Latest / Dental Mentors / Pat Bauer | How Heartland Dental Scaled to 1,900+ Practices & Why Data Fixes Everything

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Pat Bauer | How Heartland Dental Scaled to 1,900+ Practices & Why Data Fixes Everything · Dental Mentors

• speaker-0: Great leaders build great companies. That's easy to say, but that means bad leaders build bad companies, mediocre leaders build mediocre companies. You can make it families, countries, you name it. Build yourself first. So I've got to build myself to continue to build, to be able to scale, and then build your people, and then get out of the way and lead, don't manage it. That leadership model allows us to say, look, how are you building yourself? speaker-1: you speaker-0: to be able to continue to grow. I've had to have people leave my team because they weren't able to continue to grow their leadership at the pace of our growth. So if I don't continue to build my leadership, pretty soon the company's gonna go, well, you can't do it, so I'm gonna find somebody that can. speaker-2: How important is continued education and training for hygienists and doctors? speaker-0: The reason most young doctors join us, please do not, is education. When we do surveys, we know, I'm just gonna join, stay for a year, learn as much as I can and go on their own. Which is fine, that's no problem. Every doctor that's with us and they leave is an alumni of Heartland and I want them to have a good experience, even if they leave. I wanna prepare them so the education is crucial. Some people go, God, my Pat there, you spent all that money and they quit. It'd be worse if I didn't and they stayed. I want them to be better. speaker-2: Hello everyone. Welcome to Dental Mentors. This is Matt Ornstein. I'm here with Neil Zemba, founder of Rise DDS and Eric Morin, founder and owner of Tower Leadership. And our guest today is one of the few people, maybe the only person in all of dentistry that actually needs no introduction, but I'm still going to introduce him as... Pat Bauer, CEO of Heartland Dental. And I met Pat actually about six years ago before I even got into dentistry, before I bought ⁓ our DSO. Pat's just been a wonderful mentor, a great friend, and we're honored to have him here today. We're trying to get through 19 questions in 57 minutes. I don't know we'll get through all of them, but we'll do our best. So we're just going to jump right in and Pat, thanks for being here. My question number one is, can you please talk about the growth at Heartland from when you started until now and just share what you want with our audience, please? speaker-0: Sure. I met Dr. Workman in 1995 and I was with Metro dental care back in the day. I been there. I was in charge of a large group conference and Rick showed up and I stayed in contact with his people. And so he asked me if I was looking for somebody like you. So I joined him in 1997. In July of 1997, I was thinking he had, he sold 21 of his 29 practices approximately. And so we had eight in July of 97. As of this morning, have 1,928 and it's not been a straight line, of course, but we're in 40 states and DC, think. ⁓ speaker-2: That's amazing. I can jump in and ask a question, what are the biggest factors that led to Harlan's success? speaker-0: probably alignment with our doctors. our vision and mission hasn't really changed. Our mission is very clear. All we do is support doctors and their teams as they deliver the highest quality dental care and experiences to the communities they serve. So we only do one thing. We support doctors. And even when we started, I remember we just said, look, if we can help one office, then we can help another one, then we can help another one. And if we just keep on helping them, we'll be successful. And our comp model is aligned. So the doctor gets 25%. Basically, the PC gets 16 % and we split everything else 50-50. So we don't do any better until they do better. So then alignment plus they own stock, they can buy stock in Heartland, the top co, not their practices. Again, just a philosophy difference. Our philosophy is we're all aligned together. If I win, the Heartland wins, the doctors win. If the doctor wins, Heartland wins. And so that basic tenant has been the same since 1997. So we haven't... We don't take HMOs. The reason we don't, because doctors don't like them. And so our customer is a doctor. And so our whole goal is, they're customers of patient, we have to understand it, we need to know that. But the bottom line is, they're our customers. And so that alignment has helped us continue to grow because, look, you can make as much money as you want if you're a good operator. Now, if you're not a very good operator, we'll help you. We'll help you with that operations. We'll help you be successful. We want... you to be successful because we're only successful if they're successful. So it's a pretty, it's all about alignment in my mind. speaker-2: Pat, my next question is how much does leadership matter in growing a successful dental business and how do you and Heartland produce such great leaders in your organization? speaker-0: Well, leaders do matter. I got, we do all of our leadership. We've been doing it probably since 2000ish with Dr. Gerald Bell out of North Carolina Bell Leadership. He's right on campus. teaches at UNC and he's a PhD and super smart. And he's studied leadership for a long time. And so his four laws of leadership are pretty simple. The first law is great leaders build great companies. Now that's easy to say, but that means bad leaders build bad companies. Mediocre leaders build mediocre companies. You can make it families, countries, you name it. So the second one is build yourself first. So I've got to build myself to continue to build, to be able to scale and then build your people and then get out of the way and lead, don't manage. And so that leadership model allows us to say, look, how are you building yourself to be able to continue to grow? I've had to have people leave my team because they weren't able to continue to grow their leadership at the pace of our growth. So if I don't continue to build my leadership, pretty soon the company's gonna go, well, you can't do it, so I'm gonna find somebody that can. Same thing in other positions. If you can't get results in the right way for the right reason, being nice, because you gotta be nice to work here, if you can do that, then that's it. Go through and we're human, and so we have a lot of frailties. My dad and mom did the best they could, and now I can't blame them anymore. So I've gotta build myself no matter what, and how do I do that? Well, that's with three back, with. feedback from my people. Here's everybody judges themselves on their intentions. Others judge us on our actions. And so they're just watching me. They're watching me. They're watching us. They're watching each other. And they're going, I don't want to be like that. And Dr. Bell has just studied it for years and years. Here's what