3 Decisions that will Save you Years and Millions

Feeling overworked and underpaid even when your schedule is jammed? Paul breaks down the three decisions that turned a frantic, low-margin grind into a calmer, higher-profit practice: force capacity with DPH block scheduling, reclaim CEO time by understanding owner profit, and build a leadership team that truly insulates you from daily fires.

If you’re ready to stop sprinting through composites and start running a business that serves your life, this conversation lays out the playbook: intentional scheduling, owner-first economics, and a leadership team that frees you to lead. Subscribe, share with a colleague who’s stuck at the chair, and leave a review with the one change you’ll make this week.

Click here for the 3 day seminar

Come Join us at the DPH Live Retreat in Tennessee April 24th-26th.   Click Here for More Info and to Register

Take Control of Your Practice and Your Life

We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams.

Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.

Transcript

Why Hard Work Isn’t Paying Off

Paul Etchison 1:54

Now, if you've ever felt really busy as a practice owner, like you're putting in the work, the hours, all the energy, but your lifestyle and your paycheck doesn't reflect that, then this is the episode for you. I myself, I've been there, I know exactly what it's like. And unfortunately, that is a place that I lived for well over five years of my career until I figured out my way out of it. And today, I'm gonna share with you the top three lessons that I learned way too late in my practice ownership career so that you can hopefully learn them faster than I did. We're gonna be talking about the three things I would have done different if I could do it all over again. Now you are listening to the Dental Practice Heroes podcast where we teach owners how to engineer highly efficient and productive dental practices without cutting corners or skimping on patient care. I'm Dr. Paul Edison, author of two books on dental practice management, dental coach, and the owner of a large group practice in the south suburbs of Chicago that has collected over six million dollars a year. Now, if you want a practice that gives you an amazing life and amazing opportunities for fulfillment, you are listening to the right podcast. Now let's get into it. So this is not theory. These aren't just ideas. This is something that I have personally lived. I've lived this life. So I feel like I have the experience and I have the chops to talk about it here. That's what I'm trying to say. But first of all, let's talk about my practice today. Like, what is my practice like today? So we've got myself, we've got three other full-time doctors, we've got a periodonist, we've got a surgeon, we've had an endodontist, we don't have an endodontist currently, but a lot of people going through there. We've got like 11 hygienists, we've got 11 chairs, we've we're open 7 a.m. to 8 p.m., Monday through Friday. So a busy practice, a large patient base. So before I talk about what I would do different, I think it's important to clarify if I could go do this again, would I even want a practice like I have today? Would I even want a practice like that? You know, a lot of people say, Well, I don't want that busy practice. I want to keep it small, I want to keep it more family feel, better culture, all this stuff. So, you know, and I feel you, because I had that smaller practice where we had that family feel, small team. It was great. Would I do it again? Okay. And here's how I would answer that. Absolutely. And this is why I would definitely do it again. You get so much more freedom with a large practice to do whatever you want as a dentist. If you want to do certain procedures, you can do that because you've got associates to do the other stuff. If you want to take off time, you can do that. And the practice still runs without you and still makes you money. And the thing is, is when you get to a level where you've got three full-time associates running, this is where this whole three and free idea comes. If you get three full-time associates, you can be free from the chair. Now you could. I'm not saying that you should cut yourself out clinically, but I'm saying you could if you wanted to. You have the freedom to. You also have the freedom to practice six days a week if you want. It's up to you. You've got the freedom to do it, and you make a hell of a income. It's just that the only downside to it is you've got a large team and it requires a new level of leadership that goes with it. And it comes with different stresses. And I live with those for a very long time. And it took me a while to figure out how to work within those. But once I figured it out, I, you know, I retrospectively think back to my whole entire career and realize they would have helped me long before I had a big team. It'll help any size of team. So that's what we're going to talk about today. I'm giving you the three biggest things that I wish I would have done differently. And I then this third one, the third one's the big one that not only had an effect on my practice, but it redefined my entire life. I'm going to share that with you soon. Now, these are all high-level things we're talking about. I'm not talking about answering phones or something like micro like that. We're talking about higher level things. And these are the type of things I'm going to be talking about, my three-day virtual seminar coming up on February 19th, 20th, and 21st. I'm going to be teaching these three big things, but I'm also going to be teaching so many other strategies and elements that I teach all of my coaching clients so that they can completely transform their practices and their lives. So if you want to learn more about that and get a great deal, I'm