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#941: The Path to Multi-Practice Success

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เนื้อหาจัดทำโดย Kiera Dent เนื้อหาพอดแคสต์ทั้งหมด รวมถึงตอน กราฟิก และคำอธิบายพอดแคสต์ได้รับการอัปโหลดและจัดหาให้โดยตรงจาก Kiera Dent หรือพันธมิตรแพลตฟอร์มพอดแคสต์ของพวกเขา หากคุณเชื่อว่ามีบุคคลอื่นใช้งานที่มีลิขสิทธิ์ของคุณโดยไม่ได้รับอนุญาต คุณสามารถปฏิบัติตามขั้นตอนที่แสดงไว้ที่นี่ https://th.player.fm/legal

When it comes to owning and operating multiple dental practices, not everything runs the same. That’s a common surprise for those overseeing multiple practices. In this episode, Tiff and Britt discuss where practices often fall short in keeping things running smoothly across all offices, and how to set yourself up for success.

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Transcript:

The Dental A Team (00:01.134)

Hello, Dental A Team listeners. I am back today with, I've got a new nickname, brilliant brain Britt, triple B, brilliant brain Britt. I like it. I'm back here for some fun business talk today. are working hard, Britt and I, I hold her business brain for a few different podcasts today and we're working hard to make sure you guys that you've just got some really, really successful business tips and tools early on in the year.

Britt (00:09.18)

I'm going get some

The Dental A Team (00:28.014)

going to be all year long that you're getting business tips. Like always, we love the business side of dentistry because we really, really want your business to work for you, not you work for your business. So we work really hard with all of our clients and all of you listeners to make sure that you have the tips for success there. But today I've pulled Britt on a few different items. We just got done chatting some about really starting your 2025 off right, which was a little bit of a review of how to end Q4 and get prepped for 2025.

but I wanted you guys to have all of those goodies. So if you haven't listened to that yet, you don't have to do it before today. Listen to today, but they can go backwards and listen to that one as well. Today though, Britt, you have, this in your background. Like this is something that you've done. We've both had our hands in it, but you have like honestly and truly just managed multiple practices and really helped set them up for success. You've done transitions, like you've done it all. So I really wanted to bring you on today to pick your brain on some of the pieces that.

are super important and paramount in learning, maybe prior to would probably be, you know, helpful, but a lot of us are not in that situation. A lot of, a lot of doctors listening today already own multiple locations. And so really knowing what they can do and what they can learn and what they should be looking out for is kind of what I'm interested in today for multi-practices. Before we pop in though, how are you today? How is, how's Britt's beautiful brain doing?

Britt (01:53.724)

It's doing good today. It's it's not too early. Britt's brain super early is not always the best. I gotta have a little time to warm up with the day. That's that's how I work or late nights. That's that's my brain time really. So everybody works a little different, but I'm good. It's not too early. I get to sit here and chat with you about I don't know this kind of stuff is fun. Growth is fun. Different ideas are fun, so it's going to be a good time.

The Dental A Team (02:18.394)

I agree. I agree. And your brain just works like this, like numbers, the black and white of it all. Like I've given you kudos before, know, you do really well at seeing the gray too and working through the gray to find the black and white, which I think in business is incredibly, incredibly paramount to success. Working with people is not always the easiest thing in the world. I tell all of my doctors and my office managers that the hardest part about your job is going to be managing the people.

But you do really well with it because of that aspect. So I think it's really, really important to say that now because I think doctors listening and managers listening, whomever business owners are listening, that's a space for you to learn to utilize that black and white data, but to bring in that personal side and to bring in that emotional side without letting the emotions take over the results, I guess. so, Britt, that's something I really want to pick your brain on, but

From the tactical standpoint, what are a few things going into multi-practice ownership, or maybe they already own, right, but hopefully going into, what are some key pieces that they should really be prepped for, looking for, tracking, to know that they're on the path for success for both of them, and what should those look like? Should they be the same? What's the easiest way to go about this when you're taking on a new practice?

Britt (03:43.098)

Yeah, number one thing is have a practice, have your flagship running really well and strong systems in your flagship before you start taking on another one is the ideal way to do it, right? Learn how to manage what is one location before you start multiplying that stress or management of all the locations. And with multiples, it's a different mindset. And I think that's where

The Dental A Team (04:01.624)

I agree.

Britt (04:09.562)

We work with a lot of private practice and even multiples that are private practice and people that are like maybe even transitioning to DSO because it's one of those scenarios to where like the same thing doesn't work for everyone. So that's, do a lot with our practices that are custom and it's like, all right, where are we going? What are we doing? What's it going to look like? What's the feel you want behind it? And when you start, when you know that you want to potentially even go multiples and you're starting with one location, I want you to put like the multiple brain on.

The Dental A Team (04:21.478)

Yeah.

Britt (04:38.192)

We don't have them yet, but we want to start building things to where there are systems that can easily be transitioned into multiples. What I mean by that is, yes, there are going to be some steady things that are like, great, the way we do AR and send statements is going to be the same way we send statements all across all locations. The way we budget for supplies is going to be the same way we budget for supplies across all locations. But make sure you're keeping things really clean bookwise and especially at

The Dental A Team (04:45.956)

Yeah.

The Dental A Team (05:07.051)

Mm-hmm.

Britt (05:07.356)

when you start getting into multiples and thinking bigger. So for example, let's say, great, now we've got a couple locations, great, we can share resources. shoot, we ran out of something. Great, go grab some from the other location. You wanna track all those things and pay it from the appropriate business so that each business independently is going to look like the reality and the numbers will be the reality and it's not getting mucked up by the other.

