This week, the Dental Amigos welcome Dee Fischer, a seasoned practice management consultant, for an honest and insightful conversation about what it really takes to succeed as a private practice owner in today’s changing dental world. Dee draws from decades of experience helping dental teams grow, sharing practical wisdom on how to hire for attitude over skill, build strong leadership systems, and lead with both empathy and accountability.

Dee emphasizes that you don’t need 100 patients a day—or 100 practices—to be successful. With the right strategy, a strong culture, and a clear financial plan, owning one great practice can be more fulfilling and sustainable than you may  think. She also discusses the real-life responsibilities of practice ownership, from managing dental school debt to supporting the families of your team.

Whether you're an associate dreaming of ownership or a seasoned dentist feeling overwhelmed by leadership challenges, this episode delivers honest, actionable advice with a whole lot of heart.

To learn more about Dee’s consulting group and how she helps practices thrive, visit https://fischerspro.com.

Listeners who want to reach Paul can do so at Paul@DentalNachos.com and those who want to reach Rob can do so at Rob@RMontgomery-law.com.

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FULL EPISODE TRANSCRIPT:

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Bumper  

Welcome to the dental amigos podcast with Dr Paul Goodman and attorney Rob Montgomery, taking you behind the scenes of the dental business world, all the things you didn't learn in dental school, but wish you had Rob is not a dentist, and Paul is not a lawyer, but since Rob is a lawyer, we need to tell you that this podcast is for informational purposes only and shouldn't be considered legal advice. Listening to this podcast does not and will not create an attorney client relationship, as is always the case. You should formally consult with legal counsel before proceeding with any legal matter. Learn more about the dental amigos at www.thedentalamigos.com. And now here are the dental amigos.

Rob Montgomery  

Hello, everyone. I'm Rob Montgomery, and I'm joined, as always, by the Head Nacho himself, Dr. Paul Goodman. Great to be here, Rob. It's good to see you, Paul. And welcome, everyone, to another episode of The Dental Amigos podcast — the only podcast hosted by a dentist and a lawyer. We are unique. We are very special. And today, we have an awesome guest. We're joined by dental entrepreneur and now practice consultant, Dee Fisher. Dee is the CEO of Fisher Professional Group, has decades of experience growing DSOs, helping doctors create systems, accountability, and a passion in the workplace. She's been an integral part of several DSOs’ exponential growth, guiding the operations and HR management to scale to larger organizations. Dee helps practice owners construct state-of-the-art locations, providing a seamless and fun experience while delivering a remarkable turnkey project on time, within budget. We're going to talk to Dee today about her fascinating journey in the dental world, her State of the Union on private practice ownership, and what practice growth looks like to her. And now, without further ado, here's Dee Fisher. Welcome, Amigo, and thanks for being on the show.

Dee Fischer  

Thanks for having me. I really appreciate this. I'm looking forward to this. I think this is going to be fun and educational at the same time.

Paul Goodman  

Sounds good. Thanks, Dee. Our first question is always a hard-hitting one: if we were in your town, where would you take us for nachos, and what is your favorite topping?

Dee Fischer  

I would probably take you to my home, because my husband used to run the Mexican restaurant for Disney in California — wow — through dental school, and he makes the most amazing, amazing nachos. And he makes a special topping. So I'd have to bring you here.

Paul Goodman  

I like that. I like some professionally done Disney nachos.

Rob Montgomery  

That is the best answer to that question.

Paul Goodman  

Before we—before we dig in—oh yeah, what is the, what is the top he likes to put on there?

Dee Fischer  

Well, he makes a very special topping for me. It's kind of his own secret sauce, and it's got guacamole, it's got all kinds of things in it. Everybody that comes to our house says, "We need the recipe," but he says it's like—you can't reinvent it. But he's like—I said, that's how we put it. I like dental school. Dental school. So it's great.

Rob Montgomery  

That's awesome. Great story.

Paul Goodman  

Before we dig into your State of the Union, Dee, I actually want to share—I was so proud that you came to my event and you gave me a compliment at my event last year. And you've been to so many events as a speaker, as a planner, in the audience—and you came up to me and you said the nicest compliment during our Sip and Stroll, because I have a Grandmother Happy Hour at 3 p.m. during an event. And tell our audience why you thought the Sip and Stroll—the Grandmother Happy Hour baked into the event in the afternoon—was such a great idea.

Dee Fischer  

You know? It really, it really talked to me because it was so authentic and so real. And people really got to see who they were and what they brought to the table, and how the dental community really, really can pull together and make things happen for the private practice, for the dentist that's starting all phases of dentistry. So as we did that, I mean, it just was amazing to see the reactions and seeing people, you know, they really felt like we cared about them. And I think sometimes that's missed when we're at large conventions. It's, you know, it's so busy. But when you see people's faces light up, that people are actually taking time to communicate and connect—to me, it really resonates. And I think that, you know, that's what I saw in that room. I just saw, hey, these people really care about us, not only as professionals, but individuals, and they want to know our story and then be able to connect people with people, and help them be successful. I just think it was phenomenal.

