they retired. And so in many ways that became a big part of my growth strategy. So of course, trying to grow just organically and doing a good job and getting to know the referring dentist, but then also that idea of, hey, when you're ready to retire, let me know. Don't bring another person into this tiny little town. I'll buy it from you, and you can work here if you want or be done. But I wanted to grow the practice, and so that was kind of how I grew over the course of my, my, my time, but pretty much always solo. I, I, I had those two partners just for a really short time as they trying to transitioned out. But otherwise it was just me in a small town. And so that was kind of my story for my practice.

Fast forward now to the year that you sold, which was. Was that pre Covid.

I think it's been about three years now, because I believe it was right at the very end of 2019, very beginning of 2020, that I sold.

Great. So you own that practice for somewhere around 15 years, plus or minus, maybe a little bit less. And during that time, I believe when you sold, it was around 2 million in top line collections. Does that resonate as accurate?

Yeah, we were a little bit north of that, but yeah, kind of in that, in that neighborhood.

Single doctor. So you were doing all of the, all of the production in the practice, one location. You had merged that other doctor into that single location. And are you able to share why you sold? Because I'm looking at you and I'm saying, here we are four years later and you're still looking really young. I mean, you sold at a young age. I think you were still in your 30s when you sold, Is that correct?

No, I was, I guess, 41, 42 in that neighborhood. Okay, yeah.

All right. Still young. I mean, a lot of doctors are just getting in stride at that point, but here you are selling. Do you want to share some of that story to the extent you're comfortable sharing that?

Yeah, yeah, no, happy to. So, yeah, I think being a solo practitioner, there's just like anything in life, there's parts about that that are great and that I really enjoyed. And there are also some parts about that that are maybe bring a different kind of stress or there's a. There's a vulnerability that comes with being solo that is also there. And so those things are both, both a part of being a solo practitioner. So, yeah, from a financial standpoint, I mean, things were going great. We were, I think myself and my team were really happy. We had a great camaraderie, I think a really healthy culture within our practice and really good relationships with the dentists in my town. I really feel like Grass Valley is a kind of a gold mine of really great dentists. There's a lot of good, good people there and I love working with them.

I will add, if you don't mind, that you were in a very strong financial condition as your financial advisor, that you had aggressively paid down debt and that was a personal goal of yours. And so it wasn't that there was a financial need to self to cash out the equity of your practice, so to speak. A lot was trending just exactly how you would want it to be. You are definitely one of our more profitable clients. You are running a smooth practice. And so it Was kind of a. It was kind of a shock to me when it came down to realizing that you were gonna have to sell. So why don't you to share a little more?