running a flash sale today and tomorrow. That's the 11th and 12th of February. You can save yourself a thousand dollars on it. Use the promo code FLASH SALEL. One word. Okay, go to dentalpracticeheroes.com slash freedom. You can see it in the show notes. All right, let's talk about the first thing I would have changed. I would have forced capacity sooner using what I now call DPH block scheduling. Now let me tell you about the evolution of the schedule at our practice. When we first opened up, we were like every other startup, we didn't have a lot of patience. So we just put people where they fit. I was doing my own hygiene. I only did that for like maybe three weeks. My wife was a hygienist, so it was very easy for me to tell her to quit her job and come over to our practice. Um, but we put people where they fit. Then you eventually get to a point in your first recall cycle when people start coming back that you're like, okay, I've I'm a little bit more busy. I can get a little bit more creative with the way I schedule. So we moved to what's called provider time scheduling. Those are those X's and slashes, the X's and O's. It depends what system you have. But essentially what you're doing is you're deciding for every procedure how long is that provider going to be in the operatory? And you schedule with two columns and you snake left to right and you just do the provider time. So, like for instance, maybe a crown appointment might be an hour and a half, but it's only taking 40 minutes of provider time. So you only schedule it for 40 minutes for the provider. So we did that for a while, and it was a lot more efficient. But the problem with that type of scheduling is that you can work two rooms efficiently, but you you don't get very selective on what you're willing to see. So you will see whatever appointment comes in in the order that you diagnose it. And what tends to happen is you tend to have a lot of tiny appointments, and you can see a lot of patients in one day, like do a ton of composites from room to room to room, and you're just exhausted at the end of it. And you look at your day sheet and you go, dang, dude, I worked way too hard for that. But I remember we were doing that and we were working hard. And I remember we were collecting maybe about$80,000 a month. And I said, dude, there's no way we can fit any more people in here. I am running at capacity. I am running as fast as I possibly can, and I can't fit any more people. Now, in comes the new way of scheduling, which is DPH block scheduling. This is so I made something that had some of the principles, but was completely different. And what it does is it holds spaces for big appointments. It also limits the amount of small appointments you see. And what I was able to do is with the same schedule, I had the had the demand. So people were getting booked out so I could get selective about what I saw each day. We went from collecting$80,000 a month immediately up to like collecting$120,000 a month. And the only thing I changed was the way that I scheduled. Still the same amount of new patients, same amount of diagnosis, same amount of case acceptance. I just changed the way that I scheduled. And what was awesome about it, the days were so much more easier. They were more productive and they were easier. What I would change is I would have used that block scheduling to force capacity sooner. So when we're DPH block scheduling, we're holding space for new patients. We're prioritizing the new patients. I didn't do that at the beginning. So what happened? We could see as many new patients as we wanted at the beginning, but eventually, two, three, four recall cycles into the practice, we were running out of space to see new patients. We went from seeing like maybe 60 to 80 new patients a month to one point where we went down to like 20 new patients a month. And it wasn't that people weren't calling, they were definitely calling, but we had nowhere to stick them. And a lot of people get stuck in this prison because they look at this and they say, Man, I maybe I should expand. Maybe I should add a hygienist. But they say, Man, we're our numbers just aren't there. We just can't expand. We don't have the production. And the reason they don't have the production is because they don't have the new patients. And the reason they don't have the new patients is because they can't see them because they can't fit them. So what I was doing when I came up with this tenet of DPH block scheduling is I was solving an issue. The issue was we had nowhere to put new patients. So I said, you know what? Let's hold space for new patients and let's make it non-negotiable. New patients first, recall second. So now I was holding space for new patients, but I didn't have anywhere to stick my recall. So what I had to do was expand hygiene. And I expanded hygiene to three hygienists, and then eventually a fourth hygienist. And when I added that fourth hygienist, I brought on an associate. Now I eventually figured this out, but I think I could have got to that associate level, cutting myself down to three clinical days. I could have gotten there in probably two years. It took me four. And this is typically something that I do with almost all my coaching clients. We get them down to three days, usually within six months. You don't have to go the long way. I let you skip the line. All right, let's talk about number two. Number two is I wish I would have had a better grasp on my profitability and my numbers and how my own individual dentistry, my own individual production played into that because I think I was giving it way too much weight. It took me a really long time to realize that I was making most of my money as a dental practice owner and not as a dentist. Now that might sound confusing. Let me explain this. So there was a certain