Dental A Team with Kiera Dent
Dental A Team with Kiera Dent
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Dental A Team

How to Merge Patients (and Culture) Successfully

How to Merge Patients (and Culture) Successfully

1/8/2026 7:00:00 AM   |   Comments: 0   |   Views: 49



Re-releasing a DAT listener favorite!


The Dental A-Team is joined by Dr. Nate Tilman! Fascinating history aside (read his bio below), Dr. Tilman talks with Kiera about his unique dental practice situation, how he’s managed to merge five different practices into his own, and a strategy for doing so.


He also speaks to the shifting of culture in his practice, what it took for him to recognize, and the success it’s brought.


More on Dr. Tilman:

Originally from Salisbury, Maryland, Dr. Tilman attended Wake Forest University for his undergraduate degree. He was awarded his Doctor of Dental Surgery from the University of Maryland where he graduated Summa Cum Laude in 2001. Dr. Tilman served in the U.S. Navy Dental Corps for four years, including two years forward deployed aboard USS Ashland (LSD 48).


Following his military service, Dr. Tilman moved to Newport, Rhode Island, in 2007 and opened Newport Family and Cosmetic Dentistry. He has had the pleasure to work with an amazing team and amazing patients in creating a state-of-the art, caring, and comfortable dental practice. His commitment to incorporating advanced technologies and techniques allows Dr. Tilman and his team to provide dental treatment in fewer visits and more comfortably than with traditional techniques.


Episode resources:

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Transcript:

speaker-0 (00:05)

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 where we have traveled to 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.

 

Hello, Dental A Team listeners. This is Kiera and you guys. I love podcasts where I get to bring on offices that I just think are fantastic. So this is an office that we have worked with in the Dental A Team. Also fun fact, he is in the smallest state in the entire United States. So you all know me and my state traveling. His state is one of my hardest states to get to every year, because it's so tiny and it's so far away from me. But he's just one of the best people I've ever met. He's an incredible leader, incredible dentist, incredible just

 

good human. So I'm so glad and so excited to welcome Dr. Nate Tilman to the show. How are you today, Nate?

 

speaker-1 (01:27)

I am great. Thank you. Thank you. I'm super excited to be here. ? as you know, I've been a fan of the podcast for, know, pretty much since you started. And it's kind of like, it's kind of surreal being, you know, being on, being on the podcast. So I appreciate, appreciate the offer.

 

speaker-0 (01:44)

Well, I love it. love to one it's fun. Thank you for being a podcast fan I mean it's almost coming up on three years of the podcast since we created it and I never would have thought that the podcast could connect me with such cool people so one thank you for being a podcast listener and two things are just being a rad person I I liked the podcast has become a fun passion project for me to meet people to hear their stories

 

So I kind of alluded to it. You're also doing something similar to Dr. Dave Mogadon, who was on the podcast about those chart ? mergers and buyouts that's kind of helped with your growth, but kind of just tell the listeners like how you even got into dentistry and kind of what your growth trajectory has been, just so they kind of know as a background to today's podcast.

 

speaker-1 (02:28)

Yeah, I'll try not to ramble too much about it. yeah, I went to always wanted to do something in healthcare. My grandfather was a public health physician is a big inspiration for me. So kind of I think it's midway through college decided dentistry is gonna be a really good fit, you know, for a number of reasons. Went to University of Maryland for dental school, loved it decided to stay in general dentistry for

 

you know, all the variety of what we do. was on a Navy scholarship, so I was able to spend the first four years as a practicing dentist in the Navy. ? Two years I was on a ship as the only dentist. So it was a really good, didn't realize like how helpful an experience that was for like running us an organization, even though it was an organization of three.

 

speaker-0 (03:14)

Yeah, but I also feel like let's just talk about the Navy real fast because I didn't know this about you and my husband and I were literally talking probably two days ago and he said I don't think I ever could do the Navy like put me on a ship with these people for so long and dump me in the middle of the ocean like nowhere to go no hiking like what do you even do? How how was that? feel like more than anything it would teach you mental stamina is what I think I would learn from being on the Navy. But how was it for you? Maybe maybe you guys go swimming every day. I don't know like what do you do all day?

 

speaker-1 (03:43)

Definitely not at all. it was, the two years on the ship was very, it's a super unique experience. And we were a small ship, 400 sailors. We transported Marines. So I was responsible for pretty much 400 patients. had, it was me, I had an administrative assistant and I had two dental technicians that could do some basic hygiene, not a hygienist, but it was me. ?

