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Success Problems: Why Thriving Practices Still Feel the Pressure · The Millionaire Dentist™

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  Hello, everyone, Welcome to the Millionaire Dentist Podcast, brought to you by
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  four Quadness Advisory. On this podcast, we break down the world of dentistry,
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  finances and business practices to help you become the millionaire dentists you deserve to
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  be. Please be advised we do speak with an honest tongue and may not
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  be safe for work. Hello and welcome. This is Casey Hires back at
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  the Millionaire Dentist Podcast in studio with co host Jared. I love the seventies
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  Bridgeman, Casey, what's up yesterday? I'm rockinhead like I'm from the seventies.
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  My wife got me some shirts from this website. I like where it's
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  all like seventies. What's up in the Brady bunch? What's the dad's name?
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  Was it Peter? There's Peter, Greg and Bobby Bobby. Those are
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  the case of just mister Brady. Mister Brady. Yeah, you look like
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  hello, mister Brady. Going on. I'll take it. Yeah, we'll
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  throw back and you look you look sharpening in your jacket. Thanks, Yeah,
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  thanks, that's sexy. Casey. Usually you and I come on here
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  and you know, we have a good time. We talk about a lot
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  of things. One of the things I wanted to kind of touch upon.
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  We have some listeners out there who maybe say sometimes think that what we're talking
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  about may not necessarily apply to them right now because they've already they've already moved
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  up a level. They're already pretty successful. More money, more problems.
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  When you're successful, you're just trading problems. Now they may be less stressful.
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  But I kind of want to talk to you and your experience in your
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  forethought on like having these conversations with Dennis and owners. There's different plateaus of
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  success. Yeah, and there's different challenges. I was kind of joking beforehand,
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  this would be a stressful challenge. Jet fuel price went up on my
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  private jet. This is so stressful like that, that's stress, right,
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  But that's different stress than most people have. What luxury car do I drive
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  today? Gosh darn it, I can't remember which one needs to be driven.
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  Yeah, well that's stressful if you don't drive car plugged the battery and
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  you have problems, right, So some make rough problems that have see and
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  that's from my perspective from someone who's not at that tier, is like,
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  wow, cool, good for you. Yeah, I mean I from a
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  personal perspective, P due boiler Maker fan. Finally we go to the final
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  four? Was I there? Did I cry? Yes? That important?
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  Here's what's important. When you get knocked out as a one seed by a
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  sixteen seed, you have a set of problems. You know, you stink,
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  get better, it's uncomfortable. You don't like those problems. Well,
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  now you go to the final four, you have a new set of problems.
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  How do you get the fan base? There? Flights, hotels,
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  tickets. There is so much stress this week from so many people I've talked
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  to who But yet it's good stress. You want to stress, you're excited.
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  Yep, so that's your stress. You're not even going who you go?
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  We'll see. So. But my point is there's challenges regardless when I
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  travel. What do I hear? Oh? My staff and my team are
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  so hard in insurance, and there's just no way to be rich in dentistry,
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  and so many people just want to stay in that place. But inevitably
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  there's people in that room are like, I collect one to eight by myself.
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  My staff's fine, and they have different challenges. Let's get into those
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  today, right, So let me ask you Let's say a practice has mostly
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  moved on to feed for service. But is there such a thing as too
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  many patients? Oh? I've had those conversations. Now here's what's funny.
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  Most dentists who don't experience this problem haven't heard this problem because those that have
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  it don't want to share it because they almost feel a little guilty. Right,
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  But we I talk to people clients and other that yeah, they their
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  fee for service, they are producing and collecting a lot of dentistry, and
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  they're booked out almost to eternity. They and so they're that's a great who
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  doesn't want that problem? I talked to some people, you know, with
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  startups the other day, and they're going to get there, but it's going
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  to take time. Let me ask you, so, what are some inherent
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  stresses that could come from being booked out too much, too far out?
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  Well, you know, the domino effect is what do you do? Most
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  practice owners like the work four days a week? You know, do you
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  work four and a half? Do you work five? Do you work six?
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  Do do you have room to expand? Okay, do you bring on
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  an associate? Well, there's a whole new set of challenges, right,
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  do I do I, can I not expand should I have a second lak?