point in my career where I was overwhelmed. I was overworked. I was seeing patients three days a week still. And the fourth day I was coming in and just working with my team. It was like an admin day, but half the time I'd get booked with another patient, or I'd end up seeing an emergency, or I'd end up just checking hygiene for a long-term patient, but then I'd sit there and shoot the shit with them for like 40 minutes. It wasn't productive. It wasn't the right way to do it. But I was overwhelmed. And the reason being is I didn't have time to necessarily get to all the things I wanted to get to because I was practicing so much. I was seeing patients so much. So one day I sat there and I was thinking about, okay, this is what I produced last year. If I found an associate to replace my production and I completely pulled myself out, how much money would I still make as a practice owner? And what I realized is that it was like 83% of my take-home pay for the year was because I was a practice owner. 17% of it was because I was still practicing. And the way you figure that out is you look at your individual production and you pay yourself a reasonable dentist wage, 30% of your production. That's what I was looking at. So then I had to ask myself, if I'm making way more money as an owner versus a dentist, why am I spending 95% of my time that I'm here at the practice being a dentist? Why don't I cut out clinical more so that I have more time to work on the things that scale, like working with my team, creating the systems, leading the team, looking at the numbers, things like that. So when I made that change and I had the time to do that, all of a sudden, all those things that were overwhelming, I didn't have to put them off. I could address them right away. And eventually you'd start addressing things right away. They don't grow into these huge issues anymore because you address them when they're small, but versus what I was doing before, I didn't have time to address it. So I would put it off and they'd turn into these big, massive issues that required so much energy. And man, and the energy that went into it was crazy how much sleep I lost over it. So that's the second thing I would have done. And I do this with my coaching clients. I say, hey, let's look at your profit and loss and let's figure out if you paid yourself as a dentist, as an associate, what are you making and what are you making as a practice owner? Because this is the beauty of having a group practice and having associates, is eventually you get to the point where there's so much revenue coming in, you're really outpacing your fixed expenses and you no longer have to practice if you don't want to. Now, most people don't want to go non-clinical completely, but I'll tell you what I did. I said, I'm not doing fillings anymore. I stopped checking hygiene, I stopped seeing new patients. I was just doing like molarendo implants, I was doing surgical extractions, I was doing um ortho. I was doing the things I wanted to do. I started getting really selective about, you know what, I'm gonna put these boundaries up and I'm gonna practice in a way that's fun for me, and that still takes care of the patients. Now, maybe it wasn't me doing those patients' fillings, but they were still getting taken care of. They were still getting treated by a provider that cared about them, that did solid clinical work. It was still under my guidance, but it wasn't my hands doing it. So I would have done that so much sooner in my practice career. I would have gotten myself out clinically faster because now I can see the value there is on CEO time and the time to work on the business. And this is actually what we're gonna be talking about on the third day of the virtual seminar coming up. I really want you to register. I'm giving 100% guarantee that if you don't like what you heard in that seminar, I'm gonna give you your money back. That's how confident I am that you're gonna love this seminar. I just put together all the material and man, is it good. I it's all the stuff I wish I would have known so much earlier in my career. But that's the thing. You sign up and you get to learn all this stuff. You can go back to your practice Monday morning and implement it right away. All right, let's talk about the third thing. I said this was a big one. This was the one that changed my life in every regard. It didn't just change the way up at that that I felt at the practice, it changed the way I felt at home. It changed the way that I was a father, it changed the way that I was a spouse, it changed everything about me. And this was the element that was missing for how long in my life? I'm gonna say an entire decade. I'm gonna tell you from my age, about 31 to 41, I didn't have this, and my life could have been completely different. And I bet you, because I didn't have this, I will probably die 15 years earlier than I would have had I had this when I was 31. Okay, what is it? It's that I would have correctly implemented a leadership team sooner. Now, I said correctly, I mean because I implemented a leadership team in 2018, but I didn't do it correctly until about 2021. That's when I figured it out. So let me share with you my experience of a leadership team. Now I talked to a lot of doctors and they always say, man, I just kind of, you know, I feel overwhelmed by the practice. I just kind of want more people on my team, or even just one person, maybe an office manager, someone to help me manage this practice. And that's what I wanted too. So I created a leadership team. I created four leads in my practice. I had a lead, a lead hygienist, a lead dental assistant, a lead front desk person, and I had my office manager. And I said, Hey, I need help running this practice. Will you guys help me help me run it, take on more responsibilities, things