 

So having to learn like managing supplies and, know, managing appointments and all of that stuff. But the unique thing as a, as a dentist, and mean, this is one year out of a, you know, my GPR. still I was safe, but didn't really know necessarily all what I was doing, but I love to get myself out of jams because middle of the ocean, like. Mid procedure. I'm not going to be the guy calling a helicopter, you know, you got to work through it. So.

 

speaker-0 (04:40)

They're like awesome because it's gonna push your limits and you've got to just figure it out Which I think so many dentists when they do own they don't learn that stamina that stress like hey, it's you figure it out But you're like the odds are even stacked more you're in the middle of the ocean and I mean it would been a pretty cool story for me maybe not for you to hear like a helicopter to come get a patient because you botched a root canal or something like you'd have to figure that out, but that that doesn't definitely up your odds of intensity

 

for sure being out there and nobody else is there to help you. You're the man. You got to figure it all out.

 

speaker-1 (05:13)

Yeah. And I think it's, while it would have been nice to, you know, if I'd had a situation like, know, where I had a mentor, another dentist I was working with, you know, to be able to bail out, like it have been helpful, but it really, it did, it gave me a lot of, a lot of confidence, um, you know, early on for like, can work my way through this. And then also like what things I don't want to do. Cause I don't want to get stuck in that position again. Yeah. And it was, and yeah, while I didn't have to helicopter anybody out, one of the things I did do, and I don't think at the time, nobody had ever really.

 

speaker-0 (05:34)

True.

 

speaker-1 (05:42)

done it from a small ship or the even smaller ships around us that there were two times where people had some dental emergencies that I was able to fly out to their ship and take care of them.

 

speaker-0 (05:52)

No way. Well, you do have like built in planes. You travel anywhere. So it's like quick, like fly you in, but that's crazy. Cause you ma I can't even imagine the stress that those poor other dentists were feeling of like we're in the middle of here. Like what am I supposed to do? ? I guess call someone else. So, I mean, we talk about dentistry and I've said this so many times, like, feel like dental practices are like these solo islands out there. All y'all just kind of hang in your own area. You literally were in the middle of the ocean flying solo.

 

speaker-1 (06:22)

Yeah. That's crazy. It was fun. There wasn't a ton of dentistry to do. I, know, cool thing with the Navy, they give you other jobs. So I became an air traffic controller. So I was in charge of, you know, all of the flight operations on the ship. so between that and dentistry, it me pretty busy. And then I played a of video games, you know,

 

speaker-0 (06:41)

I'm like, I would be pulling pranks. mean, just throughout COVID, my husband, he makes fun of me. I feel like a roaming tiger in these four walls of our house. Like sometimes I'm like, just let me out of here. Like I can't even handle it. I'm like, I gotta go for a run. I gotta go for a hike that I can't even imagine being on a ship. would be like, I know I'd be pulling pranks on every single person on that ship and just like running for my life. Cause I probably would torment everybody, but air traffic control that like you really went for all the things, Nate, dentistry and air traffic controller.

 

What don't they say those are the top two suicide jobs? Like you really went for the whole extreme there. Nice job.

 

speaker-1 (07:15)

Well, that's that's like when they selected me to go to the school for our traffic control. What are you guys trying to tell me? You already know I'm a dentist.

 

speaker-0 (07:23)

Gosh, that's crazy. So you were in the Navy and then you went, got out of the Navy. Did you go straight to private practice? Did you go in and be an associate?

 

speaker-1 (07:32)

So I was an associate for a year, still in the Virginia Beach area and then moved to Rhode Island. My wife is, we met in college, I'm two years older, so she was awesome for following me around. then, ? so when she was done with her residency, she's from New England, so we kinda, that's where we looked up here. And I'll tell you, Virginia Beach area, super easy to get a job as an associate, tons of positions around, I figured it'd be the same thing coming up here and there was nothing.

 

speaker-0 (08:00)

mean,

 

Rhode Island is like the size of a dot on a map. I mean, it's itty bitty, which I makes you a celebrity just because you live there. Like, not many people even live there, so.

 

speaker-1 (08:11)

Yeah, it's in and it's there's there's a number of dentists, but it's it's all solo guys and it's tough like restricted covenants. You know you get a two mile radius. That's the whole state.

