165: Private Practice Isn't Dead

Participants:Wes Read, host, PracticeCFOMichael Anderson, dental marketing and brand advisor who works with practices on defining and showing value.Megan Shelton, dentist and practice operations advisor focused on patient experience and retention systems.Duration: 41 minutesA DSO opens down the street with a $49 new patient special, and the instinct is to match it. This episode walks through why price is the most expensive growth lever a practice can pull, and what to use instead: a defined value proposition, visible proof of expertise, and an in-office experience that justifies the fee. The panel closes with whether membership plans are a real alternative or just discounting in disguise.Key topicsDiscount math and margin erosionOnline reviews and word of mouthSignature details and patient experienceMembership plans versus PPO participationKey takeawaysDiscounting cuts your fee but never your costs, so volume has to multiply to break even.Low price attracts the patients least likely to stay or accept treatment.Patients cannot judge clinical skill, so they judge everything else.Membership patients accept more treatment because they already committed to you.Actions to considerAudit the full new patient journey, from the phone call and web form follow up to the bathroom, and fix what contradicts your fees.Pick one signature detail you deliver every time without asking, and train the team to build value around it before it happens.Start documenting cases on your phone this month, and run your PPO contracts through AI to confirm what your discounting obligations actually are.

Wes Read, host, Practice CFODuration: 44 minutesA solo walkthrough of the year-end tax planning work that must be finished by December 31st, built around the idea that a strong year of planning only counts if the final execution lands. Wes covers what locks in at year end, the internal checklist Practice CFO runs on every client, and why single tax strategies have to be judged inside the full financial picture rather than on their own. The central point: tax friction is the main brake on financial independence, and most of the levers close on December 31st.Key topicsRetirement plan design and funding deadlinesSection 179 and bonus depreciation on equipmentPass-through entity tax electionsTax brackets, phase-outs, and lost deductionsKey takeawaysRetirement plan design cannot be changed once the year closes, and elective deferrals must clear payroll by December 31st.Financing equipment for a Section 179 deduction can start a debt spiral: deduction now, payments later with nothing to deduct.Missing the pass-through entity tax election is the most common and most expensive oversight on a dental return.Getting income under a phase-out threshold pays twice: lower tax now, plus deductions you would otherwise forfeit.Actions to considerSchedule a year-end projection meeting with your CPA or CFO advisor in October or November, while options are still open.Confirm your W-2, spouse and children payroll, and 401(k) contributions will land on target before the final December payroll run.Have an advisor vet any supplier equipment deal for whether you can actually use the deduction before you sign.

Participants:Wes Read, host, PracticeCFOMegan Shelton, a practice management consultant specializing in dentistry who previously owned and sold her own dental practiceMichael Anderson, a dental marketing consultant with 13 years in the industryDuration: 60 minutesReimbursement is flat while overhead climbs, and most owners have at least daydreamed about dropping Delta. This session breaks the decision into three levers, price, friction, and yield, and argues that the fee schedule is rarely the real problem. Friction, the cost of collecting the money, is what owners actually control.Key topicsUCR fee schedules and percentile benchmarkingClaim denials, eligibility, and breakdownsPer-plan profitability mathMarketing readiness before going out of networkKey takeawaysThe squeeze is often the cost to collect, not the fee schedule.An 80 percent PPO practice can still be highly profitable.Not every plan delivers the same patient; case acceptance varies by carrier.A practice with no marketing history will struggle to go fee for service.Actions to considerRun a UCR percentile analysis and raise fees toward the 80th to 85th percentile, then resubmit.Pull payer distribution and case acceptance by plan to find your worst performer.Verify eligibility within two days of every visit and get a full breakdown, not a coverage table.