like that? And they are like, hell yeah, let's do it. But here's what happened. I didn't really see what the function of the leadership team truly was. If you asked me then, I would say, Well, I want someone to manage the practice with me. I want someone to take on more responsibilities. But the true function of the leadership team, if you want to zoom out and say, This is the number one function that you want your leadership team to do, is you need people to insulate you from the rest of the team. Now that sounds horrible, like I don't want to talk to my team. No, you need people to insulate you from all the little things that need decisions that need to be done at the practice so that you can focus on the big stuff. Now, you've heard me talk about the idea of the author Mike Michelwitz, and he talks about the queen bee role. The queen bee can only lay eggs. That's all she's got to do. Lay those damn eggs that grows the hive. But sometimes that queen bee gets bothered by other bees who are asking her questions. Hey, Queen Bee, I need this. No, the Queen Bee needs that leadership team to handle all those questions so she can focus on laying the eggs. And that was what I was missing. I had the leadership team, but things were still coming to me. I was still inserting myself into the practice into a lot of issues. I was allowing team members to bypass my leads and come to me. I was allowing my leads to essentially ask me for guidance on a lot of things that they probably could handle by themselves. So come round 2021, we come back from COVID, and I said, We're gonna do things differently. And I just gave them the reins and I started saying, hey, they would ask me, What do you think? And I said, just do whatever you think is best. I trust you. You know what this practice is about, you know what our values are. Do what you think the right thing is, and let's see how it goes. And my leads ran with it and they made some mistakes, and we talked about them, but they did so many things well, and they did so many things better than I did. And all of a sudden, all those things that would keep me up at night, all those things where I'd roll over and see that it's like 3:30 in the morning and I would sit there and I'd be like, huh, what am I worried about? What can I worry about right now? I'd sit there in the middle of the night and think about it. I should probably be worrying, and then you're up for the rest of the night. I stopped having those thoughts. I didn't have anything to worry about because everything was taken care of. And all of a sudden, it was like this light just opened up into my life. It's just this bright light shone, and I was like, life is good. I love my life. And I gotta tell you, I wasn't loving my life before that. So it's it's all about the way that you organize and engineer your leadership team. And we're gonna be talking about that on day one of my three-day seminar. So those are the three big things. Man, if you want to run a better practice, I am telling you, sign up for my course February 19th, 20th, and 21st. It's gonna be virtual. If you can't make it in person, it's gonna be recorded. I'm gonna record it and separate it into sections so you can share it with your team, whatever sections you like, and you're gonna get a workbook to go with it. There's gonna be the most valuable spiral that you have ever held in your hands. We're gonna be talking about so many things, but you know, we're talking about how high profit scheduling, how to do the capacity and the demand, how to scale the growth, how to do leadership that works. A lot of people said, I'm not a leader, I don't know how to do this. I'm gonna give you six things that are the easiest things to do as leaders. Anybody can do them, and you fold that into every other element of the practice, and everything else becomes so much stronger. I'm gonna teach you how to master your systems. I'm gonna tell you how you can step back clinically. That's optional if you want to do that. And I'm gonna give you what do we do? What does it mean to actually work on the business instead of in the business? What do we do with our CEO time? That's what we're gonna be talking about on day three of that seminar. So if you're interested in that, go to dentalpracticeheroes.com slash freedom. You can save a thousand dollars if you use Flash Sale. But dude, that's only available for the 11th and 12th. So if you missed it, you missed it. Do not send me an email. Say I just listened the episode and I didn't get a chance to get the deal. That would be a breach in my integrity. I'm not gonna honor it. It's gotta be on the 11th and 12th. You gotta get in there and get it before the end of the day. So don't ask me. Okay, you're gonna make me feel bad. I don't want to feel bad. So don't even ask me. But those are the three things. I would have forced capacity by being more intentional about my block scheduling. I would have paid more attention to how my personal production fit into the bigger picture of the profitability of the office. I would have organized and implemented my leadership in a in the correct way sooner. Those things that would have given me a completely different decade of my life from 31 to 41. I would have been more chill. My my kids probably would have liked me a lot better. I would have been more present as a friend. There's, I mean, it's just amazing when I think of the things that could have been different. But honestly, you know what? If I didn't go through it, I wouldn't know what I know now. So I can't be pissed off at myself about it. But people ask me all the time, what would you do differently? That's what they are. So thank you so much for listening. I really appreciate you, and I really hope to see you at the three day virtual next week. Thanks so much. Take care. We'll talk to you next time.