This week, the Dental Amigos welcome Stephanie Mapp, DMD, dental consultant, speaker, and founder of “Mapp Your Practice.” With over 30 years of clinical and business experience, Dr. Mapp helps dentists navigate PPOs, practice transitions, and sustainable growth strategies.

In this episode, Dr. Mapp shares her journey as a multi-practice owner navigating financial and legal adversity.  With the knowledge gained from this experience, she now empowers dentists to rethink PPO participation, associate hiring, and practice profitability with clarity and resilience.

To learn more about Dr. Mapp and ”Mapp Your Practice,” visit www.mappyourpractice.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. Welcome to another episode of the Dental Amigos podcast. I'm Rob Montgomery, and I'm joined, as always, by the head Nacho himself, Dr. Paul Goodman. Great to be talking, Rob. It's good to see you, Paul. It's good to be talking to you. And today I'm excited—we have a cool guest who we've both had the opportunity to meet in person. I know she's a sponsor of the Nacho Universe, and she and I met a couple of times a few years back now at one of the awesome Dentist Boost Camps. Like a reunion, it is. It's great. I mean, it's super. I mean, you've always done a great job at providing content to people electronically, but my favorite thing is always getting in the room with folks and meeting all these people in person. And the happy hours are pretty good.

Paul Goodman  

Yeah, I know, right? We... we... fun is just as important.

Rob Montgomery  

You do fun well, thanks. So today we are joined by Dr. Stephanie Mapp. Stephanie has over 30 years of dental experience as well as continuing education. She attended the University of Florida College of Dentistry after only three years of undergraduate education in the psychology department, and she's worked in many types of dental practices representing all ranges of socioeconomic backgrounds—from public health to boutique fee-for-service offices. Her experience has presented her with exposure to many types of management systems, and she's had nine associate positions, hired five associates, did a startup, and purchased a practice. So I think Stephanie's kind of firing at everything that we talk about on this show, Paul. And Dr. Mapp enjoys sharing the pitfalls of private practice to save other dentists from excessive stress. She has appeared as a guest on several podcasts, including The Practice Fixers, Beyond the Smiles, and The Mommy Dentist in Business—who we had the moderator on way back when. Yeah, and she's contributed to two books, appeared on other lectures nationally on how to have a more profitable PPO practice, as well as how to transition to an out-of-network practice. Dr. Mapp lives in Florida with her son, three dogs, and her ER doctor fiancé. Most of her time away from the office, she's traveling the globe and cheering for the Florida Gators. She retired from clinical dentistry in 2023 to focus on her consulting company, which is Map Your Practice—and that's spelled M-A-P-P, just like Stephanie's last name. Map Your Practice helps new and existing owners set up systems for dealing with PPO insurance in their dental practices. So excited to talk to Stephanie today, and without further ado, here's Dr. Stephanie Mapp. Welcome, Amigo, and thanks for being on the show.

Stephanie Mapp  

Thank you so much for having me. It's an honor, and especially because I do know you two personally from Boost events. I think it's exciting—we all get to catch up. And I do have to throw out there: Go Gators! National champions. I'm not...

Paul Goodman  

They won. You're right, Stephanie. They...

Stephanie Mapp  

I'm not going to let that opportunity slide.

Paul Goodman  

But we're still... we're still basking in our Super Bowl victory here in Philadelphia. The championship theme—go...

Rob Montgomery  

Well, how long can you gloat in the championship? What's... what's the... I think until the next champion. I think so. You've got till next March, at least, Stephanie, to continue to...

Stephanie Mapp  

You know, we have until next March, but at the same time, we get to check it off as just another championship because, you know, it was not preferred.

Paul Goodman  

So Stephanie, our hard-hitting question to start is, you know, dental nachos—I know you know well—what is your favorite nacho topping? And if we were down in Florida, where would you take us for nachos? What's one of your favorite places?

Stephanie Mapp  

Okay, so in our area, there's a locally owned—it's a chain, but it's local—and it's called La Napolera, and it's just good basic food, nothing fancy, but you know, great margaritas, great Mexican food. And my favorite nacho topping is, of course, cheese, because how can you have nachos...