 

speaker-0 (08:21)

Exactly

 

exactly that is you definitely have to look at your associate ships of their contracts really closely Otherwise, you might be booting out of that state just because like you said two mile radius is not far in Rhode Island

 

speaker-1 (08:34)

Not at all. So I ended up having an opportunity to a it's like a four operatory practice, like three, I think two and a half, three days a week. The guy was definitely like on the decline of practice. So jumped into that, had no idea what I was doing. And then six months later, was approached by another dentist who was moving from the area. I think it was a family thing too. And he was having trouble getting somebody to buy

 

his practice Rhode Island. It's not many dentists moved to the state for a number of reasons. So again, I was still trying to figure out how I was paying my initial loan and how I was running this practice or whatever. the opportunity to buy, to merge this, the patient base. So I did that and it was definitely the best thing I did because it brought in a whole new group of patients. I was able to go from like two and a half days a week to four days a week.

 

I was able to add another hygienist at the time. so it wasn't super intentional, but the growth was happening. just kind of fell in my lap. I'm like, I'll do this. And looking back, it is where I realized what a good thing it was.

 

speaker-0 (09:48)

For sure. And I hope people listening, ? I am a firm believer that opportunity doesn't always knock on the door and say, I'm opportunity. Sometimes it looks like pure chaos. Sometimes it's stretching you beyond. Sometimes it's really just showing up. I remember the day that I was asked to work with DSI as a consultant. Guys, I had one consulting client before Mark asked me to be a consultant. And overnight, I had 45 clients in my lab. I didn't know what the heck I was doing. But I people listening realize like,

 

For you, you're struggling. just bought your practice. Don't know what you're doing. Yes, you've had quite a bit of experience, but at the same time, running a practice is very different than being an associate or I'm sure even in the Navy. And so now, and then, hey, by the way, there's all this other patient base wanting to come in. And I love that you just, jumped, you took that opportunity. And I think again, so many times in life, opportunities show up. It's just a matter of, we willing to take them and figure it out or are we too scared and just let them pass by? ?

 

You brought those patients in and you were mentioning pre record that adding in patients from other practices has really been a great way for you to get new patients. ? which people are constantly looking for new patients. was just talking to, there's a guy out here. He's a pathiatrist guys. I'm like, I don't know. I just can't help myself, but help business owners. Like I love it. Podiatry is not that much different than dentistry. Y'all see patients like dentistry, we work on the mouth, but I treat work on the foot. Like

 

Basically, it's kind of like pediatric. You go to your surgery centers, they come in, you see these patients for their adjustments. But I was talking to him and he's a solo podiatrist and there are two podiatry offices around him that have just shut down doors. So he's like, yeah, it's just great. Like people are finding us and I'm like, did you call those people and ask them for their charts, buy those charts? that is two practices worth of patients that you're just hoping maybe one day will Google you when they're seriously sitting right in front of you. So

 

I'm super curious. I love this topic. know Dave's talked about it as well, but Nate, how do you buy charts successfully? How do you make that transition? Like Dave was talking about buying so many charts, but kind of from your experience, how do you buy these charts? How do you merge these patients in successfully? And other than just good luck and being in the right place at the right time, finding more of these opportunities. I'm super curious.

 

speaker-1 (12:04)

Yeah, yeah. So for this one, know, having no idea what I was doing, I did have some, think, good advice from a transition attorney that I worked with. initially, the guy that was selling his charts, wanted X number of dollars for his, I think he said, 1,000 active records.

 

speaker-0 (12:26)

And what's like X number of dollars like just give me a ballpark you don't have to say the exact amount but I'm like is it five dollars a chart ten dollars a chart thirty dollars a chart like what

 

speaker-1 (12:35)

If I remember, this was probably 10 years ago, so I believe it was 60 a chart is what he wanted. So I think he wanted 60 million, right? And, you know, I, again, not knowing too much, I definitely knew that those 1,000 people were not gonna come over, right? So I was worried about like, what's the risk? Like, are 10 people gonna come or are 800 gonna come? I have no idea.

 

Yeah. So the attorney I was talking to, he said, he'd never done it this way. said, but maybe what you want to do is offer a little bit more per record, but only for like a small percentage at first. And then keep track of it over time. And that's what I think I did. It was either a hundred or 120 a chart. And I prepaid for like 300. But then for the next year, I kept track of all the, like once I got above that 300, I kept track of it.

 

So the nice thing is it limited my, it limited my risk. It put more, I guess, importance or motivation on the seller to really like push his patients to come. Cause the more you make more, the more people that came to see me. So it was a win-win that way. And it also, it let me kind of control that the influx too, because I think if all of sudden I was getting, you know, 800 patients calling all at once, it'd be a little bit trickier to merge this all in.

 

So that worked out really well.

