Tiff and Trish discuss the often ignored practice transition — are you looking ahead for your practice? Ten years out? Thirty years? The two consultants discuss what to keep in line now so that any changes on the horizon are received with minimal panic and damage.
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Transcript:
The Dental A Team (00:01)
Hello Dental A Team listeners. We are here today with some really, really just fantastic information. We're rounding out the year, if you can believe that. It's almost 2026, so whatever year you're listening to this in, hopefully it's also still super relevant, but we are heading into 2026 here soon. And we thought that it would be really fun to just wrap the year with a couple of different practice strategy kind of.
don't know, just like how to progress where you're at, from where you're at to where you wanna go. Strategy podcast. So I'm just super excited. I have one of my favorite human beings in the world here with me today. I have Ms. Trish Ackerman. She is a prized possession on the Dental A Team team here. She is a traveling dental consultant with our team, which means that she does virtual consulting. So we do.
coaching calls, video calls, we team training calls, all those pieces, you guys know that, but she also travels to practices and sees different practices in person, kind of helping them strategize and train the team and get things working again, kind of oiling that machine. And something I like to say is, I always tell my practices, Trish, and I think you probably feel the same way, I always tell my practices that we have the most incredible practices that join the Dental A Team. We really attract the most incredible people, but
more than anything, I always know that I'm coming into a practice that's running really well. And my job is to find the areas where they just kind of feel a little bit stuck. Maybe something's a little bit inefficient. Maybe there's just something that's like, gosh, if we tweak this a centimeter to the left or a millimeter to the right, kind of I think of like implants, like, you know, you gotta just get them just right. And if we can make that little tweak ? with them in office and find those areas, then their lives become.
less stressful. like to remove the stress. So I always tell practices, gosh, like I just don't get invited to practices that aren't doing well. I'm always, I'm always just so shocked at how well practices are doing. And Trish, I know you've consulted for a while. You've been here with our team for a little while, but you have just so much, there's like a wealth of knowledge behind you and all of the aspects of everything that you've done. And I'm so excited for you to be on this team. I know your practices are thriving because you're here.
We are thriving because you're here and we're all better people because of it. So Trish, thank you so much for being here today. I'm excited to pick your brain on these practice strategies. How are you? Your hair, we already talked about your hair is stellar. I had a weird hair dream. So hair is on the mind. It's like, it's a thing today. So welcome with your beautiful glasses and your beautiful hair. And it's 8 a.m. in the morning. What were we thinking? But this is a great way to start our day. Trish, how are you today?
DAT Trish Ackerman (02:44)
I'm doing great. Thanks, Tim. I always like doing this with you.
The Dental A Team (02:47)
Okay, thank you. Thank you. That makes it much easier ? when I schedule it that you enjoy doing it. So thank you. I appreciate that. ? I do enjoy life with you. You shed a lot of perspective for me. So thank you. ? Yeah, definitely team listeners. I had this, okay, start over. Marketing, our marketing department, they help us come up with a lot of topics. And then the consulting team, we kind of look at them more like, hey, is this relevant? Is this something that
DAT Trish Ackerman (02:55)
Welcome.
Thank you.
The Dental A Team (03:17)
we're seeing pop up in our worlds of consulting with our clients and our listeners is this something that's going to be super beneficial. And this topic came up and I was like, gosh, actually, it's kind of super cool to end the year with this because now we get to look into what next year is going to be. And this could be a lot of strategy that helps build, I think, Trish long term visions. It might not be something that someone's thinking about today. Just like I know we have.
you know, lot of new graduates who listen and, a lot of doctors who've been in practice for 20, 30 years, or even three years, five years, wherever they're at on their journey, I feel like this is information that we like to shed light on for all of our practices. That's like, always be prepared. Just like, I don't feel like, I don't feel like we buy houses. We don't have a home and not know the value always. Like we're always making sure we know the value. We're making sure we know, you know, our prices right.
our interest rates are the best that we can get. Do we need to refinance? We're always looking at those aspects, but I think that we forget to duplicate that and look at it in our business as well and make sure that we always know the health of our business. And Trish, when we're building out goals, I know you and I both do this. We like to look as far ahead as we can, like 10 years ahead to say, what could that look like? And when do you want to retire?