Paul Goodman  

Very true. Cheese says it well. Thanks. I hope we can go down there and get that together. We have so many fun things to talk with you about. Just to set up—because what you've talked about is one of my favorite topics, Stephanie—with dental insurance. And maybe the question I'll ask to kind of get us started is, you know, I know we're both a fan of Mark Costes, and I always say I wish I'd met Mark Costes earlier in my career because he had me pay attention to the numbers of my practice. I was somebody who was always into building a great team and hiring consultants for my team and great customer service, but I wish I paid attention to PPO adjustments sooner. I think I could have made better decisions. So if you were just to tell our listeners, you know, what's one or two things that they should be aware of about dental insurance that we didn't know earlier in our career, what would you tell them?

Stephanie Mapp  

So I made the mistake of learning about insurance after I almost went broke. So what I tell people is: high-volume, low-fee dentistry is not as profitable as low-volume, high-fee dentistry. There's a lot of nuances to all of it, but what I didn't pay attention to was that more patients doesn't mean more profit. That was the first thing I learned. The second thing I learned is dentists need to know what they're getting paid for their top five to ten procedures from every contract, and they need to know how many contracts they're in, because I speak to too many dentists that don't know the answer to that. They don't know what's your highest and lowest copies, and how many contracts are you actually in.

Rob Montgomery  

And Stephanie, this is probably obvious to you, but why—tell our audience—why is that important to know that?

Stephanie Mapp  

So when I was in 13 dental contracts, and I had two practices, and I was doing over a million and a half dollars of dentistry just for myself—not counting hygiene—there was a day where I checked my balance and I had $20 in my bank account or less. And that moment of, "Oh my gosh, how can I be doing this much work and not have any money?" That was one of my wake-up moments of, "Why am I even doing all this work for $20?" There were years that I made more money as an associate than I did as an owner. So that was one of my wake-up moments.

Rob Montgomery  

And so what did that spur you to do at that point? Like, what action did you take once you had that epiphany?

Stephanie Mapp  

So I decided to actually start paying attention. I had always looked at my production. I had always looked at my collection. But what I never looked at was how many procedures am I charging out, and what am I earning per hour based on my production and collection numbers. And so when I started looking at those things, I started printing out my schedule and writing down the insurance fees for certain codes. So that's when I had the aha moment of, well, why am I accepting this fee for this code? When I know, for example—nowadays more than ever—this is super important. Okay, at the time, I had three hygienists in one office doing 45-minute hygiene appointments. And I didn't realize for some of these hygiene appointments, I was actually losing money. So it wasn't until I looked into that—and now, more than ever, with the hygiene shortage—if you are losing money in hygiene, it doesn't make sense, because there aren't enough hygienists as it is, and there aren't enough spots for patients to get in for hygiene. And so why would you accept a fee that you're actually losing money on in your practice? I realized I could pay this patient $12 to go across the street, and I would still come out ahead.

Paul Goodman  

I mean, Stephanie, I was just—you know, it's interesting. I made a post on a Facebook group this morning, and it often causes a lot of hoopla because dentists are very emotional about this topic. And I actually said, if you accept a PPO insurance plan that reduces 34% of your fee, the only way you can see those patients is because your full-fee patients are essentially paying for them to be in your practice. And that's 100% true because we had a podcast early on when we asked a dental-focused accountant—Rob, and maybe you can weigh in on this, Stephanie, because maybe there are some updates to this, and you might think differently. I said, if you charge $100 for a procedure, how low does it have to go where you're probably not really making any money? And that dental-focused accountant we had on said about 20%, right—$80. And our listeners now, if they're listening, there are many—and I've been in this boat myself—where we take insurances that pay 50% of our fee, right? You charge $1,000, they pay $500. What would you say, Stephanie? Like, what's the—I won't hold you to an exact answer—but if someone's just starting to think about this and saying, "I want to start thinking about this and how it works," what percentage write-off does it start to become really problematic to do that thing where they're kind of paying the patient to be in the chair?