 

speaker-0 (14:00)

And I'm just curious on that, because this is something else I've been really wondering. After talking to Dave, now meeting this podiatrist, guys, I just love this type of stuff. This is cool business stuff that I feel a lot of people don't talk about. I'm curious, how long was the arrangement? Was it for a year that you would pay him? Was it for five years you'd pay the selling doctor? Because I'm curious, how is the motivation? for me as a business owner, I wouldn't want this to go on forever. I'd want an end date of when I don't have to pay you $120 per patient.

 

So how is that kind of arrangement set up?

 

speaker-1 (14:32)

It actually, was nine months is what we had set. And I think it could work either, but I certainly wouldn't go more than a year, because it is, it becomes a major pain. And then, honestly for me, as I got close to that nine months, we sort of started slowing down. We strategically scheduled those last few patients in the nine months, but I still had all the records.

 

speaker-0 (14:54)

That's what curious. So did you get all the records? So like you paid this, all the charts come to you, and then the other dentist has good faith that you're going to be honest? Or do they get access to it? Was that what it was?

 

speaker-1 (15:04)

He could have like, had it written. If you wanted to send somebody to audit it, like absolutely. He had access to do that. He just never did. and yeah, we had an initial wave of a lot of people and then it slowed down a bit. And you know, it's, um, I think, I think it ended up, maybe we got 450 out of that thousand. Um, and it and it was close and it was close to that nine months. You know, we were getting close to like 400 and again, I just.

 

We slowed down a little bit, ? just whatever. But as soon as that nine months hit, then we started re-marketing to the people we hadn't seen.

 

speaker-0 (15:43)

100

 

% because then it's like you've got basically 400 patients on recall that haven't been in and so did you guys win it happened and of course you might say things you'd do differently or whatnot but did you have that selling doctor send a letter to all of his patients like hey I'm no longer seeing it come see Nate like he's fantastic or did you guys just pick up the phone and start calling these people what was kind of the strategy of the how-to for you?

 

speaker-1 (16:07)

So he, so he wrote, we both wrote a joint letter, which was good. And then I was able, I actually brought on his, he didn't have an office manager, but it was like his lead front desk and scheduler. So we brought her on. She wasn't a, she wasn't a great, perfect culture fit, but she knew the patients. So that worked. I think she was with us for probably about the nine months.

 

speaker-0 (16:26)

Exactly.

 

Cause in my mind I was thinking like, that's genius. Maybe you can do like a little like sweetheart deal where it's like, Hey, I'm buying your charts and also your scheduler upfront. Can I just have them like help me call these patients? I'll pay them for a couple of months or whatnot. I don't know. Like there's a piece of me that's like, I could see the pros and the cons of that, but you're right. It's me calling that person who's known these patients for years calling to get them scheduled and help out with that. That's probably again, even if it wasn't a great culture fit, it probably did get more patients in your door.

 

speaker-1 (16:59)

For that initial, yeah, absolutely for the initial. Because they already had the patients pre-scheduled, so they were able, and they know them, it was really helpful having that familiar voice.

 

speaker-0 (17:09)

Totally. Yeah. Clever. Okay. So you went higher than what they're doing, ? which I tell everybody, I'm like these people who are shutting their doors, pretty much any offer you give them is, mean, don't be like a low ball and completely have it feel ridiculous, but they, have no option to sell. There are no options for them to sell. They're not going to make any money. Like that's gotta be a hard reality for that selling doctor to realize like, Hey, I built this business up, but it's not even a sellable product.

 

So I have no asset anymore. So I'm like, honestly, any money that they can get for these charts, I do think is a good deal and something great for the selling doctor as well. So I don't think it's a ? vicious, like you're taking advantage. I just think again, opportunity shows up in different ways. And I think for the selling doctor, it also was an opportunity that they got probably way more than they were expecting to get when they closed the doors of their practice.

 

speaker-1 (18:02)

Yeah. Cause honestly, it hadn't been for new, he'd been trying actively to sell it somewhere. And I was like, I think I was like the last person, you know, had I not been able to step up and, and, work something out, it would have just been all those patients out into the ether. And, know, probably who knows how many of those, you know, 450 would have shown up with us anyway. But it's, it's, know, again, being younger, not knowing what I was doing, like it was intimidating for me. But as I look back, like he'd never done that either.

 

speaker-0 (18:22)

Yeah

 

speaker-1 (18:30)

You know, so was all, it was new for both of

 

speaker-0 (18:33)

Well, and also thinking about, I'm sure some listeners might think like, Nate, that's a bad deal, though, spending $120 per patient chart. And if you are a wise business owner and you know the cost of acquisition of a new patient, yes, I would say that that probably is on the higher end of a patient. However, I think the perk of this is these are most likely patients who have been active patients in a dental practice that are going to be good patients that are coming. And odds are they also might be, I call them sleeping.