Yeah, yeah. And I mean, I definitely didn't have to sell. And so. Yeah, you're right. There was, there was a number of factors that kind of came. Came into play. So just to give a little context to the story and how came about. My brothers are also endodontists. I'm the oldest of four brothers who are all endodontists. And two of my brothers, Eric and Mark are the kind of the leadership team that makes up a really, really big endodontic practice in Sacramento called Creekside. And they were also a part of a lot of like leadership organizations, key opinion leader meetings and other things where they were kind of moving and shaking much more so than me. I wasn't really that guy. I was just kind of. My head was down and working in practice. But they're the ones that actually started hearing about US endo, which is the group that I ended up partnering with. And they were really excited about it and brought it to me. So it was really my brothers who shared this concept. My only real knowledge of DSOs or my perspective on DSOs was pretty much universally negative through my career. I didn't think that that would ever be something I would be interested in being a part of because all the stories I heard were. Were pretty terrible. I felt like they were really. They would drive their dentists, you know, into the ground, making them see so many patients. Very profit driven, kind of to the exclusion of everything is how I had heard about it. And so hearing from my brothers about this, this group that was really kind of approaching things a little bit differently. And it was going to be focused on the Zodonyx and some of the other people who had joined. And it at least made me stop and think like, oh, I wonder, I wonder what this is about. And so I began to kind of investigate as I started talking with other. Other people who were in this and US Endo was pretty young at the time. I think it had only been around for like a year when I joined. So this is. They don't have a super long track record. There was only a handful of other endodontists who were a part of US ENDO at the time. The person that I had contacted at US Endo to ask questions, he basically said, just talk to the other doctors. You know, he was like, I'm not going to try to sell you something. Just talk to the other doctors and ask them how it's been for them and what the vision is as they see it. And so I did call all of them and began talking to them, and a lot of the stuff they said was really interesting to me. It was compelling in a lot of ways and really resonated. As I mentioned to you before, you know, some of the insecurity and vulnerability of being in private practice. If I get hurt, the show is over, right? The production stops, and everything really relies on me, even if I'm not hurt, but I just want to go on vacation. Everything stops. The productivity is gone. So while there's great productivity to be made when I'm in the office, there's also some risk and some downside and a little bit of that golden handcuff concept where you feel like, man, I want my practice to grow, and so I should be there working, but I also want to have a life. So trying to balance those two things and I guess just kind of reconcile, like, where I wanted to go in my life and what was the point of being a good financial steward? What was the end of that? Was it just to make more and keep. Keep saving more? And, you know, how would I reconcile those things? And I felt like Usindo came in and really started to answer some of those questions. For me, it created a path that I had never thought of before. It didn't really exist before in my worldview. And so the more I thought about it, the more people that I talked to about it, including you, the more I felt like I think this is at least a reasonable option, at least something that I should consider. So that was kind of the genesis and some of my early thoughts in thinking about joining us. Endo.

So they come to you and you start to entertain them. And you and I think both go into it a bit skeptical. I remember that because of all the reasons you said before, and I say this now in my podcast, that a DSO or a dpo, Dental Partnership Organization. Organization, they're not good or bad. They come in so many varieties. I think you have to look at the heart of it, the soul of it, who's running it, what's their motives, how they're structured. There's a lot to consider. Whether or not a institutional cell is going to be right for you. I don't think it's totally black and white. And there are advantages of always just staying purely private. There are some advantages of that, and then there are some advantages with teaming your practice up with a larger network of practices and sort of centralizing operations that can find a lot of value to it as well. And so they come to you and they make a proposal. And I remember they made a proposal that was a very strong proposal. And when you sell to Institutional, they always want to know, what's your ebitda? You remember that word that they came to you, they said, okay, we got to figure out what's your ebitda, which is earnings before interest, depreciation, taxes, interest and amortization. I'm not sure if I got them all there, but earnings before, yeah, interest, depreciation, taxes, and amortization. And the reason why they want to know EBITDA is because EBITDA is the cash flow to them. If they buy the practice, the only adjustment they have to make is when they arrive at EBITDA is they have to figure out what are they going to pay you as an associate, or if you're not there, what are they going to have to pay another associate in order to produce your own production to replace your production. You add that as an expense and you get to what is the cash flow that will be to them? That is their roi. That's their return on investment now, right now, and back then, probably even more than if not so then now, although I'd say it's still very strong now. There's a lot of money trying to find a home in the institutional world. There's a lot of investors, there's a lot of pe, and they're trying to find a place for good investments. Dental practices are a great place for that when it's the right fit. So they came to you and they proposed something that I was very impressed with. It was definitely higher than a private sale. In fact, your case is the most accentuated of any I've seen, where the price they offered you was dramatically higher than, I think, what a private practice buyer probably would have been able to finance through a bank to acquire your practice. And they purchased your practice. They did 70% cash at closing, and they did 30% of what's called an equity swap. Now, Jeremy, do your best to explain what an equity swap is when selling to an institutional buyer.

I couldn't answer that, Wes.

Maybe that's why I have you as my advisor.

