Where is the Best City to Start a Practice? With Kent Miller of Dentagraphics

Dr. Donny Qafleshi is a pediatric dentist in Indiana. He comes on to share some of his personal and professional experiences as an immigrant, a dad, and a pediatric dentist. Some of the things we discuss: -Dr. Donny's journey to the United States as a child to escape war - How to know when a practice partnership is the right choice - How many kids a day is a sustainable amount to see without burning out? - Internalizing emotions as a pediatric dentist and a new parent - Working on mindfulness and techniques to prevent work anxiety

Dr. Nick Luke is a pediatric dentist, originally from Iowa but now practicing at a busy office in Wisconsin. Dr. Nick is a big fan of finding creative ways to follow the guidelines and literature while also creating a fun experience for his patients. In this episode, we discuss: - Why Wisconsin is awesome - Hall crown philosophy and techniques - MTA usage in pulpotomies - Caries removal and biofilm control - How being a dad and work-life balance go together

Dr. Jay Leung is a pediatric dentist and owner at The Little Tooth Company Pediatric Dentistry. He practices and runs two offices with associates in Connecticut. Dr. Jay comes on the show to share his experience of being audited by Medicaid. After receiving a daunting letter in the mail and being threatened with some hefty penalties, Dr. Jay was able to use legal help and great documentation to defend and protect himself. He gives listeners some pointers and advice in the event an audit ever happens to them.

Dr. Art Nowak has been practicing pediatric dentistry since the mid 1960's, back when there were only seven residency programs. He taught pediatric dentistry at the University of Iowa for almost 50 years, during which he published "Infancy Through Adolescence." This textbook is a staple in our profession, and Dr. Nowak literally "wrote the book" on comprehensive pediatric dentistry. We have a great discussion on how pediatric dentistry has changed through the years. Dr. Nowak expresses his concerns that we have commercialized pediatric dentistry and moved away from focusing on prevention and treating the whole patient. Dr. Nowak continues to stay busy and he is excited to release his newest edition of the textbook sometime next year.

Dr. Kristine "Love Peace" Grazioso is a pediatric dentist with a large practice in Massachusetts. She practiced for years as contracted provider with Delta, Blue Cross Blue Shield, and Medicaid. In 2020, she made the decision to drop all insurances and go completely FFS, in order to provide better care for her patients. Even though she practices in a competitive area, her practice is busy and thriving. Dr. Grazioso shares her story about how she made this transition. She gives pointers and advice to other pediatric dentists who are interested in going OON with dental insurance plans. Dr. Grazioso has used her experience as a springboard to provide consulting and coaching services to other pediatric dentists who want to fight against being handcuffed to dental insurance companies.

You see it all the time on iPedo... "I'm tired of my associate job and I want to start my own practice, but I'm not sure where to start." It's no surprise that a large void exists for knowledge and content relevant specifically for pediatric dentists who want to start their own practice. Well we have some huge news to share on the podcast today. For the last 6 months, Dr. Corey Hastings and I have been working tirelessly on building a comprehensive course specifically for pediatric dentists who want to start their own practice. We are super excited to roll out Little Smiles Practice Mastery, an online video lecture series that walks you step-by-step through the startup journey. This "power pediatric dental MBA" has almost 15 hours of lecture material, along with all needed spreadsheets, forms, attachments, and paperwork you need to jump-start a practice. All of this in a low-cost subscription platform that is available on-demand whenever you need it. On today's episode, Corey and discuss the benefits of practice ownership over a cold beer. We review why we made this course, what all is included, and why we believe most pediatric dentists can build an awesome practice without spending a fortune on a consulting company. Make sure to stop by our booth at AAPD to get on our mailing list, or visit www.pediatricdentalmba.com. We anticipate the course to go live early this summer and we are so excited to give other dentists the tools they need to achieve their practice goals.

Thad Harker is a project advisor at Primus Dental, a design and build full-service construction company that has built close to a 1000 dental offices across the Midwest. Thad and I have a great conversation about dental office design and construction. He emphasizes that the construction process is all about managing people. We talk about how things have changed with higher interest rates and construction costs, but that it still makes financial sense to not lose opportunity cost and get yourself a "golden hammer." Some topics we discuss in this episode: - Why are construction costs high, and will they come back down? - Why does location matter? - Does it make sense to price shop a build-out? - How have pediatric office designs changed post-COVID? - Is it still worth it to do a start-up and be a practice owner?

Where would we be if we didn’t have the support of our non-dentist spouse/significant other/partner? This episode is specifically for them! Today my wife, Jenna Goetz, reflects on her impact on my journey to become a pediatric dentist. We talk about when does it make sense for the spouse to work in the office, pursue his or her own career, or to stay home with kids. Jenna gives some advice to young power couples and how to get the most out of this journey. We also joke about how annoying dentists can be when you get them all around each other at conventions and meetings. This is a great episode to listen to with your significant other who is not a dentist!

Chip Fichtner is the co-founder of Large Practice Sales and a return guest on the podcast. His firm helps practice owners complete transactions and partner with DSOs and "invisible" DSOs who allow the doctor to maintain autonomy and a minority position. We last spoke on the podcast about two years ago. Because of our episode, his firm closed a $50+ million dollar deal on a large pediatric office. Chip has a tight pulse on what's going on in the DSO world. I wanted to get an update on what DSOs are doing with pediatric practices in light of the higher interest rates. I try to ask Chip some tougher questions in this interview. In this episode, we discuss: - Is access to capital an issue for DSOs right now? - Have we seen any DSOs struggle or go under because of lower free cash flow? - What happens to the dentist's retained equity in the parent company if the parent company fails? - Who calculates EBITDA in these transactions, and where does all the variability come from? - How does LPS keep tabs and verify the quality and financials of the DSOs they work with? - What does the ideal pediatric dental practice look like in terms of commanding a high multiple? Chip can be reached at www.largepracticesales.com

Everybody in pediatric dentistry is talking about the Soan right now, so I had to learn more. On today's episode, I hosted Dr. Ann Bynum and Chris Malzone from NuSmile. Chris had sent me a demo model to try out, so I took this opportunity to talk with him and Ann about the technology. The Soan is an cordless electronic anesthetic pen. It allows you to give intraosseous injections to kids without collateral numbness. I specifically talk with Ann about the benefits of the device, technique questions, cost of using the device, and limitations. Anybody that would like to learn more is welcome to check out Nusmile.com, as they host free webinars to learn more about the device.