Why Your CPA Will Talk You Out of a Great Dental Practice

In this episode of the Shared Practices Podcast, Dr. Andrew Clingan reveals why relying strictly on a CPA and a Profit & Loss (P&L) statement can cause you to miss out on highly lucrative dental ownership opportunities. CPAs are hired to analyze backward-looking data, which means a fundamentally bad practice and a great practice being run poorly will often look identical on paper.Andrew shares his personal story of acquiring a "ready-to-grow" clinic that over ten other dentists passed on - a clinic he successfully doubled in its first year and scaled to $2 million in revenue. If you want to learn how to scale a dental practice, you must look beyond the traditional P&L and evaluate forward-thinking clinical metrics.Here are the core dental business growth strategies you need to evaluate your next acquisition:Calculate True Active Patients: Practice management software often inaccurately inflates active patient counts. Estimate the real number by looking at the previous year's periodic and comprehensive exams.Evaluate Hygiene Capacity: A standard hygiene day should support roughly 200 active patients. If the practice has 1,600 active patients but only runs 1.5 hygiene days, there is massive immediate growth potential.Analyze the Hygiene Percentage: If hygiene accounts for nearly 30% of total production, the current seller is likely under-diagnosing restorative care, leaving significant unscheduled treatment for a new owner.Review Fee Schedules: Many retiring doctors have outdated fee schedules. Properly negotiating and optimizing your PPO fees can add six figures to your top line in year one without doing any extra dentistry.Don't Touch Staff Pay Immediately: When transitioning into dental ownership, changing compensation right away will ruin your dental business hiring practices and culture. Focus on growing top-line revenue before adjusting inherited overhead.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, utilizing everything from advanced data analytics to AI in dental practice management to help dentists buy, grow, and optimize profitable practices. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

In this episode of Ask George, Dr. George Hariri tackles the most common myth in dentistry: the belief that an endless stream of new patients will magically solve your growth problems. While marketing companies will gladly sell you on the promise of fresh leads, George explains why throwing cash at loss-leader marketing is often the quickest way to ruin your dental practice profitability.If you want to achieve true sustainable growth, you must stop undervaluing the patients who already know and trust you. A highly effective ownership strategy prioritizes retention before acquisition.Here is why you should focus on your existing patient base first:Avoid Loss-Leader Marketing: Offering steep discounts (e.g., $89 new patient specials) attracts bargain-hunters who have no intention of accepting comprehensive treatment, severely damaging your dental practice profitability.The Value Gap: In George's practice, an existing patient on a recare exam accepts an average of $200 in treatment, whereas a low-quality, cost-driven new patient only accepts about $90.Understand Your Baseline Flow: Before you spend money on marketing, track how many new patients find you organically each month (e.g., via location or referrals) so you only pay marketing companies for the extra patients they bring in.Raise Your Floor: Existing patients are the predictable, stable foundation of your practice. Reactivating overdue patients costs nothing but your team's time and ensures you cover your fixed monthly expenses before relying on unpredictable new patients to hit your financial goals.Track Reappointment Rates: Your existing patient reappointment rate should be 90% or higher, ensuring that at least 70% of your total patient base is current on their six-month recare to sustain long-term dental practice profitability.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, or click "Free Practice Assessment" to let our team objectively identify the specific bottleneck holding your practice back. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

In this episode of the Shared Practices Podcast, coach Caitlin Embree sits down with her long-time client, Dr. Katelyn Miller, to unpack a remarkable dental practice ownership success story. Opening a startup in December 2019 right before a global pandemic is no easy feat, but Dr. Miller scaled her practice from just two employees to a 12-person team generating $2 million in annual collections with over 3,200 active patients.The key to her rapid growth in dental practice ownership was a crystal-clear vision: she never wanted to remain a solo clinician. By maintaining a 90%+ hygiene reappointment rate and intentionally hiring an associate, Dr. Peiffer, Dr. Miller was able to reduce her clinical schedule to just three days a week while the business continued to thrive.Here is how to evolve your dental practice ownership strategy as you reach maximum facility capacity:Communicate the Vision: Tell your early hires exactly where the practice is heading so they expect change, embrace growth, and buy into the long-term goal.Empower Your Associate: Schedule overlap days to handle administrative tasks and team mentorship, but give your associate days where they are the sole doctor so they can build autonomy and team trust.Protect Your Boundaries: True freedom in ownership means empowering your team to operate without you; stop answering non-emergency texts after hours and commit to taking your scheduled days completely off.Drop the PPOs: When you completely run out of physical chairs and provider time, the best way to grow is to tactfully drop in-network insurance plans to increase your production per procedure and selectively retain patients who value your care.Leverage EFDAs: Utilize Expanded Function Dental Auxiliaries (EFDAs) to place fillings, drastically increasing your daily patient capacity while freeing up the doctors for higher-value procedures like implants, cosmetics, and Invisalign.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

