are you looking for a podcast where you can hear from real people regarding their real dental drama if so then
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you've come to the right place join hosts bethany penny and dr reena kuba as
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we dive into the solutions we've created and the mistakes we've made while
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managing dental drama let's get started hey friends hey
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hey so i have a topic i want to talk about today okay before i do i have a
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question not for you okay for you listening are have you subscribed yet if
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you haven't go quit putting around may content is out it is fantastic we're
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already working on building up june so um go subscribe um no excuses no excuses
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i love it excuses move along um okay so the topic i want to talk about today is
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i don't think we've talked about this before and
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um satellite locations mhm can we i want to talk about i think a lot of dentists
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um either start off with going "oh that's the pinnacle of success is when i
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have multiple offices that's what i want to do my friend did it so's doing it i
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can do this." um or i you know i we're we're so full
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we're busting at the seams we have no more space to see patients clearly i need to have a satellite location or i
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need a bigger office um so do i keep this one and start another one over
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there or what do i so the topic i guess um and maybe you
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can help kind of rein it in but my question is i think all of us at some point either somebody has asked us or
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suggested or we feel like oh my buddy's doing it am i behind should i have
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another office um and it's really easy to get caught up in that and it's like
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am i doing am i doing it for the right reasons um or am i getting caught up in
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what the joneses are doing and shut up and focus like what so i think that's um
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i know early on i had a um practice uh
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what do you call it a a rep my rep um chris at the time and he said something
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and it's always stuck with me and he was like you know people always seem to think you get busier and then ooh i can
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just recreate this in another location why do i not do that and get twice the money and he's like what they're not
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realizing is you're getting twice the headache and can you really give enough attention to both or are you going to
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start giving attention to that one and then this one start dropping because you can't keep up um and so he said like
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really if if you're in the camp of "oh i'm so busy." he's like "are you are you
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maximizing your space 6 days a week are you open on saturdays and you still can't get enough room are you utilizing
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all your operatories or is it like you're full out of two operatories but you really could build out three more and you're not doing that but yet you're
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going to go start another location?" like so that's always stuck with me because i would say probably around year four or five when we finally were
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hitting our stride and our rhythm and all of that and i remember the staff going "oh we don't have any more room
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here." here and i was like normally that would have been easy for me to go yeah you're right no we're open from 7 to 3
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3 days a week we have not outgrown our space we're just not utilizing it to full capacity when we are here on
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saturdays and we're here from 8 to 5 or longer with two doctors three hygienists
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like whatever the space can accommodate and we're doing that six days uh continuously consistently then i'm
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busting at the seams that's right but i don't think people think about it that way they start going "oh we're busy." well you're busy in the confines of what
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you're doing but can you stretch those confines and i think in a in most cases
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the answer to that is no but you're you're in your bubble and in your zone and haven't thought about thinking about
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you know alternatives alternatives but then you're also going "oh a new shopping center opened up in the town
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next door or i've heard this town is growing and look we've been so successful here let's do that there."
