439: How To Merge Small Practices Into Large Ones

Kiera is joined by Dr. Dave Moghadam! This episode is a treasure trove of info. Dr. Moghadam shares his experience with smaller practices merging into his larger one. His journey is an unconventional one, and he has plenty of advice based on what he went through. The two talk about …

  • The pros and cons of bringing in a retiring doctor or buying charts (and Dr. Moghadam’s preference)

  • How to navigate new patients from an old doctor

  • And how to get practices to merge with you in the first place


About Dr. Moghadam:

Dr. Moghadam was born and raised in Morris County, New Jersey. After completing his undergraduate degree at Rutgers University in New Brunswick he went on to obtain his Doctor of Dental Medicine Degree from the University of Medicine and Dentistry (UMDNJ) in Newark. During his time at UMDNJ, Dr. Moghadam received extensive recognition for his outstanding leadership, academic and clinical aptitude, and dedication to the profession. Some of his achievements include receiving the William R. Cinotti Endowed Scholarship and the American Student Dental Association Award of Excellence, as well as induction into the Gamma Pi Delta Prosthodontic Honor Society.

He then chose to complete a General Practice Residency at Robert Wood Johnson University Hospital in New Brunswick where he received advanced training with an emphasis on comprehensive restorative treatment, endodontics, and implant dentistry. Dr. Moghadam is also an active member of the American Dental Association, the Pennsylvania and New Jersey Dental Associations, the Academy of General Dentistry, and the American Academy of Implant Dentistry. He has had the honor of serving as a member of both the Board of Trustees and the Board of Delegates for the New Jersey Dental Association. Dr. Moghadam has attended numerous continuing education courses and strongly believes that furthering his knowledge and expertise is essential to providing his patients with the level of care and respect that they deserve.

Episode resources:

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Podcast Transcript:


0:00:05.6 Kiera Dent: Hey everyone, welcome to the Dental A Team podcast. I'm your host, Kiera Dent. And I have this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, filler, office manager, regional manager, practice owner, and I have a team of traveling consultants, for we have traveled over 165 different offices coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress and create A Teams. Welcome to the Dental A Team podcast.


0:00:52.3 KD: Hello, Dental A Team listeners, this is Kiera and you guys. It is always one of my favorite podcasts to bring on a client that we've worked with, but then when they're the teacher, they're teaching us something awesome that they've been doing, I feel like all of our practices are kind of like these little mini laboratories out in the world and they try things, they test things, they experiment on things, and then they share... That's one of the things I love about our clients and our community. So I'm so jazzed to bring on one of my favorite doctors, guys, he is rocking the coolest moustache, I wish you could see this live. He's such a incredible person, he thinks through things. We're excited, Tiff's flying out to see him in November, so welcome to the show there, Dr. Dave Moghadam, how are you today?

0:01:31.2 Dr. Dave Moghadam: I'm doing awesome, thank you. Thank you for having me. I appreciate it. Super excited to talk with you today and be on the podcast.

0:01:36.9 KD: Yeah, for sure. It's so fun. Dave, I feel like we've known each other for quite a while, but I feel this is just taking our friendship to a whole new level, we are podcasting friends now, so I'm so jazzed to have you here. [laughter]

0:01:47.3 DM: This is very intimate, yes.

0:01:48.7 KD: It is, it is. So Dave, just, I obviously know you, we've worked with you for a few years, we've had... People have been out to your office, just can tell us a little bit about yourself and how you even got into dentistry, and then we're gonna dive into a really fun topic about how do you even merge in smaller practices into larger practices. So I'm gonna tee up our topic, so people are just excited, you've got so much knowledge on this, like the wins and the fails of doing that, so kind of just take us through though, how did you even get to where you are today?

0:02:17.7 DM: Yeah, for sure. When I was in high school, I just thought about the people who in my life were pretty happy with what they did on a daily basis, and my orthodontist actually stood out to me almost immediately, I kept asking him a ton of questions, he asked me if I wanted to work for him for the summer, and I just kinda got the ball rolling, I got... I worked for a general dentist then who was his friend, and this was a guy who did everything, and I saw the possibilities were endless, and that's kind of how I have kind of molded what I do on a daily basis. We try and help our patients with whatever we can and that's just kinda shape things.