Participants:Wes Read, host, Practice CFO and Practice OrbitJared Bergquist, a licensed business and commercial real estate broker in Nevada who runs his own brokerage selling dental practices and handling dental real estate across Nevada, Utah, and ArizonaDuration: 57 minutesA broker and a CPA walk through what the practice acquisition market looks like right now: where DSO activity stands, what private buyers are competing for, and why the "perfect" practice is the wrong target. They cover building ownership, rent as a percentage of collections, and how staff stability drives both value and a successful transition.Key topicsDSO activity and divestituresPrivate practice acquisitionBuying versus leasing your buildingStaff retention through a transitionKey takeawaysWaiting for a flawless practice is why many qualified buyers never buy one.DSO divestitures over the next five to ten years will create locations, equipment, and patient bases worth pursuing.Owning your building controls the one expense you cannot renegotiate later.A de novo that fails to launch is very hard to sell, because leasehold improvements and used equipment carry little value.Actions to considerCheck rent as a percentage of collections against the seven to ten percent target and know what a long lease escalates to.Widen your acquisition criteria to four and five operatory practices and offices with fixable problems.If you are buying, negotiate for the seller to stay on twelve to eighteen months to hand off staff and patients.

Participants:Wes Read, host, PracticeCFOPaul Lipcius, CFO advisor at PracticeCFO, a CPA and Series 65 investment advisor focused on higher net worth clients and capital marketsHoward Farran, host of Dentaltown, who interviews Wes and Paul in this crossover episodeDuration: 71 minutesWith SpaceX, OpenAI, and Anthropic all heading toward historic public offerings, dentists want to know whether to chase the hype. Wes and Paul explain why euphoric IPO pricing rarely rewards latecomers, how to capture AI's real growth through the less obvious companies underneath it, and why a doctor's own practice, not a moonshot stock, is still their highest returning asset.Key topicsAI mega IPOs: SpaceX, OpenAI, AnthropicCapEx trickle-down and downstream suppliersConcentration risk in the S&P 500The practice as the core wealth engineKey takeawaysEuphoric IPO valuations already price in years of unproven growth.The winner is often the second or third mover, not the first to market.Own AI through the picks and shovels suppliers, not just the headline names.A well designed portfolio's job is to be boring, disciplined, and consistent.Actions to considerCap any speculative bet, a single IPO or crypto, at a small insurance sized allocation.Pick three or four practice metrics to improve this quarter instead of chasing every new one.Pressure test your advisor's fees: ask whether anyone other than you pays them.

A Dental Boardroom data deep-dive, PracticeCFOA breakdown of the Q2 2026 State of the U.S. Dental Economy Report from the ADA Health Policy Institute, translating national data into what it means for an independent practice. The core tension: dentists feel confident and are busier than ever, yet revenue is flat and margins are squeezed from every side. This episode decodes why, and what owners can do about it.Key topicsThe confidence versus consumer disconnectThe fiscal squeeze on practice marginsInsurance reimbursement as rent controlAI adoption for the back officeKey takeawaysDentists feel recession-proof, but consumer dental spending rose just 1 percent in a year.Overhead and wages are climbing far faster than reimbursements, so owners eat the difference.Packed schedules and two-week waits mask flat revenue, not real growth.AI is being adopted fast for admin and imaging, yet 82 percent refuse it for treatment decisions.Actions to considerAudit your payer mix and renegotiate or drop the worst-reimbursing plans.Pilot AI scribing or insurance-verification tools to reclaim staff hours.Weigh a DSO's back-office scale against your true overhead before ruling it out.

