Latest / Dental Mentors / It’s Not the Surgeon, It’s the System: Scaling OMS 360 to 29 Locations with Trevor Maurer
Transcript
- speaker-0: But if we build these great systems around the surgeons, then they're able to be way more productive. And I'm proud to say the average surgeon at our at our business collects three million dollars now, right? And we have some higher, some a little bit lower, but that's probably it's not probably, it is sixty percent higher than the average oral surgeon in the United States. If you look at the five ways that we like to profit, we build the business. The first way is optimization of the practice. I haven't seen one we can't do this with yet. We can take a practice and grow at twenty percent a year for three or four years in a row without expansion. speaker-1: All right, welcome to another episode of Dental Mentors. I'm your host, Matt Ornstein. I'm here with a friend of mine, Trevor Morrer. And Trevor's the CEO of OMS 360. They are oral surgery centers with 55 doctors, 29 locations, and in nine states. And it's a ple a pleasure to have you here. I've known Tre Trevor for a long time, and we've hung out a lot at Daikoma and on rafting with Brian Caleo and he's a brilliant, brilliant, brilliant man and it's a pleasure to have him on dental mentors for this episode. So welcome Trevor. speaker-0: Thanks, Matt, with all those kind words. I'd like to spend more time with you. Great. It's great to great to be here. speaker-1: Yeah, Trevor's got the best smile in dentistry. Just it it lights up the room. I always like to just, you know, start out and just let our guests, you know, tell tell about themselves and and their career in dentistry. And everybody would love to hear like your journey in dentistry or some of your prior business accolades, and then we can we can get into some questions on on the the quest to build wealth in dentistry. speaker-0: Yeah, sure. I I would say it didn't it didn't start at a young age. A lot of people know they want to be in dentistry or they know what they want to do in their career very early. I'm a small town Canadian farmer and I was gonna work on the farm or work on the oil rigs my whole life and that's really what I wanted to do. And most of my buddies did that. and then they struck oil in my hometown and they're all they're all killing it. but be it as it may, turned out that as a Canadian, so I'm born in Canada, obviously my passion is the sport of hockey. But I was better at football for some weird reason. So I ended up going to college, playing football, and realizing that that college was fun and rewarding. got a business degree and ended up going to work in sales and marketing proctor in gamble healthcare in Canada. and then transitioned that to Novartis Healthcare. It was at the time, I think, the second largest pharmaceutical company in the world and ran their med device business in Western Canada. Came down to see the Olympics in 96, still working for Novartis. That was the global headquarters for the device business. Fell in love with Atlanta, stayed in Atlanta, worked at Navartis for a decade, loved it. Sales marketing leadership. I really just wanted to to continue that path and get into general management. And so I took a flyer with a venture-backed technology company in Manhattan. I was more excited about the opportunity than I was about the diligence. So it wasn't the best decision for a company that the recruiters invested me to, but it was. a really great entry into general management and understanding the right questions to ask and the ones that you you want to make sure you take time on. and then partly that into working with some friends, creating I went to the business development arm, creating the the world's largest optometry group. We had 4,000 locations in the United States. And next challenge, next challenge for that ownership group was dentistry. And as I'm sitting in a room and they're trying to figure out dentistry. I for some reason it raised my hands and said, Hey, I'll go, I'll go lead that. So I left this really secure 4,000 location optometry group to go lead a dental, a dental franchise. And in because it was eight years, did have a lot of success. It was a thousand dentists, seven hundred and fifty locations, forty-three states, and just fell in love with dentistry. And I met a company called Shore Capital along the way. And invested with them in an orthodontics group called Southern Orthodonic Partners as a founding board member and investor. And just really thought they were a wonderful private equity sponsor. they had a thesis around oral surgery, so we lied on that and I started this with them four years ago and it's been awesome. speaker-1: D when you started, did you start off start off as a CEO of OMS three sixty? speaker-0: Yeah, king with no castle. Yeah. CEO with no locations. wow. Just a thesis. Yeah. Thesis and MA and operational excellence. And then so we made our first couple of partnerships and then, you know, really just focused on the operational improvements that oral surgeons, patients, and referrals would think are valuable, and then built the business around those pillars. speaker-1: So did you have to did you have to completely set up your corporate office and h and hire C suite? speaker-0: Yeah, from like employee one. Well, you're looking at employee one. Employee one and then a couple acquisitions and you know, the acquisitions were awesome first partners and very involved and wanted to help set up the company. That was their why, right? They wanted to be a part of the the future path versus just kinda tacking on. Everybody has their own reasons why they want to partner with a group. And so we we built it together from yeah, hiring the finance team, MA team, marketing, HR, like the All all the functions from from ground zero. Now, it wasn't you know, napkin building. Shore capital has done this eighty-four times. OMS 360 is their 34th startup, so to speak, right? So they're they're excellent at taking microcap companies and building them to billion dollar companies. That's their their secret sauce is you know the way they use playbooks to start the companies, the way they've fought they They build their boards with six independent directors that are not affiliated with Shore. So a lot of great industry feedback. And you know, obviously big fans of collaboration, like Matt and you and I spec speak a lot. It's it's maybe just because of the kind of people we are, but it's also disciplined that, you know, we should know good leaders in the space that we're in and understand how we can help them and how they can help us. And it's been a great, great journey with you as well. speaker-1: That's awesome. is is short capital the primary private equity backer? speaker-0: They are, yeah. That's right. Okay. speaker-1: All right. And do you when you guys are you doing de novos or are you buying and growing? speaker-0: So like so good question. quick answer is a