0:03:00.1 KD: That's so cool, I love it. And so, now, you're practicing... You're practicing, so tell us a little bit about your dynamics of what you're doing currently as a dentist, I love that you had a mentor in life and then just decide to become a dentist. It's really fun. You're an incredible one. So kinda walk us through what does your practice dynamic look like right now? What have you done over the last few years?

0:03:19.3 DM: Yeah, for sure. So about... It's actually gonna be five years ago, this coming December, I took over the practice that I currently own, and even though it's been a practice since the mid-40s, I'm like the sixth person to own it.

0:03:36.0 KD: Mid-40s, hang on. Mid-40s, that's so long. You're coming up on almost a decade.

0:03:40.4 DM: 77 years, yeah.

0:03:41.4 KD: Almost a decade, or... Yeah, that's incredible.

0:03:42.5 DM: Exactly, yeah. Yeah. So I'm like the sixth owner, the practice before I took it over, took a pretty big nose dive over the last decade, about two-thirds of the patients were gone, and all of this is stuff that I did not know when I was purchasing it. It was basically a sinking ship. So the first thing was kind of plug all the holes in the bucket, get things stabilized, but in that first year, we were really able to take that same patient base, but really grow a lot by incorporating procedures that we're not just kind of basic bread and butter, but really a lot of it was just trying to create a practice where we actually really cared about the patients I was lucky to have.

0:04:30.3 KD: Dave, that's pretty incredible that you were able to do all of that. And so now, kinda walk us through... You had this practice, inherited it. Almost a decade, is how old this is. You've been working it, all these different things you weren't expecting, but now you've been able to grow it and you kind of grown it in a very unconventional way that I think a lot of offices are intrigued by. Walk us through some of the things that you've done to be able to grow this practice...

0:04:51.8 DM: Yeah, for sure. I mean, part of it is conventional in a sense of trying to grow things organically, but the things that really kinda helped us jump in a sense at certain points was incorporating other practices into our small practices, but they still made a big change. Practice was the guy across the street from me, actually. And the other one was another older doctor who was about three quarters of a mile down the road. They were both very different situations, and there is a lot to take away and learn from the two, because the first doctor across the street from me, worked for me, for about nine months. And the other doctor just needed to get out within one month and we took over his patients, so two very distinct ways of going about things.

0:05:43.0 KD: Got you. And I have to say, Dave, something I love about you is when you and Tiffany were chatting, you actually brought this up of wanting to get on the podcast to share this idea to be able to help other offices. So I just think that that speaks a lot about your character. But I also love that you have just kind of two different sides of this coin, because people often ask like, "Should I bring in a retiring doctor, should I have them work in my practice, or should I just buy the charts, which way should I really go," and you actually have both sides of this coin that you've actually lived through, so let's kinda walk it through, pros and cons of both of them. So let's go with the first one. You bought it, had that retiring doctor work for you for nine months, so kinda walk us through how that experience was, things you learned, let's just take it from that one.

0:06:21.9 DM: For sure. I think there's definitely something to be said about the patients coming over with somebody that they trust, and I think you get a good... You probably get more patients that come over a little bit of a higher level of trust in the sense that you're kinda in that same environment, so that's definitely the positives, some of the downsides are, if that doctor practices very differently than you, if the culture is very different, and all that stuff, it's very hard to kind of transition the patients into your culture in that sense. But it doesn't mean that you're necessarily dead in the water, I mean, the big point I wanna eventually get to with a lot of this is I feel like everybody has a big misconception of what patients coming from a long-standing practice that's been a certain way for 30, 40 years are gonna be like. And let's say in both of these cases, they were very like, "Let's patch it up and kinda write it out kind of practices," that doesn't mean that that's what those patients want, they just haven't been offered the right type of dental care, or I don't wanna say right or wrong. I wanna say they haven't been offered the opportunity to have more complete dental care.

0:07:39.5 KD: I want you to just say that again, I hope everybody just heard that because that is a very huge misconstrued and mis-conceived idea out there that these patients... So many people say this, "Kiera, when I buy a practice, I can't go in for comprehensive dentistry, I have to let them learn who I am, I have to make sure that they really love me." And Dave's shaking his head, no, guys like, you can't see him, but head shake, no. And I'm so glad you're saying this because it is a misconception that I think so many of us feel, but I think we're projecting and assuming our own fears onto the patients, and they don't even have it. So Dave, talk us through this because... Amen. Preach on, I'm gonna let you just keep talking about this because this is you now saying it, not just me saying it. What was your experience with that?