Right, when do you think that you want to repair? How long do you want to work? And even if that's 30 years down the road, making sure that at any point we could be ready for that. And so today is really talking about practice transition strategies, what that might look like. And Trish, I want to know from your perspective, you've done quite a few practice transitions, I would imagine, in the history of dentistry that you've got behind you there. What are some of the...
What are some common to start, like let's start just broad. What are common practice transitions that you have seen that you've worked through? Like what does that even mean when a doctor says I want to transition or we say transition in there to understand that? What does it mean to transition? What have you seen?
DAT Trish Ackerman (05:24)
What I've seen is doctors that have been with the practice for many, many years, they built their legacy and they are ready to pass the baton to a new dentist. And it's a big decision. And sometimes they're sometimes they have sellers remorse because then they realize that, shoot, maybe I wasn't quite ready. But I have, I have seen it where, I mean, most of the time the sellers are very ready and, the new buyers coming in are very ready. So
you know, it's a transition. We make sure that the doctor, both doctors are aligned, the seller and the buyer, and that it's a good fit for both.
The Dental A Team (06:03)
Yeah, I love that. love that. So transition could mean a sell and a buy, right? A transition is a change, right? Transition is we're making a change. We're looking different in the future than we do today. And I agree, I think a couple of pieces that on both sides are super important, I think is that alignment word that you used, right? And making sure that we know where we want to go. I think a seller needs to know where they want to go. Why do they want this practice?
the or why do they want to sell this practice and the buyer needs to know why do I want this practice and being in alignment with that is absolutely key. Now, when we're prepping for selling ? and transitioning, we'll call it transitioning, what are some of the things that you have advised or you've worked on yourself while helping practices to sell? How do you prepare for selling? Like what do you need to make sure is in place if they're not?
We'll take it two ways. Maybe someone's not selling today. They're like, well, one day I might sell. And then maybe someone's like, gosh, I need to sell. want to sell. I'm ready to get out. So what would you advise someone who says maybe one day I might want to sell? How do they keep their business prepared for that?
DAT Trish Ackerman (07:16)
Well, that's always the best way, like start a plan. There are times when it's like an emergency and need to sell, when they have the, when they've got the time to plan, you really want to ensure like the, like you were talking about, tip that the selling of the house, you don't sell your house if the flooring is just a hot mess or if, or if the roof is caving in, you get those things fixed first. And in a dental practice, you really need to protect the patient base because the new buyer
or even somebody transitioning in to purchases, what does the patient base look like? And if we're adding a partner, do we have a patient base for them? If we don't, this is the time that we, the doctors need to be hyper-focused on growing that patient base. That also requires like, what does the accounts receivable look like? What is the collection ratio? Is this practice producing but not collecting? And though you do like kind of a full analysis on the top.
five KPIs typically, and then ensure that they are in really good condition. You want your practice to look appealing and you want your practice to be healthy. And when you're selling anything or transitioning in, the patient base is always number one. So if you have the syndrome where the front door is open, but the back door is open as well, we need the time to strategize to get that back door closed to ensure that when we go to sell this new buyer,
The Dental A Team (08:35)
Yeah
DAT Trish Ackerman (08:43)
or new partner knows that there's a solid patient base in place. And then again, the counts receivable, that's another really big one. That's got to be cleaned up pretty well. Again, to look appealing and to be worth something.
The Dental A Team (08:55)
Yeah, I love that. I am in transition. Like we're looking at purchasing a home and we have a home that we're either going to rent or we're going to sell. And what you're making me think of now is that our realtor, I love her dearly. She is one of my best friends in life. And she is like, cool, we can totally do this, but she needs some really nice pendant lights. Like Tiff, got to open that. She's like, I know you've got some storage closet somewhere that's got a ton of, you know,
a ton of decor, like she's like, you gotta spruce this place up. Like, yeah, she got brushing up, this is perfect. And I was like, ? wow, yeah, you're right. And as I'm looking at Zillow and looking at all of these homes, I'm like, ooh, I love those pen and lights and ooh, I love that has black trim. And I'm like, my gosh, actually it's those pieces ? that just sparkle that make you want that thing.
