The Executive Session – Redefining Success in Modern Dental Practices

In this episode of the Dental Boardroom Podcast, host Wes Reed introduces a brand-new subseries called The Executive Session. This interdisciplinary series brings together experts in finance, marketing, and practice management to discuss the real business challenges dental practice owners face today.

Joined by co-hosts Megan Shelton (https://www.instagram.com/doctormeganshelton/ (Practice Management & Operations) and Michael from Wondrous Agency (instagram.com/wonderistagency/) (Dental Marketing), this kickoff episode explores how the definition of a “successful” dental practice has evolved over the last decade. The panel breaks down how marketing, operations, and financial strategy must work together to drive sustainable growth without burnout.

From tracking real ROI in marketing to improving case acceptance and building systems that support both profitability and lifestyle, this episode sets the foundation for what modern dental leadership looks like.

Key Takeaways

• Success today is more than revenue
  A successful dental practice balances strong collections with profitability, lifestyle flexibility, and personal fulfillment.
  
• Top-line growth without bottom-line control is dangerous
  High revenue means nothing if margins are thin. Profitability and cash flow matter more than ever.
  
• Marketing must be measurable
  Website traffic and rankings don’t pay the bills new patients, collections, and ROI do. Integration with practice management software is critical.
  
• Operations make or break marketing
  Even the best marketing fails if front desk systems, case presentations, and patient experience aren’t aligned.
  
• Data visibility across the entire pipeline is essential
  From leads → appointments → case acceptance → collections, successful owners track every stage.
  
• Growth requires systems, not hustle
  Sustainable growth comes from leadership, team retention, clear communication, and predictable processes not longer hours.
  
• You can’t do it alone
  High-performing practices invest in expert support marketing, operations, and finance to scale efficiently.
  

Seasons matter

Balance looks different at different stages of ownership. Clarity, reflection, and intentional decision-making are key.

Transcript:

Wes Read: Welcome everybody to another episode of the Dental Boardroom podcast. I'm excited 'cause we are launching today a subseries within the Dental Boardroom podcast that is gonna cover topics that are outside of my. Space of specialty and it's gonna get into practice management and it's gonna get into dental marketing.

And this series is gonna have two co-hosts with me that I know well. And I've seen them do such incredible things for dentists and many of our clients. And so let me welcome who is gonna be on the panel of this new series that we're launching, and it's gonna be called The Executive Session. And the concept there of the dental boardroom is.

Some of the executives come in over different areas of the business. In this case, we have the executive over finance, and that's gonna be me. We have the executive over sales and marketing, and that's gonna be Michael, who I'm gonna introduce in a moment. And then practice management or operations is going to be Megan, so we're gonna introduce both of you.

And. The unique nature of this podcast series is that it's gonna be interdisciplinary, that we're all gonna cover the same topic from our lens in the specialty service, the specialty, uh, skills that we provide to dental practice owners. And I have found that panel discussions tend to be sometimes some of the most educating and insightful, uh, sessions when I go to conferences.

I'm hoping to provide that same level of excitement and education to our listeners. So let's jump into a little, uh, biography here of each of us. All of my listeners know me, Wes Reed, owner of practice CFO, and a company called Practice Orbit, which is a tech company for buying and selling dental practices.

And we do CPA and business, financial and personal financial planning services integrated for the dental practice owner. And, uh, we've been around since about 2012 and are in San Diego, but work with clients nationwide. Okay, let's now go to Megan Shelton. Megan, I'm gonna do. Little intro myself, if you don't mind Megan.

I know Megan because Megan used to be a client of practice CFO, and in some ways still is. However, she's no longer practicing dentist, which she was. And she ran one of our most successful practices here at Practice CFO. And we worked with a lot of dentists and she did it remarkably well. And so she has now pivoted into practice management consulting and is doing really incredible things for her clients.

Some of whom are our clients as well. And so I thought, what better of an expert than have Megan come and join this podcast as one of our hosts? So Megan, tell us a little bit about you, 

Wes. Thank you for that gracious intro. Uh, so I have been working with dentists who are often clinically brilliant, and the practice is still feeling chaotic and exhausting.

Honestly. If we look at practices, they're being run on sticky notes. Memory. Memory and usually an empty ink cartridge with no backup in the cabinet and like a grain of hope sprinkled in. And so operations, leadership, wellness culture, cash flowed where, where that collides is where I intervene. And so I founded Shelton Solutions, uh, after.

After selling my practice and having an awesome run at it for over a decade, I decided that I really wanted to support Dennis in having the same confidence and freedom, not just in their practice, but in their whole life. And so that, that's what I do and I'm thrilled to be here today with both of you gentlemen.

Um. You know, virtually in San Diego, which has my heart and physically sitting here in Seattle, both to places that were pivotal in my professional career. So it's really fun to have this opportunity collide. 

Well, excited to have you as a regular host here with me on this podcast, Megan. Alright, Michael, let's pivot over to you.

Tell us about yourself. 

Yeah, so, um. Wondrous Agency is a full service marketing agency for dentists. It's been around for close to 13 years now. It's a little scary saying that I just turned 40 this year, so I feel like everything's telling me I'm just getting older. But my wife Laura and I co-founded Wondrous Agency in a, in our home.