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  There's a lot of zigging and zagging that that person has. But then
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  if they're at their study club talking about it, oh, you know,
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  what was you? And so it's a challenge that some of you out there
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  might have, and then the question goes, well, what do you do
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  about it? Most of these challenges, there's the right thing to do based
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  on your personal numbers. Right, We're not going to give you actual like
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  here's what to do today because we don't know you and your practice. Yeah,
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  but those challenges are real. And again, being insurance isn't an issue.
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  Patients aren't an issue. There are a lot of practice owners where those
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  two aren't issues, but their challenges are different. Are vacillated absolutely. Okay,
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  So let's say we've you know, you've recently moved more to feed for
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  service. You're starting to bring in a lot more income, a lot more
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  collections into your practice. What what happens if your CPA has not prepped for
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  this or has not really accounted for for this situation, Like, oh,
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  it's great, I'm making you know, hand over fist here, but my
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  CPA had not foreseen that growth that is not accounted for pun intended by a
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  CPA. Yes, yeah, what what do you do with that? Well,
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  if you're if your CPA is uh, non confrontational, they'll just create
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  a shareholder loan and you know, kick that can down the road. But
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  that is another challenge. Again, I've grown so much that now my tax
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  situation needs to be looked at or you know, oh my gosh, too
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  much growth, right, right, you're either going to have a shareholder loan
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  or you or you're going to end up with like a large tax surprise.
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  Unfortunately, those two are are wildly common in dentistry, and so most people
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  would think, oh my gosh, you grewed your practice, you know,
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  thirty forty, that's amazing and that. But like we said, you're now
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  trading one set of challenges for a new set of challenges. Right, price
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  went up on my private jet fuel, right haha. Like you're not going
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  to get any sympathy at your study club talking about all this growth. But
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  we see that a lot man, they're growing and then they just get crushed
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  by a tax surprise or how do I handle this growth? And it's and
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  it can feel very depressing, you know, or satin only lonely to the
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  person who's like, I'm making all this extra all this extra money is coming
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  in. I'm just watching a fly right back out. There's not people going
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  to give you a ton of sympathy. And a lot of people we deal
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  with when I mentioned plateaus earlier, they have hit a plateau of success,
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  a plateau of success that most of their peers cannot relate to, right,
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  and they don't know what to do. Again, that's where you know,
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  getting your house in order or affirm like ours gets you to that next level,
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  gives you that roadmap and takes you there. But so many of these
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  successful people they've hit this plateau. It's rare air and they look around and
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  go crap. I don't know what to do because most people haven't experienced this.
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  So I can't call my buddy from dinnery school and get his opinion yep,
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  because I don't want him to know all myself. I hit a certain
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  you know, upper percentage of the of the neighborhood. It makes me think
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  of that TV show Arrested Development when Lucille Bleueth, the mom, was like,
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  it's a banana, Michael, how much could it cost? Ten dollars.
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  You know what I mean, because she had no idea. She has
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  grocery shopping in forty years. The first three seasons of arrested development is so
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  good. So ten thousand dollars, sous? Sorry, got I do that
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  show? Okay, So your practice has grown, You've got a high income
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  coming in, but your practice has a wrong structure. And you know we've
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  covered this before on previous podcasts with you know, Steve Levy or CPA and
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  JD. But kind of do a brief description of what that is, Casey,
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  how how's a wrong structure en city structure can affect your high income?
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  Yeah, I've had these conversations or they're like, I've got I don't know
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  how to pay myself. I have all this money sitting around. I could
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  take it. But if you know, do I have the right entity structure?
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  Do I have the right income structure as my W two and distributions set
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  up that's right sized for me, am I reducing datam my saving for retirement.
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  They don't know what to do with the income, and if you take
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  it the wrong way again, there are negative tax implications that just can smoke
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  you by the end of the year because you're going to be getting potentially double
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  taxed on things. We have seen some situations that the practice owner had no
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  idea that simply a better structure can help them save tens and tens and tens
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  of thousands of dollars more for retirement and reduce tax liability by thirty forty fifty
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  thousand bucks. And they look up and go, you've got to be kidding
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  me. Nobody has told me this, And how many years have they been
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  doing that? Potentially? Ding ding ding. That's exactly right. So okay,
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  they've got the high income. Let's say they've got the structure fixed,
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  their entity structure. But now they look at their account, Ballot says,
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  and they're just flush with cash. They're sitting on a lot of money.