Stephanie Mapp  

So here's what I say—because your full fee is an imaginary fee. If you're mostly seeing PPO patients, you can't even go by just a percentage. However, that being said, I have made it known that I don't understand people that get out of bed for a 50% write-off. But I see write-offs higher than 50% in some practices. Now, the most important thing is, you really need to know what it costs you to run your practice, and a lot of dentists have no idea. I call it in my lecture "Sam Fair Ask Minimum." And if you don't know what it costs you to run your practice, you can't even calculate at what point you're losing money. However, the industry standard is that a hygiene spot—if it's an hour long—you should be making collectible income of three times what that hygienist's salary is. And the reason for that is people think hygienists—especially—that we're getting all this money for what's getting charged out, but they're not counting the rent, the utilities, the one or two people up front making the appointments, the time it takes to verify insurance. There's so much that goes into that—not even counting supplies. So if I'm going to lose money on an appointment, I'd rather my chair be empty than use supplies on an appointment, because then that puts you further behind. And I think dentists are too caught up on, "Oh, I have an open spot. I must need more insurance," which I prove is the wrong way to do it, because I actually did my startup as a fee-for-service. And so I went backwards during the 2008 recession because of how badly we were affected by the recession and how I went from collecting over $100,000 a month in 2007—when $100,000 in 2007 is worth way more than it is this year. But I still know plenty of single-doctor practices that are not even doing $100,000 a month. I was doing it back in 2006 and 2007. But what I realized is, after signing up for every insurance there was, I was actually doing more dentistry and bringing home less money than when I was fee-for-service and seeing fewer patients.

Paul Goodman  

If I want to bring up this topic, it's so exciting to me. I know sometimes we have guests that just talk about law stuff—Stephanie, so Rob—but Rob, I like catchphrases, but it really bothers you when there's dumb ones, right? Like, back in the day, they said "No pain, no gain," which was not a good thing to follow, right? If you are injured, you probably shouldn't push yourself at the gym. You're going to get hurt worse, right? And one of the ones for dentistry—Rob and Stephanie—here is: "The most expensive chair is an empty chair," which is just wrong. A chair with a patient—not a chair with a spoiled PPO paying you less—is worse than an empty chair, right, Stephanie?

Stephanie Mapp  

It is definitely worse. And getting that through people's brains is tough, because they feel as though, "If my chairs aren't full, then I'm losing money." But the reverse is true, and I proved this because I went from two practices with five days a week of me doing dentistry to when I finally got off the treadmill and the hamster wheel. I was working three to three and a half days a week with five weeks off a year. My team had plenty of paid time off, and I was making more money than I was with two practices working five days a week.

Rob Montgomery  

Yeah, that's crazy.

Paul Goodman  

Your clients, Rob—just curious, and we talk all the time—but like, when you're helping these people, you know, realize their dream of ownership along the way of acquiring a practice, how much does the in-network PPO factor come into play? Just with them talking to you, like, do they happen to say, "Hey, I'm buying a practice where it's 80% PPOs and it's going to be fine"?

Rob Montgomery  

We always ask, you know. But I think the wrong mindset kind of begins—this kind of pervades a lot of different places in the dental world—where, like, the status or what matters is revenue. Everybody always talks about revenue. You know, like, "This practice is grossing this," or "What percentage of revenue should I be paying to buy this practice?" And you know, we've talked about this in different ways, different contexts, Paul—like, that doesn't matter. You know, it's not about revenue, it's about profit—or at least it should be. And then it's like, well, the DSOs—they purchase practices based on a multiple of profit. Well, of course you're not interested in revenue. And so we do ask the question, and you know, I had a consult with a client today who's buying a practice, and a large chunk of the insurance that they're buying—the PPO plans that they're buying in this practice—are Delta Premier. And they're going to take, like, a 35% hit off of 25% of the revenue. And I said, "Has your accountant factored that into this?" You know, when they said the cash flow works, and they said it has. And I'll double-check that accountant too, after we get connected. But, you know, I think people talk about it, but I don't think they understand it—certainly not the way Stephanie's talking.

Paul Goodman  

And Stephanie, that's what—so basically, when you do your Map Your Practice, I mean, I'd love to just dig in a little bit into this. People come into our office with an emergency, right? Your whole career, people—your team—says, "My patient has an emergency," right? And most of these emergencies, in my experience, would say were pain or broken teeth. Would you agree, Stephanie—people came in with pain or broken teeth?

