This week, the Dental Amigos podcast features a special conversation with Dr. Paul Goodman, co-founder of the Dental Amigos, practicing dentist, managing partner of a group dental practice, dental practice broker, and founder of Dental Nachos..As one of the podcast’s original founders and a longtime advocate for the dental profession, Paul brings valuable insight into the challenges and opportunities facing today’s associate dentists.

In this episode, Paul shares findings from his survey of associate dentists and discusses the key factors driving associates to leave their first positions, including aspirations for practice ownership, toxic workplace cultures, inadequate mentorship, and compensation concerns. Paul and Rob also examine practical strategies for improving associate retention through stronger communication, effective leadership, structured onboarding, clear systems and expectations, meaningful mentorship, and competitive compensation models.

The conversation also explores the evolving dental employment landscape, comparing opportunities in private practice and DSOs, and offering guidance for young dentists as they navigate important career decisions.

To learn more about Paul and Dental Nachos, visit the website below or reach out to him directly at Paul@DentalNachos.com.

• Dental Nachos: https://www.dentalnachos.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, and 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.

Paul Goodman

Great to be talking, Rob.

Rob Montgomery

It's going to be talking to you too, Paul. And we have a very special episode today of the podcast. We used to do, like, just Paul and Rob a lot more, and—and—and we've gotten away from that. Yeah, you know, occasionally, so we're bringing it back.

Paul Goodman

More Paul and Rob, like more cowbell.

Rob Montgomery

That's right, and we love our guests, and that's fun too. But you know, I guess when we first started doing the podcast, it was just us.

Paul Goodman

Most the original was just us.

Rob Montgomery

Because there's nobody that wanted to be one.

Paul Goodman

Yeah, I know. And so build that up.

Rob Montgomery

Over time. It's changed, so I'm—I'm excited to—to talk about this today. We're—we're going to break down this survey that you did on—on the Dental Nachos Facebook group, right? I guess, or that was your...

Paul Goodman

Through our audience: Facebook, Instagram, you know, through our HubSpot contacts, we—we ran a survey with the ability for people to fill out information about their first associate job, and we got feedback over 1000 dentists. It's pretty interesting.

Rob Montgomery

Yeah, I've read this, so it's, you know, 11 172 dentists survey. Yeah, it sounds like a—a sugar-free gum.

Paul Goodman

Yes, exactly right.

Rob Montgomery

So yeah, so we're going to break it down. You know, key takeaways: why do associates leave, and how to keep them fulfilled. And I think this is really cool too, because you and I talk about this stuff a lot without any data, without any numbers. You know, we're doing exactly what I tell people not to do. You know, don't go on hunches and suspicion. But you—you've got, like, the real numbers.

Paul Goodman

I mean, I always say, you know, stats and stories are, you know, they're cousins to each other, right? And we can use some stats to just kind of outline stories with a background that makes sense. And, you know, the dentists are always asking for more data; it's kind of their favorite thing to ask for. And, you know, not a lot of groups are doing these studies, so we just thought it'd be really cool to kind of dig into a few the common reasons people stay, leave, how many jobs they've had, insight. You know, it's over a large group. I—we—I used—I used my kind of my—my life for this, Rob. So we kind of surveyed people 1977 to 2025. That's when I was born. Just a—a big circle of dental life, but I do want to interject, Rob, because we usually ask the guest where their favorite nachos are, but I want to share. I was at the Dental Success Summit with Mark Costes and group, amazing friends and sponsors, and we went to Mi Cochina in Frisco, Texas, which is right next to the Star where the Dallas Cowboys practice, and we did have solid nachos where each individual chip was dressed with their own toppings so much so, Rob, that you could order six chicken, six steak, and I want to just take a minute. The group was mainly the Dentist Job Connect and Del Nachos team, but we had two guests there. One was Jonathan Limberox, you know, who was great, and another Job Connect client who was awesome. But, like, you know, sharing a big plate of nachos with a few people who aren't your core people is tough. So it was nice that you could just evenly distribute them. So I want to give a shout out to Mikochina.

Rob Montgomery

How big were they?

Paul Goodman

They were, like, on a solid-sized round chip, not a—not a small triangular chip. So they—it must be their thing because you could order six vegetarians, six steak, and we were six people. I ordered 12 each, so everyone got two.

Rob Montgomery

So, like, nacho tapas.

Paul Goodman

Yes, yes, exactly. Yes, very, very like a tapas version of it. It was—it was good for a group sharing.

Rob Montgomery

Uh-huh, that's cool.

Paul Goodman

So shout out to me, coaching.

Rob Montgomery

Yeah, good. That's it. Well, and—and what was your favorite topping, Paul?

Paul Goodman

I—I really still always stick with the chicken. I mean, I like steak in general, but at Valves, the macho nachos, the chicken is my favorite. So it is chicken.