I'm glad to play that role. There you go. Okay. Well, Adam, I'm sorry to put you on the spot there. That was terrible of me to do that. But at least we can talk about this concept of an equity swap. When you were offered a price, 30% of that price said, hey, Dr. Young, we're not going to give this to you in cash. 30%, we're going to give you 70% in cash. But the other 30%, what we're going to do is give you ownership in our management entity. We're going to give you some ownership in US Endo. And then if US Endo does well, well, you're now, you're now a partner of US Endo with the rest of us. Now you're a small owner because that 30% might have got you a percent or half a percent or, I don't know, 2%, depending on what their valuation was as a company at that time, relative to that 30% of your valuation. It's just a math number. Let's say they're worth $30 million and you're worth $3 million. And if you take 1 million of your money and you swap it over into their company, you get one divided by their 30 million, that's the amount of equity you then get in us endo. It's just math. You can run it in Excel. But that's what the equity swap is, is you're swapping some of your own private practice equity for some of the equity in US Endo. And that was, my understanding, was how that worked with you, because later they had a. What's called a recapitalization event. And your ownership, therefore, in US Endo paid you out for that equity event, which was a very successful equity event at the time. So does that ring a bell, how that all worked, Dr. Young?

Yeah, for sure. Yeah. And I don't know, to be honest with you, if my deal is typical for every deal that US ENDO does, I don't know if that was unique, you know, to that time or to my practice. But, yeah, I think that's the general idea. And I do believe different DSOs do that differently. Some of them have different models that, yeah. Take different amounts in cash or different ways that they're partnering. Yeah. But USENDO is, you know, a portion of the deal you take up front in cash. A portion of it you take as equity in the company, and then you kind of participate as the company grows and you get to it really can become one of your best investments. You know, like, compared to stocks or REITs or any other thing, you can invest money in US endos. By far and away, been my best investment.

Yeah. A couple of comments on that. I just want to echo what you said, that I'm going to call this a dpo, a dental partnership organization, differentiating it from a DSO DSO might buy you out completely. They pay you all cash, and maybe there's an earn out feature, but you don't own any of that central management entity. You're no longer a partner in there, which means you're not going to get a K1, you're not going to get cash or dividends or payouts, any of that later on. In other words, when you sell to a dso, what you get at that point, plus maybe a little bit of earn out if you keep working and they pay you a little bit of the sale price if production is maintained, that's called an earnout. In a DSO sale, a true sort of classic DSO sell, you receive everything at that point and then you meet their terms to stay on for a period of time and then you can walk away. A dental partnership organization is where part of your sale is in an exchange of your equity for the equity in that management entity. And now you're a partner in that group because you literally own a small share of that company. And that in some ways keeps you both mutually vested in each other's success because now you are partners in it. That the term for that is a dental partnership organization. Now what I'm seeing though, is that not only do different entities structure themselves differently as a DSO versus a dpo, but how they do it. There's a lot of different variations of this, and the same company may, as it evolves, no longer offer a equity exchange option. They may sort of convert from a D, a DPO to a DSO later. That's definitely happening with some of the bigger ones that I'm seeing. When you come earlier in on the ground floor, which it sounds like you did with US Endo, there's sometimes a little more risk because they're not, well, as well established. They might not have all their billing department in place and their accounting department in place and their marketing department in place. And so they may be figuring that out a little bit. But the upside is that if it catches as a DPO and goes from having say, seven or eight offices to having 100 offices, and you're one of those first few offices, you're getting the benefit of that upside. And that's what I believe happened with you. And that the timing worked out quite well with US Endo, where you came in earlier on the ground floor, and US Endo, I think, from my understanding, has proven successful as a model so far, and so you've been able to benefit that along the way. But there are others out there. MB2 is a large one, a lot of people have heard MB2, I'm not entirely sure if they are still doing equity grants. I could be wrong. It might be a full buyout. I'll have to interview somebody for our podcast from MB2. I'd love to learn what their model is and their story. What were some of the lessons though, as you went through that, Dr. Young, that you learned about a practice sale to a DPO buyer that you think might be helpful for somebody considering the same decision?

