"David vs. Goliath" - How Small Dental Practices Can Compete with DSOs (feat. Dr. Charles Moser)

In Episode 21 of "The Dental Domination Podcast," host Dan Brian interviews Dr. Charles Moser, executive coach and founder of the Dental Science Alliance, on how younger dentists can compete with larger dental service organizations (DSOs) and build successful private practices. They discuss the challenges that new dentists face, including lack of business training and increasing student debt. In a wide-ranging conversation, Dr. Moser emphasizes the importance of leadership, accountability, and systems in running a successful practice. He also introduces the Dental Science Alliance, a coaching platform that provides one-on-one coaching and support for dental teams. For more information, check out the show notes. 

Transcript

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Alright, alright, alright. Welcome back to the dental domination podcast. My name is Dan Brian I'm the co -founder of DentalScapes scapes You already know that if you've listened to the show before and I'm not gonna bore you with the whole spiel about my company Because that is not what I want to talk about today today. I'm really excited to dig in with a special guest of mine. Dr. Charles Moser We're gonna spend some time talking about something that's really near and dear to my heart, which is How can we give? younger dentists, those who are maybe considering private practice of their own, how can we give them a leg up in terms of competing with, you know, some of the big boys out there as DSOs move into the space and really begin to dominate? It's going to take a special kind of leader, a special kind of dentist to really take that on and continue to build thriving private practices. And so I'm so excited to have you here, Dr. Moser. Thank you so much for taking the time today. By word of introduction, just a few notes here and then I'm gonna kick it over to you to talk a little bit more about yourself. But Dr. Moser is educated as a dentist, so be careful. He knows what to do with sharp things in his hands. He's also an executive coach though and a consultant to dentists and dental teams and is the founder of Blue Horse Personal Development. Leadership and coaching and also founder and partner of a really cool organization I want to talk about at the end called dental science alliance or DSA. So without further ado, no one likes listening to me talk. They come here for the guests. So Dr. Moser, what can you tell us about yourself and how you got started in this this journey? Well, yeah, it was the quintessential making lemonade out of lemons. I was a private practice dentist for 16 years, the only thing I ever wanted to do in my life. And injured my hand at three locations. This was kind of before I knew the group practice situation. I might've done things a little differently, but sold my practices, went to work for a DSO. helped them grow to almost 100 locations, went through a couple of exits. Private equity, we were the first ones to bring in private equity in 2009 and was involved with the dental entrepreneur organization for almost five years. And so yeah, it just ended up what I kind of, you know, I built a path to take me here as they say. And so here I am as an executive business coach. Leadership is my passion. And now I think what we're trying to do, similar to what you just mentioned, is make sure that the private practice clinician has a level playing field and a place where they can go and a place where they can get the information that they need so that they can do the thing that they love and want to dental school to do. And that is fix teeth and treat patients. Yeah, and I want to be clear real quick because I I feel a little bit bad especially as I've heard all of your Awesome accolades here in your experience. I am NOT anti DSO. By the way, I just have a real I have a real soft spot in my heart for the little guys and gals and so I'm just very excited to talk with you today, but you you obviously have been there, done that, you know what you're talking about and obviously come recommended by a mutual friend of mine, Janet Hagerman. She was on the show previously. So I'm really excited to dig into it, Dr. Moser, but to that end, let's kind of dig in here. So as you see the landscape right now, what are some of the biggest challenges that younger or even maybe older dentists who got started a little bit later, what are some of the challenges that new dentists will call them? are facing right now as they enter the profession. Yeah, so starting from the 30 ,000 foot view, nothing has really changed in the training of dentists, right? I mean, if you kind of look at when I graduated, which was we were still peddling in order to make handpieces go round and round back in those days. Nothing has really changed from the standpoint that we are still educating clinicians. We are not educating business people. That has not changed. let alone later. changed, right? I mean, some of the techniques and things like that, that has all changed. But the clinician is still graduating, not knowing the darn thing about marketing, about HR, about running a small business, about leadership, about softwares, insurances. None of that has changed. So. Right, well, and don't worry, they're not going to. They are not going to. What has changed is that when I graduated from dental school, I had less than $10 ,000 in debt. I had a partner that was making pretty good money. And so we could live on one income for the first five years of my practice and not have to worry about me making a dime. The other thing that has we had a guy in the podcast a few episodes back and he works with, he's a financial planner who works with younger dentists and he said