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and i think that for me is always i'm just like "whoa whoa whoa whoa whoa whoa." cuz now you really are splitting
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yourself amongst two and how can two be equally successful unless you're
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bringing on a partner or a management team i don't know but to me it's like i
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don't know about that so can we talk more about how do you know if you could and should have a
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satellite location and for people that are like "well everybody else is doing it and i'm behind talking about some of
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that mentality as well." yes so i think this is such a great
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topic because i do think you're right i think there's this like this is the evidence that you're successful that you
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have more than one location and i disagree with that sentiment completely
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now i do think there are cases where a second location makes sense but i think
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you'd be surprised to hear me say that there's very few situations that i think actually make sense for a second
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location so because often times i can get in and look and realize there's so
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many other solutions before we branch into a second lease that we're having to
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pay for utilities lights you know equipment for that space staff for that
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space it sounds easy to replicate like oh we've done it here we could just easy
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easily replicate there that sounds good but is the team that you have at your
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existing location are they all going over to that satellite location because
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replication happens when the same people are executing the same tasks so if your
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team is not going with you to that new location which i would never recommend
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because then you're not in this location anymore then you're compromising your your bread and butter base yeah it's
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your baby and now what is fueling the financial pipeline for that second
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location you just compromised it you just cut its legs off and said "i still want you to run as fast." well that
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can't happen because you you took out the team that was making that possible
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so replication of a practice which to me you're like "okay
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why would we ever take the team?" my assumption is if you're needing a second
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location it means that you're fully maxed out and what you have described is exactly what i would describe are we
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working five days a week have we lengthened our days have we added saturdays if need be are we truly best
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have we brought in an associate like what have we what have we done to fully yeah and so to me if you're looking at a
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satellite or a second location it means you're fully maxed out so then we can't
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our team members from that primary location are unavailable to go to the satellite location so replication is not
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a possibility at all if if that's in your head like oh i'll just start it the same way i did this one and it'll all
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work just the same no no no no no because you've got completely new team members there who don't know you who
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don't know the original system who are they can't replicate anything replicate
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what they have no clue what you're talking about so you're rebuilding an entirely new practice and
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yes might it turn out to be similar to your original practice the the breadand butter practice yeah it could years down
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the road but the same process that you went to went through in this original
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location the same headaches the same problems all that it absolutely will
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happen again at the new location the whole ramp up of everything and not to mention the new location is gonna have
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its own demographic so some of the marketing things that worked in bread and butter may not work in that other
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one the same types of um customer service type things you might get away
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with doing or not doing in bread and butter you may or may not those may or may not work for this new clientele
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that's right um so there's a lot of i think like little things that it makes it seem now i have a colleague that but
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this has been happening now for years maybe 7 8 years when he opened his he and a colleague opened two locations
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together but it was in two separate towns completely far away from each other and it and it ended up being he
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ran one colleague ran the other so i think they eventually split off um so he was basically running one well i talked
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to him the other day he's got five locations now but he's not a practicing dentist anymore he was done with
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dentistry and now he is overseeing and so it's a whole so that's a whole
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different that's a whole different category but if you yourself are going no i'm the provider and all these
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patients in this town love me and i've built up this great practice and i'm going to go duplicate it over
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there something's going to be different so not that it can't be done or
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shouldn't be done but i think just the realities of knowing that it's not just as simple as oh i'll just open all these
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other locations and it's the same yeah and as long as a practice owner
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knows that before they take this leap of faith into a satellite location or a
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second location i i think we've just got to be careful not to oversimplify the pro process as a matter of fact in order
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to make sure it's the right decision i would recommend over complicating it and