And so you actually know how to, one, drive each individual practice, and then two, know like, all right, when we pull those numbers together, what does the organization look like with all offices together? So it's a little bit of a different mindset when you're doing all the pieces. So great, accounting-wise, that's gonna be one piece that you wanna think of. Hiring team members even, great, what's our onboarding? It's not just gonna be one location, we're gonna be working towards more, so we wanna have a strong system.

The Dental A Team (05:45.157)

Okay.

Britt (06:04.024)

Systems awesome what things can be easily translated across all offices and then where is that great to where each office has a little bit of room for their interpretation on specific things and especially if you're wanting to Let's say I know some that they've got like a PPO practice and then a fee-for-service practice If you know that's the direction you want to go then all right create systems that can work for both And then we just customize some pieces of it based on the location

So big things I think are accounting, planning systems for multiple locations, and also leadership and mindset. Going from a team that's at one location and they think that's what it is, teams get scared of change. so prepping the team or getting them on board that like, this is the direction we're going. This is what we ultimately want. So they're on board to help. And when you get that next location, they...

The Dental A Team (06:32.997)

Mm-hmm.

Britt (06:58.46)

even though it may not really even impact them, but they get scared. What does that mean for us? What are we gonna look like? How's the culture gonna change? All those pieces. So those are some of my most important ones is just thinking multiples, even if you're only a one to start with, and that's the direction you wanna go.

The Dental A Team (07:15.827)

Totally agree. Yeah, I have a few practices, a few practice owners that I've chatted with that they're like, okay, so like, I'm just going to open a second location and restart. I'm going to try again. And I'm like, whoa, whoa, whoa. I totally understand that. But it's kind of like, we're driving our car and like the wheels, you know, are a little looser or they need air, the tires are like something like, you know, mechanically is just not right. And we're like,

scrap it, or just, I'll keep this car and I'll keep paying for it, but I'm just gonna get a new one that might be a little bit better. It's kind of what I feel like when they say that, right? Like, just fix the things. You can do that. You can have to. You can have an old car and a new car if you want both. You could sell the old car and buy a new car if you want to do that, but don't keep an old car and keep paying for it when it's broken and then get a new car and start paying for that too.

an absurd waste of money and resources. So I think of it like that. And I have had a few practice owners that are like, but this one is just like, I'm racking my brain like, cool, we haven't found the root cause yet then. So when you're digging into those pieces and really looking at why is my now this is gonna be my flagship. So how do I operate this as my flagship practice? How do I make sure that this practice is the practice model that I want my next practice to look like? And it might be.

It might be a little bit different. said, you know, PPO practice and a fee for service practice. I've got a couple of practices that run similar to that. I've got, I've got one doctor that has three locations that two of them are like PPO style, but they operate as a fee for service. Cause that's just the level of care that they put into everything. But then he's also got a Medicaid practice that's like obscure on the side. That's like, that's a little bit of an uphill battle, but they're, they're so different, but they.

Team-wise, they try to operate very similarly or just, you know, the fee-for-service and the PPO standpoints, but operationally, making sure, like you said, that those systems that we have in place, I want your patient experience to be the same no matter what type of practice you own, right? I want your accounting to be the same. I want it to be super clean no matter what. And the space that you mentioned there with the accounting that gets really muddled and mucky,

The Dental A Team (09:36.583)

is when we don't keep those books clean, especially, no matter what, you've got two different sets of bills, right, of outgoing money that's coming with each practice, no matter what. Well, even if you have one entity and one business name that owns two practices, you still have to separate that in some way. And a lot of you guys are going out and you're getting associates who want to partner in to one of them or...

I know a practice that opened a specialty practice with her best friend. And I was like, super clear from the get-go, we've got to make sure these are super separated. making sure, again, one's paying the other. And an office manager who may act as a regional-ish, you've got to dial that in. How are we paying her when she's on board?

Britt (10:09.788)

Thank

The Dental A Team (10:27.763)

And she's doing hours for the second practice. What does that look? Who's paying for that? Because if our flagship practice pays for everything and now our flagship practices at 80 % overhead and tanking in our second practice, isn't making money yet. We've got an issue there because the books are so confusing. and Britt, just to spiral down that one, when we don't have super clean books like that, what are the negative implications as far as like taxes and just.

Why is it so important from the get-go that this is clean?

Britt (11:00.836)

Yeah, it just it can just get

wild like you said even taxes what business is it coming from what's getting paid by whom and Some things that can get really wild like you said and I'm all for right economies of scale or a thing That's part of the reason of going into multiples. So just make sure it's being allocated correctly You've got a regional manager Maybe there's or an om that's maybe doing 50 50 or 75 25 then great just split their salary right 25 from the smaller one 75 from the other one

I'm just thinking that sense also because you want goals and you want your office managers to be responsible for helping you reach them including overhead So you just don't want it to get mucky to where one we've got excuses that we're like, it's just this right? We're human beings We will all will try to find any reason to like justify why we are where we are instead of digging in to see what's going on and So having it really clean gives honest numbers so people know exactly what they're responsible for

The Dental A Team (11:54.005)

Mm-hmm.

Britt (12:02.268)

They know if we're shooting for a goal, we're shooting for overhead, if we're working to control things, it's really clean for them to do so and it's fair in how we're doing it. then correct, valuation for businesses, right? Even for that, ultimately it's gonna come from like, yes, your EBITDA, but like profitability is gonna be a factor. so, and...

The Dental A Team (12:21.425)

Exactly.