little bit of de novo, mostly MA. But if if you look at the five ways that we like to profit, we build the business. The first way is optimization of practice. We can we could take and I I haven't seen one we can't do this with yet. We can take a practice and grow at twenty percent a year for three or four years in a row, right? Without without expansion. So optimization is really, really important. And we could talk about you know, how we do that if you if you'd like to later. that's super important. And then So because that's a capacity issue. And then if it's a demand issue, working on marketing, that's the that's the next thing, next place we want to spend money, right? and then adding a doctor. So doctor recruiting would be third. Fourth would be de novo, and fifth would be acquisition. So if you think about the ways we the the last thing we want to do is buy practice. But we buy a lot, right? Because you you have to do that to deploy your capital at some point. You can't, you can't do the first four and only the first four without other facilities. Although I do love I do love de novos. speaker-1: yeah, what you said about optimization, you know, growing the growing the re I guess it's organic practice based revenue twenty plus percent a year for three or four years. I mean that's that is incredible, incredible growth. Like the i in the dental space across the board, organic growth the last couple of years has, you know, been pretty flat and for most most organizations been like zero organic growth. A a good benchmark in the industry right now is if you're getting five percent organic growth per year, you're in the upper per s upper percentile. How how have you been able to, if you're willing to share, you know, grow revenues organically twenty percent a year for three or four years? speaker-0: well, it's a bit like the three sticky note story. I don't know if you know the story where the engineer that it was it was a failed it was a failed glue. Right? That they'd try to make a glue and it failed and then they figured out if you put it on the back of these little squares of paper it was awesome for like sticking onto things and taking it off. And then b they build b billion dollar business around it. And so had this thesis that if we could learn everything we could learn from our highest producing surgeons, right? The ones doing three, four, five million in collections. And we could take that those learnings and really lean in on supporting the surgeons that are doing a million and a half to two million in collections. And everybody could get to four or five. Right. So I hire an industrial engineer and he goes out with a team and a clipboard and a stopwatch and he tracks the patient journey, tracks the surgeons, right? Tracks the team members. And he comes back to me, he says, after like 12 weeks, that my thesis was wrong. It's not the surgeon, it's the system, right? It's so simple to say that and you think about, yeah, of course, but it's not the surgeon, it's the system. Because we had these these two million dollar collecting surgeons that are just tapped out, exhausted at the end of day, right? So we broke down what does that system mean? And we created our 360 operating system, which I which I won't share, but a component of it. that's major is the six phases of the patient's journey. And this, I think this is pretty standard, right? But like what does the journey look like? So the first one is patient access. And so we we break that down in terms of how does how does the patient find us? How do they make contact? Right? So one of the pillars of organization is getting patients to make contact. That's their job. And that's a handoff to ops. It's that it's that nice I guess conflict between marketing and operations, right? Like I got the patient, you didn't get them through, I didn't get a patient. Like it's the whole conflict healthy around that. And then if you look at what happens after contact, you schedule the patient, you do work before they get there, we call pre-appointment, you do a consultation, you do a procedure, you collect the money. Or you you reconcile the account because sometimes you do pre-service collections, et cetera. But at the end you reconcile the account, right? So those six phases, all of them have standard work. So we try to get the 70% standard work in everything except for consultation and procedure. That's clinical autonomy. We don't touch that. But if we build these great systems around the surgeons, then they're able to be way more productive. And I'm proud to say the average surgeon at our at our business collects $3 million now, right? And we have some higher, some a little bit lower. But that's probably it's not probably, it is 60% higher than the average oral surgeon in the United States. So this system is the magic. around the throughput and serving more patients and more referrals. And the surgeons literally will remark that it feels more like a spa than chaos. Because it sounds like chaos sounds like we're just going to make them work harder. That's not the case. We're going to have other people do things that are not value added to the patient or the surgeon. speaker-1: Yeah, that's absolutely brilliant. I remember I don't know, about a a year or two ago you told me you hired an industrial engineer. And I would if I had to guess, you're probably the only person that's ever done that. And this is a true story. I have a mirror, like this round mirror above my desk. It's it's up a little bit. It's not like I'm sitting there looking in the mirror, but it's up on the wall. And I have a sticky note, a post it note, oddly enough that you mentioned that. It's funny with your With your name on it, and then I wrote it says it says Trevor hired an industrial engineer speaker-0: Two percent. speaker-1: to perfect the system and the flow. And I I've always thought like that is th that's probably the most brilliant thing I've ever heard i in dentistry. so congrats on that. Did you think of the speaker-0: I wish could take credit for it. I wish I could take credit for it. That that came from a great discussion at the board. I think I'd have to hang it on our chairman, Chris Meoton, and actually said it out loud. But we were trying to figure out how are we going to help so so we all have the thesis wrong, I guess, but how are we gonna help these surgeons? Because we're we're a growth-based organization, it's in our core values. And doctors partner with us not to get a check and not do admin work. Some other groups do that, and that's fine if that's what you want. There's lots of great partners for you. But our Our growth orientation, our doctors want to come here and improve their business and be better leaders. So which is why we spend so much time, effort, and money on leadership skills and training courses for our surgeons to get them to be leaders and not managers. And so it was just one of those ideas we were trying to solve for. And one of