If you want to get a good price, if you want something great for your patients, you want a great person to purchase your practice and you want a great person to carry on the legacy of what you have built and a great person to take care of the patient base that you have worked so hard to get, I think you have to make it attractive and appealing. And I think you're absolutely spot on. The patient base is huge. A doctor buying a practice, a DSO purchasing a practice, like anybody purchasing his practice.
purchasing a practice wants to see that it is valuable. And the value is in the people, right? The patients and the dollars. And I think what you said is exactly true. The flip side of a patient base, you can have all the patients in the world and you can have that back door closed, but if you're not collecting the money, that back door is open. The money's just going out the door with the patients instead of staying in the practice.
That's also an issue as well. So you've got to, you've got to hang those pendant lights and get those systems in place and really, really evaluate if you were, if you remove yourself emotionally from the practice that you've built and you look at it objectively, would this be appealing to you? If you looked at your home on Zillow, you took pictures and you scrolled through those pictures and you looked at your home, would you be attracted to purchase that home? If you weren't emotionally tied to the place. So.
DAT Trish Ackerman (11:15)
Yeah.
The Dental A Team (11:15)
I love that.
DAT Trish Ackerman (11:16)
And piggybacking on that, when you're buying a home, you're buying a practice, what's your profit look like? I mean, if you're buying something that isn't going to have any value because there's a lot of debt tied to this or like a home, if you're going to purchase a home, but you're paying too much for it because it's really only worth, mean, those are also the things that the buyer has to look at. Is this practice, is it like heavy, heavy overhead? And if so,
The Dental A Team (11:19)
Mm-hmm.
Mm-hmm.
DAT Trish Ackerman (11:43)
that needs to be trimmed down along with ensuring that the patient base is strong. If you're gonna sell something, it needs to be profitable to the buyer.
The Dental A Team (11:52)
Absolutely,
absolutely. I think that's spot on because you're gonna look at a home and you're gonna say, okay, well, this is the dollar amount that they have it listed for based on these photos or based on what I see in person. This is what I'm gonna have to put into it to make it what I want it to be. So I'm gonna take that into consideration. So if you've got a house priced at 525 and I know it's gonna take 60, $70,000 to...
make it valuable to me, make it the home that I want. Now my brain is saying, this worth 600,000? Because that's what I'm actually putting into it. And then my offer to you is gonna take into consideration the upgrades that I feel I need in that home in order to compensate for the price that you've listed it for. Yeah, I love that. when you're talking strategies for, we always, think, let me start over.
DAT Trish Ackerman (12:35)
Absolutely.
The Dental A Team (12:44)
Prepping for selling, I said this in both versions, right? Because I want a doctor to purchase a practice and think that way, right? I want you to think if I were to sell this down the road.
Like how can I invest, reinvest back into this practice to make it the best that it possibly can be? I want this practice for a long time, but we're not gonna be here forever, right? We're not, we may be in our home forever, but the likelihood of that in this day and age in 2025 is unrealistic. We're not gonna, we're likely not going to serve the term of our loan agreement in our home. Like we're going to move on, we're gonna find something new and the same is true for your business. So making sure, we don't know.
We don't know when that's going to happen. We might say, want to practice for 30 years. Great. But if you wait for 25 years to get ready to sell, you're going to be in an emergent sell situation. So day one today, making sure that you think like a seller doesn't mean that you're selling your practice. It doesn't mean that you're not there for your team. It doesn't mean that we're not here for the culture and that we're not here for the growth and the patience. It means we're preparing for everything.
That will set you up for success because you're constantly thinking about the value and about the return on investment that you're making. think that thinking like a seller, thinking, what would I do if I were selling this practice right now, helps you objectively make decisions in the practice, in my opinion. ? Emotions are really, really hard. Emotions are fleeting. Emotions will drive us and we have to be able to step outside of that.
to make really great business decisions most of the time. Now, Trish, me, I always tell my practices, know the worth. So get valuations, like every so often. How do you feel about that? How do you suggest people do that?
DAT Trish Ackerman (14:35)
totally agree. think at least every five, five to seven years get a valuation of the practice because that'll also help you guide. If let's say it comes in pretty low, that will give you the valuation company can give you all the tools and the map that you need to get the value up. And if you just sit stagnant, which unfortunately a lot of doctors do, and then they're super shocked because the practice isn't worth anything.