his average, average client now is right around 300K. And so if a clinician coming out of school or buys a practice like I did two years out of out of school, you A, you can't wait before you start making money and B, you cannot make a mistake that God forbid is going to cost you thousands of dollars by selecting someone other than dental scape to do their marketing or selecting someone other than Blue Horse Personal Development. to teach your team leadership, you cannot go backwards. that's what I think has really changed is the risk of being in practice right now because of the financial debt and the emotional debt that you're putting into this. That's what has changed. And then throw on top of that the competition for the new patient, you know, right now as well. ask you about competition. what's, you know, what would you say? What would you, if you were going to engage in some real straight talks, real straight talk with someone coming out of dental school today and they say, you know, I'm hell bent on starting my own practice and, know, doing the way, you know, my dad or my mother did, or, or whatever it might be, what would you say to them about the competition that may be different than it was just a decade or two ago? Yeah, so I would say that it's not. It's not different than, I mean, you know, again, there's a lot of people out there that are right now are just going, that's an old guy talking. what the competition has always been for the dollar, not for a dentist, right? We've always been competing for the discretionary spend because dentistry is a discretionary spend, frankly. Most of it does not hurt. Most of it is not an emergency. So when you talk about spending $1 ,000 for a crown versus $1 for a new iPhone, it's pretty simple what people are going to do unless dentists can attach value, real value to what we're providing for our patients. So I don't think clinicians are the competition for clinicians. Okay. Don't think that dentistry is a get -rich -quick scheme. It is a get -rich -slow scheme. Do you see any difference though in dentists coming out of school now maybe hanging their shingle and starting out on their own having to deal right away with let's just call it what it is practically limitless budgets of some of these DSOs that they have to throw up advertising on Google and all of that. Has that altered the game at all or is that just you know. So the game has changed and so let's be clear. Let's use the David and Goliath analogy here, okay? Because if you know the story of David and Goliath, it automatically puts in your mind that David is the underdog. But the reality of it is that that's not the case. That's not really, if you look at the story, Goliath was, actually had a lot of flaws, okay? Yeah. was so big that he was immobile. Goliath was so big that in order to turn, it took multiple people to help him turn. the DSOs, while again, I am absolutely not anti -consolidation, I really think that there is a place for this. I just think that the strategy has changed from David's perspective. from what you think is an underdog perspective. But the reality of it is David is agile. David doesn't have to run ideas through corporate to make a change. David makes decisions very, very quickly and can pivot very, quickly. So I think you have to really understand where your strengths are so that you can be strategic about how you play the game with David. Yeah. Yeah. Well, I know, you know, your company and your coaching programs, you know, emphasize three really important components of a practice and that's trust, accountability and systems. I've heard you talk about that and I think it's, it's spot on. but let's again, kind of zoom out here and look at a new graduate from dental school. So you have someone coming out. What are the qualities in a leader within a practice that you would say are most critical? in determining their success. So number one is time. Great leaders understand that knowing how to stay on time, work on time, show up on time, be on time, their relationship with time is the number one thing. If you show up late to your office, I don't care. I know you write the check, I get it, and because of that you think you get to be treated differently. I mean, you get what you give in this life. And so if you want people to show up on time, you better be on time. I mean, you have to learn how to. Yeah, it sure does. And so it's really difficult to look at somebody and say, hey, you're late when you are constantly five, 10, seven minutes late. I don't care. There's a great expression that we've all heard, and that is I'd rather be an hour early, an hour early than a minute late. Been a minute late. Yeah. mean, and just look, that's it right there because ultimately you cannot hold people accountable for things that you will not be accountable for yourself. And it doesn't matter if you write the check. It just doesn't matter. That's number one. Yeah, I want to kind of build on that real quick and then I want to get into some other traits. But you know, speaking of leadership by example, what do you think as far as what a dentist owner ought to know about the operations of their practice? Because obviously they're going to be hiring staff to specialize in one area or another. That's why they went to dental school and. DA didn't and you know front desk staffer didn't but at the same time Leading by example means what to you in terms of you know a dentist knowing the the true operations of the practice Is there any any you know insight that you can give us there? Yeah, Dan, that's a, so nobody's asked me that question before. And actually that's a great question. Yeah, no that, yeah, nobody's asked me that before. It's really a good question because I think we've already talked about