Paul Goodman  

I appreciate that. Is really what I wanted to try to create. I always say the rehearsal dinner is more fun than these giant weddings, and nothing against giant events. I still go to them, but where you can meet people and learn about them as people, you know, first. And that's why, whether it's a glass of wine or a soft pretzel in the middle of the day, I think more events should bake in these snacks and happy hour in the middle of the day. I don't— What do you think, Rob?

Rob Montgomery  

I agree. I mean, look, I've said this before. I mean, you've—and it's obvious to all of our listeners and people in dental nachos—it's more than just a… a CE event. It's, it's a community event, you know. It's a… it's like a reunion, a wedding, a celebration, all—all kind of rolled together, which is really what makes your event special. And I love going to them, too.

Paul Goodman  

Thanks, Dee. I appreciate excited to see you there this year.

Dee Fischer  

Agreed. Agreed.

Rob Montgomery  

So, uh, Dee, you had a very interesting entrepreneurial journey in the, in the dental world, and which you've really taken into, imported into your, your consulting business now. But tell our listeners kind of what your, your journey was like in the dental world, and how you've come to where you are now.

Dee Fischer  

Well, you know, I was going to be a dentist, which I learned quickly, like, it's not going to work for me. And just because, you know, I love to talk, and I love the business side, and really like the clinical side, but I just kept saying, it's this, you know, as much as I want to do dental and do dental school and do all the things that I want, I just kept gravitating to the business side. I had a great thing and said to me, You know what? Go to business school, put it all together. You can do absolutely fine. And I did. I took his advice. That was one of the greatest advices that I've ever gotten. He mentored me and went through and, you know, it's so funny. I started, you know, working and opening practices and, and, you know, I realized really quickly that my passion was to really have people have a successful clinical life along with a successful business life, and put the two of them together. That would be great. And then from there, you know, I did that. And then I opened up a design build company and did design build across the country with a partner of us. We were AMDF, and we were able to, one of our shiny moments was we were able to open up a clinic with Second Harvest. We donated the whole dental clinic ourselves. We paid for everything. And so we were able to get back to the community through that. And we won an Eagles Award, which is really one of the highest design awards you can win. So we did all that. And then I said, You know what? Let me see where life takes me. And then I decided to go more into consulting. I really want to do speaking, but I realized quickly, you know, it's funny, people say to me all the time, how did you get in the DSO world? Well, I got the DSO world by accident, and honestly, I was able to grow one or two or three practices to maybe four or five successful practices, and keep the dentist, you know, still family oriented, still really where they needed to be. So that's kind of how I started to roll into the DSO world. And it was something that, you know, I realized really quickly, is if you have a good foundation, you know, only takes one practice to have that good foundation, and that's all you ever need if you decide that you want to do more. Sure, I can help you with a growth pattern. But some people are just happy with having a very good, solid, clinical, great, communicating, branded practice for their community, and that's okay. And so that's kind of how, you know, I rolled into this, because then they say, Well, we have one on the north side, that's one on the south side, and they were able to replicate what they had. So that's kind of how I started my DSO, I guess, you know, journey. And then from there, you know, started to put together more DSOs, you know, and started to put together, you know, some of my own being management partners and doing things, and it became very exciting to me. But I also, you know, always kept in my mind, it has to stay really, you know, really has to stay private practice focused, as much as you can keep it that way. And that's always been, I think, where I'm a little bit different is where, you know, I want to always keep that we have a sense of quality and we have a sense of integrity, along with even if we're going to grow practices. So, but it's been my journey.

Paul Goodman  

Tell me, Decent. I'm the only dentist at this table right now. We're going to try to do a filling fantasy camp for Rob one day, where he can do one he wants to. Maybe we can include you too, deep along the way. Since I'm the only dentist on this conversation, how do you tell us more about that? Right? You know, so these—there's so much, whether it's on the Dental Nachos Facebook group, whether it's on Instagram, whether it's on through all these things—these may be these, you know, concerns about, you know, not keeping it family oriented, not keeping it private practice. Or talk to me about the dentist owner. You know, how do you motivate, inspire, make sure that they keep it that way, keep the focus on quality, even if they do transition into a DSO world?