Britt (12:25.208)

If someone comes in and they start looking at things and maybe there was a shift at some point, they're like, two months ago you decided to sell and it's looking real different, it's gonna raise some questions that might be concerning. So keep it clean from the get go if you need to sell one or even just for valuation purposes, if you need to leverage those practices to go buy more locations, you just wanna keep everything clean, because if not, it just creates a lot more questions and it may hinder you from.

The Dental A Team (12:35.989)

Yeah.

Britt (12:51.59)

getting finances or being able to hold team members accountable and also knowing which practices really need some attention or may or may not be doing well.

The Dental A Team (13:00.277)

Yeah, I love that. So it sounds like you need a really great CPA. You need a really good bookkeeper that knows multiples. Yeah, a really great bookkeeper. I do have some doctors who are their own bookkeepers and I'm okay with that, but you gotta be really good at it and a really great payroll company that probably comes with.

Britt (13:04.746)

that most multiples are left.

The Dental A Team (13:18.199)

those two options to make sure that everything's super clean. And then I think, like you said, the office manager situation, making sure that she or he knows where the money's coming from too. And if they're employed now, like if they're getting paychecks from both, that's different. Like that's gonna look different to them on their W-2 side. It's gonna look different to you. Is one business paying, like is the corporation paying the salary and the businesses are paying the corporation? Like you've got to figure those pieces out.

Ask the right questions, ask the right people, make sure that you've got all of those super clean. As far as like that's one major piece of it. So I want to make sure we get that out from the get go. As far as systems go, making sure, operations spaniel and training. Like you mentioned earlier, your team, your culture, it should be stellar. It should be rock solid because honestly, most of the time when we...

see multi-practice locations, we're taking over another practice, right? We're buying a practice from a retiring doctor or whatever, and we're taking over a practice, taking over a team. And so if we've got a really stellar team that understands what we're doing, understands what our goals are, understands our systems and can say, yeah, heck yeah, like let's do this and let's make some more patients really, really in fantastic health, they can then help you duplicate what you've done.

into the next practice and help to welcome those team members. I think one of the most stressful parts of ever taking over any practice, whether it's your first, your second, your 15th, is the people aspect of it. And how many are we going to be able to retain? How do we tell them? When do we tell them? What's their reaction going to be? How do we get them on our systems? Well, the same as we do anything, we, you know, go in, be yourself.

and look at what's working and what's not working. Start with areas that's not working instead of coming in, in my opinion, and being like, this is our book, this is how you're going to be. But if you do what Brett said in the beginning and really make sure that your team is solid and that you've got those systems in place, you've got that culture, I think that team could be super paramount in training and helping to find those systems and really even, I don't know, Brett, going in and being like, that's really cool how you do that.

The Dental A Team (15:32.249)

I think that might be more efficient than how we've been doing it. Let's ask doctor, let's ask office manager, because I actually really like that and having that open mind because your way might, like I know our way, we've got a million ways to do anything. And the reason I think we're successful is that we customize it to the practice. And oftentimes I'll go in and be like, oh, that's not how I told someone to do it yesterday, but this is how I want you to do it. Cause this is what's going to be best for you. So having that open mind and having that team mindset ready to go also takes that

barking off the doctor and makes it so that you can kind of copy and paste. How do you feel about that, Britt? What are your thoughts on that?

Britt (16:09.36)

You hit another big point, agreed with you, right? So having that strong, for a lot of reasons, right? Again, change in people, we don't always love it. It's a transition. So even if they just know you've got a strong culture, they meet team members, right? And they see how great you are. It's gonna make the transition of that new practice a little easier and also set the standard of like, and this is who we are. like, rise to the occasion, cause this is how we function and it's great. And you wanna be great.

The Dental A Team (16:29.666)

Yeah.

Britt (16:35.608)

with us, right? You also hit on an important point of trying to get things off the doctor. That's the next, right? Also with multiples, I'm thinking of systems and multiples. How can your people help you and how can they report up to you? I think of it as I don't have children, but I'm like, once you're outnumbered, right? So like, great, usually parents, it's like two, all right, we can each take one, but then you get throw a third in there and someone's out doing something wild while you're trying to manage to.

The Dental A Team (16:37.261)

Yeah.

The Dental A Team (16:54.578)

Yeah.

Britt (17:03.374)

And so I think with locations too, right? Two offices, it's like, all right, if you're in clinical full-time, like it's going to be crazy. If you've got a little time and you're still doing kind of all the things, you don't really have a strong OM, doing a lot of it for you in the practice, you've now just doubled your work with another location if you're going off of that same model. So.

The Dental A Team (17:12.067)

I agree.

Britt (17:24.026)

training people to help you, getting office managers in place, getting things made to where they're reporting up to you. If you don't have to do it, you're starting to pass them off and you focus on the high level things that need to be done. Cause that's, can think of a client right now. We just had this conversation cause like he's still doing bookkeeping and all sorts of stuff. I'm like.

You're going to, you're at three now. We just got three. It's going to get wild real fast for you if you don't start kind of planning for other people to help you do some of the things that they can.

The Dental A Team (17:54.905)

Yeah, yeah. Do you think that they have to have leadership teams in place before they have a 2nd or 3rd or 4th location? How do you feel about that?

Britt (18:06.46)

Absolutely, think even just for the second one, Because when, especially if you're transitioning a practice, right, CEO, which is owner, right, going into multiple locations, big responsibilities for you are gonna be culture, vision, and like ultimately making sure you're holding people accountable, that we're profitable and we're growing. So you're gonna need to spend time at that new location.

The Dental A Team (18:20.762)

Okay.