Rob Montgomery

Okay, good to know. There you go. Texas listener.

Paul Goodman

We can go back to the—the stats now, but I didn't. I didn't want. I like to say consistent. So—

Rob Montgomery

That's—that's why we're nothing but consists. Yeah. In fact, we're everything but consists. Yeah, yeah, yeah. So, like, some things, you know, a lot of things don't didn't come as a surprise to me with this. But, you know, I think let's just kind of walk through some of the themes and—and then drill down on what the—the data is. Like I said, 11 172 total dentists surveyed, and this is nationwide. And I should say 821 of those, around 70%, were associate dentists, and then 330. Where practice owners reporting about what the experience jobs, yeah, why, why,

Paul Goodman

Yeah. I mean, my—my theme of first, you know, I would teach my first implant classes, you know, my first practice purchase. I just think your first is so key. So we're, you know, just, you know, someone who has never had the pleasure of doing full contact arts and crafts on people who don't want to be there or pay for it, Rob, which is dentisting, as I call you, which is sort of saying, like, I'm sure everyone remembers your first job in law, your first job in accounting, your first job in dentistry, but just kind of...

Rob Montgomery

That was very traumatic, I will say, and yeah, that's another story for another.

Paul Goodman

We could have a whole episode on that. The thing I'll kind of point out to our listeners, and as someone said, is that I've been in this. You know, I know I'm the number one client who comes in because I'm the only client that comes in, but I've been around...

Rob Montgomery

A tasty avocado.

Paul Goodman

Yeah, yeah, I know. I appreciate random acts of delight. But I've been through these this office long. I've seen you've had interns here before in the past, and people who are here. My sense is that just to set this up, in that the law world, there's summer internships for attorneys, and maybe if I'm right, do they work? You could work for a judge, right? You could work for this place. You could work for a big firm. But what I think is cool about that is, while you're in school, you taste test what it's like to be in the real world. Right. You have the bird's eye view. I just want to share: none of this exists in dentistry. Yeah. And there are people in here. We didn't hear that. The first time they ever walked into a dental office, not as the patient, was their first day of work.

Rob Montgomery

That's insane,

Paul Goodman

And that is just a huge yes. It is.

Rob Montgomery

It doesn't. It's not surprising, but reflecting on it, that just makes no sense.

Paul Goodman

Yeah, we do not have this built in, which I think is a big problem. So these are we ask them, you know, like your first job. Tell us about that. You know, why they left, how long it lasted, what type of, you know, corporate non corporate or other, how many jobs they had over their career. So yeah, it was really interesting.

Rob Montgomery

So, so, as you call it, the headline finding, you know, what—what is the—what is the big—the big news, the lead story? This would be the lead...

Paul Goodman

I was talking about this in my breakout session at the end success summit. So many of our listeners know I started a company from the thoughts in my head called Dental Nachos. Right, so there is no Dental Nachos coaching program. People cannot go to Dental Nachos University, Rob, and come out with a Dental Nachos license. We hire everyone off the street, and what is the headline is? My sense is, you know, obviously a man in my operations director could tell you that nine 90% of the people who we hire last longer than a year. Okay, just over the last eight years, 90%.

Rob Montgomery

It's a good stat,

Paul Goodman

And I think that in the this these study, it's like we're at 40% leave within a year, which shows me we're not doing a good job. You got two dentists, right? Right. Both went to dental school, hiring someone to do a very specific job in their practice, and for the teams that we talked about, like lack of mentorship in this study, toxic team, problems with their pay, it's not lasting a year. And I think the owners listening should be like, that's problematic because I've—you put in also, you don't have to credential with insurance to work for Dental Nachos, Rob. Right. So like, there's a lot of work that goes into getting the associate to start. So, like, why is this not lasting more than 12 months more frequently?

Rob Montgomery

And we have talked about this a lot. This is—this is about the investment, and it's been a while since we talked about this—this theme, and—and over the years that when you—you hire somebody, it is a tremendous investment, and—and you need them and want them to be successful, and there's a cost associated with that. So bringing somebody on in a half-baked way, and—and—and or not bringing them on in a way that is setting them up to succeed has a price, you know, and it's significant. And to your point, the—the survey found that 39% leave within the first year, right? And 46% said they stayed longer than one year. I wonder what's the...