good leaders do. Here's what bad leaders do. And so how do I do the good things? Well, I have inadequacies. And so I have to figure out how do I get rid of those inadequacies? How do I get rid of those irritating things that I do or other people do? so that I can be the best that I can be to lead. Because if people don't trust me, if they think I'm a jerk or a pompous ass or you name it, they're not going to tell me the truth. And the truth, data is key, the truth will help me make the right decision. If I don't get the truth and people are hiding and not telling me the truth about what's going on in the business, we will fail. And so that, how do you get the right information? Well, you have to build your leadership. And so we sent everybody through Bell. It's very expensive, but. If I don't build them, now they go home and their family is better, their lives are better, besides Heartland being better. So it helps us as a human, not just for the business. Yes, it helps the business, but these are better people now. They're better for their families. They're better for their children. They're better for their grandchildren. And so it's about continuing to build yourself. No matter how old you are, you can change. It's just really hard. And the more stubborn you are, the harder it is to change. And so I have to work on it. I didn't think I was that stubborn to get feedback. And so one of the things you have to get feedback from your spouse. And I said, I don't think I'm that stubborn. My wife goes, are you kidding me? And so, okay, I need to be better. And so it's just a journey. It just takes a long time to continue to get better. But you have to work on it every day. I do my homework every day. How did I do yesterday? Did I do what I said I was gonna do to be a better leader person? speaker-2: Thank you, Pat. Speaking of data, you and I sat down for like an hour and a half in Florida one time, just the two of us. It was best hour and half I ever had with somebody in dentistry. And you told me quote, data fixes everything. Can you speak more about that, please? speaker-0: Yeah. ⁓ so how do you help in dentistry? There's not a lot of standards that says you have to do this, you know, medicine, they track how long you're in surgery. They know if you're in surgery too long or they just have much better metrics to know what happens in dentistry. They've really tried to shield dentists from being under that scope. And so I can't tell a doctor, Hey, you just got to do more. That's ridiculous. They'll look at me and think I'm ridiculous. What are you talking about? So we have to help them understand, okay, will you tell me what your beliefs are? Now, if they don't, if it's something way off the wall, I've been doing this long enough to know what's weird and what's not. If it's way off the wall, I'll have a doctor talk to him and say, this guy doesn't understand, can you debate with him? Because I'm not a dentist. So I have to have dentist debate on why do you think that? But most people have similar, easy one. If you ask a dentist, do you think every dentist should have a comprehensive exam? Well, of course. So then that's not a... That's not a quota. You told me you believe every patient should have a comprehensive exam. Why are yours 80? Why do you have 80 % comprehensive exams? Well, I had emergencies. Why didn't they come back? I don't know, because you said everyone should have a comprehensive exam. Now, if you don't like that, it commence 99. It's not a quota. It doesn't matter. But why are you not getting what you believe you should be getting? And so we can do that in different metrics, different, you know, now with AI, it's just incredible. because now they can see it go, okay, I know what my beliefs are. Here's what I'm doing. Here's what the data says. So AI says this. I say this. This is what the patients are accepting. So now I have even more data to just help them be the best clinicians they want to be, they can be. So data, besides that, then you can say, okay, now I can start planning for the future. What is out there? I have billions of dollars of unscheduled treatment, billions. And so, We don't have to, you don't have to fake anything. You don't have to make anything up. The data shows you what you can do and how you can be better. But it's just also on results. But that's the main reason data will set us free, because it helps clinicians make better decisions for patient care, which helps the whole world. And so that's how strong data can be. I'll stop there, because I could go on a long time, if that makes sense. speaker-2: Well, speaking on data points, what are the top five data points that a dentist should monitor in their practice or group and how often? speaker-0: ⁓ There's always a basic, we call it schedule, produce, collect. It's not that complicated if you think about it. So is your schedule full? So what's the data? Well, you can know if your schedule is full or not. So then you say, okay, what am I producing? So those are just basic things, but you can look at revenue, profitability. So first thing I look at is a P &L, revenue, profitability. Okay, is it what I thought it should be? If it's not, then I can start getting into other data. So then, You look at, well, am getting my new patients? Is my re-care good? So in other words, am I getting what I should get out of the marketplace and are they coming back? Because if they aren't, I've got bigger issues. Of course, patient satisfaction, most people don't do it. Most practices don't do it. But, and it's probably the last thing they look at, but we use Press Gainey and that just gives them a clue as are our patients, Press Gainey is a professionalized, not NPS, NPS is fine, just doesn't tell you what to do. It doesn't tell you how to fix it. These things I have, every doctor is the same questions. So now I can benchmark them. I can see what percentile they, most patients love their dentists. So it's that small amount that they have to know. So are you really satisfying your patients? Then, well that's probably the first five, because there's so many, because then you start saying, then you start going, am I delivering what I say I'm gonna deliver? If I'm not delivering enough crowns, why? How am I going to get, am I diagnosing crowns? Am I not? What does AI say? So you can get into really more, but those are the first five that I would look at. speaker-2: Speaking of Lispad, if you could pick only three things that a doctor could focus on to maximize their EBITDA or profitability, what would those three things be? speaker-0: I would say that three things I should focus on. First of all, do you have a clear mission, vision, and core values? So clear. Do you have goals that the team's been involved in to set? Because when a doctor comes and says, I'm having all kinds of problems, or a PMO is complaining, or a regional manager, I'm like, well, what are their goals? I can't help you if I don't know what you want. And so the team needs to be clear. This