Comparing High-End Practices Over Bourbon

Dr. Shon Diguglielmo is a pediatric dentist and partner at a large legacy multi-specialty practice in Vermont. The partnership consists of seven pediatric dentists and three orthodontists. They have a unique system in which they equally split the same number of working days in a calendar year. The partners are all reimbursed equally (profits are not distributed by production percentage). Dr. Shon shares how they structure this and why it works so well for their doctors.Dr. Shon also shared with me that a previous Brews and Tiny Teeth Episode inspired him to explore the option of partnering with a DSO. He explains why their practice made that transition, how he did his due diligence, and why it was the right move for his group.

Dr. Karli Williams is a pediatric dentist at Black Hills Pediatric Dentistry in South Dakota. She is a partner at a large, established practice that serves children with major access to care barriers across South Dakota and the surrounding states. Her busy practice also owns and runs a stand-alone surgery center that operates with CRNAs five days a week. Carly cracks a beer and talks with me about South Dakota, treating Native children, operating a surgical center, using Equia strip crowns, and how they survived a Medicaid audit.

Dr. John Kiang is a pediatric dentist from Rhode Island. He is a partner in a large practice that has three pediatric dentists, a GP, and multiple orthodontists. He steps away from a day off at the beach to talk about a variety of topics including:- How their large pedo-ortho practice integrates orthodontics and makes that relationship seamless- The importance of offering partnerships to the right people- Dealing with challenging cleft patients- Nasal alveolar molding- Training for triathlons as a way to stay healthy and be a better dentist.

This episode is all about how to put a valuation on a pediatric dental practice. To help me dissect this topic, I invited on Jeffrey Moss from Moss, Luse, and Womble (MLW). MLW is a prominent accounting firm out of Texas that works with dentists from all around the country. They help approximately 150 pediatric practices with services ranging from bookkeeping, tax strategies, financial planning, and practice valuating. Jeff and I discuss the following topics:- What trends he's seeing in regards to the demand for pediatric offices- What metrics are looked at when considering high-quality practices?- What's a healthy profit margin and how is that calculated?- Is there such thing as a practice that is too big to obtain financing from a private buyer?- How does bringing on an associate who wants to eventually partner affect the valuation for both the buyer and the seller?

This episode comes to you live from AAPD in Denver, Colorado! Dr. Corey Hastings and I had a great time on the floor meeting other dentists and doing some networking. We had a ton of ambitious young docs come up to us and share their stories. Based on our feedback, Corey and I estimate that we've helped somewhere between 60-80 people start their own practice. Corey and I ordered some old fashions and share some of our thoughts about the new Cain Watters Practice Comparison Report. This is a report that shares practice production, collection, overhead, wages, etc. of mature pediatric practices that work with Cain Watters. We discuss some of the trends we are seeing, and why some of these numbers may be misleading.

Dr. Eric Phan is a pediatric dentist who decided to take the leap and go back to ortho residency after four years of practice. He developed an interest in ortho during his associateship and decided to purse being one of the few dual-specialists in our profession.Dr. Phan talks about the application process, why he chose to go back to residency, differences in personalities between pediatric dentists and orthodontists, and why he thinks adding an ortho skill set increases his value and will afford him a longer and healthier career. He also shares some tips for those listeners who may consider going back to specialize in orthodontics.

Dr. Vinny Miriyala is a pediatric dentist who wears a variety of hats in his professional career. Besides working both in private practice and academics, he also takes on an administrative roll by working with insurance companies and the federal government doing peer-reviews and fraud/waste/abuse claims.We have a great conversation about how to avoid liability as a pediatric dentist, specifically what mistakes docs make that get them served a letter from an attorney. Dr. Vinny can be reached at [email protected]

Dr. Adi Genish is pediatric dentist in the beautiful Beverly Hills area of California. She is also a well-known social media influencer and has attracted an impressive following to her profiles on Instagram and TikTok. Dr. Adi talks about why she went back to specialize in pediatrics, and what inspired her to open her practice in Beverly Hills. Her office vision was to create a dental spa for children, and you can tell she spared no expense in designing a very modern practice. We also discuss treatment modalities and parent expectations for the families she sees in Beverly Hills. Dr. Adi also gives us some pointers for social media and reviews its importance for having good content in the modern world of pediatric dentistry.

Dr. Ivy Fua is a pediatric dentist in Burbank, California. Right before COVID she purchased and renovated an established pediatric office to create "Grin Garden Kids Dental and Orthodontics." We talked about how she used a marketing and branding firm to help create her new office, along with the challenges of surviving the transition during COVID. We also discuss:- Outsourcing your insurance billing, is it worth it?- Difficulties when you hire and then lose an associate- Dealing with parents who have fluoride concerns- Being a mom and running a practice- Does it make sense to do full ortho or just phase one?

If you think your life is busy... wait until you listen to this episode! Dr. Gary Lehn is a partner and owner of a 6-office practice in Nebraska, along with the father of 8 children. His kids range from one all the way up to 16 years old. Gary shares his journey and tells us about how he grew his family and his practice together. He gives some advice about how he manages his time, and what his life outside of work looks like. This is a great episode for those docs who work in a busy practice, along with trying to grow a family at home.