the things I told you Shore is great backer, is you know, they they didn't have the answer in the book. We're like, well, let's go, let's go figure it out. And that's what we did. And yeah, I'm super glad we did it because it has paid off for You know, all the doctors and patients and referrals and droves. speaker-1: h if you I don't know if you could willing to tell me, but like what did that cost to hire an industrial engineer to to do that? speaker-0: No. speaker-1: Okay, fair enough, fair enough. speaker-0: But it's easy to figure out. It's super easy to figure out. It's just you know, time times dollar cost. It's easy easy formula. speaker-1: What you what did you guys put in place for, you know, training and leadership? Is that something that you do in house or is that you you sent the the doctors for like third party leadership and training? speaker-0: Yeah. So we mean in house we have what I would consider pretty standard, like a on online learning management system with courses, you know, the mandatory courses and then there's the to get better courses, right? You know, I think we're we still fall short there. I think we could do a better job of specific training of, you know, telephone skills and some patient interactions, right? And just unfortunately, Matt, you know this, there's high turnover in dentistry. There is, right? Front desk, sometimes in clinical assisting as well. So you gotta leverage technology, you gotta have great training. So we we do as well as we can there. I still think we can get better. just there's so much great technology. There's now, you know, these AI training bots where you can role play with them to book appointments and and if your team if you have the right culture to align your team to want to improve, you it's gonna it's gonna work, right? So we spend a lot of time on on culture and and that desire. one of the again benefits of shore is they have a a leadership academy. Where we send our doctors and our operations management team, like think office managers. We send them to this. It's in it's in Nashville. It's two weekends in person, and then six months in between of biweekly case studies. So me and you and four of the people will be in a pod, and we would solve these problems via case studies and remote learning. Right. So it's the kickoff weekend and like the graduate graduation weekend at the end of the six months. It's run by the head of strategy for sure. Dr. Michael Bircham. He's created three companies and sold them for many, many figures each time. but to have that that power to just lean in and and like hook your wagon to has been amazing. And you know, two things come out of that as as a story that I think are worth telling. One is as a Canadian watching Top Gun, the movie, right? I think that the American Air Force has the best leadership training in the world. So you can argue that, but you know, that's what I thought. And we have an Air Force. trained surgeon who when he went to the leadership academy in Nashville raved that the best leadership training he's ever been a part of. Right. So to me that was meaningful because he's had all kinds of Air Force leadership training. And he's a surgeon, right? He's been top of his fast his whole life. And so for him to say that was meaningful. But then the way it it played out, we had a surgeon that was having some leadership challenges. I'll leave it at that, right? Without the details, because they might listen to this one day. And I just was hearing a bunch of noise. So finally I called the surgeon. I was like, hey, what's going on? And you know, they started with complaining, right? They're not listening, someone else's fault. And I said, Listen, I don't even want to get into the solution of this. What if this was one of those case studies? How would you have handled it? And like the light bulb went off. He's like, you know what? This call's over. I let me go figure it out. And he just took care of it. Like, and that's what decentralized leadership does, right? If if you're aligned in your objectives. and you understand a a leadership language, those decisions shouldn't be made in some office in Atlanta. They should be made at the practice level. Right. And so that for me, that was a real world example of why we'll always invest in leadership of our leaders, right? Those that want to be, those that want to get better, give them all the avenues they can. And like in the all you can eat buffet to do speaker-1: Yeah, that is that's super impressive. I'm just curious, like what are what are the hours and days that your practices are open? Are you open six days a week, seven to seven? Like what what's a typical practice? speaker-0: So we we maintain the identity of of the partner at partnership. And I would say by and large, all of our offices are Monday to Friday practices, you know, typically open early, you know, seven to three, seven to four, and then half days on Fridays. Not a lot of cult consults on Friday afternoons, a lot of surgeries in the morning, and they'll just do surgeries all day. that's that's pretty common for oral surgery, private practice. We don't we don't change that that that footprint in the industry. Now we have when weather re related events have, you know, wreaked havoc with the schedules. Our our teams have offered to work, you know, late or on Saturdays to get patients through that are in pain, which I think's pretty awesome. Because you like all if you ask any of them what they love about oral surgery, I've never had anybody answer economics yet, right? It's always we're the last resort and we solve the problem. So it's a pretty cool statement to be able to make and they love changing lives, right? And so the They're way more willing to work on Saturdays probably than I would be. It but it's just impressive because, you know, they they live in the communities they support and they see the person at the grocery store who was in so much pain before. speaker-1: Yeah. I I had to go to an oral surgeon one time. And I I mean I would have paid anything to get that pain fixed. And f thank God he told me he's like, there's like a eighty percent chance that I'll be successful with this. And fortunately he was. otherwise we're gonna have had to have my tooth removed and an implant put in. But I mean I'm grateful. That speaker-0: Right. speaker-1: was here in Atlanta. I can't remember the doctor's name. But yeah, he definitely man, I was very, very grateful speaker-0: Pain is bad. speaker-1: skill set that he had. speaker-0: It's interesting. D do you think this show is primarily listened to by general dentists? speaker-1: you know I I would I would suspect I would suspect that would be the case, but speaker-0: Maybe somebody in the audience can help me solve a problem then. Can I share a problem? speaker-1: Sure. speaker-0: So we're spending a lot of time, obviously, on the patient journey from contact forward. That pre-contact is unsolved. So if anybody out there