So we literally sat at a couch and, and sort of recognize this problem that so many dentists had. We had one of our friends come to us that was a dentist, and, and, uh, he said, Hey, I've got this problem, you know. I've got all these companies and none of them talk to each other. I have no idea what's working.

And, and from there to today, wondrous Now is, um, a marketing agency that serves dentists all across the country, work with close to 1300 dentists around the country. And what we do for them is we make sure that we can help new patients, find them the right kind of new patients. You know, there's a lot of marketing agencies out there.

Um, I'm gonna focus on the things that make us different. So of course we do, uh, the storytelling side. We build websites, we build brands, we do photo video, and then we get the story out there through SEO Google Ads, social media. But that's not what makes us special. What we really do well is we help differentiate clients.

We help them find something that they can really, um, identify as different in their market, and that's so critical to marketing. If you don't do that, then everything else falls apart. Um. And I think one of the things we'll talk a lot about in today and in future episodes is how do we actually track results?

So many marketing agencies talk about numbers, talk about data. I'm willing to bet many dentists have had this experience where you get a report and it's got keywords up and traffic down and I can't keep it all straight. You know, what I care about is new patients. And so for me, we focus on integrating with practice management software.

We focus on actually getting to the numbers you care about. How many new patients do we generate? How much did it cost? What's the ROI? So that is such a critical part of marketing. It's something wondrous has spearheaded in the industry. And the last thing that I wanna talk about for Wondrous, which is kind of old school, old fashioned.

Is service. We're a brick and mortar business. We have 65, close to 70 people in San Diego that come to work every day. I know we're just down the street from us, so, so you know, this and just not being a band of freelancers strewn throughout the world makes such a difference. It means we can really serve our clients hard and make sure that, you know, when there's a problem, we can pick up the phone.

And when marketing thrives, it's because there's proactive. Uh, work being done by people in an office here, not reactive work. You having to remind people what to do. So, um, yeah, excited to talk about all things marketing and all things dentistry. 

Thanks for having me. Excited to have you. One of the reasons why I wanted Michael on the podcast was 'cause I think Michael has a much more of a tech focus than, uh, most, if not all marketing, dental marketing companies.

I know that I'm aware of at least in that you've invested a lot of money in creating integrations with the practice management softwares. You have a developer in-house, and so you're very tech enabled in your marketing services. And I think that dentists today, if they don't have a te uh, more of a tech enabled process.

To, uh, send out their marketing content, to retrieve it back, to track the data and to do it efficiently. I think you're gonna be fighting an uphill battle without that. So I'm really excited to hear your contributions around the tech side and particularly around how AI is starting to play a role in the marketing space, uh, for, for dentistry.

And so if we zoom out a little bit, we look at this panel. Uh, me, Megan and Michael think of like a funnel of the way a doctor earns income. And as much as I know, doctors, uh, enjoy being a dentist and they, they find a lot of value and purpose in it, at the end of the day, they need to have, they need to make money.

And that money needs to support a life that gives them fulfillment and joy. And how do they translate these patients and marketing spend and operational spend and, and spend on their team? And how do they translate all that into ultimately, what I always call their personal balance sheet? Their personal balance sheet is everything they own less, everything they owe.

And that the difference between those two is net worth and net worth isn't self-worth, but that net worth number, that balance sheet is what drives their ability to say, I have flexibility around money in my life and resources, and I'm getting to a point where I can live off that. Instead of my hands and my skillset.

It doesn't mean you'll stop doing dentistry, but it just gives you incredible flexibility, uh, in your life. Or even while you're, as a practicing dentist and maybe not financially independent yet, you're able to have, uh, adequate resources to live a good life as well. And so the marketing is helping find these patients to come in and bring them in at the top of the pipeline operations is once that call is made or once.

You, you know, that first visit come walks in the door of the patient. How do you make that an incredible experience for them and how do you properly. Monetize it. And I don't want to make it sound that patients are walking money machines, they're not. But you have to figure out how to have proper margins.

Otherwise you're not gonna run a business for long. So you have to think about it from a financial perspective, from that standpoint. And so that's what Megan and her skillset is, is how do you take that patient through the experience once Michael has helped find them into a really positive outcome clinically and financially for both you and the patient.

And then for me, is once that dollar hits the bank account. Whether that's coming from insurance companies or directly from the patient. How do you make sure that a plea goes throughout the p and l in an efficient way, ultimately pays your overhead debt and taxes. And we maximize what's left, we maximize what's left so you can pay for yourself today and you can pay for yourself in the future.

And that's where I come in to play as the finance guy on the team. So I think this is gonna be a really good pairing, the three of us. I'm excited about it. Let's jump into today's topic. And our kickoff topic is really just high level questions about what we're seeing in the industry right now as it relates to our specific expertise.

And, uh, and so I've got a handful of questions here I'm gonna kick off with. The first one is, how has the definition of a successful dental practice, how has, how has that definition changed into today to today's dental industry compared to, let's say, 10 years ago? What's different that makes a dentist?

Thrive or be successful today that maybe is different than 10 years ago. Why don't we kick this off with, uh, with Michael? 