Dee Fischer  

So, you know, I always tell them, it comes down to one thing, and it comes down to relationships. In my mind, if you're building that relationship and you have good communication with your patients, you're going to keep it, you're going to keep that focus. And, you know, I always tell people all the time is, you know, there's all things that are important in your business, but the one thing that's most important is you and your reputation and how you communicate with people. Let's face it, we're hearing a lot about AI now, hearing all these things, and no, I was on a lecture the other day and told them, I said, this is all great, but if we don't have hands in the mouth and good communications with our patients, we're not going to need AI. You know, the bottom line is, to me, is, you know, I think keeping the clinicians focused on really having that relationship and that operatory and letting that patient really feel special no matter how many offices you have is key to being successful, in my mind, and it's just opinion. When you lose that, you lose a lot of integrity, and then it becomes really that total clinical feeling that's okay if that's what a patient wants. But when you're keeping it that kind of Private Practice Center that you need to have, I think it's really relationship driven. And I think that in life, you know, you go, you go, we look at it, we say, I always say to people all the time, if someone turned around and said to you, who's most important in your life, and you put down three people or four people that are really important, and then you make that three to four people's list. Also, you have a great relationship, and you want to be on someone's list. And let's be honest, when someone, you know, asks me for a recommendation for a dentist, I'm hoping that it's one of my dentist's name that is said because of the relationship that he's built. Oh, I guess that's the word for me. It's relationship and communication.

Paul Goodman  

I love the idea Rob going a second, but I want us one further question, as someone who went to dental school, that is awesome advice. And the reality is, dental school doesn't talk about communication with your patients at all. So whether it's a dentist, 1234, years out of school, do Where do you recommend your dentist go to get communication training? Or how do you guys do it when they're all sitting around a room saying, Hey, we're going to communicate better. I found that the courses and the training in dentists, there's plenty for clinical crown preps, there's plenty for placing implants. But have you seen or do you teach? Or what do you tell your groups about how they can improve that?

Dee Fischer  

You know, I teach it. I definitely teach this. One of the first things I do. I always tell people, if you're gonna bring me in, understand that there's going to be a lot of relationship building and coaching. And, you know, we look at our young dentists going in and, you know, look, we've been in books for several years. We've doing, you know, but we have to teach them eye contact. You have to teach them it's okay to touch a person. It's okay to find out about them personally. You know, I come all the time, you know, oh, look at groups like us. Look at nachos groups, look at groups. Get on their mastermind, ask the question. I even tell them to role play with their family. You know, one of the exercises I buy doctors is to go home, and if you have a spouse, sit down with your spouse and take 10 minutes every day and pick a topic that you would like to talk to them about, that's hard, not easy. And if you do that for a month, and you can start to get yourself in that rhythm, it's going to bring a lot to you in the operator. And I've had so many doctors that say I hear that still to this day, I've done that exercise over and over, and it's brought me to where I can actually have, sometimes a difficult conversation, a funny conversation, or just a conversation. And role playing, in my mind, is a big, it's a great way of learning.

Rob Montgomery  

I love that advice. Yeah, it's really cool. I'm curious—delay, are most of your clients dentist owned or dentist led? Or do you have other sort of private equity-backed groups that you're helping too? Because, I'm—I'm curious, because this message in the DSO world is somewhat antithetical to what we all sort of see and understand to be the, quote, unquote, "the money people that don't really care as much about the clinical stuff." So, I'm wondering if—or do dentists gravitate to you more than the non-dentists?

Dee Fischer  

Yes. So, I, I would say 90% of my, my clients are usually dentist owned. And you have to read metal when I started out. And, you know, my first DS own doing, the manager, partner back in the day was DCA, we were dentist owned, right? And it was one of the big things that we prided ourselves on. So, I, you know, particularly, like I said, there's space for everybody, but I'd like to dentist own, because I think it just like I said, and there's room for everybody in the dental space. But, you know, when you have that clinical training and that clinical understanding, I think it brings another layer. Because, let's be honest, it's not only about numbers. And, you know, I tell people, I tell my dentist this all the time. I said, Listen, we're not dealing with cans of Coke because numbers, we're dealing with people. And there's a whole different relationship with a person, and a whole person. As a dentist, you know, we're clinically trained. We look at a lot of things in the body, kind of, you know, health, we look at a lot of things. And I think it's really important to understand what happens in the operatory pool. I think it's, you know, when you don't really know what's happening in the operatory, and, you know, I sometimes wonder, how could you truly lead an organization? I think that understanding is important, and like some people are, maybe are very good at it, but I do think it brings that different level of understanding what we're actually doing every day.

Rob Montgomery  

Yeah, I mean, I think that's really powerful stuff, and I've experienced that too, where I've had clients over the years that come in and will tell me about what their, their growth plan is, and they're going to do 10 de novos in the next 24 months, and this is what the growth strategy looks like. And they say, Well, okay, that's, that's, sounds great. Who are the dentists going to be for this? They're like, we're just going to hire some dentists. Dentists. Just any old dentists. Yeah, any old dentists. Okay? And I think that if you don't, if you're not a dentist, or you're not really plugged into the clinical operational aspect of a dental practice, I think you have a hard time understanding what you're talking about. You know that, you know, the importance of being able to deliver this quality care, to be able to have these conversations with patients. Because if you've never thought about that, and you've got a, you own a chain of steak houses in Oklahoma and Texas, a medical uniform business in Minnesota and Wisconsin, and a bunch of dental practices in South Carolina, North Carolina, and Georgia, then, like, all that, that message, I think, I just don't think you have an understanding of what you just talked about.

