From Solo Practice to Dental DSO Giant: Dr. Brad Hughes on Values-Driven Expansion and Work-Life Harmony

Have you ever wondered how a small dental practice can explode into a 12-location success story? Dr. Brad Hughes, the brainpower behind Vision Dental's remarkable growth, sits down with us to share his journey from starting in Indiana to becoming a titan in the dental service organization (DSO) space. His story unfolds like a  novel, where personal trials, such as a wife’s health scare, intertwine with professional triumphs, shaping a CEO who values the heartbeat of his company as much as its bottom line.

As we peel back the layers of Dr. Hughes' strategic expansion, he illuminates how core values are the lifeblood of Vision Dental. These principles aren't just posters on the wall; they're the drumbeat to which every decision and action aligns. From embracing competition to igniting daily tasks with passion, Dr. Hughes gives us a masterclass on how these values are critical for steering through an ever-changing economic terrain. And for those balancing the scales of work and home, he offers a candid look into the art of managing a sprawling empire without losing sight of family, revealing the personal systems and mindset shifts that keep him grounded.

Lastly, Dr. Hughes turns the spotlight onto the nuts and bolts of healthcare entrepreneurship: the criticality of location. He shares his chess-like approach to selecting spots for new practices, explaining why paying a premium for visibility can be a shrewd move. We also unpack the financial intricacies of real estate in the healthcare world, offering up nuggets of wisdom for those considering commercial investments. With Dr. Hughes' guidance, listeners gain a roadmap to scaling their healthcare ventures with poise and acumen.

If you need help finding the perfect location or your ready to invest in commercial real estate, email us at podcast@leadersre.com.

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Transcript

Speaker 1: 0:00

So yeah, I mean 2007 in Indiana. He left in 2010. He kind of started his own practice down in South Carolina, down right outside of Hilton Head Island, in 2012. And in 2018, kind of started twisting my arm a little bit about wanting to scale back. And you know, hey, the weather's better down here, you can play golf, etc. Etc. 12 months out of the year, all these things. And you know, it just so happened that the timing was right for us. Like you know, ironically, one of the reasons that you know, we kind of decided that my now wife and I decided that maybe this is something that we wanted to do. She had been through some medical problems had a stroke at age 34, ended up having heart surgery over New York City.

Speaker 3: 0:51

The goal of this show is to help healthcare organizations scale by leveraging real estate strategies and interviewing high-level healthcare executives who are actively in the trenches in order to pull out lessons learned along the way. If you'd like a free site selection analysis from our team, or you'd like to learn more about how we're acquiring real estate through our fund on the blockchain, visit us at wwwreuniversityorg and drop us a line that's RE as in real estate universityorg.

Speaker 4: 1:18

Hello, welcome back to Helping Healthcare Scale. I'm Austin Hare. I'd like to welcome our guest today, Dr Brad Hughes. He's the CEO and founder of Vision Dental. They started in 2019 and they have 12 locations under management. So, Dr Hughes, thanks for coming on our show today.

Speaker 1: 1:32

Yeah, appreciate you having me Austin.

Speaker 4: 1:34

Great, yeah, I love hearing people's stories, and so I would just love to hear what was it that led you on this path, that got you to becoming founder of a 12-location DSO.

Speaker 1: 1:46

Yeah, I started in practice in 2007 in Fort Wayne, indiana. I practiced there for a few years with my father, which was great. He took off down to South Carolina. I practiced on my own for a number of years, just started to see the shift in where the macro dental market was headed. Honestly, the real short answer is I still want to have autonomy to practice clinical dentistry and for myself and our doctors when I'm 50. Like I'm 43 now. I just I don't want to have to work for one of these Gen 1 DSOs they're great, nothing wrong with that but I want to have that autonomy and the culture that we're looking for in our company moving forward. So it's either I could continue doing that on my own in one practice or in risk it and try to compete with bigger major players moving forward for the next 10, 15 years, or we go, grow our own group and do it the way that we want to do it.

Speaker 4: 2:44

Yeah, I think there's. A lot of people might look and see 12 locations and there's that story, though between one and 12, that a lot of things happen along the way, and so it sounds like your dad. He went to South Carolina, started his own practice there and you started running with one location in Indiana, right?

Speaker 1: 3:03

Yeah, so what you started running it?

Speaker 4: 3:05

and what made you decide to do like a multi-site organization?

Speaker 1: 3:09

Yeah, so yeah, in 2007, indiana.