Yeah. It's so interesting. I think even over the 13 years we've been doing this, you know, you can really see the legacy of what I would call traditional dentistry. You know, you, you graduate, you go do bread and butter dentistry, uh, until you retire.

And, and then maybe you have an associate that you sell your practice to and you hand it off. And that was a full career. You, you work through back pain. You work through, show you, you, you, you take that until you retire. And I think what, what I've seen even in my career is the emergence of the entrepreneur, dentist.

Someone that comes in with a business mindset, not just a clinician. Right? Sometimes this is something that we struggle to talk about in dentistry. Does it have to all be clinical? No. Clearly we have this entrepreneur dentist, and so I think what I'm seeing is that we have dentists that are looking at lifestyle.

This could be, how do you know? How do I wanna focus my time? Am I gonna be a dentist forever? No, I'm actually not. I'm gonna progress into real estate. I'm gonna do other things. We have dentists that focus on what type of dentistry they wanna do more. That was less of an option 20, 30 years ago is all bread and brought butter supported by specialty.

And now it's, I want to get out of that and focus on implant aligner, these specialized areas. So I think, um, the combination of that has meant that we're both evaluating financial success with life success, right? Is this supporting my lifestyle? Am I happy? Uh, and so I think that there's a lot more to consider.

I think it's a great trend in dentistry, but, um, it's certainly not the straightforward path. Graduate dental school, you know, work till you're 55 or 60 sell to your associate. I think those, those days are increasingly gone and people are, are looking 

for more. Agreed. Megan, you wanna add to that from the, uh, practice management lens?

Absolutely. Wes, uh, Michael, you nailed a lot of it. You know, lifestyle is such a big buzzword in our society today and. The, the newer generations are taking ownership of that lifestyle and really, instead of, instead of working for life, we're finding ways to integrate, you know, there's, there's this common theme of balance and I really don't see balance as being the best word to use for that.

More of like integration and finding ways to. Build our schedule to support what we need to do at home with our kids or our spouses, or our fill, our other buckets and our relationships and physical health, right? Wellness is also another buzzword, and so you'll see wellness creeping into how we take care of our teams, how we take care of ourselves, and then even it's going to transpire and we'll, we'll touch on that more about how it's, it's folding into how we take care of our patients.

And I'll say, I don't have a single quote, successful dentist. And I would define that as a dentist who has, um, a good top line, but also a good bottom line and top line is collections. In my world, we just call it revenue, but it's collections. But then bottom line, which is your, what we call your operating income, that's your cash flow After paying for labor, lab supplies, facility marketing and admin, but before paying you debt and taxes.

And that operating income is kind of the punchline of the profit and loss statement. And what I find is my doctors who have both a, a, a strong top line and a bottom line, uh, they eagerly review their financial statements. Each month and they eagerly engage their financial consultant, their CPA, here at practice CFO, we call them the CFO advisor.

And, uh, because they know that what's measured, as we all know, that the quote, what's measured gets, uh, improved. What isn't measured tends to atrophy or, or flat line. And so the doctors that I find that are successful today financially know that I'll, I'll say sometimes top line can be vanity. Bottom line is sanity.

I do have some doctors who work insane amounts. They may have two or three locations and they have pretty good top lines, but their bottom line is the same as a $800,000 practice, you know, with the 45%, uh, uh, 40% profit margin, which isn't bad, but I'd rather have an $800,000 practice. Four of five employees taking home 300,000, then a $2 million set of two practices taken home the same amount because one's gonna gimme life and the other one isn't.

And so upline, vanity, bottom line, uh, sanity. That said, in dentistry, because so much of the costs are fixed, meaning regardless of how many patients come in the door, you're gonna pay the same amount for rent. Your team pretty much is gonna get paid the same amount. You're gonna pay a lot of your, your fixed overhead, it's gonna be the same amount.

Very few costs are actually variable and a dental practice. Therefore, you need a pretty good top line. So when I make that statement, top line is vanity. Top bottom line is, is sanity. It doesn't mean you don't need a good top line. You do. A lot of the problems are revenue problems, not just expense problems, but, but they really manage it.

They're, I love that term, entrepreneurial mindset, Michael, because an entrepreneurial mindset is somebody who knows that it's not just about delivering the product, it's about creating a platform around the delivery of that product or service. And that's all the business side of it. And they have to be good at that.

We've all learned that. In my case, I feel like I had to learn that the hard way, but we've had to learn that. So that's what I find. They're just really engaged with their numbers. I would define that as one of the key characteristics needed to be successful today. I think if you go back far enough, you literally just post your sign out the door, and you're probably good.

Those days are gone. Hang a shingle. Yeah, those days are gone. All right. Yeah, 

they're long gone. Let's hop into the 

next question. What do successful practice owners focus on when running marketing campaigns? So this one's gonna be in your area, Michael, a little bit more. What do these successful owners, uh, focus on when running these marketing campaigns to make sure.

They're actually driving growth and not just spending money. 'cause I have seen a lot of marketing dollars just tossed in the wind and a lot of times they don't even know, they don't even know if it was tossed in the wind or actually produced results. So what are your thoughts on that question? 