Paul Goodman  

I agree with that, dude. You can use my line anytime you want. My line is, dental offices are people places, not pizza places, because, as someone who loves pizza just as much as nachos, the truth is, I don't really care, as long as the pizza tastes good, right? As long as they get it. But in the dental world, there's so many things that you are judged on by patients that have nothing to do with the work in the patient's mouth, because our audience will appreciate this. And Dee, been around dentistry enough, not one person has ever complimented me on my crown prep taper. Dee, in my whole life, not one patient, but they have complimented how my team made them feel. They have complimented me on how our practice made them feel, and it's important to deliver awesome pizza if we're calling that clinical dentistry. But it's these other soft skills that aren't so soft that are important, that they just don't talk about. So, I think it's awesome that you're putting that front and center for your clients.

Dee Fischer  

And I tell them all the time. Well, I tell my doctors, even if they want to grow, you need to stay at the chair for just, you know, even if it's one or two days a month, because you forget. You forget what it's like. And, you know, even like I said, if even one office, you know, always say, how are you going to act as a clinical director? How are you going to—what are you teaching your team? You know? What are you teaching about what really happens in the operatory, you know? How are you—how are you making that practice be a whole? Because, you know, the front needs to work with the back. The back needs to work with the front. And the only way that we could do that is my understanding the clinical operations that happens and the business operations. So I think it's a really important piece. And I have to say, you know, you know, even on the DSO space, if I would tell people, if you're not a strong clinical director, it's going to fall apart. Like I said, it's people. We look, we deal with people every day. You're dealing with, you know, people that are walking through the door. And, you know, I think, especially after COVID, they want that family-friendly feeling when they're walking into a dental office or a doctor's office. They want to know they're going to see the same people again. They want to know, you know, the quality of care that's there. So I think it's more important than ever.

Paul Goodman  

I'll let a funny, maybe, because you talk about Disney. I'm a big fan of Disney. So, there was a time at Disney, Rob and Dave made this where everyone had to dress up like a character in the Magic Kingdom, no matter who you were, and spend a day doing that, so you knew what it was like on the ground. I know I'm still there, but I go to my dental practice two days a month. D—to what I call contribute joy. That's my job. I'm a joy contributor. But I will be there tomorrow in scrubs. We have a new associate dentist. I talk to the front desk team. If need be, I can help manage a patient of mine—that's, you know, having a challenge. And you're so right, because if you're totally disconnected from that, you just don't remember what the energy is like inside of a dental practice, and then you lose your ability to not only manage it, but, you know, also be able to have your team follow you. So, I think that's a great, great tip.

Rob Montgomery  

I feel like, too, that it kind of goes along with what—a message of similar message—when you're talking to people who are looking to sell their practices to DSOs. And I think a lot of dentists and practice owners have this sort of misconception that DSO means one thing, that all are the same, and, you know, they really aren't. I mean, there are DSOs that are interested in doing roll-ups and flipping them and making money, and then, and they aren't necessarily experienced operators, and I see those as—if any DSOs fail, it's usually those—because they miss their window to do their recapitalization. And none of them have the interest, the experience, or the appetite to run and manage a dental practice. And then you've got other DSOs who are actually interested in running, managing, and operating a dental practice, and if they don't sell within the next two years, that's okay, or if they don't do a recapitalization, because they can continue to operate the business, right? Because they have a perception and understanding of all this stuff that we're talking about. But when we talk about the, quote, unquote, the bad DSOs out there, they are the ones that just aren't, from my perspective, aren't really plugged into patient care, any of these issues we're talking about. They're more—they're just doing it for the money, and—and there's not, you know, you kind of see through that, I think, and patients, I think, see through that. And certainly, team members do. What's your, what's your thought on that?