 

patients in the fact that this dentist was on the retiring side, odds are that dentist was just slowing down with dentistry. Every dentist will have this happen to where odds are these patients actually have a lot more treatment available since their selling doctor was slowing down in their career. while it might be more expensive, you're probably also paying for it with the dentistry available with an older doctor selling. So got it. Okay.

 

speaker-1 (19:22)

Yeah. Yeah.

 

And then yeah, like, and then fast forward, you know, another five years or so from then, it's not five, about five years ago. I had a dentist moonlighting with me who was in the Navy. It was getting out, wanted to stay in the area. Awesome, awesome dentist, really good friend of mine now. And he wanted to stay, but again, at that point I wasn't busy enough to really support another.

 

an associate and I'd never really never had an associate either. And again, opportunity I had, was having, it was like a county dental society meeting. I was talking to a friend of mine as well, who was a little bit older dentist and she was like, I'm thinking about slowing down. maybe this guy could work for you for a couple of days a week and me a couple of days a week. And kind of light bulb went off my head. I was like, or I could buy your practice if you're open to it. And then you can slow down whatever you want. ?

 

be an associate with me and he could work at the two. I kind of saw the writing, like the potential if he did that, what happens if now he wants to buy that practice and then it's, you know, so that actually.

 

speaker-0 (20:29)

You would be training up your competition. So good job on seeing that and not letting that happen.

 

speaker-1 (20:35)

Yeah. And, uh, and it worked and that worked out great around the, again, just weird timing around the same as I was closing on that deal. One town over those, dentist who unfortunately had a terminal, uh, terminal cancer and was looking for somebody to help take over his practice. So I was able to take over his patient base, which another bonus of being able to help, you know, get this new associate, you know, even busier.

 

speaker-0 (21:01)

So really your practice is a makeup of four practices. Did I count my?

 

speaker-1 (21:06)

And then I had one more a little bit later. There's like five, five, nine into two locations now. So yeah. Yeah. And with that one, was the, um, I was able to bring one of the hygienists on board. Um, which again, that familiar, familiar face, familiar voice, um, was a big, was big and she's still with us and she's awesome. So, um, so that's been, that's been really good.

 

speaker-0 (21:07)

Okay, so

 

Clever. love it.

 

awesome.

 

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I love how much you have, ? I think if anything I'm taking is don't be afraid to take those risks, don't be afraid to look at opportunities and also I think you just kind of have also positioned yourself to be well known within your community and I feel like so many dentists, like yes even within big cities like New York, Denver, guess what? People are always retiring. I just had a student from Midwestern reach out to me and was mentioning how like.

 

Hey, care, do you know of anybody to buy a practice? And I'm like, what is going on? I don't know all the details, but I'm like, this is somebody who's been graduating for maybe a couple of years looking to sell a practice. so I think it's just important to get to know the doctors around you to build those friendships. Because when I think it's often like you're putting yourself in a position to be ready for that opportunity, it's kind of like right now they say have a lot of cash on hand. We know something's going to be shifting in the economy.

 

So just be ready for when opportunities there. And I think getting to know your neighbors, getting to know those dentists, hey, great, you also as a dentist might need them as a resource in the future as well. So I think it can go both ways, but I love that you've done that. So now I'm curious, Nate, because I selfishly want to talk to you about this. You've got these two practices, you've got these dentists.

 

Who knows, you're gonna like probably add on like four more practices of charts in the next five years. I mean, based on your record, like let's just start piling them all on. You'll be the only dentist in Rhode Island. You're just gonna last. But I know culture is something you and I off air. Nate is one of my favorite clients. I don't even come to your practice, Nate, and you and I will just chat business, talk shop. You are somebody that I will say publicly is someone who's just been.

 

a really great influence in my life. Periodically, you will just send me a random text of like, just tell me that we're doing a good thing. And I will say, and you know, as an owner, those kudos and those like good vibes, they don't happen as often because you're the one who's giving all that out to your team and to your clients and to your patients. And so Nate, I will say publicly, like how much you've just been an influence in my life as well. Something I just have appreciated with you as a client, as a friend, as a mentor. So I'm excited to chat. You've got all these things going.

 

I know culture has been a piece that you and I both have been talking about of developing this culture. So kind of what spurred you into realizing you wanted to shift your culture of your practice. And then let's talk about the nitty gritty, but like how did you as a business owner know you needed to do a shift within your culture? Because I think that that's humility. And I'm just curious, like what tipped you off? How are you able as a dentist to own that, that you wanted to shift that?