The Dental A Team (18:26.52)

Yeah.

Britt (18:30.676)

One, to just see what's going on, right? And to help see where things need to be done and observe and build relationships and set culture with that new team that you've got over there. So you're going to get pulled to that new location.

And this is where I don't want you guys going crazy. It should be something you enjoy. Like, yes, it's a time of a season of a little bit more effort and time, but I don't want you to go wild. If you've got an OM at your other location, then it's like, sure, I'm around. You got major things that need to be done awesome. But I can go spend a couple of weeks at the new location getting them onboarded and getting good relationships with those people while my OM is handling things at the other location. So it makes your life so much easier. If not, it gets wild. And I think doctors all know this.

The Dental A Team (19:00.292)

Yeah.

The Dental A Team (19:07.631)

For sure.

Britt (19:13.572)

Right? When doctors not in the office or O.M.s not in the office, what usually happens Tiff

The Dental A Team (19:20.257)

Yep, the team goes crazy. It gets wild.

Britt (19:22.81)

Yep, they start to get distracted and like, great, I want you to enjoy each other, but like, we've got to get work done. So you need someone there to make sure things are getting done and holding people accountable when you're not physically in the office.

The Dental A Team (19:28.314)

Yeah.

The Dental A Team (19:35.216)

Totally agree. I think it comes down to the ease as well. Like when I've got a lead hygienist, a lead dental assistant, a lead front office, whether it's just my TC is, you know, my lead and it's just that she does really well managing the schedule and managing the people to make sure it's working and whether you call them leads or not, like quarterbacks or go to, like, I don't care what you call them. It doesn't have to be something crazy. It doesn't have to mean

pay raises, doesn't have to mean all this crazy stuff. It's just that you've got those people that the team knows they can count on and that you can count on to carry out your culture when you're gone. And the culture is, you know, how are we getting to our goals in the best ways possible and serving our patients the best? I assume most of our listeners are in that kind of a category, but making sure that that's there so that you can focus some attention on another practice location when you need to. I know it's like,

really hard when the doctor's not in the prac- in any of the practices, right? The doctor is typically the one that carries most of the culture and the person who most prac- most, team members like to go to. But when you instill that culture and you infuse it into the other people and you have right people, right seat, which is a totally different podcast and something you guys should go listen to, that comes naturally for the people and naturally your team gravitates towards those people.

pretty quickly. It may take some implementation, may take some, you know, multiple meetings, et cetera, but making sure that you have that in place, I think, is a really big and important piece. So, multi-practice locations, there's a lot of things I think we could dive into. We could spend two hours talking about it today, but the biggest pieces I think that you hit on beautifully was making sure we have our accounts super clean. That includes our patient accounts, right? Making sure those systems are clean. But making sure you have systems for your accounting, your banking,

your taxes per location and per entity is really big, making sure that it's clean, it's crisp, it's clear. Anybody from the outside looking in can figure it out because it's so clean. Making sure that you have your operational systems at your flagship and your culture at your flagship ready to be duplicated. Could you look at, can you look at your practice today and say, yes, this is what I want to do again?

Britt (21:50.641)

Yeah.

The Dental A Team (21:50.716)

This is the practice I want to own again. And can I didn't duplicate that over here. If not, we've got work to do and that's okay. We just find the root causes. And then three, really making sure that you've got a leadership team on board to help you out with it. And I do have to caveat that one. Sometimes people write seat, like sometimes we put somebody in a leadership position and they're good for now. And then we get to a space where we're bigger and it doesn't work. And that's okay too. can switch things around. So I feel like those are the three top.

pieces, the accounts, the systems, and the culture to really dive into this early in the game. And then

Britt (22:24.646)

Yeah.

Britt (22:28.486)

You said something really good as well, right? Even in putting people in like leadership or leads.

The Dental A Team (22:30.963)

Yeah.

Britt (22:34.332)

I'm all for responsibility for title. Like try it out and see how they do before you give an actual title to something. I know manager is a term, like I get it, but it's like, I don't know. Like the power that can come can turn some people sometimes. I'm like, great. It might be, you're the point person for this office. You are maybe front desk lead or whatever it may be. People are like, well, we don't have a manager. Well, you go to TIFF, right? TIFF's responsible for that if you need something. So I will highlight that as you get the right

The Dental A Team (22:47.101)

Hmm.

The Dental A Team (22:59.803)

Yeah.

Britt (23:04.286)

people in the right seats is don't move too fast on giving titles and getting yourself in a scenario that's going to be a crappy one to get yourself out of.

The Dental A Team (23:05.861)

I agree.

The Dental A Team (23:12.766)

I agree. think you highlighted that clarity. TIF is the one you go to for that. So when they know where they need to go for something, that's really all they need. They don't need to know, like, she's the lead. It's just that they need to know who can I trust for this information? When I have this issue arise, who can I trust to help me get a resolution for it?

So I love that clarity. So I love it, you guys. I hope those of you who are considering multipractice or have multipractice that you guys took some tidbits from today, reach out. Hello@TheDentalATeam.com If this is something that interested you, you need more information. We're here for it. If you're a client like texture consultant, if you're a future client, we can't wait to help you onboard your new.

practices and if you're a forever listener and you're not going to be a client, we love you too and we want to make sure that you have the resources as well. So please make sure you reach out. We are here for all of you. We want to make sure that you're super successful. Britt, you're a brilliant brain. Had it again. Thank you so much for that information. I think those are three really, really easy spaces to start with a lot of details. There's a lot that goes into those, but those are three spaces that we can consume and start working at. So thank you for being here with me today, Britt.

