A DSO Horror Story

In this episode, Dr. Mark Gilstrap shares his journey through the dental profession, including his experiences with DSOs, practice ownership, and navigating the complexities of Medicaid in Oklahoma. He shares insights into the challenges and opportunities in pediatric dentistry and practice management.Topics we discuss:Experience with DSOs and practice managementPractice acquisition and startup strategiesMedicaid system challenges in OklahomaImportance of documentation and contractsBuilding a legacy in pediatric dentistryInterested in learning about the business side of pediatric dentistry, or want to start your own practice? Check out Little Smiles Practice Mastery:https://littlesmilespracticemastery.thinkific.com/We are dropping a new webinar exclusive to members of the course. Joe Lucido is our new preferred partner. His firm, Clear to Launch, specializes in healthcare marketing. We have a great discussion about the importance of social media in growing a new pediatric practice. Check them out at:https://cleartolaunch.com/

In this quick episode, I wanted to review how I calculate the most important KPI in my practice. As practice owners, it's critical to know your numbers. I like to stay hands-on with my bookkeeping so I can watch my expenses. I'm going to review how I calculate my specific daily BAM, and how I account for an additional risk premium as a practice owner vs staying an associate.

Our guest for this episode is Dr. Luke Robert. Dr. Luke is a pediatric dentist from Georgia who bought a high-end fee-for-service practice at 130% of collections. Even with people telling him he shouldn't do the deal, he found a way to buy the practice and still make it work. In our conversation, we discuss:- The benefits of a FFS office- How his practice compares to his previous DSO associateships- Strategies for growing the practice- Strategic lending to finance the practice- How increasing his infant and toddler new patients accelerated growth and value

Dr. Marc Adelberg is a pediatric dentist and faculty member at the Workman School of Dental Medicine at High Point in North Carolina. He practiced for 25 years in New York and grew a six-location practice before exiting via a sale to his partners. He shares his extensive experience in private practice, the challenges of scaling a dental enterprise, and his transition into academia. We explore topics like practice growth, team building, and the future of pediatric dentistry.Topics Discussed:Private practice startup and growthChallenges of scaling a dental enterpriseImportance of mission and core values in practiceRole of residency programs and education in dentistryImpact of insurance and Medicaid on practice managementTransition from private practice to academiaTeam building and leadership in dentistry

Dr. Aruna Rao is a pediatric dentist, practice owner, and president elect of the Minnesota Dental Association. She also teaches one day a month at the University of Minnesota, where she helps run the clinic for dental students during their pediatric rotation. Dr. Rao comes on the podcast to talk about why it's critically important for private practice dentists to adjunct at their local schools so that we can train the next generation of dentists. Many programs are lacking in having faculty members who can provider real-world experience. We even joke about how many GPs can do molar endo, but don't feel comfortable placing a stainless steel crown. Dr. Rao can be reached at [email protected]

Dr. Todd Gray is a pediatric dentist and the Chief Dental Officer at Dentaquest. Dentaquest is the largest Medicaid managed care provider in the country, and is responsible for delivering Medicaid dental services to millions of children in the United States. Dr. Gray spent 15 years in private practice as a pediatric dentist in the state of Nevada before making a career shift and working his way up in the world of dental insurance and Medicaid. We met at AAPD in Las Vegas and immediately decided that we had to do a podcast together. I was so excited to have Dr. Gray on since he has the unique perspective of being both a practicing pediatric dentist, but also knows the inner-workings of how Medicaid is administered. We have a great discussion where he busts common Medicaid misconceptions, along with sharing what he's learned about how Medicaid plans work.The goal of our conversation was to change the narrative of Medicaid being a big faceless monster, and to give providers tips on how to make Medicaid work in their office. Dr. Gray is also the co-founder of Smiyl, a dental supply company that gives crazy good deals on prophy supplies to pediatric dentists. I want listeners to support our fellow pediatric dentists, so please check them out at www.smiyl.com. You can use code Smiyl20 to get 20% of your next order of prophy supplies.

After several weeks of compiling the data, the numbers are in! This episode finally sheds light on what real-life numbers you can expect for a pediatric dental start-up. I asked listeners the following questions:1. What is the demographic of your practice?2. How much did you produce/collect your first few years of practice ownership?3. When did you break even?4. When did you start paying yourself?5. How long did you associate?I had TONS of responses, but I picked the best 15 and read them anonymously for this episode. Hopefully this provides some insight and is a helpful resource for those in the early stages of practice ownership.

Dr. Gerardo Martinez is a returning guest on the show. We met up at AAPD and decided to record a podcast after flying home. We begin the conversation around changes in behavior management, and why it's ok for kids to cry at the dentist. The key is parent expectation and good communication.Dr. Martinez is also a visionary and advocate for 3D printing in pediatric dentistry. He has spent the last 5 years learning to incorporate scanning and 3D printing crowns, veneers, aligners, and appliances into his pediatric practice. We talk about first steps a practitioner can take to get started. Dr. Martinez is also hosting a CE event in Los Cabos from July 23-26. "The One Summit" has 28 CE credits with a central theme of airway, ortho, and 3D workflows. This would be a great way to get some CE this summer along with time on the beach. Even though it's a bit last minute, you can use code BTT to get $500 off registration and lodging.

Dr. Milca Ceballos is a pediatric dentist and owner of her start-up, Pawsitive Pediatric Dentistry. Her office is in rural Pennsylvania where she has experienced explosive growth, to the point of already trying to bring on an associate while she continues to expand her tongue-tie practice. This episode focuses on how she built her office for success. We discuss:- Who she hired to do a demographic report- Why she decided to use a consultant, and why is was valuable to her- Setting goals and blowing past estimates- The importance of a good team- How a consultant allowed her to increase her lending limits- Why she chose to purchase a CO2 laser- Her vision for creating a 2 doctor practice

Dr. Gerry Samson is a dual-trained pediatric/ortho legend and founder of Gnathos, a continuing education platform teaching pediatric dentists valuable orthodontic skills. He practiced for 40+ years and continues to lecture and teach at various institutions. His list of accolades is too extensive to list so just trust me on this... he knows a thing or two about occlusion and the growing dentition. I invited him to come on the podcast and talk about a controversial topic of his choice, so we settled on airway dentistry in pediatric patients. Some of the things we discuss:- Sleep disordered breathing- Should we be referring kids for tonsillectomies?- The value of a second opinion to limit liability- Communication tips for parents- Structuring relationship with pediatricians - Are we over-treating tongue and lip ties?