Speaker 1: 3:12

He left in 2010. He started his own practice down in South Carolina, down right outside of Hilton Head Island, in 2012. And in 2018, started twisting my arm a little bit about wanting to scale back. And hey, the weather's better down here, you can play golf, et cetera, et cetera, 12 months out of the year, all these things, and it just so happened that the timing was right for us.

Speaker 1: 3:37

Ironically, one of the reasons that we decided that my now wife and I decided that maybe this is something that we wanted to do.

Speaker 1: 3:44

She had been through some medical problems, had a stroke at age 34 and up having heart surgery over in New York City Shout out to Mount Sinai on the Upper East Side. That did a phenomenal job and she's great but realized that, hey, life is short and we wanted to live near the beach. She wanted to be able to go walk on the beach when she wanted, anytime that she wanted to be able to go, and so we made the trek and we moved down there and I commuted for the first year and a half every week back up to Indiana, and so I would fly back up on Sundays. Yeah, so yes, from South Carolina to Indiana and fly back on Sundays and head back to South Carolina on Wednesdays. And then I started out working one day a week down in South Carolina and my dad's practice at that point and at the time we'd already acquired our second practice in Indiana, so we were multi site there. We were trying to figure that out.

Speaker 4: 4:36

Were you the primary clinician at this stage?

Speaker 1: 4:40

I had an associate. I had another doctor working in our Hughes Dental Group in our main practice in Indiana, but I was still the main producer in that practice.

Speaker 4: 4:50

Yes, Okay, so you had, at this stage, essentially two locations in Indiana, one in South Carolina and your clinician at all three. Two of the three? Yeah, not South Carolina.

Speaker 1: 5:03

I was in South Carolina, I was in Indiana, but our other location in Indiana was not clinically working there.

Speaker 4: 5:09

Okay, yeah, because that's always an interesting transition that I like talking about too is like when you go from being primary clinician to the CEO of multi site group. During that transition you actually take a big pay cut because you know I'm the primary producer. Now you ramps up, obviously, but it could be hard.

Speaker 1: 5:26

It is tough, it's even now. I'm currently still working three to four days a week clinically, while also running a nearly 100 employee company. And now kudos to my team like the best thing that, of all the things that I have screwed up, the best thing that I've been able to do is I have built a management team that works their tail off, and it are. They are phenomenal. Whether it's an operations, hr, bookkeeping, whatever, whatever platform you want to talk about, these guys work their tails off and they make me look good. But but it is tough and there are. There have certainly been some Rob Peter to pay Paul moments where my production practices that have struggled as we've gotten them moving forward. We've been taking my own income of what I have produced and in my own practice We've had to shove it into those practices as we've scaled them up. But yeah, it's just. It's an amazing learning curve and yeah, it's what.

Speaker 4: 6:25

What made you like, how did you find your first like? When you were in Indiana, you had one going to this. Is that as something that just fell in your lap or did you decide, okay, I'm going to start looking for more to acquire. It's really skill, this thing.

Speaker 1: 6:36

Yeah, we had a fractional CFO at the time that was working with a number of clients around the Fort Wayne, northern Indiana area and so we had a resource there. He knew that for my goals were we had. We had talked about the fact that I wanted to go look at some other practices and, as some of his clients were getting to the point where they were ready to to step out or to sell, that, he would bring those my way. So we didn't really go out and do a lot of marketing. I wasn't. I wasn't really doing anything other than when he would bring us practices, we'd run through the financials, see if it made sense, see if we did very little due diligence.

Speaker 1: 7:16

I don't even know how I decided initially that the first couple practices even made sense. It was just oh, it's available. Like this seems like it'll just be the thing to do and it seems like it's probably just easy yeah, just bring it on, let's just do it. And looking back, it was so stupid but we would go through a much greater financial due diligence culture, due diligence, doctor, due diligence. We would do it very differently now than we did then, but yeah, at the time it was just like great, yeah, practice, boom, let's go, let's buy it.

Speaker 4: 7:44

Let's talk about that a little bit. Yeah, so what have you learned in terms of, like, how you first did your due diligence and your vetting, versus how you do it now?

Speaker 1: 7:53

I think first of all you've got to have some kind of model of what are you looking for Meaning? Do you want to practice that's already doing a million dollars of collections and above, or are you looking for a certain margin that they're creating? Are you looking for a certain amount of hygiene appointments? Do you want a practice that has a minimum to hygienists? We just didn't have any model. Now we've built it out and we said, okay, we're trying to do XYZ makes the most sense for us and it has been the most successful, and so I think that a little more plug and play like if it doesn't check all those boxes, just keep on walking and so we've become incredibly much more selective in that regard. But initially I wasn't and I think that caused a lot of headaches very early on.