Paul Goodman

I'm not sure. I asked the appellate manager that. We'll put the—we had—we made a nice, like, link to this whole presentation that SaaS people can look at. But out of the leaving within the year, we kind of broke it down into these: is, you know, lack of mentorship, right? And that, you know, I talk about the 4 M's that matter most: mentorship, morale, money, and meeting expectations. And mentorship can be mismanaged expectations on both sides. So, just so you know, Rob, that sometimes a new dentist with great intentions thinks mentorship is like being in dental school, where someone's standing over them saying, "Drill this way, do this," and that's not practical in the real world. And then other times the practice owner says, "I am going to mentor you," and they are not available through phone, text, email, or ever there, right? So these are the two distinct extremes in the mentorship world. So I'm someone who likes mentorship, so there's nothing wrong with liking—wanting mentorship, but it has to be clearly defined, and that's why it doesn't meet expectations most of the time. So practice owners describe. Bit, you know, best practices describing what mentorship—I'll use my brother, who does a great job with this, you know, Dr. Jeff Goodman. What this looks like is I am available to talk about cases in our dentist debrief. We have dentist debriefs weekly. Jeff does them; they're excellent. Where we align on treatment plans, I will share with you, Rob. I would guess that less than 10% of practices do that. So asking about that, but then if you say, "Hey, are you going to have time to help me out when things go sideways?" Jeff would say, "On a need, on a every now and then need basis, yet, but I'm also seeing my own patients in my own room. So if you're looking for an office that's going to walk you through how to do basic procedures, we're not that one."

Rob Montgomery

Yeah.

Paul Goodman

So...

Rob Montgomery

Well, but—and should you be either? I mean, this comes back to expectations and—and—and mentorship. I always feel like is a two-way street. Yeah. You know, like, if you are being mentored, you have to appreciate where—where that begins and ends, and that doesn't mean that you somebody else is going to solve all the problems for you. That's not, frankly, constructive mentorship. You know that you have to have an expectation that you're going to try to solve the problem, you're going to try to fix things, you're going to try to perform, and that mentor is there to help you get that next little bit of the way there. You know, to help you solve really difficult problems or out of the word narrative. You know, but—and we have that in our world too, where somebody comes in and, you know, we've had young people that have not succeeded here, and are like, here, I did this document. Well, you know, like, there's all these blanks and all these questions. Like, what did you—did you try to figure any of this out on your own? Like, no, right? You're the—you're the mentor. Well, no, I mean, we're—we're they here for high-level stuff, but we're not. We're also not like the sixth-grade higher teacher either. Give me good work product. It's the same thing in any professional setting. And just expectation as an associate

Paul Goodman

To position this with dentistry is. I see how frustrating that could be, and you have to say, "Hey, to survive here and thrive, you're going to have to show more initiative and solving problems. You have to throw initiative and doing this, but our client is six—six inches away from you, right? And if you—you need a lot of figured out factor during the actual day of dentisting, you have to just share on both sides what your availability for that. I do want to be clear that it's the owner's job to be able to outline and make the culture clear. As an example, our listeners will understand this, Robin. Maybe it was that common thing in dentistry is that can a tooth get a filling, which is a direct restoration, which costs 500 bucks, or a crown, which is an indirect restoration that costs 1800 bucks. Right, classic challenge. And each practice has a different attitude towards when they recommend these, so it is the owner's job to mentor the associate because they could easily come from a, you know, dental school taught you every tooth needs a crown, right? Every—no. So I want to be clear that the practice owner mentoring your mission, vision, core values, mentoring your standards is important, but like—like you said with that document example, if there's mismanaged expectations on mentorship, it's a problem. The other thing that we found was the toxic team. So I was on with Dr. Summer Kassmel yesterday, who's awesome, and you know, has been a guest. And I said the number one thing practice owners don't do is prepare their team to work with a dentist who's not them. Right. To say, "Hey, we have another dentist coming." And even though, like, this sounds simple, like there could be a surprise to the team sometimes. You're hiring somebody. Guess what? Here's the new dentist here, and I think, you know, the team has to be just as aligned, and that goes both ways too, right? You know, team members might not support the new dentist, and that's a big problem. And that's why when you don't feel supported, you know, one of our associates said this nice thing. She said once, "I really like working here," and I said, "Oh, tell me more about that. That's nice to hear." She goes, "I really feel included here," and that had nothing to do with our clinical skills. But you go to places as an associate dentist, and people listening, if you're driving in your car or at the gym, think, you know, how many times did you not feel included and part of the team as the associate dentist, and that can happen easily.

Rob Montgomery

Yeah. Well, it's just I think any kind of new situation, social work, that's a—that's a challenge. Well, I think a couple things that kind of occur to me with this. You know, first is you really need to have a plan when you're bringing people on. Yeah. When—and I will be admit, we've had some people that have done better, and some people have not done so well here. And sometimes we haven't done the greatest job at—at really training them and planning to train them. And—and but it's important, you know. You can't, when that person shows up on day one, day two, day three, all the way up to day 30, maybe. Right. What are they doing? What—when and how are you engaging with them and interacting with them? When does that mentorship occur? And I think, and then the other point is, what kind of goes along with that is, I feel like if you are a busy practitioner and you hire an associate, a young associate that you know is going to require mentorship. Be realistic. When is that going to happen? Right. You know, and—and I feel like you need to free up time in your schedule to schedule in that mentorship.