is what I want. Here's what I, and then you have to set expectations. So what are the expectations I expect out of my team? And so how should a patient, we call it 13 dots in our system, how does a patient travel through the office? And what are the expectations of the leader, the doctor, when that happens? So when they come into the optatory, what are your expectations? When I walk into the optatory, what are my expectations? And so if I come in and my expectations are the pictures are up, the x-rays are up, And I'm looking at them and if they're not and I walk in and go no big deal, lost everything. But if I come in and see it's not set up and say, you know what, you must not be ready for me. I'll come back when you're ready. Now the expectations are being followed. And so you have to set the tone. I know it's hard for lot of doctors because they're not in conflict, but you have to set the tone. This is my expectations of how a patient's going to work and get the team involved in it. I think the doctor should be quiet. They shouldn't hardly ever talk because they don't have to if they're really aligned. All they can say, man, not hygienist, you could practically be a doctor. Because they're aligned on what they're going to tell the patient. There's no questions. When I see a big hole here, I know what the doctor is going to say. When I see this, I know what the doctor is going to say. So I can tell you what the doctor is going to say. Then the doctor comes in and goes, and we preheat them. The hygienist says, here's what I found in Pat. God, isn't she great? Yeah, I see the same things. So what are we going to do? And so it's that expectation is what's going to make the biggest impact. but I have to know what they want. And most doctors, I don't want to write goals. I can't help you that. What do you want? And so it's, it's really puts the pressure on the doctor to claim, and most are scared to do that, claim what I want in my business and my practice. And if they can do that, oh boy, you've got a 33 % higher chance of hitting it if you write it down. And so that's the key, I guess those are the three things. speaker-2: Thank ⁓ you. speaker-0: profitable first. And so if you're not profitable, you don't have much to sell. And so we're looking at, don't do fixed ruppers. So the first thing is, you profitable? And we looked at them one the other day and she didn't have an associate and she didn't want to work very much longer. You have eight, eight or nine chairs you want to have, you want to back off. You're not ready. You don't, can't do it by yourself. So you have to add a doctor and be profitable. And so it's every practice has a little bit, but the first thing is you have to be profitable. You have to look at why, if I'm not. fix it, then you'll be able to sell it. We're seeing a lot in, you we look at hundreds, sure you do two men. The margins are lower. They're much lower than they used to be. And it's a tough world. You don't get a PPO increase and you have higher wages, it's higher supplies, everybody else wants more money and the PPO just don't give you more money. And if you're fee for service, you've got to be a really good operator. So if you're not profitable, your expectations, you have to fix it. And so that's probably the first thing. You just have to be profitable and your box better be updated. speaker-2: Dang. speaker-0: the box is old and tired, I won't be able to put a find a doctor that wants to go to it and I won't pay as much because I gotta recruit somebody if you leave, are they gonna be happy with it or do I have to spend a bunch of money to update it because it looks like it's never been updated since 1990. That matters. so but you have to be profitable if you're not you have to be profitable you have to be it maximize your profitability if you're gonna sell it. It's just like a home you have better make it look nice or it's not gonna be sold and so that's the first thing. ⁓ speaker-2: Pat, what are the pros and cons for a dentist selling to another dentist versus selling to a DSO like? speaker-0: Well, if they're selling to another dentist and leaving, that's great, because then they're leaving. But if they're selling and hope to say, that's a con, because now you have somebody else leading you. For Heartland, the advantage is, I can still work until I want to leave, I don't have to worry about another doctor. So if you want to leave, we won't buy them if they want to leave immediately. So the con would be, I have to stay. Well, I want you to stay at least five years, because I don't want you to leave. So that would be a con if you want to leave right away. But if you want to stay, we're much easier because you're not losing any income drastically because we buy better, our expenses go down, so you could almost make as much money, many people do make more money when they're with us, but at least you have that capability where if you sell it to another doctor, that doctor's in charge, do you know them? That's why a lot of associates don't work, it's a silent, there's a silent message because they talk about turnover with DSOs because we track it. Nobody tracks how many associate chips don't go well. And so now I've gone through the third one because I just didn't work out. They don't want to buy the practice. They can't do it. And so you have all this happening. So you have to be ready. The con is the great news is sell it. You walk away. Great. That's a huge con or positive. But if you have to work with them, them, whoever it is, you better know. And so there's pros and cons to both. speaker-2: Similarly, Pat, what would you say are the biggest benefits to a doctor selling to Heartland versus another DSP? speaker-0: Well, for Heartland to have autonomy, clinical autonomy, we want, again, just write your goals. What do you want? We'll help you get there. And so we'll help you get whatever you want. We had a letter, this lady hit her first year anniversary. Now the first year of any affiliation is the hardest because nothing changes, but everything changes. Because now I have to think about every decision that I used to make. Didn't even think about it. Now I have to think about every decision I make. What do I do here? What do I do here? Even though nothing changes, Clint, in what you're doing, but just things are different that first year. So you know what she said? She said, I could send you the email. I decided with my manager, ex-manager, that we were going to dive into all the systems and just see what happens. We're going to just dive in. They went to our communication classes, our sales training class for the doctors in July of that first year, because it was January 31st. And she said it changed their lives, changed people's lives in our office. She's up 25 % from the time that she built us. Then she said, wait, January? I'm 47 % higher than I was last January. This is her. had, I never met her. Okay, I'm sure she was an orientator. I have not met her, but our systems work. So if