Yeah, I mean, it's quite a process, you know, and at the time it was stressful to be scrutinized so closely. You know, there is. As a solo practitioner, I was the king of the castle and I felt like I kind of knew everything about the office and what was going on really, from soup to nuts in the practice. And US Endo, not only internally, like the US Endo people, they do some due diligence and they bring in an outside person. So it's like a third party company to come in and do diligence as well. And yeah, that part was. It was kind of stressful. I felt like they, they just nitpicked every little thing. And so I, I found that part probably that my most, you know, kind of made me worry the most like, oh, gosh, you know, what, what are they, what are they going to find? Are they going to change the deal because of what they find? And just a lot of nerves, I guess, around that. But the thing that I've come to, I guess consider about that is now that I'm a part of the company, I look back on that, that diligence and how closely they looked at everything, I realize as now a part owner of that company, what a good thing that is for me. Right. Because they are doing a really good job trying to protect my equity in the company. They're being really good stewards of my investment in the business to make sure that every practice we bring in is who they say they are and all the numbers are correct. So, yeah, I would say still a stressful time and I would still counsel someone going through it. Yeah, you got to expect that. That type of diligence, I think for a good company is actually a good thing for you and it should give you some kind of sense that they're doing their job and they care a lot about the company. So that's one thing I'll mention, Wes, that probably stands out during that process the most.

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Let's talk a little bit about the logistics, if you don't mind when that when that occurred you had an S corporation, as most dentists tend to have an S corporation. Certain states allow an llc, but that LLC is still filing a tax return as an S corporation. So for all intents and purposes, most dentists are operating as an S corporation these days. And when you sell, you are essentially selling the assets of your practice. You are not selling the stock of your corporation and so it's broken up between equipment, it's broken up to what's called goodwill, which is a non tangible asset, and maybe a covenant to not compete. Where you go down the street, you know, and take all of the patients, you're buying furniture and fixtures, you're buying all of the stuff inside the practice and then whatever the price is less, the market value of the tangible stuff is an intangible. And that's again that word goodwill. And so that's what you sold. And so your corporation is still in place and you're still 100% owner of the stock, if you recall. And your corporation is what had the contracts with the insurance companies. So there's, there's some important characteristics about the relationship with your corporation and US Endo that needed to be maintained even after the sale closed. And so the way this often works is that you continue to bill under your corporate ID and you are still paid as you work back afterward through your own corporation. And then the profits, the net cash flow is essentially swept out and over as a management fee to US Endo or to the management firm. Do you recall that's how it was happening in your case, Jeremy?

Yeah, that's right, yeah. So my kind of technical ownership still remains in place, so.

Yes, even to this day.

Yeah, yeah, it does. So in my, my particular circumstance. So when I partnered with US Endo, two things happened at once for me that is going to be unique and this might never happen again. But because I'm the oldest of many endodontist brothers and Creekside was a practice that I had always kind of considered, is there a way for us to join and work together so that the brothers could be kind of under one roof and we were just far apart enough that it was like, I don't know that it really makes a lot of sense. But in this joining of US Endo, which my brothers and I did kind of at the same time, we made the decision to make that merge. So I was merging and kind of partnering with Usendo, but also with Creekside at the same time. So the ownership, my technical ownership over my PC is still mine, but I also became part of Creekside. So there was a lot of moving parts I think in that whole transition.