Paul Goodman

Yeah. Also, as shared, is that the owner, whether it's a law firm or a restaurant, or you know, I was one of the servers that would train people. I said, like, you have to stop doing what you're doing, like when that person starts, right? How many people have been hired and said, "Oh, just sit next to Sally, hang out with Jim, and see what they do," and then three months later, said, "Why didn't you know how to do X, Y, or Z?" Yeah, and no one's actually really sat down and trained them. And I, we talked about that yesterday. Dental practice owners have got to. I believe they should take a full week away from their patients when their associate starts, a full week—it's worth it in the long run. Dr. Todd Fleischman, we've had on, who I've helped hire an associate. He said, "If I—if I would do it again, I'd take longer. I mean, smart—smart owners take some time, right? But I will ask you this question: Rob, how many times you hired a person in your business and been like, "We have all the time in the world to hire this person, right? Whenever they start, they start. Or is it more like we need this position?

Rob Montgomery

Oh no, the house is on fire.

Paul Goodman

Right. So, you know, so this is the problem. Like, you know, you hire the associate dentist, and, you know, just to kind of just before we talk a little bit about the money part, like Jason, Dr. Jason Tanoori, who's also been a guest and is great. He does a lot of these coaching calls, and they say, "I can't wait to hire my first associate dentist to get more time off." Jason laughs and goes, "You've just given yourself another part-time job," so you just need to understand. I'm not a big deal with it. You know, you need to understand that this is a part-time job for you, that part-time job for your patients and team, and you need to be in the office more when the associate starts, and you need to dig in. And maybe this is a six-month thing, and you will get more freedom later. But as Summer says, if you wait till your red lighting, or like you said, house is on fire, you just say, "Oh, oh, I'm going on vacation next month. Can you come here now?" I literally talked to someone for Dentist Job Connect on Tuesday who said, "I'm like leaving for a month in December." I'm like, "You need the person yesterday. You can't have, like, leaving for a month, Rob, to run a dental practice, it is like a living, breathing circus, right?" So I'm like, you can't have this person start the day before you go away. So I hope people realize that

Rob Montgomery

It's unrealistic.

Paul Goodman

Hiring an associate, and this doesn't matter if it's your first or 10th.

Rob Montgomery

Yeah. Well, I think, you know, and this, you know, people have heard me say this a lot, and this is one of those challenges between being the professional who's doing, who's making the donuts, and the person that's running the business, so to speak. So, you know, you—you always have that—that juxtaposition of the clinical responsibility and the business responsibility. And—and I'm guilty of this too. That when I have, sometimes I just say, well, I'm just going to do more, spend more time, or I'm going to try to do more in the same time, right? And that, you know, guess what, Paul? That never—that never works out. That has never worked out well.

Paul Goodman

It creates a culture of what I call, as we call, stress intensity. You can ask me about my KPIs. I said, like, it creates a culture of such intensity that the new people are just like, "Oh my gosh," right? Like, yes, like Gary. You know, I—I did talk to a dental team who has wanted me to do some coaching with them, and, you know, this—this seasoned assistant made a very wise thing. He goes, the new people just don't understand that it's not always like this. We're shorthanded for this day, and they just have to realize it's just for this day. But if you're not a seasoned person. We're just like this. This is my new life, right?

Rob Montgomery

Yeah, yeah, for sure. So, I mean, to me, just backing up, I—I think that's. I think what I'm taking away from this is the importance of planning, and planning as what you're going to do with them when, and then also planning what your schedule looks like. And this is the—the ROI on this is—is a successful associateship that you are able to hopefully train this person so that they can thrive and stay, as opposed to spending, you know, a little bit of time making yourself entirely crazy and the associate failing.

Paul Goodman

I want to interject with a happy story because you have a personal relationship with it. Today, Rob, you know, is Morgan Rake is back in Philadelphia. She moved back. So, you know, the story, right? So, so this story, everyone who's listening...

Rob Montgomery

That was—that was I didn't realize that was on the board.