you're gonna join us, the pro is you're already a pretty good operator. We don't buy fixer-uppers. She was already a good operator. What I find is good operators wanna be better. And so she chose to be better. If you sell to another DSO, I don't know what their systems are. I can't see that they're bad. I'd never worked any place else. So I've only worked at Heartland, ⁓ beside Metro. And I know Metro before when I left, didn't have the communication system. And that was the lacking thing that I didn't have. We have it. And that sales training, that ability to get all that 13 dots, all the team on the same program of communication. That's a huge pro. Now most people already have a system. So you're going to put in the parts that is lacking. but we force you to go to this class at least one time every two years to sit with your team to say how are we gonna work together. So we have, we think that it'll help you be a better doctor, be a better, now there's some doctors that go, you can't possibly teach me, it's okay, go anyway, just see. And if it doesn't, no big deal. But I know on average, people who go to our tram at this, because I have the data, they're up 15%, like that. And so with others, I'm not sure you're gonna get the tools or anything that's going to help you. You might buy supplies better, you might get some of that, but are you really good? There are some groups that tell you not going do anything. Well then, what are you doing? How are you supporting them? They go, we have low corporate overhead, we don't even do anything. That's because you don't support them. They don't even have one platform. The one thing that you have with us is we put everybody on the same platform. That's a con, because people hate it. But I have to, because as we said earlier, data matters. And if I don't have you on the same system, I can't do it. So we're going to make that part, which is a con for most people that are going to join us, going, I don't want to change systems. I like mine. It's Dentrix. It's right off the shelf. It's not unusual. It's not a weird program that's still DOS based or whatever. This is a fine system. It works. I'm not saying it's the best one, but it works really well. And so you're going to, you're going to, you're going to have to do that. Honestly, it's your practice. We're just here to support you for the others. speaker-3: Other than that... speaker-0: I'm not sure how they treat them. don't know if they're going to. I only hear stories and so I can't say what are the cons except I don't because I don't know what systems they help them. I only hear stories and that's not fair. I know what we do. Does that make sense? So I don't want to I don't want to say anybody is not as good as we are. I just know we're pretty successful. Absolutely. speaker-2: When thinking about dentist-owned practices versus DSO-owned practices, where do see the industry going in the next 10 to 20 years? speaker-0: Well, they'll considered continued consolidation. There'll be consolidation of the DSOs as well as as solo practitioners in small groups. And so there's more small groups. There's thousands of small groups. I think a DSO is five practices. So if you have five practices, you might not like to be called that. You're a DSO. Well, what do you mean? Well, you have to have systems because you have to have systems to work five practices. It's like a P firm won't buy a restaurant. until it or or it won't be considered until it has three at least. have because if you can't scale it and walk away and let know that it's going to work well then you got nothing. You don't have a franchise. You don't have a way to help people. For DSOs if you have bi practices I mean Park Dental has 50, 60 locations. They don't like to be called a DSO. I'm sorry you are. It's just your ownership is different. We got called a name. We're a group practice. Five is a group practice. We're 1,928 group practice. And so people just like, you're a DSO. DSO is just a name that they gave us because we got big. We're a group practice. And group practices take other people, other than dentists, to work with dentists. And so no matter what your size is, you can parse it wherever you want. If you're offended by the word DSO because we're financed, we have a backer called KKR. Well, everybody needs money. Park this with public. I mean, now they have... They have outside ownership. And so that's a DSO. So it's a group practice though. I've been doing the same thing for 39 years. They just got big. And so they gave us a name that's like a bad name. And so it's not, it's just a group practice and some don't do well. I mean, there's a lot right now they're suffering. They're, going to the bank. People are losing equity. That has nothing to do with anything, but the operators who are running it. It's not the model that's bad. The operators running it screwed up. They over leveraged. They couldn't get it done right. That's not that doesn't mean DSOs are bad. We just got bad operators and that happens. Practitioners, you know how many bad operators are solo practitioners? ⁓ my God, let me count them. There's so many, but they don't make the news because they're not that big. Does that make sense? So you have bad operators that are going to affect things, but I think it's going to continue to this consolidate. Will it be 100 % solos are gone? No, there's not in medicine. We're not trying to to. We're not trying to eliminate solo practitioners. We're trying to be an answer for solo practitioners who don't want to practice that way anymore. There's nothing wrong with being a solo practitioner. Do it. Great. Love it. You should do it as best as you can. Get the advice that you can and have the practice of your dreams. But if you get tired of it, come join us because it's okay. There's nothing wrong with having support or doing it on your own. But a lot of people, it's hard. It's hard to be the best at everything. You know, one of the biggest things is that if you have ever read the E-Myth or the E-Myth Revisited, they think they're entrepreneurs. They're not. They created a job for themselves. That's great. Entrepreneurs know how to scale things and be able to get out. And so it's just the difference. They use the example of somebody who grew up a company. Pretty soon you hate making pies because it's so miserable. That's what happened to the solar practitioners. God, I just hate it now because they turned it into such a miserable thing for me. because I can't get increases in my fees, everybody wants a raise, I don't make more money, I gotta go to the bank and get it, I have to be the IT expert, I have to be the marketing expert, I have to be everything. It's just not that easy. So some people say, can you help me with that? And there's nothing wrong with that. And so I just think that that's gonna continue to happen because people, most of the young kids coming out, they don't care. My nephew graduated six or seven years ago. He and his wife both work in the same