The PracticeCFO investment committee sits down for its quarterly market update, digging into how AI is reshaping valuations and where the Federal Reserve stands today. The core message for practice owners: AI is genuinely transformative, but most of the hype is already priced in — so valuation discipline and diversification still decide long-term returns.Hosts & guests: Wes Read (host, PracticeCFO), Brandon Hobson (Chief Investment Officer, PracticeCFO), and Paul Lipcius (PracticeCFO investment committee).What we cover:AI's effect on market valuationsGovernment involvement and regulation of AIFederal Reserve policy and interest ratesPortfolio positioning and risk assessmentKey takeaways:AI is groundbreaking, but the hype is largely priced in already.Every prior CapEx cycle eventually reversed and normalized — this one will too.The Fed is holding steady, with a hike now more likely than a near-term cut.New Fed leadership is prioritizing inflation, easing fears about Fed independence.Strong balance sheets and diversification protect wealth better than chasing momentum.Actions to consider:Reassess your true risk tolerance now, while markets are strong — not after a drop.Trim over-concentration in high-flying AI and tech names.Rebalance toward a diversified mix: bonds, some cash, healthcare and consumables, and precious metals.

In this episode of The Dental Boardroom Podcast, Wes takes a break from his discussion of The Five Types of Wealth to tackle an important topic for dental practice owners: buying and selling dental practices.Drawing from years of experience as a dental CPA and financial advisor involved in hundreds of practice transitions, Wes explores why dental practice sales remain an inefficient marketplace, the critical role brokers play in successful transitions, and the challenges buyers and sellers face throughout the process.He also shares the vision behind Practice Orbit, a technology platform designed to modernize and streamline dental practice transactions while supporting brokers, buyers, sellers, lenders, attorneys, and advisors.Key TakeawaysDental practice transitions are complex, emotional, and financially significant events.A skilled broker can provide tremendous value by finding buyers, coordinating the process, and helping avoid costly mistakes.Dentists should carefully evaluate broker experience, incentives, and transparency.DSO offers should be analyzed beyond the headline purchase price.Technology can improve efficiency, transparency, and communication throughout the transition process.The future of dental practice sales may involve a combination of experienced brokers and modern marketplace technology.

Wes Read continues his series on The Five Types of Wealth by Sahil Bloom, diving deep into Chapter 4: The Life Razor. Building on the five categories of wealth Time, Social, Mental, Physical, and Financial Wes explores how a single, carefully crafted sentence can become the most powerful decision-making tool in your life and practice. From the cockpit of Apollo 13 to Netflix’s boardrooms, to a late afternoon assembling a hydraulic bed with his son, this episode delivers a framework that is equal parts philosophical and practical.What You’ll LearnWhy your net worth number alone doesn’t define true wealth and what fills the gapThe philosophical concept of a “razor” and how it applies to your personal lifeThe 3 non-negotiable traits of a powerful life razor: controllable, ripple-creating, and identity-definingHow Marc Randolph (co-founder & first CEO of Netflix) used a five-word rule to protect his marriage through startup chaosA step-by-step process to discover and draft your own life razorWes’s personal life razor and the touching story behind it

159: Executive Sessions: AI & The Dental PracticeWhat does AI actually mean for your dental practice right now? In this executive session, host Wes sits down with Michael Anderson from Wonderist Agency, one of the nation's largest dental marketing firms, and Dr. Megan Shelton of Shelton Solutions to cut through the hype and talk about what's really changing.They cover the dramatic shift in patient search behavior (ChatGPT now accounts for 20% of all searches and is growing), why the fundamentals of digital marketing still drive AI search results, how AI-informed patients are showing up differently at the front desk, and why the human connection at the center of your practice is more valuable than ever.Wes also shares a powerful framework from Lawrence Ford's book The Difference Between Knowledge, Intelligence, and Wisdom and explains exactly how Practice CFO is approaching AI adoption, client investment strategy, and the future of financial advisory.What You'll LearnWhy 20% of patients are now searching for a dentist via ChatGPT — and what that means for your marketingThe "unsatisfying but true" answer to ranking in AI search: go back to the basicsWhy AI-generated content is not penalized — but lazy AI content is a dead endHow the AI-prepped patient is changing chair-side conversations and silently eroding trustThe knowledge → intelligence → wisdom framework and why wisdom is AI-proofWhy documenting your SOPs is the mandatory first step before any AI automationWhat Practice CFO is doing with client investment strategy in an AI-dominated market