Speaker 1: 8:39

It was like a couple early acquisitions were like doctors that weren't going to stick around very long for us and for me, like that just doesn't work. I don't want a walk away situation. I don't, especially then. We just didn't have the systems built out to train younger doctors, older doctors leaving, get the coaching going on these younger doctors and get the production up. It was just. It was a bit of a nightmare, honestly. Just, we have better systems in place and I think we're just we're looking for different things with these acquisitions. Now we royally screwed that up. With the first couple acquisitions we did not have a model with in terms of knowing what we were looking for.

Speaker 4: 9:15

You have to sell any of those, or did you end up figuring it out?

Speaker 1: 9:19

Yeah, we just figured it out through some. There are a lot of conversations. We've built out good teams but it's taken a while. It took us, I think in both of those, specifically those offices, we had to rebuild teams from the ground up. We've had to rebuild patient bases. We've had to go out I think we're on our second doctors in both practices. The first doctors just didn't work out. We've literally built them. We almost turned them into Renovo type things and, to my team's credit, we've done the work and we've made it work.

Speaker 4: 9:49

but man, it's a lot of work. So now moving forward, what's the model? Are you looking for doctors who are planning on staying for five years and then a certain amount of success, like not necessarily distress practices?

Speaker 1: 10:03

Yeah, yeah distress practice is just not my strategy.

Speaker 1: 10:10

I think we've got a team that is able to come in. We know that we can do some things from a centralization standpoint cut some costs, help grow. The hygiene department I think that's one area where most dental practices struggle to a certain extent is hygiene production. So I think, right there we're usually able to come in and bump that up by 15 or 20 percent. Take a lot of the stress off the doctors so that as we're running HR, bookkeeping, payroll, all that stuff, they're just able to focus on producing all of those big buzzwords that everybody says. But I think, but we really do back that up and so, yes, like we want practices doing really at least a million in collections, they need to be running at least a 15 percent margin, and a doctor I would say three, but five years optimal, Okay.

Speaker 4: 10:57

So yeah, three to five years, and then are they rolling their equity into the larger parent co.

Speaker 1: 11:02

Yeah, we've done that for the last two acquisitions and yeah, I think that, yes, like that to me is a little more of the DPO model. Does it have to be that? No, I don't. We're not just going to go into the say yes, like everybody has to roll equity over. It doesn't have to be that way. But I think when there's still that little piece of skin in the game, it just seems to me like that it just creates a better relationship between myself and the selling doctor. I think when it's not that model, there's a piece that just seems like it turns off and it just becomes a little bit more of a struggle.

Speaker 1: 11:37

Yeah, a little more of a DPO model and we'd like to go down the acquisition or the the genover out a little bit more often. I think moving forward, I think buying less problems sounds way better. But yeah, a bit of an equity rollover earn out involved three to five year earn out and it just buys us time to get a good next doctor in there.

Speaker 4: 11:58

Yeah, I think a big part of it is just aligning incentives. And when you acquire any business doesn't matter if it's dental or whatever, and the founder leaves or the president leaves or the owner leaves or whatever you just there are always skeletons that come out of closet, always and at the same time it's your job as the acquirer to get the best price you possibly can. And so there's always like this balancing act, like going back and forth. They're trying to get the best price for the sellers, like the highest price that acquire trying to get the lowest price, and so, at least if they are willing to stay on, there's a little bit of an act, of a step of good faith, and then you can work through these things together.

Speaker 1: 12:38

Sure, and I think, adding just a little bit to that, the piece that I also never quite understood as much as I do now is there also has to be a cultural alignment, and that's I get so tired of hearing that word because everybody talks about it.

Speaker 1: 12:52

It's just like this massive buzzword, but it's. It is so true that if they don't, if that doctor doesn't align with your own company core values, it's just going to be a shit show because the team is not going to align with your company core values. It's going to be a mess. You're going to come in on day one and it's going to be a fight. So I think really finding docs that are ready to make that transition and align with the core values is incredibly important, because now that the team's going to, otherwise you're going to have to come in on day one and you're going to lose some team members and that's going to create some friction points. It just makes it harder. The culture aspect of it, too, aligning with the core values and finding doctors that will that align with those core values before you sign on that dotted line, I think is incredibly important.

Speaker 4: 13:45

Yeah, on that note. What are your core values, and have they changed over time?

Speaker 1: 13:50

Yeah, they have our core values we have four, and the first one is action. Second one is will to win. Third one is bring the fire. The fourth one is close the gap. We talk about action. It's just do the work.