Dee Fischer  

So for me, I, you know, look, I think there's some really good DSOs. I think there's some DSOs that really need a lot of help. To be quite frank, you know, I think, for this, this is what I look at. I hate, all the time, you know, we have a lot of young dentists to come out of school that they're, you know, they can't afford anything at this point because, you know, the schooling was so much, whatever it may be. And I think, you know, I tell them all the time, find a great place to go work, whether it's a private practice, whether somebody owns four, what, it's a DSO. But what I want you to do when you're there is learn what you want to bring to your own private practice. The one thing that I truly believe, that I still instill in people, I don't want people to want their own practice. I want people to still have that entrepreneur spirit. And I tell them, I said, you know, there's a place for that. If you can, if you get out of school and you can't find a private practice, there's some really good DSOs, go look at them, and they'll teach you, and you might be able to partner with them, but you have to take it as a learning experience. And if you can do that, and you're going to learn what you don't want to do, and you're going to learn what you could do, or how you can even make it better. And I think if they go into a positive attitude with that, and, you know, look, there's ways to screen private practice owners, and his way to screen DSO when you're going to go work for them. My first question is, you know, I always tell people all the time is, you know, the first question I teach my associates to ask for is, you know, what do you expect of me here? And a lot of people like, well, you're coming here to be a dentist right now. What do you actually expect of me? And I said, if they don't talk a little bit about culture, you should, there's a red flag. If they're just talking business to you, there's a red flag. They need to be talking about what I expect of you is to come in here, number one, do a great job, take care of my patients. When you hear those words, you know you're in a good place, whether it be a private practice or a DSO, because I don't know any private practice owner that wants to hire you so that you could leave. But I tell them all the time, too much training, right?

Paul Goodman  

I agree. Dee, one of my best retention strategies for my associate dentist, you can use this is when I'm in the doctor's operatory office, I complain as much as possible about owning a practice so they never want to own them, one themselves. I say that. I say, oh, man, you get to go do what you want this weekend. I have to work on payroll. But I say the joking, because I just gave a lecture to Mark Costas, his group, and I talked about clinical skills, clinical skills, culture fit, and communication. And it goes both ways. Right, the associate dentist needs to be interviewing the practice just as much as the practice is interviewing the associate dentist because you want alignment, because turnover in the associate position is so disruptive, so chaotic, and it starts those mismanaged expectations. I like the STD as we move on. You came to boot camp, and there's associate dentists there, and there's new practice owners, you know, tell us about the new practice owner. Can they make it? What if they say, I don't know if I can ever compete with these big groups you're working with, one from boot camp, which you're doing a great job with. But just if you could help our audience feel inspired, but also understand, you know, tell us about that solo dentist and their journey in 2025. Can they grow? Can they be happy? Can they be financially successful?

Dee Fischer  

Absolutely. But they have to have real expectations. And my biggest thing is what I tell them, exactly what you said, Paul, you're going to be doing payroll on the weekend. This is hard work. You know, I—people, time, if you don't want to put the grit in and the hard work, it's not going to be successful, but anybody can own a practice, anybody can do whatever they want to do. I think Dental is one of the greatest professions. Still, I feel that there's a lot of opportunity now. What I think they could do is, like, when they learn, when they come to—like, when it comes to dental boot camp, we talk about, well, how do you build a bit? What do you do? How do we, you know, who could be my resources? Who could I network with? You know, there's many ways that they could do it. And again, it's, you know, what I see all the time is, you know, we have these young dentists, and, you know, they want to build the Taj Mahal from day one. I'm like, you don't have to do that. You could start with, you know, one or two or three operators, whatever you want to do with, you know, be reasonable. And if they have reasonable expectations, and they don't overbuild from the beginning, they will be successful. Because I will tell you that, look at how many people there are. You know, I always tell people all the time, when I went through, you know, when it was like the 80s, or whatever, I can't even remember, and it was really tough. I said, yep, but still, 80% of the people have dental insurance or need a dentist. So they're still going to come because of our reputation. So, you know, it's hard work. Yes, they can do it, absolutely. They just have to sit down and do planning and be accessible to their—to their patients. And if you really do the new patient journey well in your office, you're going to do fine. But they have to focus on, what does it take to have that new patient journey, and what, what is it going to take me—how many hours x-ray is going to take after clinical to be able to run the business? And, like I said, it has to be real expectations. Yes, no, you're going to be doing payroll on the weekend. Yes, no, you're going to take time with your patient. You got to build a relationship. Because what's the best referral? Or referral from another patient, right? So I truly believe, you know, there's so much opportunity out there, and you just have to go get it.

Rob Montgomery  

I love that now. So, Dee, question: So, what are the challenges to growing a practice? So really, like, what are some of the things? And let's break them down from a clinical perspective and from an economic slash business perspective, because I really—I love the fact that you identified which one of my talking points, which Paul has probably heard maybe 100 times, possibly more, which is, you know, a professional practice owner has to have a foot in two worlds. Unlike other businesses, where you focus on the business, that's it. What are the numbers? What does it—what is our—what do the economics look like? What is the quote, unquote, business side? That's what a dentist has. But then you have this whole nother thing where you are responsible for being a professional and rendering clinical services, and sort of like the trade-off between those two things. I see my clients, generally—the successful ones, the unsuccessful ones, or I should say, the less successful ones—the people that can manage that, at least from the start. It's crucial. But going forward, you know, if you're going to separate those things, it's bifurcated. What are some clinical challenges to growth, and what are some business challenges?