Alright, Dental A Team listeners, I love you, Britt. I love you guys. I want to hear from you. I want to know that this was an amazing podcast. I'll leave it's a five star review below. Let us know what else we can do to help you and reach out. Hello@TheDentalATeam.com Britt, thank you as always and hope you have a great rest of your day. Thanks. Bye guys.

Britt (24:41.722)

You too.

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When it comes to owning and operating multiple dental practices, not everything runs the same. That’s a common surprise for those overseeing multiple practices. In this episode, Tiff and Britt discuss where practices often fall short in keeping things running smoothly across all offices, and how to set yourself up for success.

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Transcript:

The Dental A Team (00:01.134)

Hello, Dental A Team listeners. I am back today with, I've got a new nickname, brilliant brain Britt, triple B, brilliant brain Britt. I like it. I'm back here for some fun business talk today. are working hard, Britt and I, I hold her business brain for a few different podcasts today and we're working hard to make sure you guys that you've just got some really, really successful business tips and tools early on in the year.

Britt (00:09.18)

I'm going get some

The Dental A Team (00:28.014)

going to be all year long that you're getting business tips. Like always, we love the business side of dentistry because we really, really want your business to work for you, not you work for your business. So we work really hard with all of our clients and all of you listeners to make sure that you have the tips for success there. But today I've pulled Britt on a few different items. We just got done chatting some about really starting your 2025 off right, which was a little bit of a review of how to end Q4 and get prepped for 2025.

but I wanted you guys to have all of those goodies. So if you haven't listened to that yet, you don't have to do it before today. Listen to today, but they can go backwards and listen to that one as well. Today though, Britt, you have, this in your background. Like this is something that you've done. We've both had our hands in it, but you have like honestly and truly just managed multiple practices and really helped set them up for success. You've done transitions, like you've done it all. So I really wanted to bring you on today to pick your brain on some of the pieces that.

are super important and paramount in learning, maybe prior to would probably be, you know, helpful, but a lot of us are not in that situation. A lot of, a lot of doctors listening today already own multiple locations. And so really knowing what they can do and what they can learn and what they should be looking out for is kind of what I'm interested in today for multi-practices. Before we pop in though, how are you today? How is, how's Britt's beautiful brain doing?

Britt (01:53.724)

It's doing good today. It's it's not too early. Britt's brain super early is not always the best. I gotta have a little time to warm up with the day. That's that's how I work or late nights. That's that's my brain time really. So everybody works a little different, but I'm good. It's not too early. I get to sit here and chat with you about I don't know this kind of stuff is fun. Growth is fun. Different ideas are fun, so it's going to be a good time.

The Dental A Team (02:18.394)

I agree. I agree. And your brain just works like this, like numbers, the black and white of it all. Like I've given you kudos before, know, you do really well at seeing the gray too and working through the gray to find the black and white, which I think in business is incredibly, incredibly paramount to success. Working with people is not always the easiest thing in the world. I tell all of my doctors and my office managers that the hardest part about your job is going to be managing the people.

But you do really well with it because of that aspect. So I think it's really, really important to say that now because I think doctors listening and managers listening, whomever business owners are listening, that's a space for you to learn to utilize that black and white data, but to bring in that personal side and to bring in that emotional side without letting the emotions take over the results, I guess. so, Britt, that's something I really want to pick your brain on, but

From the tactical standpoint, what are a few things going into multi-practice ownership, or maybe they already own, right, but hopefully going into, what are some key pieces that they should really be prepped for, looking for, tracking, to know that they're on the path for success for both of them, and what should those look like? Should they be the same? What's the easiest way to go about this when you're taking on a new practice?

Britt (03:43.098)

Yeah, number one thing is have a practice, have your flagship running really well and strong systems in your flagship before you start taking on another one is the ideal way to do it, right? Learn how to manage what is one location before you start multiplying that stress or management of all the locations. And with multiples, it's a different mindset. And I think that's where

The Dental A Team (04:01.624)

I agree.

Britt (04:09.562)

We work with a lot of private practice and even multiples that are private practice and people that are like maybe even transitioning to DSO because it's one of those scenarios to where like the same thing doesn't work for everyone. So that's, do a lot with our practices that are custom and it's like, all right, where are we going? What are we doing? What's it going to look like? What's the feel you want behind it? And when you start, when you know that you want to potentially even go multiples and you're starting with one location, I want you to put like the multiple brain on.

The Dental A Team (04:21.478)

Yeah.

Britt (04:38.192)

We don't have them yet, but we want to start building things to where there are systems that can easily be transitioned into multiples. What I mean by that is, yes, there are going to be some steady things that are like, great, the way we do AR and send statements is going to be the same way we send statements all across all locations. The way we budget for supplies is going to be the same way we budget for supplies across all locations. But make sure you're keeping things really clean bookwise and especially at

The Dental A Team (04:45.956)

Yeah.

The Dental A Team (05:07.051)

Mm-hmm.

Britt (05:07.356)

when you start getting into multiples and thinking bigger. So for example, let's say, great, now we've got a couple locations, great, we can share resources. shoot, we ran out of something. Great, go grab some from the other location. You wanna track all those things and pay it from the appropriate business so that each business independently is going to look like the reality and the numbers will be the reality and it's not getting mucked up by the other.

And so you actually know how to, one, drive each individual practice, and then two, know like, all right, when we pull those numbers together, what does the organization look like with all offices together? So it's a little bit of a different mindset when you're doing all the pieces. So great, accounting-wise, that's gonna be one piece that you wanna think of. Hiring team members even, great, what's our onboarding? It's not just gonna be one location, we're gonna be working towards more, so we wanna have a strong system.