Yeah, I think this is probably one of the, um, chronic areas of, um.

Of, uh, j just something that's not working in dentistry where we see it all the time when we talk to someone who's frustrated with their marketing and, and we will ask, we'll say, well, tell us how's, you know, how's it going? What's the performance? And they don't know. And, and that's, that's kind of the catalyst for them to, to look somewhere else and say, I don't know.

It doesn't feel like it's working. And if you think about it at the end of the day as a practice. The best way for you to know your marketing's not working is when the phone's not ringing and when you look at your p and l at the end of the day and it's not growing right, so, so that never lies. You could talk about ranking numbers all day long.

You can talk about website traffic and social media likes. If you're not getting more new patients and your collections are not growing. You know, and so we have chased this problem for years. I still remember early on being on calls with doctors and, and talking about rankings and talking about traffic, and then at the end of it, them saying, well, I don't think it's working because.

And so from that point to now, what we've worked very hard to do is to integrate with practice management software. Now, the first attempt at this we made is we used to email office managers once a month and say, can you pretty please go into this spreadsheet and update, you know, the, the new patients here?

And you know, it, it's, it's funny you're laughing, right? We know about 10% or less of them did it. So we, we, we, we had blinders we didn't know, which means we had to be reactive, not proactive. We had to wait for someone to tell us it wasn't working. Well, today I think best in class marketing is focused on integrated data.

That means we take marketing data, how many phone calls do we generate, how many leads filled out a form, and then we look at that list of phone numbers and names, and we compare it with the ledger that exists in the practice management software. How many of these leads now appear in this practice management software as new patients?

So without ever having to talk to the front desk or the doctor, we can say, Hey, good news. Last month we generated a hundred leads and 25 new patients came in and you collected $30,522. Like, things are good. I would argue even more important though, is when things are not good, because here's how marketing works today, how marketing works today is the marketing agent says, we're driving leads.

This is going great. And then it, it's up to you to figure out. Is that true? And most of the time, months go by until you finally say something's wrong. So it's so important that we can proactively see when things are not going well, so we can make the changes necessary. So the two pieces, uh, of advice I have here, one, make sure you're working with a marketing agency that integrates with your practice handling software.

And number two. Wes, I loved what you said. Your clients are eager to talk to you every month, right? Eager to talk to your marketing agency on a regular basis, quarterly, if that works for you or monthly, and know which numbers you're gonna hold them accountable for. 

Yeah. I think dentist should at the end, end of every month, or maybe even a couple times during the month, but they should sit down and this is what I find successful dentists do.

I, I've got a, a, a client here in La Jolla who he has a $5 million practice. He individually only does 400,000 of collection, and he's a hundred percent owner, but he spends. Probably five times more. The amount of time on understanding his data and helping or managing a lot of the operations of his practice.

Now he's a bit of an extreme, and I'm not saying everyone should become three part business owner, one part dentist, but instead of being four part dentist, zero part in, uh, owner, I think they need to be at least one to two part business owner. And if you wanna run, you know, a two, three, $4 million practice, that ratio of business owner to dental to dentist needs to increase over time to do that effect.

Because things start to shake as you get bigger, more employees, more need for process, more need for better hr, more need for systems, more need for marketing, uh, uh, programs. All of that, uh, increases in relevance as the practice grows. So let's pivot this question over to you, Megan, when it comes to. The marketing and the marketing campaigns to make sure they're actually driving growth and not just spending money.

Where does operational management come into play in this marketing flow? 

Well, Wes, like you said, uh, it's definitely making the time to analyze is this working? And then also what is the message and who is the patient I want to attract. So, you know, is it working? Is it working in the sense of we're we're gaining and retaining patients?

Are we taking time to listen to the incoming calls and are they the right patients for our practice? So have we conveyed who we are, what our vision is to people like Michael, so that they can make sure they're supporting us in a way that fills not just our financial needs, our sanity at the end of the day, but also that it's.

The type of dentistry we want to do, and we're getting the type of patients that we want to work with. And, and that's where I see a lot of misses. Um, and, and then I also see the gap with owner docs. They'll say, you know, I don't think my marketing's working based on. They're like, I don't know. I just don't know.

I don't think it works well, you know? Are you looking at the reports that people like Michael are providing you? Are you analyzing and listening to your calls? Are you taking time to coach your team on that? And then are we also. Tracking our attrition, you know, so our, if we're not growing yet, we're getting new patients, does that mean we have a leak in our ship?

And, and what is the cause of that? 

I remember I had a, uh, a young, really ambitious. Marketing consultant and my client found him through like a local business owner group, and he would come into my office and the three of us would sit down and he would open up this spreadsheet and he would show all these numbers.

He's like, I'm doing, I'm doing my, my job. Look at all these new calls you're getting all this new inflow of, of communication coming in, and yet. Six months into it, we weren't really seeing much change on the p and l, which is the end of kind of the pipeline. And that's my view of it. And it was just this really challenging problem to understand why, and I think it's because, um, you two, your two areas need to function hand in hand.