Dee Fischer  

So I think the biggest clinical right now, of course, is the hygiene. We're seeing it across the country, less and less hygienic. And the way we've always practiced is, you know, hygienist does, you know, all the hygiene, the doctor does, all the operative whatever. I think right now, it's more becoming more of a mix. And honestly, I, you know, I tell people that I don't think it's so bad. I have associate doctors that I am teaching to do hygiene, and while they're doing hygiene, they build in that relationship with that patient. We're able also maybe to do a filling at the same time, do some same-day's care. So if you could take that obstacle and make it an opportunity, it works out really well. So, but it is an obstacle, and you have to reteach and say, hey. And, you know, I have some of my young associates that are starting out, and, you know, they're doing really well with this now. They're like, yeah, it was really good that I met the person the first time I took care of them. You know, it might not have been the most productive appointment, but they came back. They scheduled the treatment. So you have to, you know, kind of work around now on the staffing issue, you know, everything's gone up. Supply staff has gone up. But, you know, again, it goes back to the challenges. How do I build my budget? How do I stay within budget? And it's more of, what do I really need instead of want? And I tell people all the time, if you really treat your patient well, and you have a great patient journey, you have an office that presents well, they're really looking at you. They don't really care. Honestly, a lot of times, if you have, you know, design a wallpaper on the wall, or if you have granite, you know, countertops, they really care about the care that you're delivering with the compassion. And also, what does your team bring to the table? So the challenges are keeping the culture where it needs to be to your team. Hygiene for sure, do the work around and then, like I said at this time, really, what are my wants instead of what are my needs? Sorry, instead of my wants. And if you could get to those next three, I think in the two years, I think you'll come out like a shining star.

Paul Goodman  

I love that.

Rob Montgomery  

Yeah, good. I'm kind of curious, because this is the challenge. I mean, it's like maintaining culture or instilling culture. If you have the ability to sort of pick and choose or draft whomever you want, you can put together a team. But let's face it, it's not that easy. Now, like, you know, it's—you may have to hire, or at least, I see that sometimes from—from clients in every business. Now, you may find yourself having to hire people to get a job done. That may not be a complete cultural fit, but that seems to me that that's—that's part of the challenge. I guess, you know, it's not—I guess my point is, is it always that easy just to pick and choose what your culture is going to look like? And how do you deal with—I actually wanted.

Paul Goodman  

It’s a difficult, I want to add, indeed. You just have to influence this next part for you, as a dentist who has two practices, not 25 practices, but our biggest challenge is actually the dental assistant role often, because I love that. You said associates can do hygiene. I did hygiene. Our do some hygiene. I think it’s an amazing thing that not enough associates understand. But you know what I can’t do? Dee, I can’t assist myself, right? And dental assistants are so technically trained, I don’t know if people even think about this enough, that if you lose a dental assistant, or you can’t find a dental assistant, you have to cancel a $6,000 day. You have to cancel eight patients who are going to, you know, help you that day. So, I don’t know, as Rob talks about how to build this culture, I find the dental assistant role is equally challenging to the hygiene role, because you can’t assist yourself.

Dee Fischer  

Well, we, you know, it's we. So, we did a program in Arkansas, and I, you know, I went to the high schools and said, Listen, you know, we have an opportunity. We're going to do it, and we're going to do a paid internship for anybody that went into the dental world, and they could come over and, you know, they have to have a commitment for fear, stay with us. We will train them, and we, then, they can go into the dental field. So, we have had such a great response to that. We've had kids coming in and, you know, starting at sterile tech, teaching them to be dental assistants. We have, like, a lead dental assistant that's been with us for a while, and hopefully each practice has some of that, and they feel so empowered now because they're actually teaching someone, and it's really succession training, which is going on. But, again, I tell my associates, you have to train your assistants now, because we don't have a pool of dental assistants we used to have, right? And my biggest thing is for the culture of the offices. You're probably going to laugh at this, but once a month in the offices, I work with the front marks in the back, and the back works in the front. So, everyone knows how to take an x-ray. Everyone knows what a slide rejector is. Everybody knows how to answer the phone, because if someone's out, we have to be able to do that. So, we, once a month, we transfer, and that's what we do. And we also, like I said, we've reached out to schools to help us. I did the greatest ad as the other, you know, was not too long ago, and I said, if you don't want to work weekends and laytons, Call us, and we got some great people from the real estate industry, because it's flowing now, and they understand business side, and we're teaching in the clinical, and it's working out well. But, you know, I'm always a big believer is you got to find another path. You have to find it, and you have to make it work. But the one thing that I hire for is attitude. You can teach skill, but you have to make sure you're hiring the right attitude. And it's not easy, but—and when they get there, who in the practice is the keeper of the attitude? And we have a culture officer in every practice.

Rob Montgomery  

And what is the cultural—give us some examples and some things that the cultural officer does. What are their responsibilities? What are some of their, their, their strategies?