0:08:19.7 DM: For sure. So this is something luckily... And I say luckily because this is by chance, because I think everybody is a little apprehensive and shy and like, Oh my God, these were the thoughts that were running through my head. I was covering actually for the first doctor. He was out having hip surgery, and we were just basically taking on the emergencies, and we had a patient who had basically one of those very old school, from molar to pre-molar Maryland bridges with giant fillings underneath it decayed out, and I was like, oh, now it's missing. So rather than just kind of like, Oh, crown here or patch this, I was like, you know what, why not talk about doing two crowns and an implant because that's the best option. And she immediately said, yes. So I said in my mind, immediately I was like, Well, you know what, why not always just give everybody the opportunity to do what the right thing is or the best thing is in your mind, what you would want for your friends, your family, and somebody can always say no, and that's okay. And you can talk about what is gonna work for them, but if we don't give them the opportunity to do great things, then we're limiting their ability.

0:09:26.9 KD: You're exactly right, and I love that you said the word opportunity, because I think when we have that mind shift of there could be the story, these are all just stories we're telling ourselves, I could have this story that, Hey, this patient's not going to want that, they don't know me, I'm gonna come in as an aggressive dentist, I'm gonna come in, they're not going to want me, they're going to leave, they're gonna go somewhere else. That's definitely one option that I think a lot of people say. The other option that you're saying is, why not give them the opportunity, why don't I recommend the best treatment that I see, and you guys sometimes retiring doctors, they are on their way out, they kind of put their practice to sleep in a little bit of a way not intentionally, but they're just not going to be offering as much dentistry because they're tired, they're not looking for it, maybe they haven't stayed up on their CE for the last several years, so they might not even know of these options, and like you said, give those patients even the opportunity to have this dentistry done is just incredible, and I love that you're a dentist who's done this successfully and been able to retain these patients to where they will say yes.

0:10:24.2 KD: So tell us more. Other things that you learned, I love this, just offer the best dentistry to these patients and they will say yes a lot of times, and if not again, it's okay, have the conversation, but at least you gave them the opportunity to say yes versus never even giving them the opportunity. So how are some of the ways... 'cause I think a lot of doctors could be hearing this and thinking, "Okay, Dave, I like that idea, and I like that you did that, but how did you say it?" Because I think some doctors... Sometimes in their mind, they're like, I need to close this case 'cause I need to pay my bills. And that's coming from maybe a different frame of mind versus just offering the best dentistry. So what was kind of your take on it? How did you get these patients to transition successfully to your practice from either one of them. I don't mind which one, I'd love to hear.

0:11:06.1 DM: Yeah, and we can talk about a kind of universal process in this... I think a lot of these things come down to key basic principles that kinda just need to be there in general, whenever you bring new patients into your practice, you have to be ready, you have to have the capacity, you have to have the processes in place. Your team has to be on board with everything, so there's a lot to dive into with all that stuff, and you guys always do an amazing job in kind of setting that groundwork and those foundational principles.

0:11:33.8 KD: Thank you.

0:11:34.6 DM: But I think things that were helpful in the sense that we did is we always try and welcome new patients in like they are a member of the family, like a guest come into your house, so with that, we will always do a tour, give a welcome gift, stuff like that. So we did kinda in these cases, more specific particular welcome gifts to come to our practice. So one thing that we've done, we've done gift cards for the local businesses, so we had an ice cream delivery business that was owned by one of our patients, so that we got a gift card for that. Or our favorite bakery downtown, offer a cup day fair, stuff like that. So just kind of these basic welcoming things, wanna help people feel appreciated, but a little less on guard. So there's that aspect of things, and other than that, I mean, as far as the question you were asking about how some doctors have apprehension about how to talk about these things and can I get this treatment done? That's another key foundational thing, I think it comes across as to how are we presenting treatment to begin with.

0:12:44.9 DM: I mean, we have a pretty simple kind of way about going about things, and it's kind of just the concept of full diagnosis, like showing them what you see, talking about what's going on, what's gonna happen if you don't address things and what's the best way to go ahead and address this? And then what are the alternatives and the pros and cons, if you really need to get into those aspects of things. So I think a lot of... I think the biggest take home message I can say is everything has to be set up to... For any of this to work in the first place in general, just like with bringing in any new patients, but it's even more important in case like this, because you're gonna have, not necessarily you're opening the flood gates, but you're gonna have a higher inflow of new patients to go ahead and be aware of, and that was kind of the issue in a sense of when we brought in this last small practice, so we started bringing these patients in three months ago, but we did not have enough new patient blocks and a lot of these things, and all these really important things that I actually have picked up from you guys of blocking out in your schedule for new patients and stuff like that, it's like, "Well, how do we go ahead and take in this demand?"