things that really haven't changed in dentistry, but this has changed. And that is, is again, in 1990, 1980, 1970, a dentist really could have a pretty solid grasp on everything that went on in there. I don't think you can do that nowadays. There's no way a dentist can play HR executive, marketing executive, procurement executive, software executive. You just can't know it all anymore. And I think that that might be, I think you've really hit on something here. That might be the biggest difference in 2020, 2024 in today's practice of dentistry. the younger clinician is going to have to go out and get some help, a coach, a consultant, a mentor, something. They're going to have to trust somebody to say, you're gonna have to take some of this off of my plate, train these people. Now, I'm gonna learn how to be a leader and hold them accountable to certain KPIs, certain metrics, certain milestones, but you can't train everybody now. You can't. You can't know everything about your practice anymore. I think that's really a huge difference. Yeah, yeah, that's really interesting. Now you mentioned accountability. So we talked about leading by example and showing up on time and holding yourself to the same standard as that of your staff. To that point though, what are some strategies that you talk about and focus on when you look at accountability within the dental team and what can a true leader do to instill that culture in the practice? Yeah, so first let's clarify some language. The words responsibility and accountability oftentimes get used interchangeably. And if they are in your practice, then it can create some problems. I really don't care how you define them, but just when clients work with me, I'll get their team on a call and say, look, we are responsible for tasks. We are accountable. to people or to teams of people. So think about that from a standpoint of your administrative team who is responsible for collections. They're responsible for scheduling production. They're responsible for collections, but they are accountable to the practice, if you will, for doing those tasks. So when it comes to meeting with somebody, the leader doesn't have to know how to collect money. They don't have to know the ins and out of insurance reimbursement or how to file a claim or to renew a claim or to fight a claim. They don't have to know that. What they have to know is what are the KPIs that the person doing that job has to be held accountable for doing. So the leader has to at least know, hey, we have to collect 93 % of everything that is collectible. full. That's after you take discounts and things like that away from certain insurance plans. But we have to be collecting at least 93%, hopefully 95, 98 if you're awesome. Right? So the leader has to at least say to the person who's in charge of that responsibility, here are the three KPIs that I'm going to need you to report every week in our leadership meeting. And as long as these are going well, then I trust that your department is going well. Yeah, I like that. and responsibility. And so if a great leader, if a good leader can at least know what the top three KPIs are, or milestones or metrics, whatever you want to look at, what are the three things in each department that will determine if the department is running properly? Then all you have to do is have those reported on. And then if they're not, if those metrics aren't being hit, then a conversation ensues about. Have we changed the system? Have we moved away from the system? What do we need to do to get those numbers or those baselines back into the proper relationship so that we're running smoothly again? about the difference between responsibility and accountability and I think that's absolutely spot on. It does raise the question to me of delegation. Where do you see that kind of fitting in within this leadership structure within the practice? How can you know you already said and I agree with you completely. The dentist can can no longer do it all. It's just it's practically impossible and you do need to build a team of advisors or mentors around you or coaches or whomever it may be to help you navigate that. But when it comes to putting the responsibilities into practice and then also reinforcing the accountability that you talked about, how does delegation work and what would you advise dentists who may be hesitant to give up some control or or that sort of thing? How does that play into all of this? Yeah, first of all, I don't find any dentist hesitant to give up control of a lot of things, frankly. I they think they're control freaks, but none of them are doing their own collections. None of them are scheduling their own patients. I mean, none of them are verifying patients for tomorrow, you know. So all you control freaks out there. out there, but I don't think that means they want to be filing claims. I think you're right about that. right. So this is where I think the DSO world has really helped us out in making us understand that an org chart, a simple, basic organizational chart is important even for someone who has one practice. You need to know the five basic departments in your practice. There's essentially five, six basic departments in your practice. And you need to have a name for those HR, marketing, accounting, collections, production, blah, blah. You need to have a basic understanding of what those five, six departments are. And then you need to have an understanding of what job duties and expectations go into each of those boxes. And then it's a matter of assigning names to the box. No more than one name to a box. If you have two quarterbacks, you have no quarterbacks. Okay. So only one name per box, and then that box has three to five KPIs or metrics or milestones, whatever you want to