Michael can feed that pipeline, but somebody's gotta get that pipeline to convert. So there, there's finding or prospecting or. Opportunity, um, creating these opportunities. And then there's converting them to a, a patient in the chair who says yes to a case acceptance, uh, treatment plan, and then there's collecting the money.

So there's this whole pipeline, and I find that those doctors who create visibility through the whole pipeline, not just how many calls come. Not, not just how many appointments are met, but also case acceptance and ultimately collecting. Those are the, the ones who have that visi visibility can make the right decisions to improve it as needed.

So I would just want to emphasize that, um, um, uh, it is an investment, not an expense, in my opinion, to find good marketing and good practice management consultants. And I think one of the things that dentists need to, uh. Develop as a mental talent is to understand what is sort of a commodity cost that is purely about the cost and what is an investment that the results are highly dependent upon the individual resource talent.

Uh. That is being paid for. And I think your two areas definitely is an area of investment as long as the doctors are tracking the data and the results, and the sooner you can find out whether it's working or not, the better. And so when somebody's with another marketing firm, and if they're tracking the data properly and they realize it's not creating opportunities, they should.

Terminate that person and go hire Michael. That's my bottom line there. Hire Michael and then hire Shelton, uh, sorry. Megan. Megan Shelton, Shelton Solutions in order to convert those leads into patients in the chair saying yes. And then I will help you manage your taxes and cash flow. I love the flow. Okay.

Any other comments on that question before we move on? 

No, I think, I think Wes, like you nailed it. Really. Uh. For me seeing, I have a client who last month, actually the start of this month, she sent me a screenshot of her case acceptance tracker, and one thing we do that's really unique is we pull out the data.

From new patients. So we're not just seeing the revenue generated from the new patients, which is what Michael's seeing, but we're seeing the, the dentistry presented and dentistry accepted. And what I'm looking to see is like, did we get the right patient and did we meet them at a trust level that's comfortable with them?

And for this client, we had 85%. Acceptance on her new patients, which tells me her marketing and her intake is in alignment right now and that's going to be something that's going to drive her bottom line. Also going to reaffirm, you know, that her marketing continues, so it keeps all three of us working symbiotically to, to support her.

Get these patients healthy. 

So I think that feeds nicely to this next question, which is what systems or disciplines must be in place for, um, for a practice owner to grow profitably instead of just getting busier?

Who wants to take that one? 

Michael, you want it? No, I'm teasing. Um, well, gosh, which system? That's hard to say. There's so many. Uh, but I do think when we're looking at growth, having clarity of what type of growth and where we wanna go with that is important and. Clear expectations for our team and ourselves.

You know, as I see dentistry expanding, the practices that don't operationalize on wellness and don't capitalize on value-based care, they're going to struggle in the future. So, um. Building employee retention. You know, that's controversial. Right now everyone has a hiring shortage, but maybe it's a leadership shortage because not, um, the practices that are probably performing really well are not having hiring issues.

So it could be, we should start reframing and relapsing to look at, um, retention. You know, employee retention should be a system that we're, we're focusing on. Wellness should be a system. How we present cases and communicate. And then executive functions. How are we connecting with people like Michael, like Wes?

Are we making the time to analyze that, that data, and make, uh, forecasted decisions so that we can end our year? Prosperously agreed. 

I, I wanna give an example of what we run into and where, you know, we love when we have clients that work with, you know, coaches like Megan. And here's a good example. We'll work with a practice that maybe is a scratch startup.

At first they say, just give us patience. Any patients are good, right? And then all of a sudden, year one and a half comes around and say, Hey, you know, I just took this implant course. I think I wanna start doing more of that. Can, can we? Can we focus our marketing on two implants? Right? Cool. Easy peasy.

Came out of a phone call, came out of a course. No problemo, right? Well, so many things to consider. First of all, one of the big issues I see from a system standpoint is you gotta actually look at how are you gonna position yourself in the market? Do you have like no one's coming to you to start out with because of your reputation, so maybe you have to compete on price or something, right?

So how do you stack up actually. I love asking our clients, how did you decide on that special offer, prince? Well, that's what I, my friend does that. Okay. Like, and, and so, but from there we go into, have you talked to your front desk about this new initiative in your business? Do they know about this? And then have you built a system for when a patient comes in that is going to sit down with a need and need?

I love presentations. I think, hey, if you don't have slide decks, uh, that you can pull up on a screen and say, let me walk you through a few educational points, and it's systematized. All of these things lead to case acceptance, which is exactly what Megan's sharing. And so for me, I often see this spark of an easy decision.

Oh, I wanna focus on implants. Hang up the phone, slam the laptop shut. Does anyone know? Do? And if you really think about it, that is multiple weekends of your time, thinking about a system that will support a seismic shift in your business. And either you are gonna do that on your own, or you are gonna call someone like Megan and say, I.

I know I'm missing things. What do I need to do here? And, and this is where oftentimes our campaigns stall out, where we say we're getting it out there. There's people that want to do this, but the front desk is answering the phone and say, oh, you know, we, I've had people say, well, there's an endodontist down the street that does that.

And you're like, whoa, wait a second. What's happening here? You know, like, you didn't communicate. So 

Megan, I wanna ask you, um, a lot of, one of the biggest questions I get from doctors. Uh, and we've helped a lot of doctors buy a practice and step into ownership and get their financial structure in place with their accounting and their tax and all of that.