Paul Goodman

Yeah, so she came to us, Mary and I, in, you know, 2021 or two, and said, "I need to tell you something," and I just want to say, 100 of the time, there's nothing good on the other than a sentence. It's never been I'm handsome or funny. And she said, I know that she was our babysitter who truly saved our lives during the pandemic. And she said, I'm moving to San Diego to meet new people. And I said, "That's too bad. San Diego's closed." And she said, "You know, I'm going anyway." So she went for five years. So she was our to call her a babysitter. I say is an insult. She took care of our two children during the most difficult time in our life, and we had to replace her. Yeah, and it was devastating, traumatic. Because you have to trust this person. So the reason I'm using this example is when Morgan left, we had to find a new babysitter, right, or do it ourselves. You know, worse, we couldn't. I couldn't grow the company. Mary couldn't do this, and. We wouldn't accept someone we didn't trust. So practice owners, if your goal is to unlock freedom in leaving for a week's vacation and knowing your associate dentist can babysit the practice in the most complimentary way. I mean, of that, you know, take care of your most important thing. You have to put in a lot of time up front, a lot of time, and that is usually where these associates don't feel included, mismanage expectations, and then also, Rob, maybe this is something we can talk about together. You've—you've helped me with all of my contracts for all the people that work with us at our dental office. The money can't be so complicated, right? Like, like, I don't understand some of these owners, you know, associates telling me they get these offers many times, not done through any sort of attorney. I can't understand how the person gets paid. Right. It's like on the third day of this month, if you succeeded this thing, and, you know, but you can weigh in because I know you talk about this, but they leave because there's problems with their pay. And then, you know, they have a contract that says they're going to get 30% of their adjusted production, and they feel like they have exceeded their daily guarantee for months, and they've never gotten any more money. And they're not being shown. I mean, in our office, our associates see their day sheets daily. They have to check them off. They have to make sure they do the—that we don't commit accidental fraud or underbill. So that was another thing our associates said when I interviewed, "You're very transparent with numbers here," so I know this is one that we can talk about as—as a team can talk about it. Yeah, why are tennis making the money part so complicated?

Rob Montgomery

I don't know. There are, I mean, we look at a lot of associate agreements here, you know, and—and—and they're very—a very diverse sample, shall we say, from a geographic and sophistication standpoint. Some do. Some make it more complicated. Some don't. I—nothing against dentists. Obviously, these are my people. Dentists are tinkerers. Yeah, by nature. You know, like, this is, and—and to be a good dentist, you have to have that—that muscle, right? Unfortunately, sometimes that muscle doesn't end when you leave the operator, and there's a really great implication just to kind of keep figuring out a better way or a different way to solve this problem. And we, it's not infrequent that we have these conversations with clients and say, "This—there's—there's a reason why we're suggesting doing it this way. It's not because we're being lazy and we're saying it's one size fits all and you should always do it the same way every time. It's because this is the tried and true path, and it works for various reasons. Whether it's the bank likes it, or it's good for the landlord, or it's good for the associate, these—these things are custom because they work, and if you want to try to deviate from custom and reinvent the wheel on all these different issues, things are going to potentially break. And—and there's a reason why there were people that came before you tried to reengineer this stuff, and we ended up at this place where we are now. You know, trying to reengineer compensation or other provisions, you're just going backwards. It's not. It's not progress. I mean, that's one of the big things that when we're on both sides of any deal, any conscience, and...

Paul Goodman

It's wild here.

Rob Montgomery

You have to understand. Both sides have to understand what's in it. And if you've two people can read the same thing and come away with a different interpretation or understanding, you have a dispute, and that's not good with associates, partners, buyers, sellers. Take your pick.

Paul Goodman

I—I will share this. A really good point is, like, and you know, you can challenge me because you do this with the contracts, but just me as someone who hires and helps with job, and it's like for your first job and your first time working there, just like make it easy to understand. Like, you know, we talk about daily guarantees. I—I think they should be reframed as almost yearly guarantees because it can get, like, into so much minutiae. But, like, hey, if you work here for 200 days, you're going to make $160,000 no matter what. We also have some upside, right? I would say less upside, less downside, right? We also have some upside. We have bonus incentives based on adjusted production of 33%. And if you do 600 grand this year, after your lab bills, you're probably going to make 200. But you're going to have 160, and we hope you get an extra 40. And if, for whatever reason, your 160 does not, you know, you—you—you bring in 450, and we're talking in a third, and it's 150, we're not taking any money back from you. End of discussion. And, of course, you can legalify it. I know that might be, like, oversimplification. That's what it is. Like, there should these dentists. I would like to think about, like, they're making so much upside and downside. Oh, oh, we're gonna have, like, a tiny base salary, but you can make 500 grand a year. That's not comfortable to someone getting their first job somewhere, right? It just—it just doesn't even seem real. Like, we tell these Job Connect donors, I'm like, your job seems fake. Yeah, but if it goes right, you could make half a million dollars. I'm like, could you just talk about the most often thing? Yeah, it will be much more of a confidence builder if you say most of my associates make $250,000. They bring in 750 a year doing basic dentistry. We want to make sure you can pay your rent and loans and blah-blah. So we're going to make sure. You make, right, 170 to five, no matter what. But we hope that if you do well, you get an extra 75.

Rob Montgomery

That's normal in the world, right? Yeah, not—not—not in the dental world.