has a solution, the amount of patients that are referred by general dentists to go to an oral surgeon, like 49% ever show up or ever make contact. Not even show up. Like the the no-shows and all that adds to the to the number of patients, but maybe 34% of patients that are told to go. To oral surgery and actually complete treatment. So you're one of the 34%, but you were in pain. Right. Yeah. And so for those that the general dentist has said, Hey, you've you've got something we need to take care of, I'd love to figure out, we don't see it on the show, but I'd love to figure out how to message that properly for how important it is for that patient to proceed with that treatment. I mean, obviously general dentists is not referring them up for something they don't need. speaker-1: So are you are are like would you be aware that a general dentist has referred someone to you or do you have to wait for for that patient to make contact? speaker-0: In the obviously we test and and you know, we do a lot of research on a lot of things, you can probably tell through the course of the conversation. So where we are plugged in and testing and we're getting feedback on every patient that's been referred, where we have that data, that's why we know so much about this. But yeah, otherwise we have no idea if a patient's referred to us. And there's different technologies and we feel like we've tried them all to to manage that loop. And and so far we found nothing to improve that. But that is a gap to double the amount of patient care in the United States. From recommendation of referral to contact. speaker-1: So if a general dentist refers a patient and and says, you know, you need you need to go see an oral surgeon, you don't know that who that patient is or or that pati if that p that that patient's been referred unless that patient contacts you. speaker-0: Right. So they could be handed three business cards of oral surgeons. They could be handed our referral pad. They could be just told to go find a good one. And but sometimes the the referring dentist will call us, will email us, say, Hey, here's a patient, here's information, they're gonna give you a call. Sometimes they don't wanna share that because they don't want us to call them. obviously their choice. but even sometimes when we're connected to the patient, nothing. They just they don't get the care. And that's that's something that I can't understand, but obviously they don't know the importance of the care for some reason. So There's some education that we can do somewhere. speaker-1: Yeah, that's really interesting. So yeah I would say almost all the people that are wa that are watching this and listening to this, they either own their own practice or group or they do have an intention of owning their own practice or group one day. either with, you know, two two outcomes either maximizing the net income and net profit of their practice or group each year. or building their practice or group to to have a high dollar exit at some point, right? So dental mentors is, you know, the focus is how to how to build wealth in in dentistry. You know, step one is to, you know, maximize your annual income. Step two is to know how to invest that income intelligently and protect it and build wealth. And then, you know, step three sometimes is selling your practice or your group. which I I would imagine you're you're building OMS three sixty to sell it at some point. Is that a fair statement? speaker-0: Yeah, for sure. Our investors will recapitalize their equity. speaker-1: Yeah. Absolutely. So you know if you could give s if you could give the dentist some advice on just kind of the mindset of you know, of building wealth in dentistry and and the the the steps in business or protocols in in business to build a highly profitable and sellable you know, dental practice or dental group. I'd love you to just kinda, you know, share your thoughts on that. Like, you know What should they be focusing on? what's what separates you know, a highly successful practice or group on a financial level from one that's that's not as profitable? I'd love you to just talk about that and share your thoughts 'cause you've been through it a bunch of times. speaker-0: Yeah, sure. I mean obviously I'd say build it strategically, right? So ha have a good strategic plan of how you're gonna handle the pillars that are gonna be important, whether it's MA or operational growth or people and talent, right? So what are the what are the buckets that you need to execute to to build it and then what's important within? Are you going to are you gonna focus on urban or rural markets? Those are very different, right? Are you focused on on single or multi-doctor? Are you gonna go for density or are you gonna go for for breadth, right? So there's all these different ways to build. There's probably a million different ways to build a a moderately sized dental group, but you have to choose what's what's important to you. What do you also what do enjoy? Like what do you want? Do you want to open an airplane or drive to the practices, right? Like how do you want to live your life while you're building this out? What level of stress do you want? How much, how much capital do you want to deploy or do you want to deploy other people's money? Like when does that start? Right? Do you want to bootstrap it and grow slowly with your profits? Or do you want to take capital once you have a concept and grow it together with a capital partner? So many, many ways to do it. But you know, I would say focus on what are your two maximum three Differentiated benefits of your practice. Like why why does a patient come to you? What do you really hang your hat on with your mission, your vision, and your values? Right. And so lean on those three, train on those three, hire on those three so that everybody that's a patient at your practice gets it, whatever that is. Right. And your community you can you can easily market to those those principles because that's that's what your business offers. I think that's really important. focus on Profit, right? Make sure they are profitable decisions in the in the term that you can afford, right? Sometimes you can afford a month, six months, or a year for a concept or an investment to have a return on your investment, whether it's, you know, piece of capital equipment or the way you're staffing your front desk. Right. So what what will your return be by how you're spending that money? So what what margin are you looking for at that practice level? And then what are you gonna centralize and what's that gonna cost? You know, what what real benefit of centralization is there? And are you doing it for benefit or just to centralize? Right. So sometimes, you know, we we make the mistake of centralizing something, but then realizing it's better down at the practice level or vice versa. So, you know, I'd say build your strategy, understand your differentiation, focus on your