Stephanie Mapp  

Yes, those are the most common emergencies.

Paul Goodman  

So tell us a little bit about when they reach out to you. What's their pain or broken tooth—like, you know, when you're doing these first consults, what is that kind of discussion? What brought them to you? What are they saying?

Stephanie Mapp  

So the two most common things are: "I'm super busy, and my bank account just does not reflect the volume of work that I'm doing," which, in my opinion, that's the chair I was sitting in. So I can easily walk them through a series of questions and say, "Look, how many plans do you have?" Well, oftentimes they don't know. But at the same time, if they're super busy and they cannot get a patient in for months and months and months, to me, that's the number one sign that they are on the wrong path. And the second question I ask at this point is, "Are you willing to drop insurances?" Because if you're not, I can't help you—because it involves being willing to drop the lowest-paying plan. And I put people on a multi-year path to continue to drop plans until either they are getting good enough revenue that they feel comfortable staying PPO with the right plans, or Eventually going entirely fee-for-service. But if you're a really busy practice and you can't get a patient in for weeks or months, it's time to leave PPO plans—even if your very biggest patient base is on one plan that you feel like you can't leave.

Paul Goodman  

It's... it's... it's what—what I'm curious about is, the right move isn't just to drop them all and tomorrow not have any plans, because I'm assuming that could be just as dangerous.

Stephanie Mapp  

Right. Now, I will tell you, I don't advocate for that. However, I do have some clients that do it, and when they do it, I make sure that we've got the right information to figure out: Is this going to work, or is this not going to work?

Rob Montgomery  

Information—you're talking about cash flow analysis? That you're—somebody's actually charting this out and can anticipate what it's going to look like?

Stephanie Mapp  

So what I do is I actually pull a lot of data from their system, if they have the right practice management system. And I look at the breakdown of every number of patients on every plan, and what those fees are for that plan, and their new patient flow. So it's not just a "Hey, let's just drop this." I can tell you to the month exactly—assuming losing every single patient on that plan, which, of course, never happens—but I run the numbers based on: if you were to drop every patient on this plan, at what month could you afford to drop it?

Paul Goodman  

It's really smart to do, because dentists—we're often worst-case scenario thinkers. And it's... I've shifted status—I think it sounds nicer than "drop"—with multiple plans over my career, multiple times. And the number of people that have left us for another dentist has been different every time. And a lot of times—you know, Stephanie, I know for me—it was: are there other good dentists in the area that take that plan? Well, then if there are, they might leave you for them. If there's not that many, then they might not leave you. If it's during a pandemic, it might be annoying to find a dentist, right? So I think it just shows you—you never know. You don't know them, and you're going to leave. But if you plan for the worst-case scenario, dentists I'm sure really like that, because we love worst-case scenario thinking. That's kind of our favorite, right?

Stephanie Mapp  

But the other factor in that puzzle is knowing what the plan is, because I can generally predict. There's one plan that I generally ask every dentist to leave. I'm not going to name it, but I tell them: this plan will pay terrible out-of-network. We are going to assume all of them leave at the same time. There are some plans that, if you leave, they pay great out-of-network. So it's a kind of combination of knowing the other plans in the area, and I do a lot of research into their EOBs. So there's a lot of factors behind the scenes besides just knowing, "Okay, are we going to assume everybody's going to leave?" Because the ones we're pretty sure are all going to leave—I even have different examples of what to say to those patients. So it's not equal across all plans when you drop.

Paul Goodman  

Right? So I don't know, Rob, if doing these podcasts gives you more compassion for us dentists, because I know clients may switch attorneys. Clients may say, "I'm going to..." but like, they don't say it's because you stopped taking their brief and turned PPO, right? So just think about that for us, right? Yeah, we have these relationships with people. I mean, this is what happened with my dad. We saw the teacher plan in our town for decades, and our own teachers were just walking out of our practice because we stopped taking their dental insurance. We stopped participating—just so everyone's clear—they could still have utilized it, but they would have had to pay a higher fee out of pocket. And I want to share—it was kind of demoralizing. Like, I don't know if anyone understands that who's not a dentist. You develop these relationships, you do these things with people, and I get it—they come to you because of your insurance, so I totally understand. But dentists are people too. Not everyone knows we're people, Stephanie, but we are. And it was kind of demoralizing—second grade teachers saying, I'm just using an example—"We're leaving this practice after 30 years because you don't take..." Nothing to do with the care. Nothing to do with a bad experience. So it just highlights one of the factors we have to deal with that, unless you're a dentist or a doctor, I don't think you can totally relate to that.