Um, and a lot of times they really need a Megan. They need a good coach in there to help them scale their practice. Why? Because they've never done this before. They were never trained on this before, and unless they really went out of their way to learn this somehow or had some sort of a leadership experience elsewhere, uh, they're very raw at this.

And so they could benefit by your services a lot. Um, but they will often say almost every time, am I ready to afford it? Can I afford that? Because that amount, whatever that is. For you to be really engaged. It requires a lot of your time. It requires your skillset and uh, and a deep commitment. And that's not gonna come at, you know, $3,000.

It's just not, uh, and you in your area, I think in all three of our areas, people get what they pay for. Um, and especially I think with good practice management consulting. So what is your answer to that? If I'm a dentist, I say, Megan, I really wanna hire you. I just don't think I can afford you yet. Afford me.

That's the question. That's the question I get. Yeah. I don't think I can afford X, Y, or Z. I get it myself. I got an email yesterday. I don't think I can afford your, your CFO fee quite yet. I just bought my practice, you know, and so I answer this myself, but how do you address that? 

Well, for me it's can you afford to continue on the path you're on for the next few years?

Is that sustainable for you? And can you make the impact alone without making changes or having someone to help you operationalize and systematize your practice? Do you have that time?

I think what that's driving at is, um, I 

mean you can't afford not to 

a 

right. Like we both, we all know it. Our, our clients that work with. High tier marketing firms, our clients that work with high tier labs, that work with high tier, um, you know, coaches or financial advisement firms, they're doing everything they do at that level.

And they didn't get there on accident. They got there because they surrounded themselves with people who have a certain level of. Expectation and they're going to bring you to that level with them. And so I think if, if you're choosing to, it's just like your patient, you know, they're like, I'd want the cheapest option.

You're gonna get the cheapest outcome. You know, it's the same. 

That's my favorite part. I'm like, what are we talking about of. All of our dentists have the same thing said back to them all the time, need and eat every day, right? Mm-hmm. And so, so they know the answer too. And, and it's, it's, but that 

value system, maybe the answer is yes, is leaking into their patients.

And so until. I can evolve their mindset. They will never get unstuck from that because if they're doubting, if they can afford me, well no wonder their patients are doubting if their, like their patient is saying like, I'm not sure I can afford Invisalign. I'm not sure I can afford an implant. Right. Well, that's transpiring from.

This doctor sitting chairside because they have that same scarcity or, uh, you know, relationship with money and abundance. 

I think patient experiences are generally speaking very much under what they. Should be in a dental practice. And that's the same with like CPA firms and a lot of professional service firms.

I think there's an underperformance or under delivery of value commonly. And I do think, uh, people should. Be very careful in who they're lining up as their roster of, of, uh, support people and consultants in their own team. But one of the things I've found in my life, I pay quite a bit of money for a good, uh, coach.

He's a business coach slash a little bit of a life coach. Uh, and I pay really good money to to this. But the thing about it is I think business owners need to be so hungry to learn. I mean, have such an appetite, such a curiosity, such a willingness to spend not only their time, but yes, some money as an investment.

Because if it works, if, if Megan comes in and helps you increase your case acceptance right away, a stronger patient experience, all around better system, that is an immediate. Return on investment. So let's say over an 18 month period you pay, and I have no idea what what the fees are here. So I'm gonna throw out a big number just to accentuate my point.

You drop a hundred grand for a practice management consultant over a 12 to 18 month period. Okay? That is a hundred grand. I get it. It feels like a lot. But what if you increase your case acceptance by 10%? Yeah. What does that translate into, especially if that it means a recurring patient that stays around a lot longer.

In business, we, we look at what's called the lifetime value of a client or the lifetime value of a patient, and I think dentists don't understand that if you get a good patient, the cost to acquire that patient and the cost to service that patient through really good practice management processes will have a return.

That over the life of that client makes the cost. Of, of you both so insignificant when you understand the lifetime value of a patient. And that's why it's really hard for dentists who have been struggling to make ends meet for so long, and they have this pent up consumerism, I call it, to immediately go buy the nice cars and the nice house.

And I say keep living like a dental student a little bit longer so that you can invest in people like Megan and Michael and, uh, less is more, less spending in your personal life. Allows you to have more resources to build your practice and this operating system. So I'm gonna share my screen and just share one thing real quick that I, this is my viewpoint on it and I'm happy to get critique or, or feedback on this Megan and Michael.

But a lot of, uh, our listeners watch this on YouTube. So I'll occasionally show some visuals, but what you have on the screen for those that are just listening is a diagram. It's an infograph that shows the doctor at the top, and I call you the CEO, and I need you to think of yourself as the CEO because you are a, you are a, a corporation shareholder a hundred percent.

Most doctors are S corporations, and you are a business owner, and you are the CEO. It's literally in your corporate records. For those of you who are, who are corporations. And then I have on the left I have, they have a CFO. So think of a big business. They have a CFO, and then on the right they have the chief operating officer, or of course we're calling this the practice management consultant.