0:14:00.7 DM: And part of that is, it's kind of like a first world problem, we've actually gotten to the point where our marketing is on point and things are good. So this was a practice that was getting five new patients a month when I took it over, and then last year it was 25 new patients a month, and now it's like, well, we're getting 50 from online, and another 15 from this practice, it's like, where are we putting these people. And also we didn't really...

0:14:21.6 KD: Yes. That was literally what I was gonna say, like what do you do with that?

0:14:24.3 DM: Yeah, the other thing I didn't mention is we're not in network with any insurances. So to be getting these numbers to begin with because we're not such a high volume practice is a little bit of a, "Oh God, what are we gonna go ahead and do?" But at the end of the day, you kind of stick to the basics and make things work.

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0:16:31.7 KD: So Dave, I'm gonna dive into this a bit more, and I love that you gave us kudos and shout out. Thank you for that. I'm glad that we've been able to help you, 'cause I know Tiffany has been awesome with your practice and you're really smart in the fact that you use us for the areas that I know you need like, "Hey, we're gonna have all these patients, let's talk to some experts of how they've done it, let's brainstorm, let's train up our hygiene team, let's train up on teaming up the doctor," I am curious though, because I think people... Like when you buy charts from a practice, I believe you have a pretty small window of opportunity because those patients need to get in, they need to get their appointment scheduled, otherwise they are going to go somewhere else, due to the fact that right here, they become free agents is how I look at these patients. They literally became a free agent, they're choosing where they wanna go at that point in time, so what were some of the things that you did successfully? Like you said, you have a massive flood gate, it's almost like COVID, we shut down for quite a while, and then we have this massive boom and then we're trying to figure it out, how did you... What were some of the things that you guys did really, really well to bring these patients in with a massive flood influx and not to lose these patients when they became these free agents, if you will?

0:17:34.3 DM: Honestly, I gotta say that we did a pretty good job, but we could have done a lot better, and the issues were just because... Yeah, we didn't really plan that far ahead with this, but the other thing too is, this kind of happened very quickly. It was basically, I got a call one day and it was like a Thursday evening and the doctor's like, "I got three weeks, I gotta be out."

0:17:55.4 KD: Okay. I guess we go for it, we say, yes, and let's figure it out.

0:17:57.5 DM: Yeah. So, then, we made the deal the next day, and the issue then becomes, I couldn't get my attorney to get the paper work done quick enough, we had agreed on sending a specific type of letter and the doctor goes off radar for a little bit, and then he sent his own letter, which God bless him, the idea was correct, but it was written not necessarily in the best way, it was written like, "Hey, these guys down the street are looking for business, maybe if you wanna go see 'em, go see 'em."

0:18:27.6 KD: [laughter] Well, I guess technically true, but at the same... So, okay.

0:18:30.0 DM: Yeah.

0:18:30.0 KD: So if you could go back in time and give yourself advice, what would you do differently? Of course, 'cause we don't know when these awesome opportunities are going to hit us, but I do think we can learn from it and we can grow from it. So if you could go back or you had a doctor that was coming to you, and they say, "Dave, I was just given a window of opportunity, we're having an influx of X number of new patients in the next three weeks." What advice would you give that person?

0:18:54.4 DM: Yeah, for sure. I would say, be very specific about the terms of the agreement, get them ironed out. If you're gonna start looking into doing this, have your attorney ready for something like this, and say, "Hey, I gotta get this done, we gotta get this ironed out." And keep constant communication, because at the end of the day, I think one of the biggest problems I have just in general, as a team member, a business owner, everything like that, is I assume everybody thinks the same way that I do and knows everything that I do. And this is... You're talking about somebody who's been doing something a certain way for 35, 40 years. More than likely, God bless him, he's a wonderful dentist in person, but probably a poor business owner.

0:19:42.1 KD: Sure.