I think that was smart though. And here's why is, you know this EBITDA number we talk about, whenever a valuation is done, it's always a multiple of that earnings number. And usually you're seeing somewhere between maybe four and a half on the low side and you're seeing maybe seven on the high side, six And a half seven on the high side, however, the bigger you are, the more practices you have, the higher the multiple is. And you want a high multiple because you take your EBITDA times the multiple and that's the price that you are being paid, you want that up. Therefore, when you take your practice, say as a standalone practice, it might have an ebitda multiple of six, but then you go and merge it with say three other endodontic practices, I.e. creekside, suddenly the value of your practice is more to an institutional buyer because in the a larger operation is lower risk. And lower risk means they're willing to have a higher EBITDA multiple. That's just finance. That's Wall street finance right there. Higher risk, lower price, lower risk, higher price for the same return. And so by you doing that, you may have seen a step up in what was the EBITDA multiple. So anybody who's listening, who is going to sell, and perhaps you have a friend or brother or somebody in town who's also thinking about selling, there's a way for you to batch your practices together, almost as single unit, to a potential institutional buyer. There are synergies there financially for both of the sellers. So I think that was a very smart move for you and your brothers to do that because you both collectively benefited from doing that. Let me ask you now a little bit. So, yeah, just to finalize that conversation about your corporation, how the logistics work, your corporation remains intact for some period of time. Now, we used to do your accounting and tax and payroll, but usually what happens is the institutional harm, the management entity will fold that into their centralized accounting and tax and payroll. Not always, but usually that ends up being the case, especially as they get bigger. And that's what was happened. And so you and I continue to work together a little bit on the personal finance side, which I really enjoy. How about your team though? How did this go over with your team and how did you talk to your team about that?

Yeah, yeah, good question. Yeah, this is something I think is probably something that many dentists, I put myself in this category maybe are kind of ill prepared to do well, or don't, don't think a lot about it, or don't consider. I think this is probably me don't consider the kind of the context of that conversation. So what I mean by that is when I sat down with my team, who were really tight, right, We're a family in a solo practice at the time I, I talked with them, I had already had months of conversations with us Endo Working with the diligence team, talking it through with my wife and my brothers, and lots and lots of time to digest. Right. I had been thinking about it and had gotten through a lot of the questions I had had early and a lot of the concerns and worries that I had. And I was to the point of actually being really excited about it, you know, and so when I sat down to tell them, I think I kind of expected them to be excited like me. Come on, guys, this is going to be great, you know, and that is. That's not right. Actually. Where they're at now in the journey is at the very beginning. They're where I was maybe many months ago, where, you know, they're in the dental world, too. They know the reputation of DSOs. They know that what we had in our practice was diametrically opposed to that. We were all about quality. We were all about taking care of every patient and loving on them and caring for them. And so just the bringing this up and kind of not asking their opinion about it, but telling them, hey, this is what I've decided to do, you know, and that was the discussion. It's tough. It's tough for them. And it really, it required, I tell people now, it's an iterative process, meaning it's something you have to go back and talk about over and over, because your team is going to go through these cycles of, okay, I think I get that part of it. And then they have another question and they're feeling kind of down again about it, and they want to come back to you and talk. And so I guess just a word of counsel, you know, that I would give to a doctor who's thinking about going down this road is to really spend a lot of time caring and counseling your team. Because it is. I think it has the potential to be a break of trust where you. Many things in the practice, I was very consultative with my team. We talked about ideas together and really function in many ways as a group. But in this case, I did not ask for their opinion about joining this dso. This was a decision I made on my own. And really, I think that's how it has to be. I think that the owner of the practice. This is a very personal decision and it's going to work great for some doctors and for others, it's just not the right thing to do. But, yeah, that's a. It's a great call out, Wes. I'm glad you, you brought it up. It's actually something that I, you know, if I could do over there's probably many things in life I wish I could do over, but that's one of them. I wish I could have been more thoughtful and sensitive with my team as we walk through that process of going through the partnership. And then all the stuff that comes when you join, all the changes that come to the pract. There are small things, but they add up, you know, and if the team's not on board with you and has your back, that's terrible. Right. We don't want the practice culture to be destroyed in the process. We want it to be just as strong as it was before, if not even stronger, you know, going through the process. So, yeah, that was a tough one, but, you know, we worked our way through it. Everything's fine, but it was probably harder than it needed to be because of my leadership, or lack of leadership, maybe.