Dee Fischer  

So they do a check-in every day with the—on how they're feeling, what they're doing. They, once a month, have the team build a team-building event that they want to do altogether. It could be on-site or off-site. They're given a budget for it. And the biggest thing is, number one, is they are the one that's honest with the dentist behind closed doors, and they're the one that's telling the dentist, hey, listen, you know, we had a great day today. The team, we worked hard. Let's make sure we're complimenting them. Or, hey, we had a great day today. But, you know, maybe things didn't roll the way you thought they should be, and we were a little harsh. You know, she's really telling the dentist or whoever in that practice, you know, what our day really looked like. And if we have to go back and have a conversation with someone, whether good or bad, we have to do it. So there's, there's a check-in every day to keep that call where it needs to be. And I think the thing that we love most is they get to build a team event every—every month. And Mike said it doesn't take a lot of money to do that. It just takes time, and they do it as a whole team, and they love it.

Paul Goodman  

I think it's awesome that Dennis would do more of that. I think, you know, just to—just want to deepen this conversation—is a good one. Is that, you know, I will mention, I have 11 months left to mention how many times the Eagles have won the Super Bowl this past year. D, and you know, they're just wearing, yeah, and wearing, wearing Eagles green demo—not your sweatshirt. What Rob had said before, having your foot in two worlds is a great thing. And what I want to share is the Eagles coach is not playing in the game. So, when you see them running up and down the sideline, they are not tasked with throwing the ball. Ball, or catching the ball. So, as a dentist, it's actually so hard to understand what's happening in your culture, because you're in your operatory the whole time you're in the game, and that's why I love this culture officer who has the time and the bandwidth and the ability. I'm sure it's a very special person to practice, because it's unfair to ask the dentist to do it, because they were doing crown preps or placing implants, and it's just an impossibly difficult task for one person. Hopefully, what this podcast does to you is—that's why you need to ask for help. That's why you need to hire coaches. That's why you need to have people in dental school. You know, makes you think you're supposed to do everything yourself, learn how to do Google ads, run a practice, do your own payroll. And that's why finding people like what you do—coaches can transform people's lives. I want to ask—I don't want to—I wanted to not miss out on asking this. D, and your name's D, so it's a perfect D. I think the three Ds influencing dentistry right now, whether you want to say positive, negative, is dental school, debt, DSOs, and dental insurance. So, I'd like you to tell us a little bit about dental insurance, because it is wild to me, as a dentist of 20 years, that some dental insurances are paying less than they did years ago for work that costs more. Currently, our offices are out of network. We were in network for 17 years. Both sides have challenges, but when your practices are coming to you with dental insurance pain—this plan isn't increasing their rates, this plan is doing this—how do you help them navigate that?

Dee Fischer  

You know, you have to understand the mix that's in your practice. How much is PPO? How much is fee for service? What is it? And, you know, Paul, you can't be afraid to say, I'm worth this value. I might have a little bit of hiccup, but once I get at a network, it's still going to be okay. And I think you really have to understand, you know, how that mix works in your practice. And, you know, I also tell people all the time, don't be shy to ask dental insurances for a raise. Don't ask them for a small raise. You know, ask them for the codes that you do most. You know, you go down that road. But again, it goes back to, you know, sometimes we're afraid to make that jump and say, You know what? It's really not worth it for me to do, let's say cleaning for $30. Yes. But if you educate your patients, and you say to your patients, this is why I cannot take this insurance. This is what I'm doing. I'm willing to take care of you. We have a members discount plan, whatever. You have to be able to have those educational conversations, and a lot of times we're able to maintain some of those, a good number of those patients, because we've, we've had a good relationship with those. They don't want to go anywhere. We're offering them maybe, you know, like I said, a membership plan. You have to have your plan put together before you decide to jump out of insurance. But I'm going to tell you there are some insurances you should not be on. And again, you need to know your value as a dentist and as a team. And if you are having a great patient journey, you're going to be able to say, you know, this is what I want. I have... I work with a client up in Bend, Oregon, and several practices or whatever. And, you know, he's had a network for, you know, most, most of the insurances up there. And he had one practice that was in network. And he finally just said, Why am I doing this? And I said, you know your value, the community knows your value, you—that's a decision you have to make. But, you know, and it's like, I say this, you know, I go to some of the bigger events, and people come to, oh, gee, I have 12 practices. And my first question is, well, how many are profitable? And they're just like, What do you mean? I said, Well, we have 12. How many are profitable? And, you know, they don't understand the mix. They don't understand how insurances work. You know, I just, I even find sometimes when I go in, they're not even billing properly. There's so much to go through into it.

Paul Goodman  

I think, Dee, what you're sharing is so amazingly insightful. You talk about the economics, Rob, this should be one of the things you pay attention to the most. And I will share, I didn't pay attention to it soon enough in my career. Doesn't mean you have to drop a plan tomorrow or take a new plan, but I just didn't pay attention to it enough, right? I had an amazing dad who was a dentist, but it's sort of this old school 80s mentality, oh, we're in with some plans, not in others. I said, this one, we're writing off 50%, why are we doing this? And in 2025 dentistry, I think you need to pay attention to those economics, because if you don't, you can be in a very painful place.