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  And there's that sounds great and obviously it's not a bad thing to have as
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  money, But why why is that a stressor? And why can't that be
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  an issue of having having too much money in your account? Yeah, it's
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  a it's a it's a challenge. People are embarrassed to mention again because there's
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  most people won't have sympathy for you. No, you know, and and
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  and you don't hear many people with these issues. But your practice account balances
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  are flush with cash, your personal cash flow and income. You you feel
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  like you have plenty of money you can do what you want, and and
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  your personal bank accounts are high. And so you're looking around and you're not
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  sure what should you do with it? Right? And and nobody's really given
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  you a roadmap. Should I zig? Should I zag? Or if they
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  if you had asked them, they might have spent a yes ban and said,
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  yeah, sure, just go ahead and do whatever you want. We
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  hear that so often you go to one of your you go to one of
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  your external team, and you ask for some advice, and they just sort
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  of back up what you float as an idea. We're in reality again.
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  People in this rare era of heavy success. They're looking for good advice.
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  Tell me what I need to hear, not what I want to hear.
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  Ye, what should I do with all this freaking money? Like that's a
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  challenge for some practice owners out there, I mean, and they know,
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  you know, we're all smart enough to realize that having it set in a
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  potentially just like a savings account, running a minuscule percentage is not the is
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  not ideal. Well, you know, When I say zig and zag,
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  I mean there's a lot of different things you can do, but in totality,
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  your team needs to have a very personal relationship with you where they understand,
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  you know, retirement savings, debt reduction, cash flow at home,
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  cash flow in the practice, reduce tax liability. That's just five factors that
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  need to be looked at comprehensively and universally. And if they're good and work
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  for Ressault, they'll also be able to tailor it to your interests as well.
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  You know, what you like doing the X hobby, Let's find a
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  way to make that work into into what you can do. Yeah, versus
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  a CPA or a personal financial planner that just has the same plan for their
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  two hundred clients and it's just it's a it's more of a just a cookie
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  cutter, rubber stamp approach. Yeah, which might be fine for the for
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  the normal person, the civilian out there. Yeah, yep, all right
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  here, I am practice owner. I've got patients out the ass, I've
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  got cash coming out of my bomb. Let's do every every form of that
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  word. I'm feed for service. You know, I've got my structure fixed.
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  What's next do I do? I want to keep this golden goose opportunity
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  that I have, or should I look into maybe maybe it's time for an
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  associate, or maybe a second practice, a second location, or beyond that.
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  It's interesting you say that, right, you're crushing it human nature.
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  It's like, okay, what's next? Yeah, and it's and so you've
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  mastered it, right, You've got this golden goose. As you said,
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  there's a temptation to well, I'm going to go bring on two associates,
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  I'm going to add three locations. I'm simply going to multiply this thing.
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  And that's just going to be that easy to be close. A terrible business
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  strategy, but there are times where it could be appropriate for a growth strategy.
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  Again, it comes back to what's the practice owner want most say?
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  If I can just keep my life simple and hit all of my goals and
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  maximize my profitability, I'll take that. And sometimes sticking with the golden goose
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  is the best way to go, but other times it might make sense.
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  Again, your team should be showing you business model options to add another location
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  and a different geography. Now adult babysitting comes into play. I mean,
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  now you're going to go another one or two million dollars in debt. These
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  are things that you'll have a lot of cheerleaders at your side when you float
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  these ideas, and so you've got to be very, very careful. It's
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  a challenge. I've dominated this part. Do I try to make it a
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  multiple We've seen place people that it has set them back five to seven years
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  and it in their personal lives really suffered because of it. I can see
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  that for sure, because it's hard to not bring stress home, no matter
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  how good you are at it. But there's other people where yes, it
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  makes sense to add another location, to bring on an associate, to expand
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  your practice. Right, people jump into those three things typically way too quick.
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  And then because it feels good, it feels like it's a check it's
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  a check mark you can make. It's like I opened a second location I
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  was able to and it's like real tangible. I did it once, why
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  can't I do it again? And you know a lot of folks get about
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  sixty percent down that path and they go, oh, this emotional decision that
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  felt good and it seemed logical, I'm now hemorrhaging cash all those challenges that
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  I had, I don't have anymore, and I fingers crossed, I really
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  hope this works. Again, you need to have a plan and a team
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  where you are more certain, right, And is that worth potentially seven or
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  more years of your time playing catch up? Yeah? I mean it can
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  really set somebody back. But again, those challenges, You're not probably not
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  going to go to your sential community events. And hey, every you know,
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  do you already make eight hundred thousand a dentistry and save two point fifty
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  and you're on track for twenty million dollars and your fee for service and your
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  staff and team are are great, in your overhead's low, and you want
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  to do a second location, you'd probably get boot out of the place.