mission, vision, values, make sure you're making profitable decisions at the practice level and and then really understand how you want to scale. speaker-1: All right, great. Can you can you explain for the people that don't like really understand that terminology what you mean by centralization? speaker-0: Sure. So there's functions you can centralize, such as accounts table. So instead of somebody at the practice writing checks or selecting vendors, you can do that. You can do that centrally. Hiring is very difficult. You're busy, you're serving patients, but you need an assistant. So at the practice level, place the ads, you do the interviews. You probably have no training in writing a job ad, no training in doing doing interviews. obviously people can figure it out because lots of people enter the field and do it. Right. But if that's centralized, you can you can have a shorter window of an open position. You could probably have less turnover because you hired more of the right people because the centralized function should be an expert, should be more disciplined about putting the right final candidate in front of the office. And so if you could take the things out of the office that don't provide patient value immediately, you should be able to find an expert, even for a four or five location group, that's better at it centrally than twenty percent of a person everywhere at the practice level. They can't, you know, it's the was it Jack of all trades, master of none, I think Matt, people talk about, right? speaker-1: Yeah. speaker-0: So where can you have a master of a trade that's beneficial to the practice? speaker-1: Yeah. And just just in case anybody missed the point, if you're gonna be centralizing certain tasks, you you need basically you need a corporate office. You need a you need a corporate office where you have employees and specialists that are not located in the in the dental offices. You can you can centralize those tasks and have someone highly skilled and hyper focused on on on those tasks. So the people that are In the dental practices and dental offices are focusing on the patient journey and on things that are really generating revenue and profits for the dental office. Did I say that right? speaker-0: Absolutely. And and I've seen lot of groups. The the first corporate office is upstairs at the at the main practice. Yeah. Right. Which is great. Because then then the doctor leader is able to still be by the chair, so be right, practicing and close to team. They need to be involved in, you know, certain key meetings. And th you're also gonna have to trust but verify. You're gonna have to hire a great team, but keep your nose in it because Sometimes what's reported is not always the truth. Like, how did you get to that number? Show me. Right. It's really important. speaker-1: What as CEO well there there's two things. I'm gonna talk about KPIs in a minute, but you know, there there's an old saying, like if you want to go fast, go alone. If you want to go far, you know, go with others. And speaker-0: And African proverb. speaker-1: Yeah, and it's I mean it's it's certainly true. A lot of people that are thinking about growing that have never worked with private equity and having an outside partner, not just financially, but a partner that has a lot of expertise and business experience. a lot of people are like, man, I don't know if I want to have a private equity partner and, you know, what does that really mean? I'd love you to just take a little bit of time, just, you know, talk to talk to the audience about, you know, what it's been like, what it's like working with private equity. We we do have a private equity partner at our at our DSO, but I'd love to hear it from your perspective. Like, if you were if you were talking to a doctor that says, look, I've got I've got three offices right now. We're doing a million and a half in EBITDA. I really want to get to ten million. I do not have the capital. I don't have the expertise. I don't know how to set up the proper organization. you know, how do I do that? Well, it's if if you don't have those skill sets and you haven't done it before, in my opinion, it's really hard to do that yourself. And you know, in many cases, if you pick the right private equity firm that has a great leadership team and great executive team. you can r you can get there. You can get there faster, you can get there more profitably, you can get there more efficiently and still have a a really good experience personally and financially. You gotta give up some of the ownership. But I'd love you to talk, you know, talk to people about, you know, the benefits of of having a great private equity partner. speaker-0: Yeah, I'm gonna anchor on something you said about halfway through your setup there. And it was if you have a good private equity partner, right? Because just like dentistry, what is it, 200,000 people in dentistry, right? They're they're not all the same quality. No chance. Right? The private equity firms are not all the same quality. There's there's 15,000 in the United States. Right? So if if you know one, you know one. So You have to understand their track record and you have to have a relationship with more than one person at the firm and you have to trust them. If you don't trust them and they don't have a great track record, keep looking. Right. So that I'll just start with that if you choose to go down that path. And then there's the should you go down that path or not. Right. So I have had the opportunity over the last call 25 years, four time, four time CEO in healthcare. And this is the right private equity partner in terms of great track record, high level of trust. They do the right thing, right? Good medicine is good business. Treat the doctors really, really well. And there are other funds out there in the US that are the same. Right. There's some really great funds up there. I think this one's the best, but whatever. I'm sure there's tons of tons of great ones that, you know, it's not too hard to come up with that list. If you go to do this by yourself, it is a lot harder. Or if you use the wrong fund, it's a lot harder. I feel currently, I know this this is not supposed to be a short capital commercial, but I feel currently like I'm at CEO camp. I wish this was my first CEO gig, but then if I didn't have experience, I wouldn't have this job. Right? Because they're so focused on process and discipline and learning from other people's mistakes. You're going to make mistakes. Right. And some some could be catastrophic to your business. Revenue cycle management can take a business down, for instance, right? Just not collecting the cash, right? So one of the things that having a really good partner does is anytime you go to execute something that could have hair on it, they're able to say, Hey, here's here's some snags that we've run into or you could run into or sister businesses run into, right? And how how are you sure that's