Rob Montgomery  

Makes sense. Well, it's scary. I mean, anytime you have a business where you rely, obviously, on people coming in the front door, and you sort of put up a barrier to that—it’s a scary thing. But you know, Stephanie's saying the flip side, which is putting people there when you're losing money, is much worse.

Paul Goodman  

I won't rob the joke question—I can't miss this joke. Stephanie, I don't know how you felt about this, but we dropped a plan. Sometimes one of the patients that I thought didn't like me would stay, and then the other ones that did like me would leave. And it was very interesting. I don't know if you've ever dealt with that—you go, "Oh, if we drop this plan, Bill Smith's leaving. He doesn't like us." "I'm never leaving you guys!" And I always thought that was a little bit funny—that who you predict would leave would not be who actually leaves. Have you found that, Stephanie?

Stephanie Mapp  

Well, here's a funny thing that I started doing as I left plans. I realized there were patients that we all have—I think Gordon Christensen said it best in a lecture I was at with Gordon Christensen. He said, "The patients that fly in on Monday morning on their broom—you know, you might want to write them a letter and dismiss them at the end of every year." So I always remember Gordon Christensen saying that. And so I now tell offices that what I did is—the patients that I really wanted to leave—I made sure that I wrote those patients a letter saying, "We're leaving your insurance, and where would you like your records sent?" Because I just wanted to get them out. And that was a good excuse for me to send them a letter saying, "Where would you like your X-rays to go?" Because then it was less likely that they would stay. Most of my other patients—I never sent letters. I just had one-on-one discussions with...

Rob Montgomery  

Yes, aren't we to do it? Yeah. Well, so this is probably a good time to transition a little bit. You're very involved as a consultant in practices, and I know that you're also very passionate and have a lot of experience with associate dentists in practices. And so, if you can share with our audience, Stephanie, what are some things that you think—what things do you find yourself repeatedly telling your new consulting clients when it comes to associate dentists and associate dentist relationships?

Stephanie Mapp  

So the one thing that I hammer out to everybody that asks is: there are three things that happen when you have an associate—you make money, you lose money, or you break even. Only one of those things is making money. That means two out of three times you're either going to break even or lose money, because an associate is not a guarantee that you will increase your revenue. You may lose money when you hire an associate, and it's for a variety of reasons. Number one is, if you're getting a 50% write-off, and now you're giving 30 to 35% to an associate after you've written off 50%—there's no profit in that whatsoever. So I think one of the things dentists also think is that, because they're a dentist, if they bring another dentist in, it's going to double the growth of their practice. It doesn't work like that, because the owner-dentist generally does more production than an associate. It doesn't mean there's anything wrong with the associate—it's just the patients trust the owner more than they trust the associate, and it's a little bit of a detriment to the associate. An associate has to be in a practice for a long time to gain the same trust that an owner has. So an associate is also an extra moving part that can create more headaches than help if they are not a good associate. So I tell people: an associate is not a magic bullet. I had one phenomenal associate that I loved. I had a couple of okay associates, and then I had two awful associates. So out of the five, I had one that I loved—that it would have been great to keep her forever. But it's just not always this fairy tale thing that a lot of people think.

Paul Goodman  

What made you love the one you loved, Stephanie? What was so great about the one that you loved?

Stephanie Mapp  

So she and I, first of all, had the most common treatment philosophy, and that's something you can't train somebody. You know, they have it or they don't. We went to two entirely different schools—she wasn't even from my school. Ironically, the one that was from my school, I think, was my worst associate. So it's just treatment philosophy. Philosophies are grown over time and experience. And so, you know, she just was a level-headed, solid associate, and she just gelled the best with my team. And that's an intangible—you don't know when you're hiring.