Speaker 1: 14:04

We run into people all the time. Let a little action. Yep, just do the work. Just shut up and do it Like it's you either driving the result or you're not, and that's in anything in life. And the second one is will to win.

Speaker 1: 14:22

I just I love hanging out with people that just have that desire. They have an energy about them, they've got an aura about them, whether they're a dentist or they're a ninja warrior. Like those people that have that will to win, like they're just, they're good people to be around. They tend to be a little more charismatic. Those are people that we want in front of our patients. I think that's incredibly important. Bring the fire, just bring the energy. Come into a morning huddle. We're ready to go. Bring energy. Don't be the bump on a log that's sitting around. Bring in all your BS from life, because everybody's got stuff that they're bringing into the office. They're ready to go every day, ready to go. Bring the fire, bring energy and let's get after it. And then the last one's close the gap.

Speaker 1: 15:05

If you've got goals, close the gap between where you're at and where you got to be and really set benchmarks If you're. If you're, just as an example, if you're a hygienist who's doing $850 a day and you want to be a $1400 a day producer and you're doing zero SRP, you have no confidence in presenting Periodal treatment to a patient. What do you have to do to close that gap between where you're at and where you want to get to? Who do you need to talk to? What type of role playing do you need to do? Who do you need to do it with? Just set the benchmarks, close the gap and then go yell it from the mountain tops. When you do it, celebrate that, but really focusing on closing gaps and being goal oriented and growth mindset.

Speaker 4: 15:46

With the growth mindset, I think it's super important we had something like this Is this something that you're coaching individually with these people, or do you have somebody in place to do?

Speaker 1: 15:55

this. It's me. That is my biggest passion in this company. I am way more passionate about going out. I spent two days not long ago, we were in six of our Indiana practices and I spent 90 minutes with all those team members. I went individually per practice, spent 90 minutes talking about just these core values with every team member. We sat everybody down and we just talked about them and I'm way more passionate about that. I love doing dentistry, but I'm more passionate about this. It's so energizing talking to our teams sitting down with these guys and just so many of them aligned. It's always so fascinating. It's so energizing to me because we have so many good team members that work with us.

Speaker 1: 16:35

But it's also, I got so many text messages after I left just going. Man, that was great. I love working for a company that wants to talk about the core values and also lives the core values that you can come in talk about them. This is what we live these things on a daily basis. We get our teams talking about these things in huddles in the morning every single day and, yeah, like that really is, my biggest passion is getting out and talking about these things, as opposed to sitting there and prepping crowns all day.

Speaker 4: 17:07

No, that's great. Yeah, I think that's so important because, back to what we were talking about, it's things have changed. The tie lifts all boats and so, specifically when we were in the lockdown stages where they were doing quantitative easing, lowering interest rates to zero, that kind of fiscal stimulus elevates everybody and I remember thinking like at the time, talking to so many people, it was just up to the right forever. Nobody was talking about if this could ever stop because the gravy train was rolling.

Speaker 4: 17:37

I had conversations in early 22,. So this is after the peak of the market. This is when they'd announced all the interest rate hikes and this is when the market started coming way down really quick. And my thought was where the public markets go, the private markets follow, and so are we going to see a huge correction like this. But people just wouldn't believe it. It's no. When the public markets are down, people shift the private markets because they want diversification, because they see how well they're performing, and it's going to keep going up and up, and it's just not the case.

Speaker 4: 18:05

There's always macro factors to take into consideration, but what happened as a result was you could just package it and flip it, meaning you could buy a bunch of different locations, put them all together real quick, flip them to the next guy. There was no core value, core values, there was no synergy, there was no same-store growth, but it didn't matter because it was moving so fast and there was the appetite was so big this capital to use that you could just like throw them all together. And so I think that if you look at the data, there's very little like same-store growth. There's very little like same-store increase.

Speaker 4: 18:40

Performance is really just all about the arbitrage, which is it just a house of cards over the long run? And so now a lot of that stuff is shaking out. I still don't really know like which groups successfully did it and which groups didn't, because there are winners and losers, but it's all very, it's all very like confidential, but there are just stress groups out there, right, and it's like a question of what's going to happen to them. And so it just leads us back to this whole thing, like just about doing the fundamentals right, like people forgot about fundamentals, and I think core values is just such a big part of those fundamentals.

Speaker 1: 19:13

It's a big part to your point. That's all it was. It was duct tape practices together, arbitrage them and sell them, and I think that's why there's whatever 2,500 dental groups out there, because 1,500 of them were like I can buy for six and I can sell for nine and I don't have to work as much, and that just sounds great and it's what it's doing, is it's we're going to find out who survives, because, you're right, the leadership of the top, my own job as CEO of the company, like I'm a dentist, I'm not trained in business, so my feet are to the fire because I've got to learn. In a with macro, we get like the headwinds are. We're getting pushed in the wrong direction right now, macro economically, like I've got to be a better CEO than I was two years ago. I've got to continue to learn because otherwise it's just going to keep getting harder and harder.