The Dental A Team (05:45.157)

Okay.

Britt (06:04.024)

Systems awesome what things can be easily translated across all offices and then where is that great to where each office has a little bit of room for their interpretation on specific things and especially if you're wanting to Let's say I know some that they've got like a PPO practice and then a fee-for-service practice If you know that's the direction you want to go then all right create systems that can work for both And then we just customize some pieces of it based on the location

So big things I think are accounting, planning systems for multiple locations, and also leadership and mindset. Going from a team that's at one location and they think that's what it is, teams get scared of change. so prepping the team or getting them on board that like, this is the direction we're going. This is what we ultimately want. So they're on board to help. And when you get that next location, they...

The Dental A Team (06:32.997)

Mm-hmm.

Britt (06:58.46)

even though it may not really even impact them, but they get scared. What does that mean for us? What are we gonna look like? How's the culture gonna change? All those pieces. So those are some of my most important ones is just thinking multiples, even if you're only a one to start with, and that's the direction you wanna go.

The Dental A Team (07:15.827)

Totally agree. Yeah, I have a few practices, a few practice owners that I've chatted with that they're like, okay, so like, I'm just going to open a second location and restart. I'm going to try again. And I'm like, whoa, whoa, whoa. I totally understand that. But it's kind of like, we're driving our car and like the wheels, you know, are a little looser or they need air, the tires are like something like, you know, mechanically is just not right. And we're like,

scrap it, or just, I'll keep this car and I'll keep paying for it, but I'm just gonna get a new one that might be a little bit better. It's kind of what I feel like when they say that, right? Like, just fix the things. You can do that. You can have to. You can have an old car and a new car if you want both. You could sell the old car and buy a new car if you want to do that, but don't keep an old car and keep paying for it when it's broken and then get a new car and start paying for that too.

an absurd waste of money and resources. So I think of it like that. And I have had a few practice owners that are like, but this one is just like, I'm racking my brain like, cool, we haven't found the root cause yet then. So when you're digging into those pieces and really looking at why is my now this is gonna be my flagship. So how do I operate this as my flagship practice? How do I make sure that this practice is the practice model that I want my next practice to look like? And it might be.

It might be a little bit different. said, you know, PPO practice and a fee for service practice. I've got a couple of practices that run similar to that. I've got, I've got one doctor that has three locations that two of them are like PPO style, but they operate as a fee for service. Cause that's just the level of care that they put into everything. But then he's also got a Medicaid practice that's like obscure on the side. That's like, that's a little bit of an uphill battle, but they're, they're so different, but they.

Team-wise, they try to operate very similarly or just, you know, the fee-for-service and the PPO standpoints, but operationally, making sure, like you said, that those systems that we have in place, I want your patient experience to be the same no matter what type of practice you own, right? I want your accounting to be the same. I want it to be super clean no matter what. And the space that you mentioned there with the accounting that gets really muddled and mucky,

The Dental A Team (09:36.583)

is when we don't keep those books clean, especially, no matter what, you've got two different sets of bills, right, of outgoing money that's coming with each practice, no matter what. Well, even if you have one entity and one business name that owns two practices, you still have to separate that in some way. And a lot of you guys are going out and you're getting associates who want to partner in to one of them or...

I know a practice that opened a specialty practice with her best friend. And I was like, super clear from the get-go, we've got to make sure these are super separated. making sure, again, one's paying the other. And an office manager who may act as a regional-ish, you've got to dial that in. How are we paying her when she's on board?

Britt (10:09.788)

Thank

The Dental A Team (10:27.763)

And she's doing hours for the second practice. What does that look? Who's paying for that? Because if our flagship practice pays for everything and now our flagship practices at 80 % overhead and tanking in our second practice, isn't making money yet. We've got an issue there because the books are so confusing. and Britt, just to spiral down that one, when we don't have super clean books like that, what are the negative implications as far as like taxes and just.

Why is it so important from the get-go that this is clean?

Britt (11:00.836)

Yeah, it just it can just get

wild like you said even taxes what business is it coming from what's getting paid by whom and Some things that can get really wild like you said and I'm all for right economies of scale or a thing That's part of the reason of going into multiples. So just make sure it's being allocated correctly You've got a regional manager Maybe there's or an om that's maybe doing 50 50 or 75 25 then great just split their salary right 25 from the smaller one 75 from the other one

I'm just thinking that sense also because you want goals and you want your office managers to be responsible for helping you reach them including overhead So you just don't want it to get mucky to where one we've got excuses that we're like, it's just this right? We're human beings We will all will try to find any reason to like justify why we are where we are instead of digging in to see what's going on and So having it really clean gives honest numbers so people know exactly what they're responsible for

The Dental A Team (11:54.005)

Mm-hmm.

Britt (12:02.268)

They know if we're shooting for a goal, we're shooting for overhead, if we're working to control things, it's really clean for them to do so and it's fair in how we're doing it. then correct, valuation for businesses, right? Even for that, ultimately it's gonna come from like, yes, your EBITDA, but like profitability is gonna be a factor. so, and...

The Dental A Team (12:21.425)

Exactly.

Britt (12:25.208)

If someone comes in and they start looking at things and maybe there was a shift at some point, they're like, two months ago you decided to sell and it's looking real different, it's gonna raise some questions that might be concerning. So keep it clean from the get go if you need to sell one or even just for valuation purposes, if you need to leverage those practices to go buy more locations, you just wanna keep everything clean, because if not, it just creates a lot more questions and it may hinder you from.