Paul Goodman

I mean, also, I'm like, I—I think we could just, like, we went to dental school for a reason. My other friend, you know, he's a hedge fund guy. Like, those are two different worlds, right? So maybe he does talk about base salaries that are a fourth of what they get with bonuses, but nobody wants to do that with dentistry. So my mission is—my message is less upside, less downside, just for the first year, and then if you work so well together, you have an associate that knocks it out of the park, and you want to add in some other bonuses, do that.

Rob Montgomery

I like it. I like it. Let's go back to the survey just for a minute and just kind of talk about some numbers that—that support what you're talking about. So, you found the—the top three top reasons the associates leave their first job. 23% said they had ownership ambition, which is interesting. 159 of these respondents said toxic culture, 141 lack of mentorship, and compensation issues. 233. So that turns out to be the—the basically tied for—for number one there, and, you know, I guess every situation is different, but this—this supports what we're talking about: lack of mentorship, which we talked about a few minutes ago, and compensation issues, either that being pay problems or better pay elsewhere. That's, you know, talking about, I think, the—the lack of understanding, unmet expectations, a lack of communication, and it's a—it's a solvable problem for sure. And let's just talk about toxic culture for a minute. Like, what—what are we talking about there, Paul?

Paul Goodman

Yeah, the—the real examples of that is team members not supporting the associate dentist, which obviously sounds like a general cliché, but examples of this are they're checking a patient on hygiene and they're not booking the procedure with the associate; they're booking it with the owner. Right? When an associate needs help, the dental assistant's not available, even they're supposed to be available, right? So these are the—these are the things where they feel, you know. Just I was started my presentation or one of my, you know, things at the breakout session was an owner called me and said they have to terminate a $1.3 million associate dentist. So I said that's a pretty big deal, and it was because the associate dentist was talking trash about the other people, right? So, the trash talking, whether it is from the NBA Finals, good job winning the Knicks, right? We're good. I'm with the Villanova crew. I don't know. You got to like Villanova. The Villanova's got to penetrate.

Rob Montgomery

I have a complicated relationship with Villanova. Oh, gotcha. Okay, fine. As a temple. Oh, gotcha. That's true. I went to Villanova three decades. I—and what the Villanova tried to break up from the—yeah, okay, so I'll give it to you. I still, you know, I—so got back.

Paul Goodman

I went to Villanova. I only have the Jay Wright goodness of Villanova, but what I'm sharing is, you know, even though it sounds like a sports thing, the gossip and trash talking and there are environments where that happens, and it—it—it's—it's where the owner dentist has to at least pay attention to it, Ralph. Right? You know, daily check-ins. Is there, you know, I say this all the time in all of my companies. Is there any resources here that you would need that would help you do a better job? I believe that people like hearing that. And if they say, "I need a brand new computer tomorrow," it doesn't mean I just run out and buy one for someone. If they say, "Oh, I need this material tomorrow," but I think owners, I believe this. I think dentists have a very difficult time talking to other dentists about conflict. I mean, they have problems with patients, but I think the associate dentist may not say it early enough, and I think the owner dentist may not be asking the right questions. So this toxic culture, even though this is, like, kind of, you know, off the pages of every blog and podcast, you know, do you have a toxic culture? It was significant enough that many of the people responded this. You know, it would be lack of mentorship.

Rob Montgomery

Yeah, yeah, for sure. And—and—and but, you know, I feel like I hate to say this, but, you know, we had Matt on recently, and it was really cool, you know, talking about hoops, right? Carolina legend. Then, but these are the things that, you know, dentists just aren't necessarily trained to do. When I—when I hear about toxic culture of these sorts of examples, where the associate is—is—is basically causing harm to other people in the office, to me, I visualize a scene where the owner dentist is checked out. That, and it's not. And I get it. You know, like maybe they've owned the practice for 25 years. They've got their team. All they want to do is just go to work, do their thing, go home, get out of there, and, you know, deal with as fewer problems as possible. But look, even you have to be engaged, and even for those that want to be engaged, you have to know what to do. And, like, solving complicated HR problems, I don't think you should expect a dentist to be able to do that. I mean, that's where you have to get help. You have to have consultants. You have to have a team. You need to have people that can help you put systems in place, help monitor and enforce and update those systems. And—and this is not something that runs on autopilot. But I don't think, you know. And it sort of goes along the line of. And then again, this is the challenge, you know, that—that professional practice owner faces is just wearing all these different hats. You, I don't think you can expect to—to wear this HR hat and solve these problems as, like, a little side hustle to what you're—what you're doing. I think it—and nobody wants to spend money on outside consultants if they don't need to, or just throw—throw money away where it's not necessary. But there are certain times that you need to for sure.