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playing out all the horrific whatifs that could happen with a second location
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and once you've played through all those horrific whatifs that jazz because i think the people
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that are ready to do that and wanting to do that don't they're just like "oh this is we we've already been so successful
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here we'll just repeat it there." so what are what are you talking about like the horrific so what if i can't find
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good staff members for that location what would i do it how could i recreate
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a really good practice having subpar employees so right now my bread and butter works great because i have
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fantastic team members they execute everything but what if i have team
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members that don't show up they do show up and they do a terrible job they're
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not good at customer service i'm having to they leave so it's just an environment where i haven't built
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retention with my staff members and so they're constantly funneling through and i'm having to retrain from the ground up
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i don't have a long-standing team member in this new satellite location so i don't have a good trainer built in like
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i am the trainer so what if i'm having to manage a lot of hr headaches and i
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had a a colleague that that did that with and i think you know of course i i'm never going to know the ins and outs
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but he bought another started another location could never keep a good associate frankly then he couldn't keep
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an associate in his main one either and i'm like "oh so now you're constantly looking for two associates." um and so i
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don't know if his original plan was get an associate and they helped summon one and summon the other but the towns were
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pretty far from each other like you know if you lived near one it was going to take you a good 45 minutes to get over
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to the other one and anyway i think ultimately he ended up having to sell that one or close it down because it
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just wasn't sustainable and he tried for multiple years um so uh it's common it's
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a common problem so what if staffing is a real big head headache for me another
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what if is what if the marketing that i did in my original location doesn't work
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in the new location and i'm struggling to get patients in the door i'm struggling to get production on the
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schedule having in your mind a
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longer negative cycle what would i do if it actually doesn't become net positive
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covering the bills until 2 years down the road and making sure financially
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that you've built yourself up enough of a cushion in the original practice that it could continue to feed that satellite
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practice so we don't want to go in assuming "oh my gosh this location's perfect the the culture is just right
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i'm going to get in there and i'm going to be net positive in 6 months." nope play out the what if it's not net
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positive for a longer period of time are you still feeling good about that and you may you may say "yes because i know
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that the situ the the ground is fertile for a practice in that location so i'm willing to continue to kind of filter
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off the top out of my original practice for two years to to pay for that okay so what if i can't get the new patient flow
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i can't get the profitability up fast enough that's a good what if what if to play
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out what if i ultimately find that i can't handle
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both practices which is a very real possibility what if mentally i'm just having trouble managing both the staff
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at the satellite the staff at my original the patient problems that come up between the two what if it becomes
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too much for me which is a a possibility we have to consider what would you do in
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that particular case so the more we can kind of project out worst case scenario and go ahead and come up with
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preventative solutions to those then we're going to be more prepared and have even thought about those boundaries and
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kind of go what would my threshold be if i'm thinking okay can i you know support
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this for two years and not have it be profitable but what is my line is it two
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years is it one year like at what point and if if it gets to that 2year mark and we're still in that same boat what am i
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doing then but if you've kind of gone well no it will be but then you find yourself like 2 years later and you're
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like oh my god i'm bleeding money now because i wasn't thinking about that boundary of 2 years or one year or 6
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months or whatever it is um so having had some boundaries in place i guess
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would be the the question yeah and i would say too as far as projecting worst
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case scenario to me you've got to have somebody that's side by side with you on
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this so it doesn't mean that they're moving over so you might have your
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office manager that's just like you can't live without this amazing person that doesn't mean that your office
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manager is moving over to the satellite location that's not what i'm saying it's just you need somebody to run ideas past
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to potentially support you with some of the things that are needed like maybe you don't have the capacity to do all
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the hiring at this satellite location but thank goodness you've got an office
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manager that can help you filter through some resumes and conduct some of the initial interviews so just i think