In this vulnerable episode of Ask George, Dr. George Hariri pulls back the curtain on the lonely, difficult realities of dental practice ownership that most doctors refuse to discuss publicly. Despite years of rigorous preparation, George found himself battling severe imposter syndrome on day one as a 25-year-old boss managing staff 30 years his senior. He openly shares his turbulent dental practice ownership journey—from hitting early financial milestones to a devastating nine-month "rock bottom" where he worked four days a week with a 100% overhead, taking home zero personal income.If you are currently struggling to achieve sustainable dental practice growth and feeling completely isolated in your dental practice management, this episode is proof that you are not alone.Here is your guide to avoiding the hidden traps of early dental practice ownership:Beware the Honeymoon Phase: Early clinical success often comes from diagnosing the untreated needs of a legacy patient base. Once those existing treatment plans are completed, your production will crash unless you have intentionally reinvested in new patient marketing as a core part of your dental business strategies.Identify Your True Bottleneck: Stop throwing money at random ideas. George was losing money because he was paying for a bloated, multi-doctor team while only serving a solo-doctor patient base. Identifying patient flow as his primary constraint was the only way to right the ship.Profit Requires Intention: Scaling your collections will not automatically fix your dental practice profitability. Generating true profit requires intentional cost control, especially when fighting against modern inflation and stagnant insurance reimbursements.Do Not Isolate Yourself: The isolating struggles of the "messy middle" are incredibly common among growth-minded dentists. Plugging into a community of peers and utilizing objective coaching will drastically shorten your learning curve.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, or click "Free Practice Assessment" to let our team objectively identify the specific bottleneck holding your practice back. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

In this episode of the Shared Practices Podcast, Dr. Andrew Clingan sits down with Steve Steinbrunner from Provide, Inc. to map out the financial realities of dental practice acquisitions and long-term dental practice ownership. Understanding exactly how a bank evaluates your risk profile is a critical piece of dental practice management, whether you are buying your first clinic or investing in a multi-doctor commercial real estate project.Master Your Initial FinancingDo not aggressively pay down your student loans at the expense of your personal savings.Banks care significantly more about your liquidity—your cash on hand minus any revolving credit card debt—than your total student loan balance when funding dental practice acquisitions.General dentists should aim for at least six months of associate experience to prove clinical production capability, though specialists can often secure funding immediately out of residency.Include consulting or advisory fees in your initial loan request. Banks view professional business coaching as a core part of your dental business strategies that reduces risk, and they will gladly finance it.Leverage "Ready to Grow" ClinicsIf a target practice is underperforming and lacks traditional cash flow, ask your lender about a jumpstart loan to drive sustainable dental practice growth.These unique loans treat the acquisition like a slow-growth startup, potentially offering up to $500,000 for the purchase alongside additional working capital and interest-only periods to boost early dental practice profitability.Scale with Commercial Real EstateNever prioritize owning the real estate over the health and location of the actual business during early dental practice acquisitions.Once your practice is established, you can leverage the equity built up in the business to secure 100% financing for commercial real estate or ground-up construction without needing a massive cash down payment.Navigating the complexities of dental practice ownership requires a specialized team. Surround yourself with dental-specific lenders, attorneys, CPAs, and advisors to ensure you make objective, data-driven decisions at every stage of your career.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.Disclaimer: Provide, Inc. is a wholly owned subsidiary of Fifth Third Bank, National Association. All opinions expressed by the Provide employee participant are solely their current opinions and do not reflect the opinions of Provide, its affiliates, or Fifth Third Bank. The Provide employee participant’s opinions are based on information they consider reliable, but neither Provide, its affiliates nor Fifth Third Bank warrants their completeness or accuracy, and they should not be relied upon as such. This content is for informational purposes and does not constitute the rendering of legal, accounting, tax, or investment advice, or other professional services by Provide or any of its affiliates. Please consult with appropriate professionals regarding your individual circumstances. All lending is subject to review and approval. https://www.getprovide.com/Are you currently focused on building liquidity for your first acquisition, or are you exploring real estate expansion for an existing practice?