not gonna happen to you, right? It's just a little extra time, one extra question. Speaking to, you know, me calling Matt, saying, Hey, I'm thinking about doing this. Heard you did that. What was your experience? Right. So I think that it's really important to leverage your networks and the right fund will will give you that network. also, you mentioned when you set this up, is you'd have to give up some of your ownership to bring in a partner. You've got to be able to prove to yourself that your piece of that ownership is going to have more value sooner than if you owned all of it and if everything went perfect. Right. So you have to figure out Why why you want a partner at all? Is it timing? Is it ultimate exit value? Right? Is it you share like there's a bunch of reasons why you you want a partner? There's a bunch of reasons why you wouldn't. You don't you don't play well with others. Do yourself. You don't want to partner, do it yourself. That's fine. You'll do you'll do whatever you'll do at your pace and it'll be all yours. And sh whichever path you take, just be confident about it and go all in. speaker-1: Yeah, great advice. I I ask everybody on this on this podcast same the same question. What are the top KPIs that you focus on as a as a CEO? Because the KPIs that a dentist is going to focus on in the dental practice are not always the same as the KPIs that a CEO or COO or business owner needs to focus on. So As a CEO, what are your top KPIs that you really, really keep a close eye on? speaker-0: Sure. future bookings on the schedule across the business. What's tomorrow look like? What's two days out look like? What's a week look look like? Right? What's the future look like? Not today, but tomorrow, right? current trends and referral volume. Roll surgery is up to 91% referral based. So what are our referrals doing? And what's happening amongst our referrals? And what are we doing to help our referrals? Like why why do they choose us? Why are we sticky as their oral surgeon partner? What are we doing for them that's helpful other than just helping their patient? Like how are we easy to work with? So referral numbers are really, really important. and then beyond that, like very simplistic, doctor days. How many days like are we having a doctor in the facility? If you no doctor day, no revenue. We don't have hygiene. Right? So doctor day. Number of visits per day. What are we doing to help our doctor have seventeen, twenty, twenty-five, thirty visits a day that are safe and effective, good for the referral, the patient, and the team? So number of visits is important. Then you just go down the path, production per visit, right? So what are what are we doing to to optimi optimize the the productivity of that visit. Like is the patient getting the care that they need or is are we point and pull? Right. Well, tracted tooth with no thought around the long term care of that patient and collaborating with that referred dentist and saying, hey, here's what what's your five year plan for this patient versus pull number eight or whatever, right? Where are we trying to where are we trying to get to? So I'd say those would be the key, key up front. And then obviously point of service collections and managing AR really valuable. speaker-1: Absolutely. Stay on that. Yeah. So, you know, for me, as as you know, CEO or co CEO of the different businesses I have, my top KPI that I follow is is free cash flow, free cash flow. I'm not saying I mean that that's just me, 'cause like, you know, you could have you could have great production, you could have great revenue, you could have great accounts receivable. But if you don't have enough money in the bank to make payroll and pay all your bills, you're out of business. So th that's what I always you know, I'm laser focused on free cash flow amongst other KPIs. There are many that I focus on, but free cash flow for me is is absolutely speaker-0: Ca cash is king, man. No cash, no king. speaker-1: Yeah, and there have been a lot of great businesses that went out of business just because they ran out of cash for a period of time. And then you're you're in a lot of trouble. I mean you could have a you'd have the best car in the world, like, you know, whatever, Lamborghini, Rolls Royce, whatever it is. speaker-0: No gas. speaker-1: You run out of gas, you know, halfway halfway across the country and there are no gas stations around. Well, your car's worthless. Yeah. speaker-0: How true is that? speaker-1: This is something that everybody li you know really has a lot of questions about. you know, how do you how do you if you're willing to share, like what are s what's some advice you give to dentists on optimizing their schedule? You know, given that dentistry does have a fairly large no show rate. Any advice on that? speaker-0: Our scheduling optimization is a little different. I mean, obviously we use the the industry tips and tricks for preconfirmation, what you're doing five days before, two days before day of appointment, right? so we we do, you know, I think pretty standard patient service and and confirmation type things. But for for oral surgery, what maximizes our schedule is a couple of things. One is just say us. If if you're in pain, come on down. Like You might have sit in the lobby for a while. It's gonna be after one o'clock, but just get in here and we won't go home until we treated ya. Just get here. Right. speaker-1: That's amazing. speaker-0: If you're not in pain, you know, we'll look at schedule, get you in at a convenient time. But if you're in pain, show up. Wow. And then that's that's a real practice builder too, right? Because you just if you think of what I said at the start of the show about what's so impressive about this business, they did they love helping people and being the final answer. So it's pretty hard to say that out loud and say, Yeah, but I don't want to see it today. speaker-1: Yeah. speaker-0: and then the second thing we do to optimize our schedule is a tremendous amount of same day surgery. So if you're on a schedule, you know, one of the six six phases of the patient journey that I talked about, right? Is that pre appointment work. We will do the work at our practices to make sure you're ready for surgery on the day of your consult. Get that pre work done, right? Get the medical history, get the clearance, get the drugs, like get get everything known. assuming the consult will be converted to surgery, with the ability to say, so Matt, you're a candidate for whatever treatment, and we can book you for next Wednesday, and you can take another day off of work and get a driver, or we can do it today. What would you rather do? And it's eighty percent like can we just get it done? Sure. Great. And then that convert to surgery is so important. It takes us an hour forty minutes of in clinic time. To have consult on one day and a surgery on another day. It takes us 58 minutes to do the same day consult and surgery