The Dental A Team (12:35.989)

Yeah.

Britt (12:51.59)

getting finances or being able to hold team members accountable and also knowing which practices really need some attention or may or may not be doing well.

The Dental A Team (13:00.277)

Yeah, I love that. So it sounds like you need a really great CPA. You need a really good bookkeeper that knows multiples. Yeah, a really great bookkeeper. I do have some doctors who are their own bookkeepers and I'm okay with that, but you gotta be really good at it and a really great payroll company that probably comes with.

Britt (13:04.746)

that most multiples are left.

The Dental A Team (13:18.199)

those two options to make sure that everything's super clean. And then I think, like you said, the office manager situation, making sure that she or he knows where the money's coming from too. And if they're employed now, like if they're getting paychecks from both, that's different. Like that's gonna look different to them on their W-2 side. It's gonna look different to you. Is one business paying, like is the corporation paying the salary and the businesses are paying the corporation? Like you've got to figure those pieces out.

Ask the right questions, ask the right people, make sure that you've got all of those super clean. As far as like that's one major piece of it. So I want to make sure we get that out from the get go. As far as systems go, making sure, operations spaniel and training. Like you mentioned earlier, your team, your culture, it should be stellar. It should be rock solid because honestly, most of the time when we...

see multi-practice locations, we're taking over another practice, right? We're buying a practice from a retiring doctor or whatever, and we're taking over a practice, taking over a team. And so if we've got a really stellar team that understands what we're doing, understands what our goals are, understands our systems and can say, yeah, heck yeah, like let's do this and let's make some more patients really, really in fantastic health, they can then help you duplicate what you've done.

into the next practice and help to welcome those team members. I think one of the most stressful parts of ever taking over any practice, whether it's your first, your second, your 15th, is the people aspect of it. And how many are we going to be able to retain? How do we tell them? When do we tell them? What's their reaction going to be? How do we get them on our systems? Well, the same as we do anything, we, you know, go in, be yourself.

and look at what's working and what's not working. Start with areas that's not working instead of coming in, in my opinion, and being like, this is our book, this is how you're going to be. But if you do what Brett said in the beginning and really make sure that your team is solid and that you've got those systems in place, you've got that culture, I think that team could be super paramount in training and helping to find those systems and really even, I don't know, Brett, going in and being like, that's really cool how you do that.

The Dental A Team (15:32.249)

I think that might be more efficient than how we've been doing it. Let's ask doctor, let's ask office manager, because I actually really like that and having that open mind because your way might, like I know our way, we've got a million ways to do anything. And the reason I think we're successful is that we customize it to the practice. And oftentimes I'll go in and be like, oh, that's not how I told someone to do it yesterday, but this is how I want you to do it. Cause this is what's going to be best for you. So having that open mind and having that team mindset ready to go also takes that

barking off the doctor and makes it so that you can kind of copy and paste. How do you feel about that, Britt? What are your thoughts on that?

Britt (16:09.36)

You hit another big point, agreed with you, right? So having that strong, for a lot of reasons, right? Again, change in people, we don't always love it. It's a transition. So even if they just know you've got a strong culture, they meet team members, right? And they see how great you are. It's gonna make the transition of that new practice a little easier and also set the standard of like, and this is who we are. like, rise to the occasion, cause this is how we function and it's great. And you wanna be great.

The Dental A Team (16:29.666)

Yeah.

Britt (16:35.608)

with us, right? You also hit on an important point of trying to get things off the doctor. That's the next, right? Also with multiples, I'm thinking of systems and multiples. How can your people help you and how can they report up to you? I think of it as I don't have children, but I'm like, once you're outnumbered, right? So like, great, usually parents, it's like two, all right, we can each take one, but then you get throw a third in there and someone's out doing something wild while you're trying to manage to.

The Dental A Team (16:37.261)

Yeah.

The Dental A Team (16:54.578)

Yeah.

Britt (17:03.374)

And so I think with locations too, right? Two offices, it's like, all right, if you're in clinical full-time, like it's going to be crazy. If you've got a little time and you're still doing kind of all the things, you don't really have a strong OM, doing a lot of it for you in the practice, you've now just doubled your work with another location if you're going off of that same model. So.

The Dental A Team (17:12.067)

I agree.

Britt (17:24.026)

training people to help you, getting office managers in place, getting things made to where they're reporting up to you. If you don't have to do it, you're starting to pass them off and you focus on the high level things that need to be done. Cause that's, can think of a client right now. We just had this conversation cause like he's still doing bookkeeping and all sorts of stuff. I'm like.

You're going to, you're at three now. We just got three. It's going to get wild real fast for you if you don't start kind of planning for other people to help you do some of the things that they can.

The Dental A Team (17:54.905)

Yeah, yeah. Do you think that they have to have leadership teams in place before they have a 2nd or 3rd or 4th location? How do you feel about that?

Britt (18:06.46)

Absolutely, think even just for the second one, Because when, especially if you're transitioning a practice, right, CEO, which is owner, right, going into multiple locations, big responsibilities for you are gonna be culture, vision, and like ultimately making sure you're holding people accountable, that we're profitable and we're growing. So you're gonna need to spend time at that new location.

The Dental A Team (18:20.762)

Okay.

The Dental A Team (18:26.52)

Yeah.

Britt (18:30.676)

One, to just see what's going on, right? And to help see where things need to be done and observe and build relationships and set culture with that new team that you've got over there. So you're going to get pulled to that new location.