Well, we are all learning about leadership in our lives. And one of the things that I've learned when it comes to leadership, though, to empathize with your decision a little bit, though, is that there's been a few times where I think out loud, I share information too early, before I've distilled it down in my own mind and made decisions and have clarity in my own mind. And I will leak sort of some of my thoughts out before I have come to a conclusion. And then it. And this has happened here at practice cfo, and then it. It will just fly throughout the company within a couple days, it will just fly throughout the company. And then when it goes three links away from you, it starts taking on a whole new thing. It can create panic. And people are worried because this is what pays for their livelihood. Am I still going to be here? What is this going to mean for me? Am I going to see a reduction in Sal? Are they going to take over the billing, for example, there? Or am I still going to have my job to handle billing here and just all sorts of concerns can arise. So I actually think you holding off was probably a good decision, how you presented it. I wasn't there for that. You can judge that one. But that's where kind of the communication skills come in. But also doing it in a way that just helps reassure people. Now, a lot of these sales, you continue to work in the practice after so many of the experiences where I have been involved in, the doctor continues to work for a number of years. Sometimes they're not even looking to retire. They just want to join in with sort of a bigger group. And so not a whole lot shakes out for a lot of the team. It's almost just this change in equity structure and ownership and there's some sort of administrative changes, but nothing terribly disrupted. In other cases, there's a pretty significant overhaul in operations in the practice. It depends on where that DSO DPO is. I think the more mature, bigger DSOs, the bigger ones have their operations dialed in a lot better. And so they basically come in and just plug it in and it can feel a little bit more disruptive. But because they're so good at it, if a staff member were to leave, they know how to fix that solution really quickly. I think the younger DSOs and DPOs who don't have all the operations ready yet, they're primarily just sort of bringing together the equity. They're sort of co joining equity, but not necessarily all of the operations right away. A lot of things will just stay tact at the office level and so there's not as much need for concern across the staff level. I find so many different scenarios play out in these cases. So tell us, where are you now? What's been your path since selling to US Endo?