Rob Montgomery  

Yeah, so hard. I was going to ask you—how do you vet that? Like, how do...

Paul Goodman  

You gel the best with your team—is the game. And how about on the other side?

Rob Montgomery  

What do you do, Stephanie? Like, do you have any tips for interview questions? Or, like, how do you try to flesh that out if you're hiring somebody?

Stephanie Mapp  

Well, so what I learned after my experience is—I, with Paul, disagree with working interviews. I'm very against them. I also, with Paul, don't believe anybody should have a job without a guaranteed daily...

Paul Goodman  

Guarantee. We're on the same page with our two things, right?

Stephanie Mapp  

Yeah, and I will beat that drum all day. I think it's totally insulting. There is no other profession that doesn't get a daily guarantee. You will never see a pharmacist, a doctor, a lawyer, an accountant—anybody—show up for work without a daily salary. So the best thing, I think, is to sit down with multiple sets of X-rays. And first of all, you need to have your treatment plan philosophy listed out and say, "Look, number one, I believe every new patient, toothache or not, should have an FMX and a pan." That's my philosophy. If this person's philosophy isn't that, then they're not going to gel. The second thing is, how do we go through a treatment plan? Okay, here's a set of—here's an FMX, here's a pan. Now, are we going to know everything about this patient without the patient being present? No. But I'm going to have this potential candidate go through the FMX and pan and say—I'm going to say, "What do you see? What are your thoughts on this?" And do they bring up the right questions? Do they bring up, "Hey, I see this on tooth number two. This is what I'm going to be looking for." So you can learn a lot just from holding up the FMX and pan to know: what are they now going to look at? Now let's say you've got the FMX and the pan—you can show them now, after getting their feedback, "Okay, now here's the patient's actual charting." Now that you see the actual charting, what would you do the same, or what would you do different? Based on what you saw on these X-rays, you can learn a lot from somebody. It should take some time to go through that. If somebody is going against my philosophy from that point, I know it's not going to work.

Paul Goodman  

It's actually great advice. I never thought of it that way. And I want to ask you a question, Rob. And I know this is not legal advice for stuff, but like—Rob just helped us. We hired—just not while we're doing the show, yeah—but we just hired an awesome associate. I used my own service to hire my own associate, and so far, she's working out great. And Rob helped with the contract. And I feel like we make good decisions. We've never had some wildly out-of-bounds situation with our associates. But like, Rob, why can't I just say to—why can't a dentist say, "Hey, we're going to work together for a month. We're going to give you, like, things that are simple. Let's see how you fit with our team." We're still going to do the agreement right, to set up for success. But if, after 30 days, it's not a fit, you don't have a restrictive covenant, right? Like, could people do things like that?

Oh, sure, and they do—like, way better than this one-day, weird "go and do a filling on somebody"—you know, and see how you do. And like your patient—it's a trust factor, your patients. Part of me feels, Stephanie, that would be way... It would be what you said is great, and then just say, "Hey, let's work together four days a week for a month. We expect it to go well. But if it doesn't, if for any reason one of us decides after a month it's not the right fit, it's great to do no restrictive coverage." Could someone do that?

Rob Montgomery  

Yeah, and you do. In some states, if you don't sign or have a non-compete at the time in the agreement when they start, it may not be enforceable. So it is important to nail down that agreement that has that in it, but it doesn't mean that it has to kick in right away. So absolutely—I mean, we refer to those as trial periods. And I think it makes a lot of sense.

Paul Goodman  

I think it just—I don't know, Stephanie. Stephanie knows us dentists. We're dentists. We're very dramatic thinkers, right? We're very intense, and we need something to calm our brains down, right? You know, I talk to owners for Japanese—you say, "But this is my baby. What if I hire an associate and they don't do dentistry the way I do?" I go, "Okay, maybe you hire another associate," right? And, you know, like Mark Costes said, no decision has to be permanent. So I think the way you framed it, Stephanie, is great. But also, you know—one you loved, two were okay, and two were not good fits. I want to ask you, though, Stephanie—and I actually ask you this out of curiosity—would you have rather practiced without associates for your career? Was the one that you loved and the ones that were okay worth it to help you through that time of helping you with patients?