Most dental practices cannot afford to pay a full-time CFO and a full-time chief operating officer in the practice. So they typically fractionalize these things. Same thing with marketing. They don't have, uh, the, the resources in a $1.5 million practice to go pay $250,000 for a full-time, $300,000 for a full-time marketer.

And, um, and so what I don't have on here that I need to add, Michael, is I need to add. You I need to add, I would think those are monthly, in my opinion, monthly meetings of at least reviewing the data and a 30 minute to an hour long conversation to review the data. But I have meeting with the CFO, that would be us every three or four months, and that's what we do with our clients.

Meeting with a practice management consultant monthly or quarterly, or maybe in the beginning. It's weekly, I don't know. But these periodic meetings with the strategic leadership team. Then I think every dental office needs a really good. Operations person, uh, a good front office person, somebody who can really act as a support to you.

And in my business, I have someone, her name is Janine, and she makes my life infinitely easier because she deals with so much of the commotion at the front, so to say, metaphorically speaking. And, and then on the bottom I have of course, your main team members, hygiene assistant, front office, and associates with sort of daily huddles and periodic trainings.

But there needs to be a really good roster. A really good pulse or cadence to how you meet with these people to absorb information and learning and then to your team to of course inspire them and to, and to run a good, a good dental practice. So I would say when it comes to what systems, I really am a big believer in your, your, your team and your cadence of meetings is one of the most important systems that you could have.

I'm gonna stop sharing that. Alright. And the last question I'm gonna, I'm gonna ask is, is just this, um. For a dentist to have a really good personal life as they grow their practice, um, what should they be focusing on as a dental practice owner to help them have a balance in their life so it's not just about the business all the time in their mind.

Michael, you want to kick off a thought on that one? 

Yeah. I think that's something that we all struggle with. And the first thing I would say is that there's chapters and seasons to this, right? So I think one of the tough things is someone that's listening to this, right? The, the answer I would give today or the answer someone else would give I is different.

And, and I like something that Megan said, right? I think a lot of times people throughout this word balance, and, and I'm here to tell you as an entrepreneur, balance is not right for every season, right? If, if you come in and you listen to some podcasts of people that have spent 10 years building their business, they say balance is what I'm focused on today, and it's your first month.

I'm gonna tell you right now, balance is not your thing. Like you're gonna go hard, but, but I think the biggest thing we don't do is we don't have meetings with ourselves, right? We don't, we don't look and say, where do I want to go? It's gonna change, but I need a vague understanding. Is my goal as a dentist to get to four days a week, three days a week, is my goal to prioritize family?

Is my goal to prioritize a different clinical pursuit or passion? What, what is it long term? Get that out there, write it down. And then check in with yourself. I think that's the biggest one. And then my wife and I have found this in our journey. I would just say be open to seasons, be open to change it.

It's, it's not something that just smoothly, you know, goes to one place. All of a sudden you're back to a place where you, you have passion and you want to make the business the focus. You're grinding, you're, you're there. And then there's other seasons where you step back and say, I need to focus on something else.

So I think just being open to the fluctuation and having clarity. Don't let the river take you. Which is often what happens if we're being real with ourselves. I don't even know how I got here. Be happy that you stepped foot in the river and you chose to go on that ride, and that's where you wanna be.

Megan Chi some light on your 

thoughts 

here. Yeah, a few things that come to mind. Uh. I would echo what Michael said. And then I would also add not being afraid to communicate or invest in the support and help you need. Uh, I think as entrepreneurs we can sometimes be very passionate or controlling about a direction that we see and.

Using the support, whether that's your teams, your significant other at home. I would say, you know, some of the best things I did was elevating the people that believed in me within my organization. Right. You go back to that organizational chart. The person who became my ops manager was someone who started.

An assistant who could barely hold a suction, but she had the attitude, she had the dedication, she had the need, and she, I mean, she could probably teach some of the things I know about dentistry. She understands and can communicate and she cares, but I could tell her when I was in need. Um, and then the other thing was.

Making a good choice on your, on your spouse. I think that's a huge one. Um, who that person is standing beside you and we don't probably give enough emphasis to that. And for me, that's been a, a huge ability to be able to go through the seasons. And, and, uh, dedicate my time to my business. When I was my practice, there were times I was, you know, people see this like I was in my office till 1:00 AM sometimes, you know, my phone's dead and my husband's checking my location, like, where are you?

But I was just like, so in the flow. And so he knew that those were the times I needed to put in that, that labor of love. And so having communication. Using your support, hiring help at home. And then, gosh, I think also for dentists, mental health support is a huge one, uh, if you need it and, and having coaches and advisors on your team.

I love all those comments. And, uh, it is so true that there is a, uh. There's a life cycle to being a business owner. And when I started practice CFO, I was making so little money and I was working like 80 hours a week. My highest week, I clocked 109 hours. It was pretty insane. That was during tax season, back when I was doing the tax work myself.

And eventually you'd start to take off these hats. You start to, to have a little bit more resources, a little bit more reputation, a little bit better branding. And uh, one of the most important things I think all business owners can do is what we call capital allocation, which is how do you allocate your surplus dollar to get the most incremental benefit out of that dollar?