 

speaker-1 (25:03)

Yeah, I mean, I think for me it was noticing, you know, sort of the patterns over the years of the just the ups and downs of culture, you know, and it's, you know, whether you call it the vibe or how everybody's getting along. ? And there, I mean, it's over the years, like we've had some pretty painful, painful times and times where it's like, nobody likes being here. That's way better, you know, in the last few years and it had been in the past, but.

 

It's, I was realizing I didn't really know how to, I didn't realize I had, that I could have influence on, on how to change that. It's, you know, some of it, I'm not a confrontational person. I'm pretty laid back and I want every, you know, I want to be the one that's liked. I want to be everybody's friend. And it's hard. It's, mean, whatever 13 years into practice ownership. And I still, you know, struggle with that.

 

kind of not being able to be everybody's best friend. Like I actually own the boss and like I have to own that. So it's, know, again, I finally got like just really got so exhausting of the ups and downs of like, is this going to be a good month or is this going to be a good week or who's going to be upset and all that. that it's like, you know, it's not just on me, but it's like, creating that environment that people, you know, that people want to be here. You know, people are happy people.

 

playing well together and trying to manage all that. it's, you know, it's certainly I haven't figured it out completely, but it's, you know, just trying to work on little things.

 

speaker-0 (26:41)

Yeah, well and I love that you said that because incidentally I'm like, ? Nate, why didn't I even think about this? I know why you and I are good friends. We're eyes on the disc profile. We both love to be liked. We're both very outgoing. We're like, you know life at the party have a good time. We're also okay to like let other people be the life of the party, but just really that and I do think a lot of dentists have that personality. ? I was thinking about dentists last night actually while I was falling asleep and I'm like gosh you guys have to charm and dazzle and wow all day long.

 

Like you walk in and you have to make friends quickly and it's in an uncomfortable like, hey, let me like get real up and close and personal, like look in your mouth. And I got to like win you over and make you like me. I want to say yes to treat Mike. That's a lot of output of energy all day long for you guys. And so for you to realize that you also have to be a boss, I think one takes humility and two, also is ownership. And I would agree. I think it's like you get to a spot where I'm like, all right, being friends is fun.

 

But we got to have this like even kill because this up and down is just causing me to feel like I'm in whiplash all day long. So what were some of the things that you started to shift again? You and I chatted in December and I know we both like I've taken this from our conversation of culture is a slow burn. It is not something that happens overnight. It is not something that is instantaneous and I am an instantaneous person. Like I will figure it out. I will come up with it like we will find the solution and culture is like, all right.

 

Cool, I'm here for the journey. So what were some of the things you started to shift that you've been able to see? know Tiffanie's been helping you guys in your practice quite a bit as well, but I think ultimately at the end of the day, consultants can only help as far as the leaders are willing to go. And so for you to be willing to shift and change is why your team's been shifting and changing too. So what were some of those specifics?

 

speaker-1 (28:26)

One of the, I would say the hardest thing for me and I still like, it still gives me anxiety and trouble is having difficult conversations. And while, you know, it's

 

you wouldn't think it would necessarily play toward helping with culture, having difficult conversations. I think it really does because I think it resets some of that, ? like where the expectations are, what kind of the clarity on what needs to be done. But I think that's part of, on my ups and downs, I, again, wanting to be agreeable and being pretty laid back, if there was some...

 

trouble happening or there's some conflict between the team. Like a lot of my default for years was, it'll just blow over. Like, let's it work itself out. And it would work itself out by exploding after a drink or two. And then everybody would hug it out after a drink or two, and then we're fine for a while. But like, was no way to operate, right? So for me, getting over my fear and my anxiety of having those hard conversations, you know, and that's actually, that's one of the things that Tiffanie has been super helpful.

 

with on helping me through some of those. And I think one of the biggest skills that I've gotten with working with the Dental A Team is that, to have those conversations. They're not fun. People don't like them. I don't like them. But I think it makes a big difference and means a lot once people, like once you get through that.

 

speaker-0 (30:02)

For sure. And you're lucky to have Tiff. think Tiff is one of the best at it. Tiffanie is very masterful on being able to, I say word ninja it. She's also just very direct, which is odd because she's so lovable and so nice. But something her and I have chatted a lot. And to your exact point, when team members have those uncomfortable conversations and they know their employer is willing to do it, everybody actually feels safe.