Paul Goodman

You need to find the time. You know, you've heard me talk about morning huddles. You know, obviously, I'm in the NBA finals. You know, I watch the after-game debrief. Right, I like to hear what happened during the game. I was watching the game, and I want to hear what the coaches have to say. And I think owners should just take, like, you need to find the time for whether it's a morning huddle, one-on-one meeting, after-game debrief. Because go back to your original goal. Your goal is to fuel your practice growth, get more freedom, and check fewer hygiene patients. And, like, you know, we said with my KPI of ESPIDA stress building inside towards dental annoyance. That's what you're trying to solve. And this is how you solve it, right? You know, like, you know, sometimes people, owners, have said to me, Rob, like, I hired an associate dentist and I had to do redo six months of their work, and I go, how did that get past month one? Like, it wouldn't get past week one for Doctor Jeff Goodman, my brother, and he because we're constantly—we're not micromanaging, we're managing. You know, I think that should be a problem. Like, people are saying you're micromanaging, and I go, I don't think we are. I think we're actually managing, right? Like, like we're not saying, oh, we're not dental school instructors. We just want everyone to succeed. So when someone says, oh, for six months I didn't check on their work, I go. That's 100% on you. You know. Yeah. Unless you're an attorney for six months, you check any of her documents, and then you're. Then, you know, we have the recall exams, and the clients come back six months later, and they go, "Oh, what happened here? It says, "You know, I thought they were an attorney. And that part, I hope my our listeners realize is assume nothing, just support, manage, check in, monitor, and that's where that's where the team will align with the associate. The associate align with the practice when this goes well, because I want to see it goes well. You know, we have we had people in the survey who are still at their first job. You know, they bought into it, so I don't want to make it seem like this never goes well. I mean, I'm just sharing from this data. I'm surprised it doesn't go well more often.

Rob Montgomery

Yeah, yeah. Well, let's let's kind of say flip the script a little bit, but this is like a little bit of a downer. The next insight from the survey, when you look at career mobility insights, 54% of dentists have held two to four associate jobs, and only 35% stay in a single associate role. So, two-thirds essentially dentists will leave, yeah, and and some of that is because of things that are within your control, and some of these things are not. And so I guess, you know, when and you were talking about Summer Kassmel and and, you know, that whole gang of of consultants that that work with Mark and are affiliated with with Mark Costes are great, but, you know, I think what what I take away from those folks often because even though I'm not a dentist and I sit in the audience, I take notes, and as I've said to Jason Tanoori, like you, I I have takeaways from his presentations, you know, and and and that's the sign, I feel like, of a really good speaker, but it's just the importance of having structure, processes, and just documented ways of doing things. Because even with all these other things, I think you have to be prepared that people are going to leave, and you have to be ready to efficiently deal with the next person, and if you're going to do it on an ad hoc basis, every time you hire somebody, you're going to reinvent the wheel with what training looks like, what onboarding looks like. You're going to spend a lot of time training and onboarding that you don't necessarily.

Paul Goodman

You need the system. So our calls are the Alien Abduction Manual, and you need that for the right now. There's someone listening over the past week has felt one of their team members been abducted by aliens, which could be firing, quitting, moving. Sometimes it's very poignant health problems.

Rob Montgomery

There are aliens.

Paul Goodman

Yes, yes. Yes, I like that. And I and I've learned so much from because you got to just when you're doing it, document these systems like J. Tomorrow, talk about make it systems driven. I also like, you know, just we'll share for a second, like, dentist, and I understand, and you know, you've talked about founding your own law practice, and I founded my own company, but like, they're just so dramatic of how they describe their practice. They're like, oh, nobody else can work with my baby. I go, that's kind of an insult to your real children, right? Like, this is a place that does fillings and crowns. Like, you should be able to master having another licensed you here, and that energy that you bring to a practice owner is why you might not be succeeding. Right, and that's where the micromanagement can be a problem. But yeah, you have to be ready to replace because one of the things I'll share is I need to do a survey on this, but I feel it's going to be close to 100% Once you've had an associate dentist, you never want to go back to practicing alone. And we've shared with you a significant number are going to leave for career development, concerning reasons, spouse relocation we have on here, purchasing a practice, starting a practice. So the take-home message is: be ready to replace someone who's so important. You're just like the Morgan, you know, babysitter story. So I wasn't like, oh, we're not having a baby story anymore. We'll just manage our own kids during the pandemic. That was not feasible. Yeah. So I think that that's a really important point. Create systems and onboarding things, so that the next one hits the ground running faster.

Rob Montgomery

Yeah. Yeah. Hits and and it actually ensures the success too, because again, it forces you if you if you have that process and that system in place, then it's just a matter of executing it. And even if the person doesn't work out, at least you've you've done what the best that you can do to set them up to succeed. And now you're ready to to step in and and and shift to help there.