call it, associated with it. So that's why I think, like I said, the DSO world consolidation has done us a favor by making us understand that I don't care if you're one practice or a hundred practices, it gets more complicated. But nevertheless, having an org chart answers your question, making sure that you understand one of the major departments that we have. What are the roles, responsibilities, expectations, and KPIs for each one of those departments? And which name goes into the box? And that way, when Dan leaves me because he's outgrown his position as a solo practitioner's office manager, and I hire somebody else, I now get to say to that new person, here's your job description, here's what you're responsible for, we'll find a way to train you on these things, and you really don't go crazy. It's not like this big total. know, chaos ensues, right? you just teed me up for the next topic I wanted to dig into. Real quick, you said, you know, being able to hand off the playbook, so to speak, to the next person in that role, critical, mission critical. I'm all about SOPs and transition processes. So you're preaching to the choir here, but you just sort of hit on the next pillar that I wanted to get into, which is systems. Talk to me and our listeners if you don't mind about the importance of systems in the modern practice. Yeah, just had this conversation today. And by the way, I will give anybody any resource that I have. I have a systems playbook and I have a systems checklist. They are robust. They're not just little tiny one pagers. Okay. They are 25 pages. Yeah. I mean, I'm happy to give them away because frankly, you can't do anything with them. You can read them. You know, I can give you everything, right? And you really can't do much with it. other than read it and get a basic understanding of it. But that's where it all starts. So systems, okay. Step number one, your team has to recognize and be told over and over and over again by the leader that it's okay for things to break if they follow the system that caused them to break. I cannot have Dan going rogue and not getting the result because then I don't know what Dan did. But if Dan uses the system and doesn't get the result we want, then we know it's a systems problem and we can fix the system. Okay? So your team needs to understand, follow the system. Well, doctor, our system is like two things. Fine. Just follow the system and then let's keep improving upon the system. Every week we'll add something to it. Every week we'll add something to it. But if you continue to go rogue on the system that we have and we don't get the outcomes we want, don't know. You know, all I have to do then is say, well, you're screwing up. and it's easier to fix systems than it is people. Okay, so that's, and they have to understand that it's okay to get the improper outcome as long as they're using the system. You have to empower them with that, okay? So there's three reasons that people don't follow systems. It's really simple. Either they're bad people, okay? I bad people don't follow systems. And what we do with bad people is we tell them, Dan, hey man, we're gonna be friends. We're just not gonna be coworkers anymore, okay? So that's what we do with bad people. The other reason people don't follow the systems is because they're not trained properly on them. So what do they do? They revert back to the system that they knew best, which was the system that they were using at their other office, which was the system that the boss there couldn't get them to use, right? Which is kind of ironic, right? But now they're using the system from their last job. And then the third reason that people don't follow the systems, because they don't buy into the system. being better for them from an efficiency standpoint or better for their patient, client or customer. Because if I gave you a system and said to you, Dan, here's a way where you can get 100 new patients every month and you only have to spend 30 minutes a day doing A, B and C, why would you not do that? I mean, of course you would do that, right? So. the first two, the response to the first two, certainly the first one. The third one, the lack of buy -in or acceptance of the system, how do you tackle that problem? Yeah, so you're looking at your KPIs. It's the same thing. We're evaluating the result that we got and we didn't get the result that we wanted. So we turn to the person that's in that box and we say, what part of the result came from either, are you a lousy person? And they'll go, no, dude, I'm a great person. It's like, I've been working for you for eight years. Okay, so we put that one aside. Are you well -trained on this? Could you teach this to a new person coming in? Are you an expert at it? I'm not an expert at it. Okay, I need you to be an expert at it. So we're go over the training again too. And then the third one, Dan, and I need an honest opinion on this because I value your opinion. I mean, you're a leader in this organization. Is this system efficient and effective either for you or for our client, our customer or our patient? Is it the best system that we could be using to deliver the quality of care that we're trying to deliver? And I need an honest opinion on that, Dan. that's Dan comes to me and says, you know what, Dr. Moser, I really know. I think this system's pretty stupid, actually. It's like, I muse it to my ears. Because that means you have a better one in mind. Right? Yeah, I mean, or let's at least have the conversation. But that's how you go through that sequence. And that's why it ties back completely into the org chart. It ties back into roles, responsibilities, metrics, KPIs. Again, which I think has all been really hammered home by the consolidation, by the DSO world. I I think