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anytime we're talking about a full-time practice the original practice is a full-time practice and that doctor is
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now choosing a sla satellite location even if they've already got a good associate in mind they may even have
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some key team members in mind that out in the community that they already know for that
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location you're still going to want like your inside person that's kind of helping you with it in other words just
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don't try to do it on your own is what i would say h have a good buddy that's walking alongside you it could be your
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financial planner that you're they're making themselves more available to you while you make some of these decisions
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just have somebody that you're running ideas past now having said all the negatives to a satellite
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location in other words just think about all the negatives before you decide to do a satellite location there are times
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that it really does make sense i'm coming from a practice that i was just at where uh he his practice really is
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like we're we're running out of space it is a very busy practice he's got you
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know five hygienists himself and an associate doctor um by they're you know it's open five
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days a week they've both him and the associate doc are just unwilling to do saturdays and that's fine real quick
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before you keep going with that the next question would be is that when i mean is he fee for service yes okay because that
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would be my next question like maybe that's the time to stop maybe you think you're busy but you're still taking hmos
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dude you are working and not making money so before you go start a satellite location thinking you're busy like are
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you working smart or are you just working and so at that point if you think you're busy and you're like "yes
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i'm there 5 days a week and we don't want to work the saturday and we're we're good but we still don't there's still a two-month wait to get in here
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maybe that's where make sure to look at your insuranceances and stuff and say "wait if we dropped this one insurance
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that pays nonsense how many patients am i going to lose could that free up the space we need for better paying patients
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here?" um so i think that's the other thing to think about you absolutely need to consider that
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before starting a second location it it just yeah it doesn't make any sense to
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me because if you're doing dentistry for 50% off which is what you're doing if you're in network then you're you need
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to make sure could i just lose a few patients and be okay and also not just
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on capacity with the actual physical space but also capacity with your team
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like if you're looking at i'm in network with everybody and i'm to a point where
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i can't that me and the hygienist just can't handle this patient base any longer we've got to add an additional
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hygienist or an additional doctor make sure that that makes sense
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financially so is is that high that new full-time hygienist do you have enough
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volume to pay for her and still be net profitable or let's say it's an
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associate that you're bringing in so even capacity from a staff member standpoint does it make more sense to
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drop insurance before adding that new hygiene which i think what a lot of
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people do i think is going "how could it not how could it not?" like we're making all this money and we could see more
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patients and we'll bring in these providers like that seems easy it's not that simple you might be paying a doctor
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top dollar you know to come in but you're you're not making top dollar
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right you're making 50% or less of your fees by taking this insurance so i think
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that's one where a lot of people don't really put that together and that's you're not doing yourself a service
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whatsoever you're actually going to end up in struggling to make profitability yeah and again this is where you have to
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look at capacity through multiple different lens at the end of the day we
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have a certain number of chairs we have a certain number of patients those
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certain number of chairs needs to be able to to service provide enough capacity for our certain number of
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patients and there's going to be multiple times in a practice where you go "these chairs are not enough to
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service the amount of patients that we have in our practice." and wow that's a huge blessing okay well how can we
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lengthen the chair time the same number of chairs but how can we lengthen it how
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can we add a day so that now those four chairs that we have available are also available on fridays and the owner doc
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is like "uh uh uh i ain't going to be doing that." that's fine it doesn't have to be you who could you put in your
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practice on a friday to service your patients and make sure that there's capacity there so there's
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so most times there is just untapped capacity solutions that we're just
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immediately going based on our current circumstances we don't have enough chairs to be able to service the patients yes but you can reduce the
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patient base oftent times with some very creative uh solutions or you can extend
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those chairs so that they're available more hours in the day or more days out of the week or it could be that a doctor
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you know in a especially in a startup practice it could be a year or two in they still haven't added a hygienist and
