Even with a broad interest in practice ownership, giant student debt is negatively influencing future practice ownership. This was the summarized conclusion from a recent cross-sectional study in the AAPD journal evaluating practice ownership intentions and educational debt.
On today's solo episode, I wanted to do a quick review of this article and share my thoughts. I receive inquiries several times a week from young pediatric dentists who express interest in starting a practice. I can tell you first hand that there is a lot of interest in the subject. Some dentists commit and make it happen right away, and for others it takes more time due to additional barriers. Even with the stresses of running a business, I still encourage practice ownership and I think this article does a great job shedding some light on restrictions that come with it.
Shoutout to Dr. William Alexander, Dr. Joel Berg, Dr. JoAnna Scott, Dr. Roger Sanger, and Dr. Zheng Xu on publishing this study. The study is title, "Practice Ownership Intentions of Pediatric Dentistry Residents and the Influence of Educational Debt." Pediatric Dentistry V 44, No 1. Jan/Feb 2022.

Why Aren't More Pediatric Dentists Starting a Practice?

Grab a cold beer and join us as Dr. Casey Goetz sits down to discuss all things pediatric dentistry. Topics include uncensored and unscripted conversations with special guests regarding start-ups, practice management, finances, hot topics and clinical pearls in pediatric dentistry. Our profession might not always be pretty, so might as well drink beer and have some tipsy tiny teeth talk. New episodes released weekly.

Medicine

Science & Medicine

Health & Fitness

Dr. Kristine "Love Peace" Grazioso is a pediatric dentist with a large practice in Massachusetts. She practiced for years as contracted provider with Delta, Blue Cross Blue Shield, and Medicaid. In 2020, she made the decision to drop all insurances and go completely FFS, in order to provide better care for her patients. Even though she practices in a competitive area, her practice is busy and thriving.
Dr. Grazioso shares her story about how she made this transition. She gives pointers and advice to other pediatric dentists who are interested in going OON with dental insurance plans. Dr. Grazioso has used her experience as a springboard to provide consulting and coaching services to other pediatric dentists who want to fight against being handcuffed to dental insurance companies. 

Dropping Dental Insurance, with Dr. Kristine Grazioso

You see it all the time on iPedo... "I'm tired of my associate job and I want to start my own practice, but I'm not sure where to start." It's no surprise that a large void exists for knowledge and content relevant specifically for pediatric dentists who want to start their own practice. 
Well we have some huge news to share on the podcast today. For the last 6 months, Dr. Corey Hastings and I have been working tirelessly on building a comprehensive course specifically for pediatric dentists who want to start their own practice. We are super excited to roll out Little Smiles Practice Mastery, an online video lecture series that walks you step-by-step through the startup journey. This "power pediatric dental MBA" has almost 15 hours of lecture material, along with all needed spreadsheets, forms, attachments, and paperwork you need to jump-start a practice. All of this in a low-cost subscription platform that is available on-demand whenever you need it. 
On today's episode, Corey and discuss the benefits of practice ownership over a cold beer. We review why we made this course, what all is included, and why we believe most pediatric dentists can build an awesome practice without spending a fortune on a consulting company. 
Make sure to stop by our booth at AAPD to get on our mailing list, or visit www.pediatricdentalmba.com. We anticipate the course to go live early this summer and we are so excited to give other dentists the tools they need to achieve their practice goals. 

Ultimate Guide to Starting Your Own Practice

Thad Harker is a project advisor at Primus Dental, a design and build full-service construction company that has built close to a 1000 dental offices across the Midwest. 
Thad and I have a great conversation about dental office design and construction. He emphasizes that the construction process is all about managing people. We talk about how things have changed with higher interest rates and construction costs, but that it still makes financial sense to not lose opportunity cost and get yourself a "golden hammer."
Some topics we discuss in this episode:
- Why are construction costs high, and will they come back down?
- Why does location matter?
- Does it make sense to price shop a build-out?
- How have pediatric office designs changed post-COVID?
- Is it still worth it to do a start-up and be a practice owner?

If You Build It, They Will Come

Where would we be if we didn’t have the support of our non-dentist spouse/significant other/partner? This episode is specifically for them! 
Today my wife, Jenna Goetz, reflects on her impact on my journey to become a pediatric dentist. We talk about when does it make sense for the spouse to work in the office, pursue his or her own career, or to stay home with kids. Jenna gives some advice to young power couples and how to get the most out of this journey. We also joke about how annoying dentists can be when you get them all around each other at conventions and meetings.
This is a great episode to listen to with your significant other who is not a dentist!



The Non-Dentist Spouse Episode

Chip Fichtner is the co-founder of Large Practice Sales and a return guest on the podcast. His firm helps practice owners complete transactions and partner with DSOs and "invisible" DSOs who allow the doctor to maintain autonomy and a minority position. We last spoke on the podcast about two years ago. Because of our episode, his firm closed a $50+ million dollar deal on a large pediatric office. 
Chip has a tight pulse on what's going on in the DSO world. I wanted to get an update on what DSOs are doing with pediatric practices in light of the higher interest rates. I try to ask Chip some tougher questions in this interview. 
In this episode, we discuss:
- Is access to capital an issue for DSOs right now?
- Have we seen any DSOs struggle or go under because of lower free cash flow?
- What happens to the dentist's retained equity in the parent company if the parent company fails?
- Who calculates EBITDA in these transactions, and where does all the variability come from?
- How does LPS keep tabs and verify the quality and financials of the DSOs they work with?
- What does the ideal pediatric dental practice look like in terms of commanding a high multiple?
Chip can be reached at www.largepracticesales.com

Why Aren't More Pediatric Dentists Starting a Practice?

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