Dee Fischer  

Absolutely. And I think, like I said, I, you know? And it goes back to, like I said, you know. And that leads into, you know, if you're going to own private practice, and then you have school debt, right? How are you going to, how are you going to be able to pay for all this? What does it look like? And I tell people all the time, you know, you don't have to have 100 patients a day to be successful. You just don't, if you have the right mix in your practice, between fee for service, PPO, whatever it may be. And you know, in my mind, I like to maintain a 50-50 balance. I like that 50, you know, fee for service, maybe 50, you know, plans, whatever. I like to have that healthy mix. And I'm monitoring, that's one of my KPIs, that I look at every, every quarter. Because if I two cash patients, you know, walk out of the practice, I want to make sure I have four that are coming in, right? How do you do that? So always, you know, looking, looking at that. Because we do have school that we are business owners, you know. And I tell people all the time, when you hire people, whether it's one, two or three people, you're also hiring their family, because it's our obligation to make sure that everybody gets a healthy paycheck, and we're able to do that. So that affects the families that are in your practices that are working for you. But I do agree with you. I think it's, you know, you have to pay attention to that. And I also think is, you know, how are you paying down your school debt? Do you have a plan for that? What does that look like? You know, you want to own a home, you know, a lot of things you want to do. Have you really sat down and have you put a strategy to that? What does that look like? So I think those are some really key conversations you have with your dentist when you work with them. And you know, a lot of, I know a lot of consultants, like this, don't want to get into that, but I think it's really important, you know, when you're, right, when you're running a private practice, and, and that's your, you know, that's your income, that's what's going to feed these families. You need to be on top of those things. Along with your clinical game.

Rob Montgomery  

Totally with you. It's good stuff. And that's, I think, a great segue into our final question, which is, Dee Fisher. Tell us, can a private practice, a dentist that owns one to two locations, compete and survive in today's current dental world?

Dee Fischer  

Absolutely, no doubt about it. And I think, you know, and I'll tell you just really quickly, there's a space for everybody. And if you create the right space with the right plan, and you have compassion and empathy, and really want to take care of patients, you could have one, two, or three practices. And it doesn't take 100 practices to be a successful dentist. It takes one, great one, and that's what I tell my doctors all the time.

Rob Montgomery  

Awesome. That's, that's a great, a great message for, for our listeners, and the thanks for taking the time to be with us today. And if, if people want to reach out and learn more about what your consulting group does, and possibly want to work with you, what's the best way for them to do that?

Dee Fischer  

Actually, is to go on my website, reach out through the website, and, and most people have my phone number in the industry anyway, but, yeah, like, said, probably through the website.

Rob Montgomery  

And we'll get that URL up on, on our show notes too. And thanks so much for taking the time to, great, great chatting with you.

Paul Goodman  

Thanks so much Dee, thanks. Really appreciate it.

Dee Fischer  

Thanks for having me. I appreciate it.

Rob Montgomery  

It's great to have somebody that just has that kind of experience and knowledge that they're able to bring it to their, their clients. And that's why you hire good consultants, right?

Paul Goodman  

Totally. I mean, people think that dental—not just as a JBN, just be nice attitude, which it does, which means not to, if someone does dental work differently than you, not to call them the worst dentist in the world—but we have a JBR attitude that I think Dee, you know, is totally part of. Just be real, right? You know, Dee didn't say it's impossible to be successful as a practice owner. She said, what you need to do. And she also said that there’s DSOs growing too, and I think that's the reality that dentists need to learn. I'm glad she was able to share it with us.

Rob Montgomery  

Yeah. I also liked when she talks about needs, not want, to me—that's like, that's the classic thing where you're out there on the island. You think this is a good idea. There's nobody else that you can really, in your practice, bounce certain things off of. This is where a good consultant says, "Yeah, but maybe you shouldn't," right? Yeah, you know. And that's oftentimes you're not looking for advice as to what you should do, but sometimes what you shouldn't. Yeah, exactly. Totally with you. That's always fun. Paul, thanks everybody for listening. Thank you, Paul.

Paul Goodman  

Thanks, Rob.

Bumper  

Thanks for listening to another great podcast with the Dental Amigos. And don't forget to tune in next time to have the dental business demystified. If you're looking for more information about today's podcast, you can find it on the dental amigos.com if you're looking for Paul, you can find Paul at drpaulgoodman.com and if you're looking for Rob, you can find him at yourdentallawyer.com This podcast has been sponsored by Orange Line Media Group, helping dentists and other professionals create content people love. Find out how we can help you take your business to the next level at www.orangelinemg.com. Till next time.