practice. They make a million and half a year, something like that. Why would they? go do that on their own when they don't have to have that hassle. They don't have to worry about payroll. They don't have to worry about, you know, is cashflow where it should be? I worry about that. So it's just, again, there's just pros and cons to everything and there's nothing wrong with being solo, but there's also nothing wrong with wanting to work with it. speaker-2: said, Pat, heard you will be winning the Dental Titan Award this year at Dicoma. You're gonna be part of a very exclusive group of people that have won this incredible honor. I'd love to ask you what does that mean to you? speaker-0: I'm old. It's an honor, honestly. mean, Brian is a Titan himself and he always has the best shows. mean, no offense to anybody, but he has the best shows because he's organized and he's on it. And he's making sure that the right topics are discussed. And I think if you look at it, we just made sure that the right thing is happening in our practices, that we're helping our doctors because our doctors are the most important. No offense to anybody else. speaker-2: ⁓ speaker-0: If I don't have a doctor, I have nothing. And so I have to support them. Are we perfect? No. Do we make mistakes every day? ⁓ God, let me tell you, I got a hundred problems a day and they just keep coming. But in the end, it's about our doctors and being aligned with them. And if we can be aligned with them, that's what's given us our success. That making sure that we are absolutely just all over making sure and everybody, what I, you know, I just, we just did our budgeting process and our year of planning and we're into the year. Everybody's preparing, making sure that they're hitting their own goals and just a lot of stress and trying to figure that out because I have to remind them everything you do at the support office or anywhere else is only about helping our doctors be successful. And I have to push that message and push that message. What happens is brilliant people start saying, hey, I'll just centralize things. Philosophy again, just our philosophy. If you do that, you will destroy your business. Just a belief that I have. you will destroy the trust of the doctors. And if I destroy the trust of my doctors, I got nothing. And so I think that's probably why we've been successful. so getting the award basically says that you've done a good job over these years of delivering on your mission. And it's great honor by going with Brian with the right ethics and the right way of working. So it's pretty awesome. Amazing. speaker-2: Pat, my next question is, what advice would you give to the solo owner-operator dentist that does want to scale to multiple locations on their own? speaker-0: Well, I'm going to go off my experience and I know that Dr. Workman, he didn't get married until he was 42. He worked his tail off. He worked. That was fun. He let work is fun for him, but he worked. And so if you have a family, you better prepare them because I watched a little bit of AJ Asernow recently. It was on Instagram and he was being interviewed by somebody. Some of the things because he had a family while he was trying to grow a DSL. That's hard. And I've seen people have failures because it takes a lot. is not, people think it's easy. Well, hello, Pat Bauer can do it. Anybody can do it. Probably true, but it's not that easy. And so how do you get, how do you get people to build it? We just affiliated with a six office and I think he was just tired. He did a great job, built a great business and he's the only one and he has to do everything and it warm out. And I think he finally just said, I'm just tired. So you have to be prepared to understand this is not easy. And I think most people know that, but it's not easy. We do a lot of like two group, two offices. I've just looked at two this week. They have two offices and we basically say, well, we will affiliate with you if you get rid of the loser because you have one bad office because they could, they tried to do it and they couldn't do it. So you have to have a good team. So Dr. Workman had a good team. had a hygienist. a dental assistant and a business assistant that were his management team when he started. And those three are the ones that I stayed in contact with. And they knew how to set up an office, use their systems, how they wrote the systems. So you have to have somebody who who understand what Dr. Workman in this case wanted, what his vision was to be able to deliver it. And if you have that good team, but if you're by yourself and you don't have good people and you don't reward them well, you will lose. So you have to have the right people. that understand your systems. If you think, I'll just figure it out as I go. It's okay, you can do that because you don't want to get in the way. Nothing has to be perfect before you grow. One thing I know, one of the mistakes some people make, and I've had a lot of doctors come to me and go, you know what, we should just stop growing, fix all of our problems and then grow again. Well, that'll never happen. I have a hundred problems a day. Whether I stop today growing or not, I'm going to have a hundred problems a day and they're going to be some doozies. So you're never going to be perfect. Don't an entrepreneur like Matt knows that you can't. wait to be perfect because you'll never grow. I can get a practice to 80 % effectiveness pretty quickly. 80 to 100 never happens. I mean, they can get a little bit better incrementally, but you're not going to hit 100 % because even that practice will have 100 problems a day. They'll have problems. go, how does that happen? Shit happens. Excuse me. speaker-3: at speaker-2: What are the two biggest mistakes to avoid if you're a dentist that owns your own practice? If you could pick two mistakes that you could advise to try to avoid. speaker-0: If you own your own practice, if you're a solo practitioner, well, like I said, most don't have goals. Are you clear? Now we have 10 goals. I say 10 and you really go, oh God, you're gonna do 10 anyway. So you might as well prioritize them, because you're gonna do 10 things. So that's probably the biggest mistake that I see. They don't really understand what they're trying to accomplish and where they're going and what they're doing. And then they don't know why they're profitable or not. That's probably a big, they just don't understand it well enough to know, how do I really get profitable? And profitable, it's not all about money. Money allows you to do the things that you wanna do for patients. If you wanna do free things, then you better be profitable. If you wanna take care of the community, you gotta be profitable. You gotta make money so that you can keep going. This is not about, ⁓ we're money loving suckers of money. If you aren't making money, you cannot continue. You will have a sister-in-law who lives in the middle of all that stuff going on in Minneapolis and the Lake Street. It's just