Stephanie Mapp  

You know, I think that, looking back, I would have just kept my office smaller, and it just would have been my baby forever, instead of trying to do, you know, multiple locations and all this. But it was after the fact that I realized multiple locations, to me, weren't worth it. Let's say if it had been wildly financially successful—it wasn't worth it to me, the extra stress and headache of multiple locations.

Paul Goodman  

Yeah, know yourself.

Stephanie Mapp  

Yeah, but you don't know that until you do it, because you just think, "I've done this one thing." It's just like kids—you know, you've got man-on-man coverage with two kids, you throw a third one in, and now it's zone defense. The same thing with offices—it's like man-on-man, and then you've got zone defense. It's like, you don't realize how much more difficult it is to add in. Now, I did not grow up in the time of Facebook and all that when I was doing all this, so I never heard anybody say, "Hey, you know, you really need to get to about four practices to have the revenue and the manpower to have a level of middle management." So there were things I learned after I was a big flop. And telling people what flopped—you know, the things you learn after things not working out—can be just as valuable as things when they do work out.

Paul Goodman  

Really wise. More practices can also bring more Rob as well. As we finish up, Stephanie, I want Rob to be in the final thing. Tell us about your attorney time—why you needed five attorneys at once. Rob was waiting for the story.

Rob Montgomery  

Yeah, I am curious. That does not sound good on its face, but yeah...

Stephanie Mapp  

Yeah. I call this the perfect storm of life disaster. So I went through—and I made it through the recession—and I had a couple of attorneys during the recession for an issue where I had tried to open a second location. And I had a project where I had put down a large deposit to open a second location. That project went into bankruptcy, so I had an attorney for that issue. And then I get through the recession, I sign up for all these insurances, I realize my main practice—which was extremely profitable before the recession—was now this PPO mill. And I decided, "This is not how I want to practice." So I bought a fee-for-service practice about 45 minutes away from my initial practice, thinking that I could put an associate in my PPO practice, and I could be mostly in the fee-for-service practice. Well, it turns out I did have an attorney when I bought the fee-for-service practice. But that attorney—actually, sadly, great man—ended up passing away of cancer. From the time I had that attorney to a landlord dispute that arose—and also during this chaotic time—I was going through a divorce. So I had a landlord attorney and I had a divorce attorney. Well, then during my divorce, both my ex-husband—who was a dentist—and I, we both pulled money out of our 401(k)s because we had multiple real estate holdings at the time. And now we're living in different homes, and we're paying attorneys for the divorce. We pulled money out of our 401(k), but we weren't legally divorced, so then I had to bring in a tax attorney—because trying to settle the 401(k), bringing too much out, owing too much taxes—they were going to put a lien on one of our homes. So we have the divorce attorney, the landlord attorney, the tax attorney. And now I'm having trouble paying for one of my practices to keep the revenue going, so I bring in a contract attorney to try to negotiate with my bank on that second loan. And it gets better—because on my lunch break, because I have dogs, I used to drive from my office to my house—seven minutes I would drive—and I got in a car wreck on my way from my office to my home to take my dogs out at lunch. And it was just a fender bender. No airbags went off. Nobody went to the hospital. But you know what they do when you get into an accident? They sue you—not only your insurance in the state of Florida, but they sue you personally. So now I need an attorney for this personal fender bender where they were going after hundreds of thousands of dollars. Well, I tell people—you cannot really get much lower than that in your life. You're in the middle of losing a practice, you're getting sued from all directions. All of this took, obviously, more than a year to iron out. But when I came out the other side of it, I somehow just started telling my story to other people—just so they would feel less alone. And I would also admit—during the midst of all of this—a very successful dentist, literally down the street from me, of my office that I was having a nightmare with, put a plastic bag over his head in his office after work and killed himself. So imagine you're going through all of this, and a guy who's killing it in his office—people were fighting over this practice—he puts a plastic bag over his head. And I say to myself, "What is all of this really about?" And that was my aha moment of—it's not about the money anymore. This is about: how do you create a space in life where you can do the best you can for your patients and for other people? And let's take money out of the equation first and do the right thing first—and then we'll figure out how to make money after the fact.