Speaker 1: 20:07

I think over the next probably 12 to 24 months, I better be really good at my job.

Speaker 1: 20:11

So I try to hang around people who are way smarter, way better, way further along in the game than I am because, again, I'm a dentist, I'm not an MBA with 20 years of experience doing this, but that's who's leading most of these groups and I think, those that are going to come out really on fire in 2025, get through 2024, keep focusing on core values and same store growth and just get the fundamentals right.

Speaker 1: 20:38

Get back to patient experience, get back to case acceptance, get back to really influencing patients at a high level and then in 2025, let's go, because I think things will start to shift back a little bit, but in the other direction, hopefully. But yeah, I've got to be way better than I was two years ago because it was easy then. It was just easy like patients were just happy, people were just happy to go anywhere. In 2021, 2022, like people were, like they were just happy to go hang out with human beings still, and when they were coming into a dental practice, it was we were a safe place for them and they were. The patient flow was like you didn't have to market much, and that has changed over the last eight to 10 months significantly.

Speaker 1: 21:23

We all have.

Speaker 4: 21:24

Yeah, let's pivot a little bit and I want to hear a little bit more of the story of your wife, like what happened. And then how does that chronologically lineup with the story of your business?

Speaker 1: 21:34

Yeah. So in 20s, a month after we were engaged, she had a stroke, found out that it was a congenital heart issue that she had. This is like former division one soccer player, former professional soccer player, post college, like in great shape. It was a smack in the face that mentally, honestly, I'm the first to admit I it affects me way more looking back than I probably realized that it did. But you realize you get smacked in the face Like somebody who is in great shape. There's, we're not invincible, were. Life is short.

Speaker 1: 22:14

We get to do this one time and I think that was one of the reasons that I had been talking about getting into the game of growing a group. I had that entrepreneurial mindset. I felt it. With the practice I was in. We had doubled the size of the practice. I enjoyed what I was doing, but I wanted to take it to the next level and so that was like, look, we get to do this one time. We get one life. Let's go figure this out, let's go acquire more practices. And again, if, like living near the beaches, she went to school at Florida National University down in Miami, so being near the ocean, warmer weather, all those things, was what she was looking for First was like look, I, we've got a place we can go down and help head my dad's. Hey, I want to scale back. I'm like great, that's a practice that we can acquire and go work in. I think it was just more of the mindset part of it. Life is short, like this, is it? We got to go do this.

Speaker 4: 23:08

So that was really when you let the fire to start creating multiple. It's ironic because that ramp up period is very harsh, so, like at that time, there's a lot. It's probably a long time before you can just sit back with your toes in the sand.

Speaker 1: 23:20

Yeah, and the ironic part is that it was like there's way less time now than there was, that like one practice where you're off like Friday, saturday, sunday, and it was just.

Speaker 1: 23:34

It was way easier, and I'm not saying it's easy to go run one dental practice Like I think sometimes people think take that wrong. But it's just different than when you have a hundred and whatever employees and your 12 practices in and you're still clinic working X amount of time. As the next shift is it like 18 months or now, Like I've got to be done and we're working on kind of that plan right now and working to make that happen. But I think it was just more of a mindset thing, Like it was a big smack in the face. But she's great, we have twin, four and a half real daughters that are healthy and happy and it's been a good shift for us. It's been. It was a good move for us, it was. But the logistically it was tough. Leaving three days a week to hop on airplanes, go back to Indiana to work was was not easy, but I think it was the right decision.

Speaker 4: 24:22

Yeah, I think it's interesting and it's like sometimes the lowest point in your life creates the circumstances for change that will have a great outcome at the end of the day.

Speaker 1: 24:33

Yeah, it was. It was a very scary. Having never dealt with anything like that in my life and it wasn't it just I still to this day, I can remember when she came out of surgery and it was. You can still go back to that moment and remember what that feels like no-transcript, the amount of relief when everybody says she's good and everything should be good to go.

Speaker 1: 24:56

At the end of the day, we get to do this one time and we get one life and I think that we got to shoot our shot with that one life that we got.

Speaker 4: 25:05

Yeah, and you never wish anything ill to happen on people, especially with health. But everything is happening for you not to you necessarily, and so I like Alex from Mozi. He's got a great podcast and just listening to him talk about it's okay. What's the goal? The goal is think about yourself when an older person, what type of person do you want to be? Right, imagine that person, whatever it is.