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  It's most likely they're still complaining about staff and insurance. Yeah, and those
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  are real challenges. We talk about those, but they are not the only
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  challenge. And I'm getting to a place where I've got to take a deep
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  breath because it's not here. But like when I go to events, I
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  just oh my insurance and staff and where I live, and it's just impossible
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  to be to be successful in a wo I'm getting to the point where I'm
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  hearing people on the back end of the career becoming bitter, and all they
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  do is complain and just say it's not possible, right, And then I'll
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  talk to somebody in that same room that's younger and go, I'm good on
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  that stuff, man, Like I don't want to do with the half a
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  million bucks got to sit in my practice account, and like should should I
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  wipe out my debt in one fil swoop or should I have balance to it?
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  Like? That's that's the different challenges that we have. Casey, you
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  actually speaking of, you know, going out and speaking. You just got
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  back from Nashville, nash Vegas. That's nash Vegas. How'd that go?
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  Did you have a good time out there? Great venue, full house that
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  they'd had a table? Yeah, I mean again, educating the dental community
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  on this topic is the primary purpose. Do we want to meet people to
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  talk and have offline conversations? Absolutely sure, we can't help everybody in the
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  room, but if we find one or two that we can, then we'll
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  allow them to go through a vetting process. But no, it was fun.
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  It's a good time. I got I got out of there though,
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  I'm getting too old. Broad away And what's said plans? What is that
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  nice urban. Yeah, I pleaded the fifth. That's right, Casey coming
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  up soon too. We will be in Boulder and Denver, both those in
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  Colorado. By the way, had a summer internship in Denver once. Yeah,
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  it's changed a little bit. They made something legal and every Yahoo and
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  a van decided to go live out there with no plan and now it's a
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  it's a challenge. And Boulder, who used to be keep Boulder weird,
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  they used to be like the crazy suburb. Now they're almost as normal as
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  Denver is. But love the area, great area and a lot of good
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  practice owners. We're packing that house right, it'll be great. Yeah,
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  it's I mean, honestly. You go to four quadrants dot com slash events
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  and check it out. We have very very very few seats left for our
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  tasting in Denver, and for a brunch, just a handful of seats left
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  for that one too. That one's going quick, so please get on there
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  and register if you're interested in coming. You get to hear some great things
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  here, Casey speak, see all kinds of great things, Taste some good
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  things, eat some good things. After that, we'll be coming to areas
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  like Saint Louis. We'll be in Boston. I mean, we're we're really
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  putting you through the ringer, Casey and getting you out there. We have
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  a stable of good presenters. That's right, That's right, Yeah, case
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  anything else you'd like to add before you go today. Whatever plateau of success
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  you're on, you don't have to stay there. If you're struggling, you
• 16:52
  can get out of that. If you're crushing it, you can get to
• 16:55
  the next level and retire five years sooner with millions more. Wherever you're at,
• 16:57
  get to that next level of success. Don't be complacent. Mediocrity is
• 17:03
  should not be acceptable. Don't let the boogeyman and those excuses keep you where
• 17:07
  you're at. And don't be afraid to reach out and talk to talk to
• 17:11
  anybody you can, anybody that's a professional in that area. If you're afraid
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  of you know, my CPA is not doing what they need to do.
• 17:17
  Maybe start researching and looking to a new one. Give four quadrants a called
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  you know what I mean. I'm gonna get off my soapbox and go watch
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  an episode of The Brady Bunch, all right, have a go one.
• 17:26
  So that's all the time we have today. Thank you to our guests for
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  their insight and for sharing some really great information. And thank you to you
• 17:33
  the listener for tuning in. The Millionaire Dennis podcast is brought to you by
• 17:37
  four QUADRANTCE Advisory to see if they might be a good fit for you and
• 17:41
  your practice. Going over to four Quadrantsadvisory dot com and see why year after
• 17:45
  year they retain over ninety five percent of their clients. Thank you again for
• 17:48
  joining us and we'll see you next time.