 

and that safety can create stability, which also creates like easiness. So my husband and I felt like I used to be a people pleaser with him. And just this week, he and I had a really big decision, a really awesome opportunity, and we ended up turning it down. And I was so frustrated. Like, I'm such a like driver and doer and like, this is an opportunity. We've been working for five years for this and we're just gonna like walk away from it. And I was not my most polished Kiera. ?

 

Thankfully, I would never do this with my team, but my husband, was just like full on expressive on like, and not anger at him, just the frustration of the situation. Like we've worked for this for five years and we're still not going to go through with it. And he made a comment to me, said, Kiera, I love that we've worked on our relationship so much to where you can feel comfortable and confident to have this conversation, to express your true feelings and we can work through it and find a solution. And I use that example because I feel like it's very similar with teams with

 

bosses that are willing to have these uncomfortable conversations because there's a there's a trust and a confidence that I can come to you. I know we can go toe to toe. I know we can work through this even though it's not fun in the moment per se. There's so much beauty and ease and flow that happens because we're not just always like holding it inside trying to like charm everybody else around us.

 

speaker-1 (31:47)

Yeah. And what I have sort of seen ? as I'm doing that more often and as I'm getting more comfortable with it, I'm seeing my team do the same thing with each other, in a, you know, in a respectful way. And they're confronting things before they become like these underlying deep seated issues. So yeah. So that's been good. ? Working on gratitude is another, is another big one. Yeah. It's funny. It's, it's, ?

 

That's been, that's taken me a little bit to get used to and kind of coming up with a pattern of how to do it because it doesn't necessarily come naturally to me. You know, I think it all the time in my head, you know, how appreciative I am, but it's expressing it is what's hard and finding the way that resonates because everybody's different. What, you know, what lights everybody up is different. So it's trying to, I'm still trying to figure that out for everybody individually.

 

speaker-0 (32:42)

But I think it's awesome that you're taking that on and like you said and I will say kudos to male doctors that are willing to share their appreciation because I'm not a male, but I have heard from several male colleagues that it's very uncomfortable. They're like, I'm just not somebody like you said, I think it, but I don't necessarily say it I don't know how to say it and sometimes it's an awkward thing. But I will say as a team member, I worked only with male doctors, except for one time I had a female doctor. But most of the time males were the doctors I would work with.

 

And as a team member, especially a female team member, it meant the world to me when they would share that appreciation. it just would, most women are very much ? people who love those words of affirmation that are genuine and sincere. And so I think that that's a great thing that you've taken on. And I know that that's shifting because you shifting that way is shifting your entire team as well. Very cool. Okay. I just want like a quick highlight list as we wrap up, Nate, I appreciate you so much. What are some of the things working with Tiffanie that you've

 

that you guys have implemented in your practice or some things that you've seen, like we've talked about chart mergers, which gosh, it's just so fun. And we talked about culture shifts, but what are some of the things over the last year? I think you guys are just wrapping up your heading into year two. What are some of the things you guys have implemented with her this last year that were really just impactful for you?

 

speaker-1 (33:59)

Yeah, it's, it's, it's, it's a, we've done a bunch of like small things, you know, and, and, that's what I think has been great is like they, they're easy concepts, but communicating ? better handoffs from front to back and committing to that. ? It's, one of the first things that she introduced with us. And, you know, it seemed like such a simple thing, but it's made a huge difference in. ?

 

and just having consistency of communication and then also it helps the teamwork. ? That's been really good. She's helped a lot with trying to ? have us have a better of sense and strategy around our revenue cycle. Just little things that we didn't necessarily know that we weren't doing, you know, as efficiently as we could. But what I love the most is the process and the accountability part that's put in. ?

 

there, you know, I, in previous years, you know, I've worked with other coaches and consultants and things. Um, and it's always been like a kind of a cookie cutter type thing. And it's, you know, it has been helpful, but what I really love about Dental A Team is how. Yeah. She's able to look and see exactly what it is that we do and how we do it and tailor those systems to us. Um, uh, but also that holding us like holding us accountable to do it. Like we had a, we had a call.

 

this week, I think it was. we've been looking at outsourcing things for, and I think we've probably been talking about it for a month, two months or so. And it was kind of funny because she has, she's like the sweetest person in world, but she was like, all right guys, I'm tired of talking about this. You're going to buy the end of it. And we're going to, we're going to make a decision on this in my head. This is on Tuesday. I was like, all right, by the end of Thursday, we'll have this done. She's like today, like today that you've done this and tell me who you're going with. And I was like, all right.