0:19:42.6 DM: And that's kind of what the situation was in both of these cases. So they don't understand how some of these come across, because everything that we say, everything that we do is marketing. So, if you let them take the reins sometimes, their patients love them and they could do no wrong, but they're not gonna present things in the most positive way. So really, I would say, being organized, being on top of things, being very clear about the specifics of how you wanna do the transition. And also, you gotta have a good conversation with this doctor a lot of times, and talk them off the ledge, because what you were talking about as far as projecting our beliefs onto the patients, I've learned in this last transition here, I had to basically talk in circles with the doctor for about an hour to try and explain to him that that's what he was doing. Because when he came to check out our practice, he said, "My patients... This place is too nice, there's too much good technology, my patients are gonna feel like they're gonna be over-treated."

0:20:39.8 DM: I was just like, "But have we given them the opportunity to really have a discussion?" He was basically just like, "Yeah, I wanted to just kinda, after I thought about it, give them the opportunity to come here." I was like, "Well, that's not really what this is."

0:20:54.5 KD: I'm sorry, I actually bought your charts and I paid for the...

0:20:56.1 DM: You need to... You trust me. I'm assuming you trust me, after we've talked about things that we're gonna take great care of your patients, where in, I've explained to them our philosophies. And at the end of the day, all I'm asking is for your cooperation and allowing your patients the opportunity to get the level of care that we provide, and if it's not a good fit, we're never gonna force anybody to do anything. It's a matter of we're gonna take... There are plenty of things that myself and my associates that have patched or done this and that, and at the end of the day, that's fine. I tell people all the time, I don't want you to take this the wrong way, I don't care what you choose. My job is to help you in the best way possible. If I haven't given you all the opportunities to do the best, then I haven't done my job. But if you wanna go ahead and pick another option, that's fine, as long as I've given you the pros and cons, and you realize that that may not work. But that's on you, that's not on Dr. Dave.

0:21:51.1 KD: Right, exactly. So if I were to break this down for all of our listeners, Dave, you've given so many nuggets here that I just love. Number one, I think we should always be prepping our practices, which I think you did. Not I think, I know. Because you called me during COVID, you were doing hygiene calibration. You literally called me and said, "Kiera, what can I do to get my hygienist calibrated?" Maximizing that time. So I think, first and foremost, be the doctor who is investing in your team and prepping for this. You also are really, really great at having your hygienist tea treatment up for you. You're also doing a good job already, of an amazing new patient experience, because we never know when... Like right now, a lot of doctors are retiring, and right place, right time, yes. But also preparing, I think, helps a lot of these situations either flourish for you, or not flourish for you. And so I think you did a great job on that. Also, like you mentioned, have your attorneys ready to go, so if this does happen or when it happens, make sure that they know this is an urgent matter and you need to move very quickly.

0:22:46.2 KD: I also love that you talked about talking to that selling doctor, because what they say to the patients, is going to be planting the first impression, whether they see it that way or not. And helping that selling doctor realize that. And then, like you said, I also think you did a great job. I love that you worked with the local businesses around helping other patients there, because it's a great way... And you guys really did put on a whole... Almost like event production, it sounds like, for these new patients coming in. They're different, you're welcoming them from another practice, and helping them just see that this is the opportunity for them. And then I think the last piece to this is, no matter what you do, no matter how much preparation you have, no matter how much training you have, I think it comes down to, what is the ultimate experience you're giving those patients, because that at the end of the day is going to keep and retain, and referral, word of mouth, all those different things, of these patients. And then, moving quickly.

0:23:30.9 KD: So I think a lot of those pieces were just brought out that I think people, one, should be doing just in general, and two, I think you did a really good job of that. So if you were to choose, again, let's say you just had a magic life happen to you, and somebody was going to say, "Hey, I'm a selling doctor and I wanna work with you for nine months." Or, "I'm a selling doctor and I'm just gonna sell my charts to you, and you take the patients." Which would you prefer to take on?

0:23:57.8 DM: Yeah, I'd take the charts. [laughter]

0:23:58.8 KD: Would you take the... Okay, tell me why. I agree with you, actually, I would choose the same thing. Why would you take the charts?

0:24:05.4 DM: [laughter] I would take the charts because... And I would say each situation is different, but I would say... This is one of those things, if I had to just be biased about it based on the two experiences I had, somebody's been doing things a certain way for about 40 years, they're gonna continue to do that that way in your practice, whether they believed or agree with you whole-heartedly and everything like that, or not. The doctor who came to work with me was super receptive to kind of the way we do things, he was appreciative of it. He's like, "This is awesome, this is great." But to go ahead and change 40 years of habits, was a little... It just wasn't gonna happen. So it's one of those things, like he had done maybe one or two crowns a year for the past 10 years, and I was basically helping him in like, "Okay, prep this, I'll scan it. I'll make the crown for you, we'll do everything." All this stuff. It took him a while to even get going with that, but it was like... It was an uphill battle.