terrible. She's going to lose her business because they want her to shut down. want, you know, nobody's coming in and so sure business, but she also needs to have a plan. And I'm not sure she's one of the best things that a solo practitioner, if you really want to be a better, get the book Traction by Gina Wickman. Traction is about data, but it's also setting you up to hold yourself accountable. And what happens is doctors think they can just go and go, I'll just take care of patients that don't make money. God bless America, that does work sometimes. But if you have a better, if you actually have a plan and work it and look at the metrics that are important to you, you'll actually be better. Your patients will be better, your team will be better off. Everybody wins if you have a better business sense. And so learn from the people because you're running a business, it's not just a job for you. and how do you really optimize what you're doing? And that's hard for some people to do because it takes a lot of work. I you have to literally work all day, taking care of patients, and then work on the business. And that's hard. So that's the biggest mistake. They don't work on the business. They're just working in the business. And so I'm really thinking about how do I really do this? know, Dr. Workman used to have a guy that he graduated with. His name was Paranoid Bob. He loved Paranoid Bob. Bob was paranoid about everything. And they'd talk to each other about the business and how to make it. And he's always talking to paranoid Bob and Bob was great. He was paranoid about everything. And so how do you get, you have to be clear about your business. And so they were sharing things, but Bob couldn't grow where Rick could. Rick's probably one of the most entrepreneurial people I've ever met. I'm not like Rick. Rick is an entrepreneur. I have entrepreneurial skills, but I'm not an entrepreneur. And so without his skills and vision of what, and he can think we can do anything. It's just amazing. And so that's the kind of thing that. that they make mistakes on. They don't understand the business. speaker-2: What are your thoughts on morning titles and goal settings for the team at the office level? speaker-0: I don't know how anybody does. Morning huddles, if you don't have one, again, it's just a business thing that you're missing. Ritz Carlton has a morning huddle. Why? Because they're going to be better if they do. They're talking about what's happening today. Who are the people coming in? How are we going to take care of them? Our method is yesterday, today, tomorrow. IT squared, we call it. We didn't invent it, but somebody else did. So we look at yesterday, how did we do? Let's celebrate our successes, where could we have gone better? Why didn't Pat schedule? What's Matt doing? What happened? Did we ask for referrals? I if you don't ask for referrals, now, boy, that's scary. Ask for referrals? Yeah, you better. The average is 25 % in America. If you don't have 25 % of your patients coming through referrals, you're not asking. And so there's no shame in asking to, want patients like you. And so that's yesterday. Today, Okay, who's coming in? Pat's coming in, he needs this taken care of, who's gonna ask him of this? Who's gonna ask for the referral? And so you go through the process to prepare for your day and then tomorrow, okay, do we have anything going on tomorrow? If I have to move something to tomorrow, who's the best to do it? How does it look tomorrow? Do we have all the cases? Do we have everything organized? If you don't do that, you're just hurting yourself. I, dog, you can do it. That's so dumb, dumb, dumb, stupid, stupid. I don't even understand it. But it's, it's... speaker-3: I don't need to do that to T- speaker-0: It takes it. It takes work. I don't want to get there at 745. I roll in there right at eight. Dumb, dumb, stupid, stupid. If you want to be a better practice, then do it. Because it, but it's work and it's hard. There's all kinds of excuses, but you have to. Just like setting goals. I don't want to do that. It'll just help you. And so you're just, you're absolutely sabotaging yourself. Why would you want to sabotage yourself? Go outside, take a stick and hit yourself over the head a few times, walk back in and start doing it. Cause you're dumb. It's, there's no other. I don't know how else to say it, because if you don't do it, why, it's just everybody sits around. Don't let them sit down. Everybody stand up. This is a meeting. This isn't, I'm going to have my coffee and just sit here. Are you kidding me? This is real stuff. These are real people coming into our practice today. These are humans who are frail, have problems. I mean, we, we had a patient who our doctors at a huddle said, Hey, Pat came in yesterday, couldn't afford it. He needs a lot of work. And what do you guys think we should do? This is a hunt. You think we should take care of them? The team goes, yeah, let's take care of them. So they take care of this guy. Two months later, he comes in, brings a bullet to the front desk and says, why are you giving me a bullet? I would have killed myself had you guys not taken care of me. And you took care of me and you saved my life. That is the power of planning and talking about the people who are coming in. These are not just fake people. These are not just things. These are human beings coming in to be taken care of by a group of people who are fantastic. Let's kick care of them. And God bless America, we make money on that. And so it's fascinating. Sorry, I probably should have said dumb, dumb, stupid. speaker-2: was great. No, that's amazing. Pat, how important is continued education and training for hygienists and doctors? speaker-0: Well, that's a good one. are probably, the reason most young doctors join us, believe it or not, is education. So that when we do surveys, we know that they primarily join us to, it used to be more, now it's less, because most Mark people will want to stay with us, but it used to be really big that I'm just going to join, stay for a year, learn as much as I can and go on their own. Which is fine, that's no problem. Every doctor that's with us and they leave, is an alumni of Heartland and I want them to have a good experience even if they leave. Because they don't have to all leave in a huff. I don't want them to leave in a huff. I want them to helping them be successful in the next venture. Because eventually things come around. Now are we perfect with that? No. Do we have doctors who leave or are pissed off? We do. We're not perfect. But I want them to have good experience. So I want to prepare them. So the education is crucial. Now when we affiliate with somebody there's only one class that we I demand that they go to which is communications and orientation. That's the only two. Then they can take because they're experienced and if they want to take, if they want to, there's plenty classes that they can take. But I don't force them to. But the young doctors