And that is what we don't want to happen, especially to our clients, know, if this is something that they're talking about. So if the valuations, sure, they might cost something, but get it done anyways, because you can continue. It's almost like when you remodel the home. I love using the house as the analogy and get the valuation consistently through the years, because they don't know what they don't know. And when you're only in those four walls all the time,
You don't see what you can be actually doing. the valuation, that totally helps, because it gives all the current owners new perspective, new ideas.
The Dental A Team (15:45)
beautiful. love that new new perspective, new ideas. I love that. And I think I'm addicted to it's like a it's a problem. I am addicted to model homes, just going and walking model homes. I love it. I love walking model homes because I love new perspectives and new ideas. And walking into a model home for me is like, ? my gosh, I wouldn't have even thought to do that with that kind of a space. Right. So I'm getting to see
DAT Trish Ackerman (15:56)
I don't know how to tell you.
The Dental A Team (16:14)
all of these interior designers work their magic in brand new homes, fresh and new, and I can go, my gosh, I can do that. And we we toured a spec home, meaning it was already built, ? but nothing's in it. it's new, but not all the upgrades. But I thought there was the spec home that I'm like, what do you even do with that space? Like that is the most random space I've ever seen in a house. It's just this little cubby in the back of a kitchen.
So I was like, we need to go look at the model home. So we went and looked at the model home and I was like, oh, that's brilliant. I never would have thought to do that. But what you made me think of was that, like touring model homes, right? If we're not getting the valuation, we don't know the value of our home, but we're also not looking at what other people are doing and touring models. We're not going to...
It makes me think of the ADA, the CE courses and the Arizona Dental Convention and the California Dental Convention and going and seeing the floor models of new chairs, new, like getting all of these new ideas and doctors, caveat, it does not mean that we need to implement everything. I do not buy everything I see at the model homes. I just get ideas and then I watch for really good deals, right? But that's where I think we can get those pieces, those missing pieces in something
that I think we have really exciting here at Dental A Team is we have such an amazing community of doctors who are like-minded, but doing things in a different way in every practice. Every practice has their own flair. And when the doctors come together, when they get together at our masterminds and they're in person and they're at our doctor-only masterminds on the first Tuesday of every month and they're sharing these ideas, it's like touring a model home with your best friends. Like, ? my gosh, I didn't even see that.
I didn't even hear it when Trish said that to my team. I didn't hear it that way. I'm to take this back and communicating with each other and getting that fresh perspective, like prepping for selling valuation and have some really good people surrounding you to constantly keep your brain fresh. Yeah, I love that.
DAT Trish Ackerman (18:21)
For sure. For sure. The team
is also another, they are also a big factor of this. If this is a legacy practice and there's a hygienist that's been in this practice for 20 years, that is also something that needs to be considered. it can be a little scary when you've got a legacy team, a new buyer comes in and then the seller is out and team goes with.
The Dental A Team (18:26)
Yeah.
Yeah.
DAT Trish Ackerman (18:46)
And if we can also like your locking in your patient base, you're ensuring that your profit margins are good, that your accounts receivable is healthy, what's the team going to be doing? Because we also need to strategize for that too.
The Dental A Team (18:55)
Yeah.
I love that you said that because I think one of the scariest things to a practice owner or business owner in general is the loss of a team. And I think people shy away from talking about the inevitable because they're afraid that the team's going to be scared and run away. And I firmly believe that the people that are meant to be in my life will stick around no matter what my life looks like. And if I'm prepping for
for selling, like I want my team to know too, hey, I'm here for the long haul, but we've got to make sure that we're super healthy because if we're not super healthy and not a buyable practice, if we can't sell, we're not doing right by our patients and I'm not doing right by you. I should be able to ensure that this business is healthy enough that it would want to be swooped up by someone because that means it's healthy enough that I can pay you. And that's how we do it. Yeah, that was beautiful.
Trish, some things that I picked up from you in the systems and I heard, re-care. You are a genius when it comes to re-care strategy. I have never seen someone pull out a re-care strategy like you do and it's beautiful. So if you all need some re-care strategy, like pick Trish's brain. If she is your consultant, you are in fantastic hands. Your re-care, your reactivation is amazing. So.