Yeah, well, a lot, A lot happened actually. And kind of hearkening back to some of my, my thoughts when I partnered and made that decision to partner, some of that, I'd say a portion of it was trying to take some risk off the table. And it's pretty risky, you know, being a solo practitioner in particular in a small town, that if something happened to me and I couldn't practice anymore, how would I sell my practice quickly? And I had mentioned early on, you know, the guy before me had this very practice, you know, on the market for two and a half years, somewhere in that ballpark. And it was just tough for him to sell. And I thought, gosh, you know, if that happened to me, that'd be really tough. My practice could lose value overnight, you know, if I was, was hurt or something. So yeah, partnered with us Endo and worked pretty much just as normal, really. No change to my day to day. My team and I were treating patients just as we had always done. US Endo had essentially made a promise like, we're not going to mess with that. Like you're just going to keep doing your thing and just kind of keep the train on the tracks, you know, so to speak, and keep, keep doing what you're doing, you know, that's why we want to partner with you. And so I did. Everything was going fine, but about a year and a half or so after partnering, I ended up developing a neuromuscular disorder just kind of out of the blue in my. My dominant hand for my right hand, that essentially kind of started popping up in small ways and over time was just progressively getting worse and worse where I lost my coordination, essentially when I tried to do dentistry and other things too, even typing on a keyboard or using a mouse, I just, like, my hand would just stopped functioning well. So, you know, I started the process of going to specialists and trying to figure out what it was and eventually found a doctor at UCSF who knew exactly what it was. And we began the process of kind of sorting through that. But the long and the short of it is that it continued to progress to the point where I had to stop practicing. So I had an early retirement less, not a planned retirement from clinical practice, but that's how it worked out. So the Lord had a different plan than I did. So, yeah, essentially my worst nightmare kind of came to pass as far as my practice. That I would not be able to find a buyer if I hadn't been a part of US Endo just would have been a catastrophe, I think, financially. But because I was partnered with US Endo, I was able to go to them and say, hey, this is the situation. And I was really scared, I will add, because, you know, you mentioned the equity, right. So I've got this money that I've invested in the company through the partnership, and that is contingent on me doing my job. You know, we have a contract that says, hey, you got to keep doing your job and keep working, and you've got a period of time you need to commit to. And I wasn't going to be able to do that. Right. Because I couldn't practice now. And so I was really scared. And I tell you, it was so such a blessing to talk with the leadership there, let them know what's going on. And the first thing they said was, like, don't worry, you know, we're gonna take care of you. You're gonna be fine. And, boy, it was just a huge, huge relief. So, yeah, so my. My path totally changed, and I have ended up becoming kind of part of the leadership team or at least contributing to the leadership, you know, as kind of an intermediary. Right. I'm not trained as a business person and in the way that our business team is, but I've got the perspective of a doctor. And so as the leadership team is thinking through ideas or they're working through issues, I can bring the perspective of our doctor team to the table. And so that's a lot of what I Do I kind of help consult and I do some teaching and training of doctors in some different programs that we have some leadership programs and programs to think about practice efficiency and just trying to help connect our doctor group together. One of the things I will just mention, Wes, I think one of the cool things about the partnership model and I don't know how much this happens at other DSOs, but at least at US endo I can speak to, we place a really high value on doctors just talking to each other to share best practices and to get ideas out on the table. And we don't really have a model of like making people do certain things, but we do have a model of wanting people to talk together and so sharing ideas, coming up with best practices, creating avenues and forums for people to share ideas and information. What's working for you? What's working for me? And so together we can grow, right? We can grow together by communicating a lot of people. And so part of my job is just help facilitating that. But it's been a real blessing. It's been something that I've enjoyed actually stepping into. You know, it's not as lucrative as being an endodontist, but that's okay. Still am enjoying this change in direction and I've really liked getting to meet a lot of the doctors that are part of our team.

Very different work criteria that you are in now. In fact, you even moved from Grass Valley down to Texas. Right? You are outside of. Was it Austin? I could be wrong on that.

Dallas. Yep. Yep. Our central hub is Dallas. We do a lot of our meetings in Dallas and so yeah, the frequent airplane rides were, were hard on my marriage. So we decided we're very happily married, but we decided, hey, I think, you know, for, for this job it would be better for us to be closer to, to all this activity. So yeah, we live in a town outside of Dallas and pretty, pretty big change for us as a family.

Selling your practice led to a lot of changes there. But I've been very happy to see how life has evolved for your wife Katie and family. And just the, I think the experiences that you're having now is in some ways a, a mentor of sorts or working with other doctors in a totally different capacity than, you know, doing doing root canals is, is a change up for sure. But I see it being something you're really enjoying regardless of, of that change and starting to know about that medical condition. I remember going through that discussion with you and seeing you make some of those hard choices. It was pretty gut wrenching because I know you loved what you did. You love being an endodontist, and. But you. You've done some really great things with your life. Well, Jeremy, thank you for being on the show. A lot of valuable lessons we got into just the story, some of the emotions, the feelings of it, the journey we got in, some of the technical side of DPO, DSOs, talking to your team. Some really valuable points. Thank you so much for. For contributing.

Oh, happy. Happy to do it, Wes. You know, I told my wife I always had a hunch that I was going to be famous, but now I know, like, this is it. I'm on the west podcast.

We have about, yeah, 30 million followers. We're about 35 million followers at this point. So. You're welcome.

You're welcome.

Marketing.

Well, I appreciate it, Jeremy. And if there are others who have sold who you think have some cool stories to share about their process, please let me know. There's a lot of dentists out there looking to understand what that journey would look like for them and get a little bit more educated. Thank you again.