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they're running out of capacity they're like "oh gosh how do i continue to serve?" well there's a chair that's
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never used it's fully equipped and we never get to that fourth room so you don't need chairs you actually need
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providers is what you need so yes before you consider i'm at capacity and need a
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satellite location make sure that you've actually thought through so you were saying this doc that you were with they
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they've done all of that and their fee for service meaning it's not like they could drop on insurance they have and
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they still have this volume what is he doing then why how tell him to give us the secret i know he he's got a
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fantastic practice and he has um due to
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kind of some prevention training that he's gone through you know a lot of his
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patients see him more than every six months in his mind like a lot of carries
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a lot of perio comes from just they're not seeing the dentist enough and so his hygiene department is very robust he's
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got a great practice so he's in a situation where we've done all that we
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possibly can including which i hardly ever recommend this but including
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cutting back on marketing because i'm like we don't need the new patient flow we can't we can't service the new patients right now because of the space
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limitations and so for somebody like that he's going okay does it make more sense to have a second location does it
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make more sense to expand the physical space you know saturdays and sundays are not
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an option for him and that's that's great he doesn't want that to be an option for his team because he's got you
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know a lot of working moms on the team and all of that so there's some boundaries that he's put into place but
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he's still in a capacity situation when you're in that and you've done everything that you can to reduce that
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capacity problem then you're looking at a satellite location and in that case
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sometimes the satellite makes sense um sometimes it doesn't and you're just like "okay well we got to turn that new
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patient nozzle down to just a trickle and we're okay with that." and um but
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even in that situation we talked about he and i talked about a satellite location and then we really started
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looking at options within his current space current space to go can we add can
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we extend given the layout of his property that is not a possibility so we're like
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okay it's got to be satellite nope no because there's a building next door that he can purchase and either bulldoze
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that and kind of build out or he can connect the two buildings so just be creative is what i'm saying don't
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immediately go to second location even if you're in a true capacity situation
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you may want to look at just what can i do with my current space um so that's
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one thing when you truly have a capacity situation satellite makes sense but then sometimes there are just opportunities
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that present itself where hey you know i wasn't even wanting necessarily a second
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location but this great opportunity came up came up in a neighboring town i know
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that's an underserved population it would be really helpful for them to have a dentist in that
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location i don't necessarily need it from my patient base here but it's kind
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of an exciting possibility so i think that happens a lot with people or they
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talk themselves into that and i think the times where i could see where it it truly does make sense or potentially
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um cuz i had a colleague that in the next town over there was like a a dentist who like for whatever reason at
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like age 70 decided to start a practice and fully equipped it and did all of that and then never quite took off
24:57
because he didn't you know do all the things he needed to do to build a patient base whatever then was like "oh
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never mind i really don't want to be here." so almost like a flash sale you know like "who wants to take this off my
25:08
hands?" and so this colleague was like "it was too good a deal to pass up you know like 50 70 80 grand that for pretty
25:17
much new equipment pretty much whatever decent lease contracts." so he did that
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i i've got a couple of colleagues that actually have done that and um so what are your thoughts on that
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like does that do you think that's a good idea or it can be it can be
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dependent upon the owning doc's capacity right so that's where we still play out
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all of the whatifs we go what if i have staffing problems there what if it's not
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profitable fast enough what if it's too much for me to handle do i think i can handle that so you still have to play
25:53
through all the negative what-ifs and then go okay if kind of
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worst case scenario happened in this second location am i still okay with it or what can i do to potentially prevent
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worst case scenario in that location and i will
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say in all my years of dentistry very seldom is a practice
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bankrupt for some reason it tends to be a pretty surefire bet that you're going to be
26:28
profitable at some point sometimes it takes longer sometimes it's quick but
26:34
most of the time you're going to hit a net profitable situation and so is a dental practice a
26:40
good investment almost always it really is but i think you've got to make sure
26:48
you're okay with the risk that it may not be net profitable as soon as you
26:53
want it to be or it may take more mental capacity than you were wanting to commit
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to it and if you're okay with that it's going to be profitable for you it is