In this episode of the Shared Practices Podcast, Dr. George Hariri interviews Dr. Paul Etchison, founder of Dental Practice Heroes, to uncover the secrets of elite dental practice ownership. Dr. Paul shares his incredible journey of growing a 2012 startup into a highly efficient dental practice, hitting $3.34 million in revenue out of just five operatories by 2017. He achieved this by mastering schedule efficiency and identifying the ultimate rate-limiting step in his dental practice: himself.As your dental practice scales, relying purely on clinical hustle becomes a liability. Dr. Paul explains how dropping down to three clinical days a week allowed him to step into the CEO role, eventually expanding his dental practice to 11 operatories and building a business that thrives while he only sees patients two days a month.Here are the crucial strategies to optimize your dental practice ownership journey:Implement Split-Shifting: Maximize ROI and lower fixed costs by keeping your dental practice open 13 hours a day with staggered provider shifts.Prioritize Proactive Leadership: Effective dental practice management requires freeing your office manager from reactive daily fires so they have the time to proactively solve team issues before they escalate.Use the CVI Method: Address dental practice team friction by getting Curious about the problem, offering Validation for their perspective, and extending an Invitation to collaborate on solutions.Don’t Fear Turnover: Never let toxic attitudes run your dental practice; confidently let go of legacy staff who refuse to align with your core values.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

In this solo episode of the Shared Practices Podcast, Dr. Andrew Clingan reflects on his three-year anniversary of practice ownership to share exactly what he wishes he knew during his first 90 days. For any dentist stepping into ownership, mastering the fundamentals of dental practice management is far more critical than chasing the latest trends. Andrew warns against the “shiny object syndrome” of immediately investing in 3D printers, mills, or aggressive marketing schemes before securing the foundations of a healthy practice.Sustainable growth in dental practice management comes from doing the predictable, repeatable things right every single day.Here is your playbook for surviving your first year of practice ownership:Play the Long Game: Do not let the pressure of your new practice loan force you into a scarcity mindset. Leave breathing room in your schedule during the first six months so you can focus on building relationships and becoming that patient base’s new trusted dentist.Fix the Leaky Bucket First: Before trying to add new patients, leverage your existing base. Focus on closing the “back door” by drastically improving your reappointment rate, which is the most reliable way to boost your dental practice profitability.Master the Basics Before Specialty: Get highly efficient at everyday quadrant restorative dentistry and patient communication before attempting complex specialty procedures. You cannot successfully sell a high-dollar case if you lack the communication skills to properly educate the patient.Live Like an Associate: While it is tempting to upgrade your lifestyle after closing on your first practice, start conservatively. Live below your means and build up your cash reserves; having liquidity provides you with the flexibility to eventually invest in new CE, equipment, or associate doctors.Move Slowly With Leadership: The hardest skill to master in dental practice management is leading your team. Do not make massive changes immediately. Take time to observe your staff, identify the top performers, and build leaders who will row the boat with you.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

In this episode of Ask George, Dr. George Hariri tackles one of the most common questions from listeners: Is coaching right for me? If you are an ambitious dentist trying to master dental practice management alone, you are likely hitting a severe bottleneck. George breaks down the fatal flaw of the DIY mentality: an owner typically has only four hours a week to manage the business, while their team clocks in 240 labor hours executing operations. Without a data-driven strategy to focus those four hours on the highest-leverage constraints, owners end up wasting time chasing random ideas they saw on Facebook.Shared Practices coaching bridges this gap by combining strategic analytics for the owner with tactical, hands-on training for the team. The result? A proven track record of growing client practices by an average of 37% to 39% annually for four consecutive years.Here is your guide to evaluating if dental practice management coaching is the right investment for your sustainable dental practice growth:The Early Ownership Fast-Track: If you are in your first 18 months of ownership, a coach is the ultimate cheat code to quickly scale a "ready to grow" practice and avoid the costly trial-and-error phase.Fix Stalled Growth: If your revenue has flatlined for the past two to three years despite your best efforts, you are no longer focusing your management time on the correct bottlenecks.Solve Team Inefficiencies: When you feel burnt out because you are doing everything while your team underperforms, a coach steps in to directly train your staff on crucial systems like revenue cycle management and case presentation.Calculate the ROI: Coaching is an investment, not an expense. Adding just $50,000 in top-line revenue covers the annual coaching fee and the cost of additional supplies, meaning the explosive growth you achieve by months 9–12 is pure profit.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