 

But sometimes that's what we need, know, cause we were stuck in this little cycle. So she, you she's good with that. And then sort of same thing with, you know, those are one of the difficult kinds of conversations I needed to have, but was Tuesday was funny. She was, she like really lit a fire under us. Cause like three or four things are like, you're getting this stuff done today and it's happening. that's the push we need, but there's other, know, there's, it's not always that intense. You know, there's also, ? you know, if we need a little help with, you know, with things and,

 

It's process. She's there each step of the way.

 

speaker-0 (36:25)

awesome. I love it. Well, I think that other no, go ahead.

 

speaker-1 (36:28)

Sorry, it's

 

been really, it's been really good that I haven't seen with anybody else I've worked with before is she's totally accessible to my team. And I have a couple of the people on my team who are like very growth mindset, growth oriented with us. And, know, they, I think they talked to her more than I realized. And it's, it's one of like, felt initially like when she, you know, gave everybody her contact information, she like, I don't know, I hope that doesn't get abused. And she's like, I love it. That's what I'm here for.

 

and not knowing the specifics of what she's helping some people with. Like I've had a couple of people on my team, they're like, is so great to be able to reach out to Tiffanie and get this advice on this. And she's helping them just as much as she's helping me. That's awesome.

 

speaker-0 (37:09)

That's huge and I appreciate that Nate because one it's fun to hear how our consultants are doing and I love like a few pieces you said which makes me happy because like as an owner and I'm sure as dentists we have this great vision of what we want our company to be what we want our practice to be and then to hear a patient experience to hear a client experience I'm like we will never be cookie cutter I refuse like forever because no practice is cookie cutter so to hear that it's systems that are customized to you guys where it's what's gonna work with you and also like you said

 

that accountability. Tiff and I, will say kudos to Tiff because at first, you know, we were like, how do you consult offices? And most of time we'll just kind of go through with you holding you accountable. But there are times when we will need to like laser in, lay it down and be like, guys, here's the reality. Just like a coach at the gym. I'm like, I don't want you like high five. I mean, that was a great workout when my squats look terrible. Like tell me to get my booty down, get my back out. Like

 

make sure I'm actually doing the work if I'm going to put in the work. And so I love that she did that. And like you said, that is something that we are so pro having those team members elevate rising them around you. That's something like we have kind of, I have a three prong approach and it's making sure you are profitable as a business. Cause if we're not profitable, fantastic. And to hear that TIF is helping you guys with that revenue cycle, making sure that's there at the handoffs, but then also growing people themselves.

 

You with those hard conversations, you making sure, I mean, we were just talking, you're having time off and your whole team is like killing it and you're not even there, which is awesome. ? Also elevating team members. So it's not just the dentists themselves, but the team and then putting in those systems and team development top to bottom. So to hear it from a client experience, and we didn't even rehearse this prior to it, but to really hear the, and I didn't even prep you Nate. I didn't tell you to like, Hey, think of the last year and the highlights before we get on it. And I purposely did that because I wanted to hear.

 

what really stood out to you over this last year? What were the things that, because sure, you could go back and reread the emails and prep for it, but I'm like, that doesn't actually matter. What matters is what sticks in the moment. And so I just appreciate that. I love you as a client. know Tiff loves you as a client. You're just a, you're a great example of execution, of humility, of seeing opportunities and executing on them. And I hope people realize that success in my opinion doesn't just happen by chance. It is methodical. is...

 

Executed on sometimes you get sprinkled with that good luck charm But I also think that good luck charm is only good luck if you actually execute on it So Nate, you're just a dream. I love it. I love what you've done. I appreciate you being on the podcast you're just such a happy human and You're you're a great person who's doing great things in this world and your team's super lucky to get to work with you and learn from you as well

 

speaker-1 (39:48)

Oh, thank you so much. And I feel so, you know, so lucky to have come to come across the Dental A Team, you know, three years ago and, and, and gotten to know you, gotten to know your team and all of you thought, you know, to me, my team and my life, it's awesome.

 

speaker-0 (40:00)

Totally.

 

Well, it's, you know, we said yes, because you're in Rhode Island first. That was the first like initial yes. then you know, so but no, I appreciate it, Nate. So guys, if you if you have questions on mergers, or how to buy these charts, like please reach out, we'll connect you in with Nate. And if his story and the successes he's had resonate with you, email us, we'd love to chat with you. Hello@TheDentalATeam.com. And Nate, thanks for being here today. Thanks for just being a good human in this world that we need more people like you. So thanks for being here today.

 

Thank you. Awesome, guys. All right. As always, thank you all for listening, and I'll catch you next time on the Dental A Team Podcast.

 

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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