Paul Goodman  

Love that message. You're so resilient, Stephanie. Thanks for sharing all that, and it'll—I know—inspire listeners in so many different ways, but also just show why it's so important to have the right team, especially attorneys, on your side when you're going through all these things that are sometimes out of your control, sometimes within your control, but you need somebody who knows what they're doing to guide you.

Rob Montgomery  

Yeah, it's just...

Stephanie Mapp  

I never made a single move in my professional career without consulting an attorney. And believe me, I was dirt poor. I had to take out a loan just to pay my first and last month's rent for my first dental job. So I don't buy the fact that people don't have money for it. You can find a way to pay an attorney to protect yourself. I think that's super important.

Rob Montgomery  

Well, we help people with their agreements, and we also talk to people that have signed bad agreements. And inevitably, it's always cheaper—without a doubt. It's just a matter of how—factor of how many times cheaper—to try to protect yourself at the outset than to try to manage a problem. I mean, litigation is just a complete black hole, and anytime you can avoid that, you should—pretty much close to all costs. Yeah, but no—it's just been great, Stephanie. I love, love reconnecting with you, and it's great to chat with you again. If our listeners want to learn more about what you do for dentists and dental practices, or get in touch with you, how can they do that?

Stephanie Mapp  

So first of all, I always am glad to talk to anybody. I give anybody who wants a 30-minute free consultation some time with me, because even if they don't work with me, there's probably something—some little tidbit—that I can help them with. And that's my goal, first and foremost, is just to try to help people along the way as best I can. You can find out how to schedule a consult with me on my website, which is mapyourpractice.com—but I spell "map" with M-A-P-P, so two P's: mapyourpractice.com.. And I believe if you are doing your best and putting good things out into the universe, things will come back to you positively. So that's why I don't mind helping out anybody who ever has any kind of small problem. I've gotten so many wonderful messages back from people that said I helped them immensely just with a 30-minute consult. And I—you know—I wasn't necessarily the best fit for what they needed at the time, but I provided them enough information to help them get out of a problem that they had.

Paul Goodman  

Love that, Stephanie. It's really, really generous of you, and thanks for being our friend, sponsor, and supporter. Can't wait to see you at Margarita Alvez, because I know you're a big Alvez fan.

Stephanie Mapp  

I do! You know how badly I would love to just pop into Alvez any day? I mean, that's honestly my favorite restaurant in Philly.

Rob Montgomery  

That's good stuff. Well, thanks again, Stephanie. Thanks for taking the time—some great, great talk.

Stephanie Mapp

Yeah. Thank you so much. It was an honor.

Rob Montgomery

I love talking to Stephanie. She's always got insight and perspective.

Paul Goodman  

Great perspective. I think it just shows you that, you know—like the Dental Amigos motto—life has a lot of different toppings. Some of them are brutal to deal with, and you gotta... Like, the resiliency is key. Grit is key. It's a popular dream, and also paying attention to stuff—paying attention. I mean, paying attention to PPOs. I wish I did it sooner. I would have more money, less stress. I didn't know stuff. People our generation—we didn't have Facebook groups, and we just did what we felt was right, and it wound up not being the best thing.

Rob Montgomery  

It's hard though, too. I mean, you're practice owners. You're busy. You wear a lot of hats. And then now it's like, "Okay, here's another important thing that you have to deal with." And it's just—it's hard to do everything that you need to do in managing and owning a practice and managing people and treating patients. But this is one that you really have to make time for, you know, because it affects your financial situation, your sanity, your quality of life.

Paul Goodman  

I mean, whatever people can learn from me—it affects the amount of time you can spend with your family.

Rob Montgomery  

Yeah. And another thing too, though—you know, to that end, Paul—like, you don't have to figure all this stuff out yourself. You can get help. You can hire consultants that know what to look for. You still have to be involved in the process. It still takes time. It takes money. But there should be a return on that investment. And you don't have to DIY this either. You can DIY being aware of it, but it helps. And if you don't have the time—which most people don't—there are people like Stephanie who can help you.

Rob Montgomery

All right. Well, as always, thanks everybody for listening. It's good to talk to you, Paul, too.

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.