In this episode of the Shared Practices, host Caitlin Embree sits down with Dr. Aditi Agarwal, co-founder of Practice by Numbers, to discuss how analytics can completely transform your dental practice management. Dr. Agarwal shares how she evolved from pouring over confusing spreadsheets to creating an all-in-one dashboard that allows dentists to instantly diagnose bottlenecks, monitor team performance, and maximize their dental practice profitability.Relying on "gut feelings" is a dangerous way to run a business. Effective In this episode of the Shared Practices Podcast, host Caitlin Embree sits down with Dr. Aditi Agarwal, co-founder of Practice by Numbers, to discuss how analytics can completely transform your dental practice management. Dr. Agarwal shares how she evolved from pouring over confusing spreadsheets to creating an all-in-one dashboard that allows dentists to instantly diagnose bottlenecks, monitor team performance, and maximize their dental practice profitability.Relying on "gut feelings" is a dangerous way to run a business. Effective dental practice management requires a fact-based approach that empowers your team with clear, actionable metrics rather than overwhelming them with unnecessary data.Here is your guide to using KPIs to drive sustainable dental practice growth:Track the Pre-Appointment Rate: The most holistic indicator of practice health is the percentage of active patients who have a future appointment. Aim for an 80% pre-appointment rate to ensure your retention, scheduling, and case presentation systems are actually working.Balance Your Production: A healthy hygiene department should account for 30% to 35% of your total practice production. If hygiene exceeds that threshold, it reveals a severe breakdown in your doctor-driven restorative diagnosis or case acceptance.Analyze Treatment Rejections: When a patient declines treatment, your team must track the specific reason (e.g., finances, fear, timing). Reviewing this data allows you to tailor your case presentation and better train your financial coordinators to overcome common objections.Master Insurance Metrics: Do not drop a PPO plan based on a single low reimbursement code. Use your insurance dashboards to analyze the overall profitability of each plan and identify patterns in claim denials to drastically reduce your reimbursement cycle.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.requires a fact-based approach that empowers your team with clear, actionable metrics rather than overwhelming them with unnecessary data.

In this episode of Ask George, Dr. George Hariri addresses a critical issue facing the industry: selling your practice early simply because you are tired. While the administrative and HR burdens of modern dental practice ownership drive many doctors to sell to DSOs, doing so prematurely cuts off your greatest wealth-building vehicle. George explains that burnout is not just a qualitative issue—it is a massive quantitative financial threat because the highest return on your investment in dental school comes from operating your cash-flowing practice for the longest possible time.If you are feeling overwhelmed in your current stage of dental practice ownership, you haven't failed—you simply haven't "nailed" the systems required for that level of success yet. By proactively identifying and solving the specific bottlenecks causing your exhaustion, you can secure your equity, reclaim your time, and maximize your income.Here is your guide to extending your career and maximizing the financial return of dental practice ownership:Audit Your Exhaustion: Track exactly what drains your energy over a two-week period, whether it is a specific type of demanding patient, a stressful clinical procedure like surgical extractions, or daily HR headaches.Delegate HR Burdens: If managing staff causes you severe stress, hire an office manager to handle schedule requests and team accountability. The cost of their salary is a small price to pay for the longevity it brings to your career.Design a Sustainable Schedule: Restructure your clinical days to prioritize rest, such as working an alternating three-day week that allows for a six-day weekend every two weeks without dropping your operational hours.Find Outside Outlets: Once your practice stabilizes and no longer needs aggressive growth, channel your entrepreneurial ambition into hobbies or fitness rather than constantly disrupting your business.Protect the Cash Cow: While outside investments like real estate are important, never fund them so aggressively that it ruins your personal lifestyle and causes you to burn out of dentistry.Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.