Is that in marketing? Is that a new op? Is that a new CAD cam? Is that, uh, into practice management consulting? What is the best use of that dollar and um. But it takes, it takes time to do that. I think getting this time alone, like you said, Michael, I, I call that a clarity break and I, it's something I struggle to do, but every time I do it, I, I'm like, Wes, I need to do that more often.

Where I'll take a day to myself, I'll go to the local library by myself. I'll go get an Airbnb. I've done that once by myself and just take a day away from it all. Go analog. Get rid of that tech and just start letting your thoughts go down on paper and organizing them, and you start to see your life, I think with a lot more clarity in context when you set everything aside to do that.

The last thing I'll say is in terms of seasons, when you first buy that practice, or if you've never really built out a good system around operations and marketing and finance, I think you've gotta do that. And I view it almost like developing a software. In the beginning, there's a lot of time and even quite a bit of money that can go into coding that software, and you have to think about all the different sort of scenarios and whatnot.

It just takes time. Once the software's done and released, then it becomes, it's just a simple maintenance of it. I call that maintenance mode. It's like you get the tire going, you have to really pump it, and then once it's going every once in a while, you just give it a nice spin and it keeps going or. Or getting that rocket ship outta the atmosphere.

It's so much energy at first, but once you're in that, the atmosphere outta the atmosphere. It's just really little checks. Little, little balancing going on, and so for everyone, I know it takes a lot of time, a lot of mental, mental energy and even some money, but please build out that system to be a really good business owner as well as a clinician, and define what you want outta life and what's enough and what will make you happy.

Alright, that's the end of the questions. I just wanna showcase a little bit what we're gonna be covering going forward on the finance side this year. Here are some of the things I'm excited to talk about. Financial KPIs that every practice owner should review monthly, when to reinvest in the practice versus take it out of the practice to sort of pay yourself red flags, uh, to watch out for in growing practices, I would say cost cutting versus strategic investments.

And cashflow forecasting and how to do these things and the value out of those things. So really excited about that. Megan, what are some of the topics you want to present here this year on the practice management side? Well, I'm 

looking forward to discussing with you all systems that help predict growth, uh, so we can prevent chaos.

Uh, KPIs to ensure that the practice is getting our patients healthy and leadership tools to help with employee retention.

All relevant for practice owners. Michael. 

Yeah. So, you know, I'm excited to actually get into some things that you can do, right? Sometimes marketing feels theoretical and, and we'll talk about some of that. But I wanna really boil it down to things that you can take away. And so there's a lot changing.

Marketing always does. And so things that are top of mind for me that we'll talk about, um, ai and now this new thing that we're calling AI o. So a lot of you might know SEO, right? Hey, I just learned about that. I'm doing that. Oh my gosh, there's something new. Yes, there is. We have to optimize for ai. A lot of you have an idea that we should get the word out there through ads, like Facebook ads, meta ads.

What is holding those campaigns back? Everybody's probably tried it. A lot of people said, Hey, it hasn't worked. What's the number one thing holding your, your meta ad campaigns back? Um, the power of video. We all kind of know video's a thing, but it feels pretty inaccessible to a lot of us. What do we do if we actually wanna use video in a way that's gonna be meaningful in our practice?

And then. Um, you know, something that we talk about all the time. I am sick of insurance. I wanna do this fee for service thing. How do I do it? What is a path in marketing without just discounting to get you to a sustainable fee for service practice? 

Amen to that. I'll tell you what, when I started the practice, I practice CFO, I was just giving discounts all over the place.

Yeah. Because it was like. I just need people in the chair, so to speak. And uh, but you get to a point, eventually you realize I actually need to define my strike zone. What is the patient, in my case, the client that fits my strike zone? Because if you scale. You scale when your margins are negative, guess what?

You're just inflicting a lot of pain on yourself. And, uh, so that defining your, just like defining your life goals, you gotta define your practice goals and the type of patients. But I'm excited to talk about ai. It's also playing a role in MySpace of accounting and finance. And I'm working to be able to do more real-time reporting where our clients can log in and have a dashboard and see their numbers partway through the month.

To where they are. They don't need to wait until a week or two after the month to see their historical data. I'm really pushing toward that here at practice CFO. And then Megan, I suspect you're seeing AI softwares, um, coming. They're popping 

up left and right. Yeah. Helping with diagnosis, helping with patient coordination, all the things.

And so finding ways to utilize that. Uh, to allow us to have more connection with our patients. 'cause that's, you know, people are still longing for that human connection. So making sure we're delegating the right things, and then how are we using that time that we're buying back through that delegation.

Well, I'm excited to do this. We're gonna do this episode, the, the executive session, uh, twice a month, and we're going to try to be really consistent about that in spite of us all being very busy. And this was our first session, so we're sort of breaking the ice, getting comfortable a little bit with each other, but I am just so, uh, optimistic and excited about the content we're gonna create for our listeners and, uh, this, uh, multidisciplinary approach, I think.

Relevant because that's what it's like in business, that's real life, is you have to see how it all feeds into each other in this circular reference, the way it all relates to each other. So thank you Megan and Michael for being on the show. Until next time, have a great one.