Speaker 4: 25:27

Now, put yourself in that position and think back. You're that, you're your older self. You're looking at your current self. What has to happen for you to become the ideal version of yourself when you're older?

Speaker 4: 25:38

Right, that older version of yourself is probably going to put you through a lot of trials and tribulations, because they know that's how character is made, that's how your character is forged, and so when you're going through all of these crazy problems, yeah, it sucks, but what happens is that's forming a person that you're going to become down the road in the long run, and so it's like, when you look at it through that perspective, it allows you to really take, it allows you to handle these things a lot better, because it's like this if you want to, if you truly want to become better, you want to be the best version of yourself, and if you want to just improve your like, your character or anything, then you have to go through these types of things, and so, for me, it's given me a great perspective on like, okay, this is just this too show path. This is a temporary thing, and so I'm going to be stronger because of it.

Speaker 1: 26:30

No, I think that's everything. It's just perspective. I think back to things that bothered me four years ago and it's like laughable, what, how like, how weak could you be? It's just different now and I'm sure obviously I want to be able to look five years from now and look at the challenges that we have now and just be like what, why was that ever even, why did you even think twice about that?

Speaker 1: 26:54

And but it is tough, it's for me, it's I struggle with not bringing those challenges home, because when you get home at six o'clock at night, like your kids and your wife don't care what issues you dealt with that day, like now your husband, dad and in your entire, it's just, it's different. That's the challenge and it's that that's the biggest thing for me in life right now is just giving everything that I have in all three avenues and really trying to fill those buckets. And because we do have big goals and I from the business standpoint, but I want to, but you also want to be a great husband and you want to be a great dad and you know I perspective comes into play a lot in those areas. So you've got to keep a good perspective on life in order to think, to be able to fill those buckets.

Speaker 4: 27:44

Yeah, on that note, do you guys have any kind of ground rules for personal time and family time versus work time? Like I know, recently my wife was upset. I was on my phone a lot and taking calls and doing all these things in the evening. So I gave her, I got a box that has a code on it and she says to lock, and I said here at seven o'clock you can take my phone and you can lock it in this box until it's time to charge it and we don't have access to it. I'm just curious if you've ever dealt with anything like that.

Speaker 1: 28:11

Not to that extent, but that's a phenomenal idea, honestly, like that is great because that's the what, like that is a big thing that I hear a lot because it's teen and you're getting a text message from which is fine, like I've got again. Like my team, these guys work right. But it's like your HR director is calling you and it's seven 15 because he just got off an interview with this doctor. We got to get another interview set up. This doctor is phenomenal. I want you to talk to him tomorrow. We need to get this done. And so now you're on a phone call for 15 minutes or you're replying to text messages.

Speaker 1: 28:43

She's really good about it, but I'm terrible with like calendar and organization and she's phenomenal at it. So it's, I just need to be better from a calendar standpoint. She doesn't care if I have a meeting at eight o'clock. Like just have it on the calendar so that she knows like a day ahead of time or two days ahead, like she's fine with it. It's usually the times when I'm sitting there at the, at the kitchen table, and I've got my phone added and she just no idea like what's going on with that's just people blowing me up or whatever. But so it is. I try to be better about it and I try to do it, but it would be nice, if you have, maybe I should just throw my phone in a lock box and I've done much better at it.

Speaker 1: 29:24

I'm really working on being present because I'm just, I'm just not good at it. I'm usually like a week ahead, I'm a month ahead. I'm still thinking about something from yesterday, ten years ahead sometimes. Yeah, I'm just like, I'm just, I'm just, I'm just, I'm just, I'm just, I'm just, I'm just, I'm just a week ahead. Yeah, and like I, I just I've got to be better at just like being in the moment and focusing on that. So I'm working on calendar Like I'm going to be way better at it. I've gotten better at it and I'm going to continue to get way better at it, like hiring personal assistant, like things like that, I think will be incredibly beneficial.

Speaker 4: 30:01

Yeah, I think it's just a topic that doesn't get that much attention because the scale of organization and I think that's the strategies and mindsets and all these types of things by what cost? Because it's really hard to have a balanced family life and create like a massively successful organization in any industry. And so one thing that I heard recently too was a guy talking about how getting married, having a kid young, forced him to prioritize his time better because he knew that his wife wanted, wanted, his attention. I think that's really important too. Now, obviously there has to be exceptions, right, you can't just say even for me, there's a good I want every single day. I won't necessarily be able to put my phone in there from seven to bed, but for the most part, if that's the goal, I think that it changes your behavior for the better.