I know you tackle those, right? So patient-based, re-care, reactivation, and new patients, which also turns into some marketing, making sure that marketing is working. But then you also said ? AR and that our collections are healthy. So patient-based, AR, and then team. So culture, right? So those are, and profit, profit, yes, yes. And if your AR ? is in line, your collections is in line, your patient-based is healthy.
DAT Trish Ackerman (20:37)
prop. ?
The Dental A Team (20:47)
you watch your spending, your overhead should follow those things. Your overhead, typically like to, we love 50%. I love a 50 % overhead margin. Typically what we're gonna see if I'm truthful and honest is 55 to 65%. I really like that 50 to 60 % is really healthy and safe. And I see doctors feel really good and like they can save for what they need to save for and not be stretched too thin, but that 55 to 65 % is pretty common.
? So, re-care strategy, these are the pieces guys, these are your action items from Trish. Make sure you are ready to sell so that you're not in an emergent situation. If you're in an emergent situation, meaning you're trying to sell within the next one to five years, bust a move. You can still do this. Re-care strategy is in place. We're not losing patients out the back door, meaning they're getting reappointed. They're coming in, your new patients are staying. Re-activation.
So what patients have gone out the back door, who has not been seen in the last 18 months or so, AR, make sure that your collections is super clean. That is a space that doctors get a little scared. Reach out, Hello@TheDentalATeam.com, reach out, we will help you with this. And then your profit and your culture. Okay, so watch your culture. Go ahead, Trish, show us what can see. yeah.
DAT Trish Ackerman (22:02)
I do want to add something to the accounts receivable that just popped in my
mind. I can't believe I left this out. Not only is it the accounts receivable, but also the credits. When you see some practices that have like $100,000 worth of credits, that is also something that it's got to be cleaned up. It's got to be cleaned up before sell.
The Dental A Team (22:11)
Yes, yeah.
Mm-hmm.
I completely agree. That was a massive, massive space. Good job. Yes. I agree. We focus really heavily on, by we, I mean the dental community, on the outstanding money, what is owed to you, but what do you owe to the people? What needs to go out?
DAT Trish Ackerman (22:38)
Yep. That is a big
one when we go to sell.
The Dental A Team (22:42)
Yes,
and I've seen it, you guys, I've seen it upside down. I have seen our AR, our accounts receivable that's due to us is lower than our credits. That's a scary place to be, okay? So watch for those, that was huge stress, yes. So get your re-care, reactivation in line, okay? Get your patients in line, your new patients as well. Make sure that your collections is healthy, so your AR is healthy.
DAT Trish Ackerman (22:53)
Yes.
The Dental A Team (23:09)
Your credits are healthy, that your profit is healthy and that your culture is healthy. Those are the spaces to ensure. then every once in a while, Trish, I love the five to seven years, go get that valuation. Make sure that you know the value of your practice and go walk some floor models. You guys, it's super fun. So if you're bored on the weekend too, like they're open all the time. So there you go. That's where you'll find me. Um, I know I do love them so much. I'm like, oh my gosh, I take pictures. I have pictures of tables and like.
DAT Trish Ackerman (23:28)
Perspective and ideas.
The Dental A Team (23:39)
lights on my phone that I'm probably never going to use, but I've got them because I saw them and I was like, that's a beautiful table. I'm going to find that. You never know. They're there. All right, guys, go do the things. Trish, thank you so much. I knew you would have just a ton of information for us. And you guys, again, if you have re-care strategy questions, Trish's
DAT Trish Ackerman (23:46)
Yeah, you never know when you might get it.
That's cool.
The Dental A Team (24:01)
Trish is our go-to gal. We've all got our stuff, but I have literally been in an office standing next to her watching her do it, and I was like, I don't even know how you're doing these numbers. So she's got a lot to teach all of us, and she's your gal. So Hello@TheDentalATeam.com. You guys, go do the things. You know where to find us. Drop us a five-star review. Let us know what you loved. Let us know what you want to hear, like I said at the beginning.
We come up with these on our own, you guys. We just kind of dig through our brains and think what could be healthy for practice, what could somebody want. So if you have ideas, if you have things that are burning desires, please reach out. We would love any suggestions on topics that we're maybe missing. Hello@TheDentalATeam.com. And thanks guys, we'll catch you next time.
DAT Trish Ackerman (24:43)
Thanks, Tiff.