we owe them an enormous debt of gratitude for presenting that to us and making us aware that even in a private practice situation, it's still important in how to run a business. Yeah. Well, I want to kind of come full circle here as we're getting down to the end. But you had talked earlier about some of the traits, or at least one of the traits that dentists really need to be successful in this environment now. And that was leading by example and, you know, adhering to time and, you know, really understanding the message and the tone that you're communicating to your team. Just as we close on out here, your last thoughts on other traits that you would absolutely say are irreplaceable in a leader within the dental environment. Well, I would say that in conjunction with what we were just kind of talking about is vulnerability. Nobody knows everything. Nobody can know everything. And nobody wants to work for a know -it -all. I mean, people nowadays really want to be heard. I think that that's one of the things we're finding out with today's workforce. It's not a come in, work eight to five and leave, work for 30 hours, get the gold watch. People want to be heard. They want to be empowered. They want to be accountable. They want to do a good job. And I think a leader who is humble and vulnerable and uses that to their advantage to say, like I just said to you, Dan, I don't know everything. You tell me what you think about this system. And Dan has the opportunity to say, I think the system's lousy. And then the leader says, you know what? I mean, it is lousy because I'm a dentist and I wrote a system on HR and I don't know doodly about HR. So let's figure out how we're going to collaborate. Mm and how we're going to create an HR system that's efficient and effective. And so I think you've got the ability to lead by example, show up on time, and then the ability to be a little bit vulnerable and humble and say, I don't know everything and I really want to use my team to help me with things. You're on your way. You're off to the races being a great leader. Yeah, and vulnerability and humility are sort of, they're not exclusive by any means. And so they really work hand in hand. Well, I love what you said about that. Being humble and stupid is not good, right? I mean, just being, no, I mean, I'm serious. mean, people confuse vulnerability with being able to say, well, I'm a dumb idiot and I don't know everything. It's like, nah, don't go that far. mean, just, yeah, just say, hey, I mean, you're trained at what you're trained to do. And so you're vulnerable enough to recognize that you don't know what you don't know. I think that's important. There's a distinction. Good deal. Well, as we close on out here, Dr. Moser, you have just provided so many insights and I can't thank you enough. What can you tell folks about the new venture that you've started, the Dental Science Alliance, and what that's doing for new and emerging dentists who may be considering private practice or own their own practice already? What's it all about? And we'd love to hear how people can connect with you if they wanted to take it to the next level. Yeah, so it's www .dentalsciencealliance .com, just like it's spelled, it sounds. Again, I saw a big need to level the playing field for someone with one, two, five, 10 practices to compete with Goliath, if you will. And the one thing that all of my clients have always said is they want one -on -one coaching. And we created a platform where now your entire team, your office manager, your hygienist, your dental assistant, everyone on your team has access to, we have 20 expert coaches on our platform. And we coach in 30 minute increments. So your hygienist can get on a call with Janet Hagerman, who you mentioned earlier, who I refer to as the hygiene whisperer. And you can have a 30 minute call with Janet about how to schedule effectively. efficiently and create a profitable hygiene department. And the doctor, again, doesn't need to be on that call. The hygienist needs to be on that call and then they report the findings to the doctor in one of those amazing leadership meetings, right? So the Dental Science Alliance has 20 amazing coaches in just about every aspect of dentistry. It's $600 a month for the first 30 members we launched in September. Okay. people that want to get in touch with us can go to dental science alliance dot com, fill out a little information and it's it's going to be the next big thing in coaching communities. Yeah. And honestly, those first 30 spots, grab them while you can, because that sounds like a hell of a deal. Well, Dr. Moser, thank you so much. DentalScienceAlliance .com. I will be adding that in the show notes, as well as links to some of those resources that you talked about as well. What's the best way for folks to get in touch with you directly if they wanted to reach out? Charles at DentalScienceAlliance .com. How's that for pretty easy, right? Yeah. Sounds good. Well, Dr. Moser, thank you so much for stopping by today. If I have my way about it, I'd love to gently drag you back on at some point in the near future. really, really enjoyed this conversation and I appreciate you taking the time. Thank you so much. Awesome. Yeah. And thank you all for listening. Thank you so much for tuning in again to the Dental Domination Podcast. We are here just about every other week and really appreciate all of your five star reviews. Any comments that you have please go ahead and leave those on Apple podcasts or Spotify wherever you get your podcasts I appreciate it It is the best possible way that you can help us reach more dentists and help more people. So thank you so much Thank You. Dr. Moser and we'll see you back at it Alright, so what did you think? I thought that was good.