0:25:02.0 KD: Yeah, for sure.

0:25:03.1 DM: The other thing too is, a lot of times, some doctors will be... Up until their 70s and 80s, and killing it and doing an awesome job, a lot of times, in situations like this, and the other doctor who I just took his charts from, was very upfront about it, he's like, "I just... I know I haven't been doing my patients the best the last year, so. And I think a lot of times, that's the situation. So sometimes, you may get yourself into a situation where you bring on a doctor and you know the treatment may not necessarily be being done the best, and then you're responsible for it.

0:25:40.3 KD: For sure.

0:25:42.1 DM: So in this situation, in the nine months after that doctor had left, myself and my associate either re-did almost every filling that was done, or we went to endo crown down a lot of the time.

0:25:57.1 KD: Right, exactly. Well, and I think that is a good point.

0:25:58.0 DM: Which I feel really bad about.

0:26:00.6 KD: For sure.

0:26:01.1 DM: It's like, "Well, what can you do?" I'm not gonna be the person who's gonna be over somebody's shoulder, especially when they've been practicing longer than I've been alive.

0:26:07.5 KD: Yeah, definitely not. I think that's a really good point that I don't think a lot of people realize, 'cause we're thinking of, we wanna transition the patients, we wanna make sure that they wanna stay with our practice, but I ultimately look at outcomes like, yes, I do wanna retain these patients, however, I also don't wanna go do free dentistry for the next six months after that doctor has left me, and I also don't wanna be hovering over, like you said, somebody who's been doing this for their whole career in a professional, respectful manner. So I agree, I'm very pro.

0:26:34.7 DM: And also some of the habits of patch this, patch that, have been enabled in a new setting.

0:26:43.0 KD: Correct, yes, you're setting up that standard in your practice, which is not your standard, so then when that doctor leaves, it actually didn't benefit you a lot because now you're going to have to have all those conversations like they're new patients, and they've been established with you for nine months, and it's like, "But other doctor could do this, why can't you in your new space," whereas charts come over and they're the new... This is the new practice, and you're either going to love us and have an incredible experience or you're not going to like it, but I am curious, Dave, with the chart practice, how did you... So, doctor sent out on the letter of, Hey, you could choose them or you could not choose them. It's your choice. How did you guys as a practice quickly go after all those charts, because I truly do believe they become free agents. And it's a matter of time to get them to come to your practice. So what were some of the things that you guys did to make sure that they wanted to come to your practice, that they knew they should come to your practice versus just going wherever they thought, and it could have been that you guys were convenient, you're not too far, so that helps for sure, proximity, but what were some of the things you guys did specifically for that chart practice?

0:27:42.5 DM: For sure. So I edited the letter that I was originally gonna send.


0:27:46.8 DM: As kind of we're re-introducing ourselves. I made a little postcard about our office. And the postcard about our membership plan, and we mailed this to all of the patients, so I think that was really helpful in giving us another opportunity to put our best foot forward in a sense there, so I think that was super helpful in trying to kinda fix that situation there, but I think really a lot of the times too, once we started to see these patients, they were referring their friends and families. It was like, "Hey, Dr. Dave and Dr. Seth were awesome. They helped me out and I ended up buying here, they explained everything well, nothing was pushy or salesy, and you know, this is... I feel very, I feel like doctor so and so made such a good choice in providing our trust and our care with that."

0:28:42.6 KD: So you brought up a great point there, Dave, that I just wanna highlight of, yes, you did everything you possibly could, you send out the letters, you sent the membership plans. You are just awesome, and I would agree. So maybe first impression went, so now you've gotta work hard to get your next impressions to be really positive, so, good job on that. I think the biggest piece that I hoped people took from this and drove home is you made sure that those first patients that were coming to the practice that are going to speak about you, you had incredible experiences for them. And again, I think it's not just that you did it for these patients, that is your practice, but I am so pro, those first couple of patients that are coming, they're testing you out, they're gonna go tell a lot of the other people around, especially in smaller towns, older doctors, those people are tight-knit connected, if you're in a busy metropolitan city and people are coming and going, it might not have as big of an impact, but on these older doctors that are leaving, those patients have been there forever, they talk...