Speaker 1: 30:41

Yeah, I agree it just does because you can't yeah, you can't be in 90% Business all the time, like your family can't have 10% of you, for, yeah, they're just gonna get tired of that. I think I, honestly, it's For me it's always just good to hear and to talk to other people who have that same issue, because it's exciting for me, because you're like it's fun to talk to like really driven people who just like want to go get stuff Done, like execute, execute. But understanding that that family is important, like your spouse and your kids, are Incredibly important. They're important to your success, they're important to your health, they're important for just so many aspects of life and I think that Having those conversations with other people when they, and hearing how they manage it, how they deal with it, and just understanding that you're not alone in trying to manage.

Speaker 1: 31:33

It Is really cool.

Speaker 4: 31:35

Yeah, and because there's multiple times where somebody's put on a pedestal because there's great business that they built. And then I'm looking at them Like, oh, I wish I could do what they did. And I'm like I'm trying to do as much as I can and replicate them as much as I can. And then I found out, oh, by the way, you've got divorce from your wife when you had a three-year-old kid and, like now, you never get to see them and you're on your second or third marriage. I wish I would have known that a handsome, because then I could have known like to pick and choose some of these things that you're saying. And so, the end of the day, the outcome is that I make less money but I stay with my wife and kids and have a Productive family. That's a good, that's a trade-off of willing to make, but just not a lot of people talking about that.

Speaker 1: 32:11

A lot of people don't talk about it. I think one of the things that really drew me to the dentist entrepreneur organization Initially like hearing Eric Roman who was one of the partners there and he's coming on now and and has started his own company around organization called One Life and but he was very open about that, saying, while he was scaling his group in North Carolina is like I, just about a loss of my family. He was very transparent about that, very open about that. I was like man, I feel that bad and like it just really Because that is that's not something people talk about and a sacrifice that comes with trying to have big goals and do things is that that struggle is real.

Speaker 1: 32:55

I hate to use that cliche. Yeah, the struggle is real. Yeah, you do have to prioritize what's most important sometimes and but he was very open about that and I think that really opened the doors For me to really enjoying and get into another organization like that where people are just very open about it. I've had a lot of conversations over the last 12 months with doctors that From that have three practices, some that that have 75 practices and they're like it's just tough and but hearing how they manage those things has has been awesome.

Speaker 4: 33:29

Yeah, no, I think it's true and it's good. It's great to talk about this because, yeah, this podcast honestly serves as A benefit for me too, because I'm reminded of all the stuff that I should be doing.

Speaker 4: 33:39

But anyways, yeah, I know you mentioned de novo. So who's put it back to DSO for a second here? But moon forward, which I I think is a great strategy, by the way, because there's just there's a, really there's a. With private equity, it's all time driven like the shorter the amount of time, the higher your IRR is right, and so what happens is that time sensitivity Creates different incentives for different decisions, and so when you're doing these acquisitions, like we talked about, it's all about the arbitrage You're buying a existing evita.

Speaker 4: 34:09

At the end of the day, a lot of times you got to take on debt, and your actual hard dollars that you make May be less than what you do with a de novo and so you can make more of the de novo, but your IRR is lower because it takes longer, and so I think it's a really interesting calculation to have, because you can definitely make a business that's built to last by doing de novo. So I'm just curious what your guys strategy is, and then even talking about the site selection, like that's such an important part of it too.

Speaker 1: 34:35

That's everything. Yeah, I think it's just. It's. It excites me, there's an excitement from going from zero to wherever you get to, but I think it's just the whole plan like just Developing the plan from to your point the site selection aspect to Building a team, to getting the initial marketing going, and just scaling it up from there is the problems that are created are our own problems, then? And I think that there's a certain. It's just a little easier to go to bed knowing that if there is an issue, if there is an issue, you're the one that created it and not that I'm throwing anybody in the bus and saying, hey, other people are creating problems for us.

Speaker 1: 35:11

But, like you said earlier, there are just skeletons that come out when you do acquisitions. And Our practice down in South Carolina, the one that I still work out of clinically, we're the lone duck. Or in Indiana, we're around Atlanta and then there's me down there. So we need that probably becomes our next growth point. We're in an area between Bluffton, okadee, pooler, savannah, all the way up highway 170 up towards Buford, south Carolina. There is massive growth in that area and I don't see why we couldn't go build out two or three more practices around there over the next probably 16 or 18 months.

Speaker 4: 35:50

Are you guys focused on retail locations?