have to go through a pretty, we call it self, it's a process to help them clinically and leadership because that's what they need. Young doctors, you know the number one reason young doctors leave us? You're going to die in this one. Work-life balance. Now think about that. They work 32 to 36 hours a week. And I don't know the last time I worked 32 to 36 hours a week. And so what that means is I don't know what I'm doing clinically. I go home and think about it and scare somebody. I don't know how to lead a team. I go home, I'm freaked out. They want me to be my friend. I need to tell them what to do. They're not doing what I'm doing. And if they don't make enough money, money's not everything. But if they don't make, I know, if they don't make 60,000, if they don't produce $60,000 a month, They're going to quit. I know it. I can see it. I have the data. I know that they're going to quit. And so I have to get them productive. Well, that means they have to go to classes. They have to get reps. They have to do it. I'm doing more things now where I'm sending them to clinics where they're Medicaid or they're even out of the country to practice taking out teeth, doing endo, because if you don't do that, you're going to be less successful. Now, people, I don't want to do endo. Well, your patients want you to. They don't want to go to another place. And so there's, if you want to be the best that you want to be as a dentist. Now, if you say, I don't want to do that. Okay. Join somebody else. Maybe you don't have to do those things, but we're going to help you be better clinically. now we have also what we call the DNP program. It's Dr. Master Week program. And if you go through, have and get your F-A-G-D, which is a lot of classes, a lot of education. I mean, this woman that I was talking to the story about earlier, that year, she took like 60 hours of CE as well through us. And so it's available also. So she did that while she was growing. And so you can take as many classes as you want, but if you get your FAGD, grow your practice by a million dollars at a doctor, you get $250,000. So if you, over five years, you have to do it over five years. But if you do that, now look, we have more FAGDs as a percentage of our number of dentists than the country by far, because we encourage them to be the best that they can be. I don't tell them what they have to do, but this is... incentive for them to learn. So we think education is pretty important. If we don't, I mean, honestly, some people go, God, my path there, you spend all that money and they quit. It'd be worse if I didn't and they stayed. I want to be better. And so, yeah, it costs money. It does. We spend a lot of money. If you think about it, one, one and half percent of a very large number. And so it's a very big number. But I don't know of another way to make sure that they're prepared and want to be the best they can be. Again, if they want to take other classes, let's say they want to take a class that we don't get, all I expect them to do is stay and they have to sign a document and practice will pay for it. But they have to do the procedure. See, we have a different, also we have a different look at education. And this is something Dr. Workman coined many, many years ago. I mean, at the beginning. The purpose of education is results producing action. It's not just for me to know more. I need results producing action. What are you going to do different? When we do communication class, I expect you to put it in, in place, try to make it work. But most doctors go to a seminar and they mean well and they don't know how to put it in place. We know how to put it in place. If we're better at anything, we're really good at change management, even though we could be better at putting things in place. We do more in this line than anybody in the world. Why? Because we are really good at helping people put it into place. The systems to get doc patients to say yes, occlusion is a big deal. Malocclusion is massive in the United States and people need it and it's clinical. It's not about looking better. It's about long-term bite and if you're a dentist, the bite matters. And so how do you get people to have better bite? Well, that's we don't talk about. It's just for cosmetic reasons. It's about having your dentistry last for a lifetime. And if you want really care for people, that's what we want. So we educate them and then we put them in place because most of the number of people that we've affiliated with. So saying, know, I go to these things, I just can't get my team to do it. I don't know how to make sure that they're actually going to put it in place. I have to do everything and it's just hard. Well, with us, we have support systems, follow-up calls. We have just a whole process of helping them be successful at putting these things in. And so, yeah, it's pretty big. speaker-2: That's awesome. Pat, what are your thoughts on AI and embracing AI in dental practices? Because we're hitting an inflection point right now, I think. speaker-0: Yeah, I don't know if we're the fastest. We have the largest installation of AI probably in the world at WVIDIA. So every one of our offices has a WVIDIA AI and x-rays. Now, do they all use it? Nope. Why? They all have their reasons. But I'm changing it so that it's going to be automatic. So I'm putting in Dentrix imaging. And so they'll have no choice because it's on every x-ray. So now they'll have to explain it. And again, I'm not forcing them to. This is their clinical decision. If they disagree with it, they should disagree with it. if they really disagree with it and they should learn from it and we should tell the, you have to tell AI that it's wrong, because it's not wrong very often. I had a woman who, great operator, I I'm telling you, she'd buy herself this $3 million, just profitable. Her supplies as a percentage of revenue is 1%. That's how good of an operator she is. I mean, it's better than our average, I can assure you. She's an amazing operator and she went home and her husband's a physicist or... scientist, he's smart, super smart guy, works on nuclear power plants. And she came home and she said, I don't know about this AI, I'm just not sure. And he said, what did you say? You know, I don't know. mean, honey, one thing I know is you have bad days. You just do because you're a human. And so you're going to miss some things sometimes because you're just because you're human. never has a bad day. It's not emotional. It's never wrong. It never goes well today. I'm not going to see that. It sees it no matter what. And so that aspect is massive for us. doing it. We're just testing AI listening in the operatories so that we can chart, make sure the charting is done. It's being done other places for us to make sure that we implement it correctly. We have to test it, make sure we get the bugs work out before we can roll it out to 1900 practices. So we're doing that right now, but we have a goal this year. Our 10th goal is AI. I have