0:29:36.1 KD: You're talking about ages and ages and ages these patients have been going there, they're probably the people that sat on each other's couches, they hang out with their kids, they know each other at church, they go to the community events together. So you did a great job of having that awesome experience loving on those patients, so that way by nature, they just did referral, which is ultimately what we want of all of our patients. So great job on that marketing. Gosh, so many fun things on it, and you were able to successfully do it. Do you know, and this might be putting you on the spot and I don't intend that. Do you know how many of the patient charts you actually were able to retain? Was it like 50%, 75%, 25%, do you know? And maybe we haven't even looked at that but I'm just curious, or what the ROI was for you?

0:30:17.5 DM: You know me well enough to know that I do that.

0:30:18.8 KD: I do know.


0:30:21.6 DM: So this is the thing here, this is a good point. I actually made sure that we look this up because I was pretty negative in the sense of the total number of people that have come over, but if you ask me my overall impression of like, "Was this really successful?" Yeah, so it's only been three months.

0:30:40.6 KD: Okay.

0:30:41.0 DM: And we basically have only got about 15 patients per month to come from this office. But it's...

0:30:45.7 KD: How many patients did they have? Just out of curiosity, how many did you buy so I can get a reference?

0:30:50.3 DM: So, basically, in the last two years, so this is including all the COVID timespan and everything like that, they've seen about 200 different patients.

0:31:00.4 KD: Okay.

0:31:02.1 DM: Now if you go back a little further, there's probably about 400 that we could really market to that are tangible, that we could really try and target in a sense. A lot of the issues that we have is the capacity to bring them in, but at the end of the day also, this is the... The point I wanna drive home is, I think these are the best types of patients to try and get because they have been loyal to somebody for 15, 20, 30, 35 years. At the end of the day, their families are all kind of grouped together, they're coming together and everything like that, they're wonderful, loyal people, and despite the letter, even a lot of these patients are like, "You know what, I knew that doctor so and so, if he was gonna trust you, this was the place to go." Now, as far as getting back to was the successful or not? Yes, because at the end of the day, we've done so many... If you looked at it strictly from a business financial standpoint and everything like that, tons of root canal build-up is in crowns.

0:32:03.4 KD: For sure.

0:32:03.5 DM: You talk about in most practices, that's anywhere between $2000 and $3000, what's the return on that? If you've done a handful of those, also not that I do a ton of big cases, but one of these patients next week we're starting a $60,000 case on.

0:32:20.1 KD: For sure. The other point too, I wanted to make is, I call these sleeping practices, they've kind of been put to sleep for the last several years. Again, not intentional, Dave, you will be this doctor at some point in your life, every doctor will get to this point where you will stop doing as much dentistry, maybe you won't, Dave, you're a pretty go-getter, you're drinking water a ton this podcast, as is like you're fit, your go-getter status, but a lot of times our older doctors, just by nature, you get tired, that is the physiological effect of getting older. We do get tired, we do less, we're not working as hard. So a lot of times those practices are actually very successful in the fact that there's a lot of patients that need a lot of treatment done just because they haven't been treated for so many years, again, not intentionally, it's not that doctor's fault. It is literally the fact that they got older, maybe they're not as advanced, they're probably placing implants.

0:33:10.9 KD: And so, again, I love that you point out, so if I do that, it's been three months, you've been averaging 15 patients, you're up to 45 patients, and if we look at there were 200, to me, that's a huge success of how many patients you did bring over, because we look at that, you're almost up to, what is that? 20% of the practice base that you've been able to bring over in three months, if you continue that trend, you're going to bring over a good substantial amount of them, and like you said, loyal family members referring other patients in, and they also have patients that need a decent amount of treatment to be done, so that's what... I'm glad you knew the numbers on that because I'm like, "Of course, you do."

0:33:44.2 DM: I think when we talk about the last transition, that speaks a little bit more to the success more within a year and more long-term, so basically, that practice... I don't remember, I think it was probably a similar number of patients, may be a little bit more, the practice was only doing about $160,000 a year, but in that next year, our practice grew about $350,000.

0:34:11.0 KD: Right, because again, you're doing treatment that wasn't diagnosed, that wasn't seeing opportunities.

0:34:14.7 DM: Exactly, and that was even with that other doctor there still kind of keeping some of that stuff pumped down a little bit too.