because you've got all the information. It's all set up. You're not pulling files and pulling trays and getting ready. You just you just do it. Right. So it's better for the practice. The patient saves two half days. Right? Because they got to take time out of work. They got a 10 30 AM consult. They don't go to work before that. They get there after lunch, whatever it is, they're school, right? And then they get their surgery at no time. So If you think about consumerism in healthcare in the United States, nobody wants to go to their doctor twice to get one treatment. And by the way, if you're at nobody also wants to be at an oral surgery's oral surgeons practice, well, all they want to do is not be there. They wanna be home. They wanna be out of pain or they wanna get their implant or they wanna get their restoration done to the GP dentist and they just they just wanna get home. They don't wanna be at the dentist. At they don't get the oral surgeon. Maybe G P feels differently. speaker-1: No, I th I think you're right. I'm a big proponent of same day treatment. I mean, that's a if if you at least, you know, at at a r at a general dentist's office, if if you have some flex in the schedule for same day treatment, it's a game changer. I hate going to dentist. I had to get a crown about a month ago and you know, went in for my cleaning, blah, blah, blah. You need a crown. And I'm like, man, I gotta go home. I gotta come back, get my crown and go home. And I was like, If they had offered me to do the crown like that day, I would have been very, very happy about it. And I agree with you. You know, so that's amazing. speaker-0: It's a referral builder too, because they know it can just listen, the referral, as as soon as there's a consult and no surgery, there's gonna be some lack of conversion. They'll speaker-1: yeah. speaker-0: forget about it, they get busy, they whatever, right? So now the referring dentist is not gonna be able to give that patient the care that they need, right? Versus same day surgery, back to the referring dentist, and patients handled. Yeah. Close the loop on the care. speaker-1: Man, you're running a an incredibly efficient business. That's awesome. speaker-0: We're trying. We have great surgeons and operators. I'm telling ya. This team is amazing. Spent the weekend last weekend in Nashville at our annual summit. It's just so fired up spending time with those people. speaker-1: Yeah. How old are you now? speaker-0: Me, I'm fifty six. speaker-1: All right. I'm I just turned fifty seven. So one thing about Trevor, this dude is in great shape. I mean, he is in great he is in great shape. so a lot of a lot of people that listen to this, you know, they they a lot of the questions that they ask is like, man, I always want some some tips on on health and fitness. What are the you know top five things that you do to to s stay in great great health? Because y you dude, I mean you are in great shape and you are healthy. So You know, w what are the top five things you you focus on to maintain that state of health? speaker-0: Appreciate that, man. very kind. I love the expression, you get what you measure. Right. So as much as it pains me, I step on a scale every day. Like I just do it. I don't know. yeah, I use that that that Renfall scale so it tracks your biometrics over time and set goals. And so I'm always I'm always gamifying my health and setting some little goals and I'm not fad dieting. I'm not saying I'm doing that, but I'm just gamifying, you know, am I am I winning or losing at my at my health? And then Do it first. I can't exercise at night 'cause I get busy and there's a spreadsheet and there's a call and there's a dinner and there's whatever. Right. So get it get up, get it out of the way. And then team sports. Like I as I said earlier, I'm Canadian. I play hockey two or three times a week with a bunch of guys that I think are great guys. So, you know, my I I do fun things that are also sports. And, you know, I think you know this about me. I also love to surf, like the wake surfing, so I'm always out there wake surfing as often as I can. with a good group of healthy people and you just it's just the people you maybe I'm not giving you a list of five, but like the people you surround yourself with are the people you're gonna be like. speaker-1: I agree with that. I agree with that. I think I mean that's that's an a known axiom, right? If you want to see, you know, what you're gonna become, look at the f the five people that you spend the most time with. and I I actually do think that's a a truthful axiom. And I think it's really important too. maybe like d do you watch what you eat? Are you are you you focused on food, just consistent? speaker-0: Yeah, I'd say, yeah, I'm pretty disciplined. Like I listen, I always think I've got five or ten to lose, like my whole life, but then I'm always like, Do I want to work that hard to be that unhappy? Right. Yeah. There's there's there's there should be a limit to what you're trying to do, I think. but yeah, I try to eat well and try to be disciplined and stay away from things I know are bad for me and I don't wanna be taking fifty pills to manage my health. Yeah. You know, I'd rather manage it with a carrot and a salad. speaker-1: Yeah, I agree. I'm on the same page. All right, so we'll be wrapping up. speaker-0: Man, cheeseburgers are good, buddy. They're so good. speaker-1: Yeah, man, I my my weakness is tater tots. speaker-0: Yeah. speaker-1: Ice cream. Yeah, tater tots and ice cream. And if that's man, you gotta I gotta I need I really need to go man. Yeah, speaker-0: I think you're doing great, buddy. speaker-1: I could I could have tater tots every single day. So the last thing I'd like to chat about, you know, we're we're moving into a very interesting time in in humanity with the exponential growth. and explosion of technology and artificial intelligence. any any thoughts or comments on, you know, best way to use technology and AI in the in the dental space? speaker-0: Well it depends on when the show's gonna be getting released because every day you wait to release it, things are gonna change, which means it's just happening so fast. speaker-1: I mean, are guys embracing, you know, tech and AI? speaker-0: Yeah, we've got tech in revenue cycle management. So AI phone and you know data services work with payers. after three rings, it goes to an AI bot, like we're going from missing twenty eight percent of calls to missing zero. Right. Our our efficacy with AI is actually a little bit better than our efficacy with humans, which is scary, right? But it's never as good as our best human. Right. So and I and I do think my s even myself, I want to talk to a person. I I want to talk to a person. So we always give patients that chance. You can you can call back or you can book with our AI bought right now. You pick. Right. So, you know, on a very entry level, we're doing those type of things. But I but I think the