27:05
going to pay off at some point so in that case yeah most of the time it's a
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good situation depending upon the practice owner's capacity so i guess that would be too like if it is a a
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flash sale type situation or you know looking at opportunities that present
27:23
themselves and suddenly you're like well i never thought i was going to do that but now now there's a space available
27:30
that's already plumbed and my you know portion would be $200,000 instead of
27:37
$600,000 like i had to do originally and you know i've got um a colleague that i
27:43
know is moving from out of state and is looking for a place to practice and we've always gotten along and we want
27:49
like things like that if it looks like you can make that work but keeping in mind that it's still not a replication
27:57
exactly and there is going to be maybe maybe financially it may make sense but mentally doesn't make sense for you
28:03
exactly um and trying to figure out like okay what same thing where are my boundaries on that like if if this
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colleague comes to town but then they actually don't come to town they it turns out that they are in a suburb
28:15
somewhere far away and okay now does that mean i've got to work out of that location or do do i oh gosh like who
28:22
what's my plan okay well maybe that location's only open 2 days a week well that kind of sucks cuz that's going to
28:27
take me 3 years to make my money back rather than the 18 months i thought it was going to take but okay so same kind
28:34
of concept um but those are times where it might make sense i to me those are
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often times the cases where they do make sense i love when a practice owner can
28:47
be presented with an opportunity where they can get in and essentially do a startup for a majorly discounted price
28:56
you know e if it's already equipped and you're talking about 60 $80,000 i'm like
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do it there's very seldom times that that doesn't make sense um or even it's
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a finished out space but there's no equipment in it and so now you're having to look at maybe a $200,000 investment and i'm still like
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do it because because a startup at a $600 or $700,000 initial investment from
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the ground up a true startup they're still profitable they they reach a point
29:27
where they're profitable so then you look at an $80,000 investment and i'm like you're going to be profitable so
29:33
much faster true but i still do think uh not to um take away from the mental
29:40
because one of the colleagues that that did that and took over a practice um and
29:46
was like "oh this is great oh i might look for this in other towns too to see like what else is you know somebody's
29:52
got to be vacating and i'll just keep my ears to the ground and and be ready to pounce on that ultimately what ended up
29:59
happening with him is his main practice that was
30:04
fantastic he eventually ended up selling to corporate oh and i'm like okay but
30:10
but in his eyes he's very uh successful because now look i've got two offices
30:16
and the flash sale one that i got for 60 grand and had all this new equipment and
30:21
i didn't have to put much in no but it was so much on you mentally you needed
30:26
help and you that's such a good point was that really a good investment um so
30:32
it depends on how you look at it yeah but um but i just
30:37
thinking through all of those things because it's very tempting a lot of times for all the reasons we just talked
30:43
about above and and i guess my point is go back to your why was your why because you're again you
30:50
you think of that as a measure of success but is it truly a measure of success if you're making minimal profits
30:58
out of both when you could be making maximum profits out of one um are you a
31:04
are you a husband and wife pair are you a sibling pair like maybe that makes sense in those cases where both of you
31:10
are dentists and you need more space but i would say it's tempting it can work it
31:15
is smart in some cases but i think just looking through all of those things before you jump on that bandwagon yeah
31:22
and i would say too you're going to have to approach it from the standpoint of
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you will need more administrative time it is for a practice owner to be
31:35
able to manage two locations and still be practicing dentistry 5 days a week
31:41
that is next to impossible so i think that's where the colleague of mine that now has five that's what he's doing he's
31:47
not being a dentist he's 100% administration and the other one that sold to corporate did so because he
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wanted the back help like the administrative help which i'm like okay
31:59
but at what cost now so yes you think this $80,000 one was a great deal but you sold half your practice to get the
32:06
admin help you needed to run both so again there's different ways to do it but just think making sure you're
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thinking it through yes without blinders on or just going in and going "oh well
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you know my buddy in kentucky did it i should be able to do it i've got better
32:23
grades than him in dental school like look at him." like don't don't fall for that yes foolery there's no there's no
32:30
clout in own i know we think that like oh they must be really successful they
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own two or they own three or they own five but to me it is just as valuable to
32:41
have a very successful one location practice and that is something to be proud of you don't have to have multiple
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locations to show that you're successful and then i would also say when you think
32:53
about starting to divide yourself out that means less clinical time at your
32:58
original bread and butter practice and the last thing you want to do is to
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compromise the success of that that was your flagship place you know and so
33:09
don't if you don't have the mind that can be equally still as committed and
33:17
fervent at your original location if you're like "ooh sparkly shiny i've got this new thing now that i'm focused on
33:24
and now i'm not focusing at all on my original location or i'm very
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unavailable or or divided there." it's gonna impact your even if it doesn't impact your production because you put a
33:35
phenomenal associate there in your place it's going to impact that culture that you're create that you created and your
33:41
team might start to feel different your team might start to feel less loyalty to you because they're not with you as much
33:48
so there can be negative side effects if you're not able to stay just as firmly
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committed and available to your team as you were before the two locations so it
34:02
really does take some careful planning of how you're going to do both well thanks for joining the conversation
34:08
today we hope that you are comforted in knowing that you are not alone but we
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also hope that you're walking away with some really great tips and tricks to try in your
34:19
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