0:34:22.0 KD: Sure. So I'm gonna ask one last question on this as we wrap up today, how do you say... I'm sure a lot of people hear this and like, but how do you become a Dave and get two practices that just naturally come to you, how did you... Was it just proximity? So you talk to these doctors, you knew you were the closest doctor to them, how did you get these doctors to transition to you?

0:34:43.2 DM: Now, this is a really good question. I probably should have talked about this earlier on and things, yeah. [chuckle]

0:34:47.6 KD: That's okay. This is for the people who hang out with the whole podcast, you're welcome. I save the best for last.

0:34:51.5 DM: This is the real gold right here. So the first doctor was just by chance that I knew he was older, he was across the street, I was always just friendly with him, and I always try and go say hi. And we went to lunch one day. And that just kind of happened. Now, that's not very likely.

0:35:08.2 KD: Sure.

0:35:08.7 DM: As far as the most recent situation, when I was sitting at home while we were closed aside from working on hygiene and stuff like that, I started thinking about this and I figured...

0:35:18.0 KD: And having a baby, don't worry, you guys had a baby too.

0:35:18.1 DM: Yes, and having a beautiful baby girl, yeah.

0:35:22.6 KD: [chuckle] I think I called you on your way to the hospital, and I was like, "Oh well, congratulations."


0:35:30.1 DM: Aside from that, what I did was I realized that I felt a lot of doctors were gonna be potentially getting out, whether it's right after or the next few years, anything like that. So I created a letter and I made sure to include a gift that somebody would keep and it had my name and my contact info on it.

0:35:49.3 KD: Okay, what is that gift?

0:35:50.7 DM: So in this case, so I had a theme here, it was called... The letter was called, 'Are you looking at things differently now?' And it was a really pretty glass kaleidoscope.

0:36:00.8 KD: Oh, that's a gorgeous gift.

0:36:03.7 DM: Yeah, it had my name and number on it. I sent it to the 20 closest doctors that were... That basically did not have websites and seemed old enough where this would be a situation. Of that, there were a couple of people that I talked to other than this most recent doctor more immediately after we came back, and some of the things, the reasons we didn't move forward with that is, I could tell it was not gonna be a good fit for our practice, it just was not gonna be a good situation, it was gonna kinda do more harm than good, and then fast forward a year later, I got a call on my cell phone at 5 o'clock on a Thursday, I gotta be out within the next month, so these things, you don't realize what or when or what the return could really be.

0:36:58.4 DM: I didn't spend that much money on those, I maybe spent maybe $600 on sending those letters and gifts and everything like that, and then a year later, even with just picking up a few emergencies at that time period, it's paid itself back and then some.

0:37:13.8 KD: That's clever. I also love that you... I think you did two things really, really well. I mean, you did a lot of things, but the two things I wanna pull out of that are number one, you saw an opportunity and you also saw a benefit, those patients are going to go somewhere. You guys, at the end of the day, I don't think Dr. Dave here is being aggressive or anything, those doctors are going to retire, they're going to do something and something is going to need to happen to those patients, so seeing that as this is the reality, and then thinking about a way... I love that you did a gift that they would keep... I love that as well. So I really do think guys that Dr. Dave has so many ideas on here, I think you guys should hands down take the tips that he's done, I know he is an incredible doctor, and all the things that we've just re-capped on here of transitioning going from paper or a doctor coming in to charts, buying the charts, the different things he did, having the... Like you said, the real gold here is just an incredible idea to reach out to those doctors and maximize.

0:38:14.5 KD: So Dave, you've been incredible. I appreciate you, I'm so excited for Tiffany to come see you in your practice, that was... And just thank you for sharing this idea of reaching out and wanting to share this, I know you have so much there. But as always, guys, these are the things that make practices better. So if you guys have a cool idea like this, wanna get on the podcast, literally Dave reached out and said, I've got this crazy cool idea that I'd love to share with the listeners, please guys, if you have something awesome like this that you're doing, reach out I'd love to hear from you. Just like we did with Dr. David, Dave, gosh, cannot wait for Tiff to get to your practice. Love you in my life and in our world. So, as always guys to take this on. Alex, I'm thinking that a great title for this is like, 'Are you looking at things differently?' I love that. I want one of those kaleidoscopes, so let's be real. But guys, as always, thank you, Dave, and thank all of you, and as always, guys, thanks for listening, and I'll catch you next time on the Dental A Team Podcast.


0:39:06.6 KD: And that wraps it up for another episode of the Dental A Team Podcast. Thank you so much for listening and we'll talk to you next time.



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