the philosophy as a CEO, not going to, IT doesn't run my AI. I want people to experiment. I want the processes to be better. Whatever you think, if you want to experiment, experiment away. Because I want our systems to be better using AI. And so I use ChatGPD at least four times a day. Now, probably sometimes more, at least four times a day. I'm asking questions. I'm asking, trying to figure it out. But I have to make sure that the vision is that, guys, let people run with it. Are we going to, are some people, you know, we have it in our AP department. We haven't added an AP person in years because it's already there. It's doing a lot of things that it's being able to recognize that I don't need a person for. I didn't lay off a bunch of people, I just don't have to add people. Accounting is, so the first wave is going to probably be more cost savings, but then we'll figure out ways to generate more revenue. know, we're looking, was talking to Ray Caruso who runs Lone Peak, they're doing some AI agent. Now he does Medicaid, so I have to be careful with the AI agent answering the phone, because so I'm testing it at night. Now, Maul is working with me on it, other people are, and so I'm testing answering the phone at night when we're not there to see how patients react to it, because we're free for service. And I don't want my patients to be frustrated. I don't want my doctor's patients to be frustrated. I want the doctors to be upset. because I put this in and they're pissed off and they're losing patience because an AI agent is not a human being and they expect to talk to a human being. So I have to be really careful with that one. But I know it's going to save me money. I know it's our... We outsource to Africa for some of our calls because they speak English and they do very well. Now, some doctors don't like it. So I have to be very careful just because they speak the Queen's English. They don't speak our English. And so it doesn't bother me, but it bothers them. And so our doctors are my customers. So I have to make sure they don't get frustrated with the AI that I put in. And so had one guy goes, I don't want to use AI. Like, tell me why. Well, I've had one experience where it wasn't right. Okay. And then my dad told me, don't let a machine, because he had a business of his own, talk to your customer. So he has a really belief, a hard belief in that. Why am I going the guy's a great operator. I'm going to beat him up. You have to use it. But I can nudge him and I can explain to him, but let's just try it. See how your patients react. Cause if in the end, Patients have to be happy for our doctors or our doctors won't be happy and then I lose. And so putting AI in, have to be really experimental, do as much as we can, probably start on cost savings and then start on revenue. I have a world where, in my world, that someday an AI agent will talk to the patient in the chair so that I can make sure every exam is consistent, asking the right question. You would call a smile SWAT. What was your last office like SWAT? so that I can get the data and I know the words, because I'll be listening, that made that patient say yes. So then I can learn about how do I talk to the patients with an AI agent, because the humans have to be there, to make the patient arrive at a decision that's in their best interest. Not just to oversell things that aren't, trust me, we do not overdiagnose. That is one thing a lot of people think, like insurance companies think dentists overdiagnose. I can 100 % tell you that is not even close, because now I know. speaker-3: ⁓ and a human. speaker-0: using AI, what I treatment plan, or no, what I do so the insurance company knows what I do, I know what I treatment plan, and now I know what we miss. Think about that. We miss so that the insurance company sees this much and thinks we overdiagnosed. I'm like, dude, there's so much more that you don't even see that's there. This actual decay, actual perio that the patients aren't hearing about, or that aren't accepting. Nobody's gonna die, generally, so it's not the end of the world, but. To accuse dentists of over-diagnosing, 100 % wrong. Not even close. I mean, there's so much decay and so much, now with Curadont, ADA is thinking about taking the code away. Ridiculous, because they're getting pressure from lobbying groups who saying, well, that's only one company that does it. It's not fair. Not fair. That technology works. It can see, it can fix a small lesion that now AI finds way better than a human. So now they're finding it so many interproximal lesions that are small that you put curinol on it, it fricking goes away. So you've just saved hundreds of dollars down the line for spending a hundred dollars doing it. Hundreds of dollars. Maybe thousands. so, but it's changed. Insurance comes like, ⁓ my God, why is this happening? We don't even encourage them putting them into the insurance company because insurance companies don't understand it yet and they don't want to pay for something. They'll let the next insurance company pay for it. And I'd like to look, this is about hell, I know. My grandkids will never have to have a drill. they brush floss, go to the dentist, they'll never have to have a drill because as soon as there's an inapproximal lesion, it'll be taken care of. And that's different. That's a lot different. I somebody say, why would you encourage that? That's just gonna hurt your business long-term. There's plenty to do, as I said. There's plenty to do. We don't have to make up anything. It's about helping the patients be healthy. And AI will help us with that. speaker-2: Pat, I want to be very respectful of your time. have like two or three minutes. So grateful for you being on here. We would just like to end with closing thoughts or final advice to the doctors that are watching this podcast. Do you have anything else you want to add before we end? We've got like two minutes left. speaker-0: I'd probably beat a dead horse, but just decide what you want. Get the team around you that can help you deliver what you want. And because that's in the end, you'll only get what you want when you have people around me are clear about your vision, mission, core values, what you want to accomplish. And if your goals are clear, then you have to do the extra work. You have to go to Huddle. You have to do that. But the best advice is just if you don't know how to do it, if you need help, join Heartland. We'll help you. But if you want to do it on your own, there's plenty of people that can help you. Give me a call. I'm happy to help you anytime. speaker-2: Thank you very much. ⁓ was absolute gold and we really appreciate you being on dental mentors, Pat. Thank you so much. speaker-0: Have a good day. you. Nice seeing you. speaker-2: Thanks, Pat. If you enjoyed today's video, we'd love to invite you to join the Dental Mentors Facebook group. The group is completely free, but it is private and invite only. 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