industry is exploding with the idea. Like if you think about general dentistry with i with the imaging that that they're using to, you know, to find carries and and to help treatment plan and show the patient, well, here's here's the problem versus just telling them. Right. And you can actually see it. This is the th the forward predictor model. yeah, definitely then I'd also say don't lead. Don't create it on your own. I don't I'd if you want to be a you know, a scientist or or if you want to create your own business, that's great. But but there's you can go down a lot of rabbit holes versus letting somebody else run up front a little bit and then when it's proven, bring it in. Just depends how much risk you want to put in your business. I love proven, right? And then when it's something that I know makes sense, decide if we're gonna use an industry leader or then create our own. But I don't like Trying to guess where the industry's gonna go. I'll just be a very, very close second. speaker-1: Yeah, that's some that sage advice. I I will say this though. you know, if if you're if you own a dental practice or a group, you've got to be keeping your eye on technology and AI because i if you're if you're not keeping up with what's going on, you are going to get left behind in a big way. Because the problem you know, the the intelligent use of technology and AI really, really can make the the patient experience a a whole lot better and a lot more enjoyable. Like I mean, this is just a small example, but if I need to reschedule, the last thing I want to do is pick up a phone and call the office. Like I mean, I want to be able to do it. No chance. Yeah. I mean, you know, I just want it I want it nice and easy. but, you know, with what's going on with with AI and tech, it's been it's been really great in terms of eliminating errors when you're submitting claims to insurance companies. it's great for answering the phones twenty-four hours a day, allowing patients to schedule on the phone, you know, verbally on the phone with AI, using their phone to to book their appointments, you know, change their appointments, et cetera. So stuff that's going on is really incredible. Yeah. speaker-0: Incredibly useful. speaker-1: Incredibly useful. And it also, if the is right, it makes the patient experience a lot better. And the better the patient experience. As long with everything else being equal, you know, the more profitable your practice. speaker-0: Yeah, Matt, isn't that the point? Patient experience, right? speaker-1: Yeah. Yep. speaker-0: Would you would you recommend this place to your friend? speaker-1: Yeah, I agree. And speaker-0: metric. That's the KPI that you asked earlier that really matters. speaker-1: Yeah, that's probably the most important one. Would you recommend this this office to to a friend of yours? And if the answer is r a resounding yes, that dental practice is is doing doing the right things and doing a great job. I had one other thing I wanted to What is some final advice that you would give to any doctors that are in you know, intentionally growing their their practice or their group because they want to sell it and have a high, high dollar exit? Like what are the you know, if you can give any just kind of free flowing advice on like if you really want to maximize your your dollars you get upon sale, these are the things that you should be aware of. maybe these are some things to avoid and these are the things you really need to fo focus on. speaker-0: Sure. build it to last forever. Right? It's gotta be a solid company. be able to identify to that next partner why it's sustainable and articulate it. And leave some leave some gas in the tank in terms of what else could be improved that gives you upside. Like if I look at a business that is absolutely perfectly all the way optimized, I'm less interested. What am I gonna get out of it? I'm gonna pay a premium and not and not improve it. Like how how does that benefit me? Interesting challenge. speaker-1: Yeah, that's that that there's a fine line there. There's definitely a a a fine line there. Well, this has been great, man. I appreciate it. Are you going to you gonna be at Dykoma in July? speaker-0: absolutely. It's a great meeting. Yeah. A hundred percent. speaker-1: I always enjoy hang hanging out at the pool with you while you while we're there. You can always find Trevor. speaker-0: I can't wait to catch up. speaker-1: All you gotta do is look around and just look for the look for the best smile at the pool and and there he is. He's always always smiling. Well Trevor, I really appreciate all the wisdom that you shared with everybody. I learned a lot in this conversation and my you know, w anytime I think about you, I talk to Trevor, you know, on a fairly regular basis, either texting or or we chat, but The w the one thing that just sticks with me all the time, anytime I hear your name, is the story of of hiring the industrial engineer because I was like, that is literally the most brilliant thing I've ever heard. And I know you said it wasn't necessarily your idea, but it it doesn't it doesn't make it any less brilliant. So thank you very much for being on Dental Mentors, sharing you and it was it was great to see you, brother. Have a great one. speaker-0: Always a pleasure. Thanks for your kind words. See ya. speaker-1: See ya. Bye. 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 at invite only. The group is for practice owners, dentists, specialists, and dental CEOs. If that's you, we'd love to see you inside. As part of Dental Mentors, you're gonna have direct access to the brightest minds in dentistry and the brightest mentors and some of the greatest CEOs that have ever worked in the dental space. You're gonna learn all the best practices that you're gonna need. To optimize the profitability of your practices, to properly scale your practices, and to achieve a high value exit. You're also going to learn the closely guarded secrets that the rich and wealthy use for asset protection and the access to private investments and investment strategies that will allow you and your family to create generational wealth. Inside the group, you'll also be able to speak directly with today's guest and all of the guests on the Dental Mentors podcast. You'll be able to ask them questions specific to your practice or group and get the specific answers that you need for that next big breakthrough. Speaking of exclusive, one of the great things we're gonna do at Dental Mentors is our events. In these events, what we've done is bring together the industry's top experts, people that you want to be in a room with. These are very curated exclusive rooms just for the best of the best and the people inside of the dental mentors community. And I promise you, you're not going to want to miss these events. If you'd like to apply to the group, click the link below and we'll see you inside. And remember, it's completely free to join.