And this is where I don't want you guys going crazy. It should be something you enjoy. Like, yes, it's a time of a season of a little bit more effort and time, but I don't want you to go wild. If you've got an OM at your other location, then it's like, sure, I'm around. You got major things that need to be done awesome. But I can go spend a couple of weeks at the new location getting them onboarded and getting good relationships with those people while my OM is handling things at the other location. So it makes your life so much easier. If not, it gets wild. And I think doctors all know this.

The Dental A Team (19:00.292)

Yeah.

The Dental A Team (19:07.631)

For sure.

Britt (19:13.572)

Right? When doctors not in the office or O.M.s not in the office, what usually happens Tiff

The Dental A Team (19:20.257)

Yep, the team goes crazy. It gets wild.

Britt (19:22.81)

Yep, they start to get distracted and like, great, I want you to enjoy each other, but like, we've got to get work done. So you need someone there to make sure things are getting done and holding people accountable when you're not physically in the office.

The Dental A Team (19:28.314)

Yeah.

The Dental A Team (19:35.216)

Totally agree. I think it comes down to the ease as well. Like when I've got a lead hygienist, a lead dental assistant, a lead front office, whether it's just my TC is, you know, my lead and it's just that she does really well managing the schedule and managing the people to make sure it's working and whether you call them leads or not, like quarterbacks or go to, like, I don't care what you call them. It doesn't have to be something crazy. It doesn't have to mean

pay raises, doesn't have to mean all this crazy stuff. It's just that you've got those people that the team knows they can count on and that you can count on to carry out your culture when you're gone. And the culture is, you know, how are we getting to our goals in the best ways possible and serving our patients the best? I assume most of our listeners are in that kind of a category, but making sure that that's there so that you can focus some attention on another practice location when you need to. I know it's like,

really hard when the doctor's not in the prac- in any of the practices, right? The doctor is typically the one that carries most of the culture and the person who most prac- most, team members like to go to. But when you instill that culture and you infuse it into the other people and you have right people, right seat, which is a totally different podcast and something you guys should go listen to, that comes naturally for the people and naturally your team gravitates towards those people.

pretty quickly. It may take some implementation, may take some, you know, multiple meetings, et cetera, but making sure that you have that in place, I think, is a really big and important piece. So, multi-practice locations, there's a lot of things I think we could dive into. We could spend two hours talking about it today, but the biggest pieces I think that you hit on beautifully was making sure we have our accounts super clean. That includes our patient accounts, right? Making sure those systems are clean. But making sure you have systems for your accounting, your banking,

your taxes per location and per entity is really big, making sure that it's clean, it's crisp, it's clear. Anybody from the outside looking in can figure it out because it's so clean. Making sure that you have your operational systems at your flagship and your culture at your flagship ready to be duplicated. Could you look at, can you look at your practice today and say, yes, this is what I want to do again?

Britt (21:50.641)

Yeah.

The Dental A Team (21:50.716)

This is the practice I want to own again. And can I didn't duplicate that over here. If not, we've got work to do and that's okay. We just find the root causes. And then three, really making sure that you've got a leadership team on board to help you out with it. And I do have to caveat that one. Sometimes people write seat, like sometimes we put somebody in a leadership position and they're good for now. And then we get to a space where we're bigger and it doesn't work. And that's okay too. can switch things around. So I feel like those are the three top.

pieces, the accounts, the systems, and the culture to really dive into this early in the game. And then

Britt (22:24.646)

Yeah.

Britt (22:28.486)

You said something really good as well, right? Even in putting people in like leadership or leads.

The Dental A Team (22:30.963)

Yeah.

Britt (22:34.332)

I'm all for responsibility for title. Like try it out and see how they do before you give an actual title to something. I know manager is a term, like I get it, but it's like, I don't know. Like the power that can come can turn some people sometimes. I'm like, great. It might be, you're the point person for this office. You are maybe front desk lead or whatever it may be. People are like, well, we don't have a manager. Well, you go to TIFF, right? TIFF's responsible for that if you need something. So I will highlight that as you get the right

The Dental A Team (22:47.101)

Hmm.

The Dental A Team (22:59.803)

Yeah.

Britt (23:04.286)

people in the right seats is don't move too fast on giving titles and getting yourself in a scenario that's going to be a crappy one to get yourself out of.

The Dental A Team (23:05.861)

I agree.

The Dental A Team (23:12.766)

I agree. think you highlighted that clarity. TIF is the one you go to for that. So when they know where they need to go for something, that's really all they need. They don't need to know, like, she's the lead. It's just that they need to know who can I trust for this information? When I have this issue arise, who can I trust to help me get a resolution for it?

So I love that clarity. So I love it, you guys. I hope those of you who are considering multipractice or have multipractice that you guys took some tidbits from today, reach out. Hello@TheDentalATeam.com If this is something that interested you, you need more information. We're here for it. If you're a client like texture consultant, if you're a future client, we can't wait to help you onboard your new.

practices and if you're a forever listener and you're not going to be a client, we love you too and we want to make sure that you have the resources as well. So please make sure you reach out. We are here for all of you. We want to make sure that you're super successful. Britt, you're a brilliant brain. Had it again. Thank you so much for that information. I think those are three really, really easy spaces to start with a lot of details. There's a lot that goes into those, but those are three spaces that we can consume and start working at. So thank you for being here with me today, Britt.

Alright, Dental A Team listeners, I love you, Britt. I love you guys. I want to hear from you. I want to know that this was an amazing podcast. I'll leave it's a five star review below. Let us know what else we can do to help you and reach out. Hello@TheDentalATeam.com Britt, thank you as always and hope you have a great rest of your day. Thanks. Bye guys.

Britt (24:41.722)

You too.

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