Paul Goodman

Yeah, and you you you also maybe think something really really valuable, like you're also setting standards that they can meet or not meet, and sometimes the position isn't a good one for them long term. Sometimes it is, but at least you have these objective standards and these things that they can meet. Or I think every you know employee, and I'm not saying I do a perfect job. They're like, "Am I doing a good job here? Right in dentistry, as associate dentist, your stat sheet is your production, so at least that's part of it. But that's not the whole story. You know, that highly productive associate talking trash is not is not success. Yeah, but that amazing team fit, Rob, that takes five hours to do a crown, also not a fit either. Right, right. So, you know, you know, imagine if you had someone who said, "I am I am on board. I am a team player, but it takes me a full day to do one document, and everyone else does eight documents in that time. It's not going to work either.

Rob Montgomery

That's not. Yep, that doesn't doesn't work. That just kind of wrap up just with one sort of parting stat, just because everybody likes to talk about DSOs and everything is practice type trends. So, in this survey, you had 56% of the people start it in private practice, and 35% started in a in a DSO.

Paul Goodman

And then other ones. There are there is another category of this, and I think what's interesting about this, and we're going to do more of these, and this is just a big survey, and we are not professional statisticians, everyone, but we'll share this. Is that I find this interesting because the corporate DSO is almost higher than I thought. Now I do know that a lot of younger dentists pay attention to me. It—

Rob Montgomery

It gets higher,

Paul Goodman

Yeah, because because Rob, I had made this survey from my whole life, right, my whole existence of 1977 to 2025, and I and I know I know if people were I know if people were doing this like I do have a a newer demographic answering things right, like someone was giving us feedback on our survey. I'm sure there's ways for us to improve it, but I got a lot of fans who are, you know, graduate from dental school. What I call in the in the 1900s, And there's like almost almost no. They always like that joke. There was no real DSO jobs there, right. So I would love to survey more specifically into this, and it's just it's just sharing with this audience that a lot of times DSOs in corporate settings are the only ones giving them a chance for their first job. Yeah, and I mean, and I feel this as an owner, you know, and it's it's an interesting dilemma or challenge or something that's happening.

Rob Montgomery

Yeah, and let me just say before, sure, on this, you should continue to do this. Yeah, this is—you have you're really in a great place with the the size of of your group to to do these sorts of surveys. I feel like I'd love to see more and drill down on these and and continue to do it. I really really applaud you. But I mean, to me, though, with the DSO number, I guess I felt like so many people have just resigned themselves to the fact, or at least they say that the only place you can get to work is for a DSO. That's just not true.

Paul Goodman

Oh, and that's clear too. And yeah, I want to be clear. That's I would like to do a last 10 years survey. But you're right. This is your completely good point. There are plenty of private practices hiring associate dentists. You're talking to them. I'm talking to them. And you know this goes back into another confusing stat, like, how many practices are even DSOs? Let's just let's just for the sake of this next five minutes say it's 20%. Right, that means there's still 80% of privately owned practices that are growing and looking to hire associates.

Rob Montgomery

Yeah, and I think certainly DSOs are, at least for the time being. That's a whole nother conversation in in the dental schools, and and are recruiting. Actively, they're very visible. I think a lot of times they they spread that that prophecy that we are taking over, but it is a somewhat self-fulfilling one, and I I don't believe that it's always true, but I think it also tells people, and I think to a young dentist out there or a a dental student, these jobs do exist. Sometimes they just might be a little harder to find, or maybe harder. Just might have to take some different steps. You might actually have to walk out of the dental school and and seek employment someplace other than the the the job, the headhunter recruiter from From bigdso.com, who comes walking in and says, "I've got a job for you." Like, really,

Paul Goodman

One of my followers said once, and I gave them. They said, "Paul, I wish I met Dental Nachos earlier. I went to a school where I didn't know you couldn't work for anywhere besides a DSO," but that is not totally all their fault. That person could have walked out of the school. Person got into C event. They're great. I like, I like, but, like, young dentists, dental students, take control of your career. Yeah, explore your next options. That's like, you know, my a good take-home message from this. There's both out there for you.

Rob Montgomery

Yeah, yeah, and and sometimes you just might have to look for it.

Paul Goodman

Yeah.

Rob Montgomery

So this is awesome, Paul. Like I said, I I really I look forward to you doing more of these, and us having the opportunity to talk about them more for our listeners. We'll have a link in the show notes to the to the survey and some other related media that that goes.

Paul Goodman

Awesome, yeah. We'll give you the link, and practice owners use it as a tool. And same with associates looking for jobs. Thanks so much, Rob.

Rob Montgomery

Yeah, thank you, Paul. Thanks for taking the time. Thanks for listening, everybody.

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.

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