Speaker 4: 35:53

Preferably yeah yeah, no, I think it's smart. We referenced and it's got earlier, but he just has a saying that rent is a factor of your marketing and you gotta pay higher rent. Or if you're buying a higher cost, how does that equate to your monthly patient acquisition? Because usually it's a formula you can do Okay, I know that my patient acquisition cost is this, and then my increased rent is this, and is the amount of increased rents that I pay going to yield me more patients than the amount I'd have to pay? And advertisements, digital platforms, direct millers, whatever that you do, and usually the answer is yes. When you actually break down like that.

Speaker 1: 36:28

Yeah, yeah, you got to be able to get eyeballs on you if they're driving by Because we're going to Publix or they're going to Kroger or they're whatever right like. The eyeball effect is just way better than having to worry about Paper click and all that other jazz.

Speaker 4: 36:44

Yeah yeah.

Speaker 4: 36:45

It's stuff that we love too. The average Stanley vigorous to grocery store like 2.4 times a week or I guess, yeah, on average 2.4 times a week. And so you got to think where these people already going to and where they already frequenting and then like, how can we piggyback off of that? Because even in a market where there is saturation there's competition. You can out position that competition by Getting close to the grocery store, getting a better street visibility, because what happens is these people are driving by and then it becomes in their mind subconsciously and sure, we use google to look at things all the time but like, if you know that you're going to pass right by it on your way to the grocery store or Whatever it is that you're doing throughout the day, that it just makes it so much easier because now yet it takes less planning. So those are like we're constantly trying to, you know, piggyback off of the work that's already been done to make it easier for our clients. I don't know if you guys are doing similar things.

Speaker 1: 37:32

No, but We'll talk.

Speaker 4: 37:36

Do you like to buy or release your locations?

Speaker 1: 37:39

Yeah, so we've got two buildings in indiana that we're currently in the process of acquiring. Right now It'll be a mix. Is it probably In the long run? Do I have some commercial real estate? Do I want to own some buildings? Yeah, absolutely, that'll make. Once we get those two practices or the buildings acquired, that'll have one, three of our buildings. At that point I think, probably, moving forward, there'll be a couple more that we'll buy, but I think most of it will just be rent because we're gonna again, we're gonna move into that retail type space where it's not really we probably won't even have the option to buy. It's gonna be more of just let's get really good locations, let's be retail because the industry has moved completely retail. We need to be front and center in front of people and yeah, there's no right or wrong answer for buying or releasing.

Speaker 4: 38:30

It's just what's the trade off? That's always the question, because it will make you grow slower. You have limited bandwidth, you have limited capital, you have limited debt that you can take on from your banks. But sometimes people would rather go slower and own the real estate too, and so it's just it's what's your speed of growth? And like, is this gonna cost you From opening up another practice or not? And so if you're okay with those trade offs, then yeah, absolutely makes sense. But I think it's really so. I just know Some people that will want to acquire the real estate at all costs, like doesn't matter, they won't grow unless they can buy it. And I don't really know if they understand the trade off that they're making. Like they think they can grow to as many practices and on the real estate, but like you, just you can't. There's gonna be a consequence to that. So it's just figuring out what's your strategy, what's your goals and what's best for you.

Speaker 1: 39:14

Yeah, we had just through. We owned One building. We've just amassed enough cash in that account from owning that building for the last nine years that I can go buy two more buildings with cash. So I will only buy the buildings when we have the cash available. I don't want to go take out debt to do it. I want to be debt-free on that side so that when we do go to the banks and ask for more money, from the practice standpoint we're good to go. I love it. Listen, this has been great.

Speaker 4: 39:45

Any closing? Is there anything that you want to talk about that we didn't get a chance to touch on?

Speaker 1: 39:51

No, I think this has been good. Yeah, we've hit a lot of, we've gone through a lot of tunnels, so this has been fun.

Speaker 4: 39:57

Yeah, all right, if anybody wants to learn more about what you guys are doing. What's the good resource?

Speaker 1: 40:02

Probably vision dental partners calm. They can contact us on there or shoot me an email directly BDQ's DDS at gmailcom and I'm open to chat about anything. And yeah, I would love to hear from anybody perfect.

Speaker 4: 40:19

Yeah, I left that in the show notes for everybody listening and yeah, so just click on that. And again, thanks for your time.

Speaker 1: 40:23

Yeah, I appreciate awesome.

Speaker 2: 40:28

If you need help finding the perfect location for your practice or you're ready to invest in commercial real estate, email us podcast at leaders readcom. That's podcast at leaders re re as in real estatecom, or go to leaders readcom and fill out our form. See you next time.