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730: The Alliance of Independent Dentists: Why and How to Remain Independent – Dr. Christian Coachman & Dr. Jill Tanzi

Do you feel stressed from running your practice? Are you ready to give up ownership? Before you do, listen to this episode! Kirk Behrendt and Dr. Christian Coachman bring in Dr. Jill Tanzi, president of Alliance of Independent Dentists, to explain the importance of staying independent and to offer solutions for struggling dentists. If you're feeling overwhelmed, help is out there! To learn more about Dr. Tanzi’s organization and how they can support you, listen to Episode 730 of The Best Practices Show!

Learn More About Dr. Coachman & Dr. Tanzi:

Learn More About ACT Dental:

More Helpful Links for a Better Practice & a Better Life:

Main Takeaways:

  • Having ownership gives you more freedom.
  • Staying independent is also great for patients.
  • Independent dentists CAN compete with DSOs.
  • Identify and leverage your strengths and advantages.
  • Selling to a DSO won't make dentistry more enjoyable.
  • Don't sell your practice out of frustration and desperation.
  • If you're stressed from practice ownership, help is out there.

Quotes:

“Practices should be owned and controlled by doctors in medicine and in dentistry.” (8:47—8:51) -Dr. Tanzi

“Ninety percent of ethical, good dentists will always put the patient first. As soon as a business takes over, we know that it doesn't matter how good the clinician is — once the patient comes slightly below the revenue and the numbers, everything shifts. Key components of the whole process shifts.” (9:41—10:11) -Dr. Coachman

“With corporate dentistry, you're putting the patient in a second position when they should always be in the first position. But you can't really blame so much private equity or corporations. That's what they're trained to do. They're trained to make money. That's their goal, is to make money. And I'm not going to lie, I'm sure we need to make a living too. But we're coming at it from a different angle. We're trying to provide a service. They're trying to say, ‘How much can I grow this business and sell it for a higher multiple?’” (10:24—11:02) -Dr. Tanzi

“I actually worked for a DSO when I graduated from dental school. I joined it right after the purchase, and I saw the owners thinking about how they are going to get out of this. I saw them lose really great staff members. I saw this really early on, so I knew that I didn't want to do it again.” (13:09—13:34) -Dr. Tanzi

“Quality dentistry is not scalable. Actually, when you choose healthcare in college, when you decide you want to be a physician, you want to be a dentist, you are committing to a profession that will give you a great lifestyle but will not make you a billionaire. If you want to be a billionaire, find something else because there's a conflict of interest. And you need to understand that when you achieve the peak of your profession and you're delivering the best quality, that's when the temptation comes for you to scale and multiply — and I'm not judging. People open a second, third location and hire new associates. They grow. Everybody should be free to do whatever they want. But the quality will drop, period. Period. That's my opinion.” (15:00—15:54) -Dr. Coachman

“A lot of people that want to work for DSOs say, ‘Well, I don't want to run the business. I just want to punch in and punch out at the end of the day.’ But dentistry is a career where you really shouldn't have that mindset, I believe. You're a dentist. You should probably be thinking about dentistry a lot of the time, unfortunately, because you're a professional — you're a doctor.” (16:13—16:36) -Dr. Tanzi

“[There are] too many things to deal with as a practice owner. So, staffing — not just staffing your office but dealing with staff — insurance reimbursements. Those are the big ones right now . . . [and] all the other little things. But I think what people need to realize is you don't have to do all those things if you're an owner. You can have an office manager. You can do outsourcing. There are a lot of solutions to keep your practice going and giving yourself a break and having the right frame of mind. You can’t expect to do everything yourself, and that's so important to know as a business owner.” (19:34—20:18) -Dr. Tanzi

“One important point is education for the patients on this matter. They need to understand that there are some good-quality practices out there that are privately owned by the dentist that is there every single day. There are some practices that are not DSOs yet, but a dentist that owns a couple of locations and is not there 100% of the time. Then, you have practices that are part of a small DSO that don't look like DSO practices. They keep the branding as if they were private. Then, you have practices that are part of a big DSO that still keep their individual branding that looks like it’s private. And then, you have the “McDonald’s”, where everything is branded low-level. So, you have all these types of practices nowadays. If I was a patient, I would definitely try to understand all these different types of practices and choose the one that makes more sense to me.” (22:13—23:19) -Dr. Coachman

“Staying as the owner gives you more control over your life. I know everyone will eventually retire. But for the future of dentistry, I believe we should try to sell to other dentists and keep as many practices as independent as possible. This is great for the consumer and great for patients. We know this from medicine.” (27:34—27:57) -Dr. Tanzi

“For the owner that's stressed out and they're like, ‘Well, I'm just going to sell and I'm going to work for someone,’ whether it's the DSO or work in another private practice, you may want to think twice because there are definitely solutions to staying independent — and it's better for everyone if you do stay independent.” (29:56—30:17) -Dr. Tanzi

“The key is to succeed first — succeed as a clinic owner, not only as a clinician. We need more clinicians that are becoming masters of practice management and leaders of their team. We have great clinicians. We are professionals, clinically. But we are amateurs running our practices, and that generates frustration that makes people say, ‘I want to sell my practice. I just want to be a clinician.’ The problem is that as soon as we sell and we are just clinicians, we lose freedom. With freedom loss, we lose motivation. And then, the attention to details and the quality is not the same, and you have that sequence of factors that drop the quality towards the patient.” (30:31—31:20) -Dr. Coachman

“My practice runs very smoothly, and it didn't start out that way. But everyone needs to work at it. You have to inform yourself and educate yourself, and finding groups like [Alliance of Independent Dentists] is important to your journey, I believe.” (33:11— 33:27) -Dr. Tanzi

“We need to stop and build a plan as soon as we can. Build a plan so we don't have to sell because we are desperate. That's the problem — and that's what investors are taking advantage of, because they see great clinicians that worked hard and built an amazing clientele and reputation and are burned out. That's when they jump in and say, ‘Look, this is for you. We're going to take over from now on, and you're just going to enjoy dentistry.’” (34:14—34:47) -Dr. Coachman

“[Enjoying dentistry after selling your practice is] not always what happens with the DSO offers, and you don't hear about it because clinicians sign non-disclosure agreements. Sometimes they're paying you what you would have made on your own if you had just stayed an owner for those years, and now you've lost all your equity. So, you have to be really careful.” (34:47—35:07) -Dr. Tanzi

“Usually, people that sold, I don't see them coming to me and saying, ‘I'm having so much fun doing dentistry now.’ Usually, that's not what happens. It's what people think is going to happen. It's funny, but it usually doesn't happen. What they say is like, ‘I'm happy because I don't have the pressure to run, and I'm having more fun with my life,’ or, ‘I'm doing something else with my money.’ And if you're smart, you can also do great things with your money after you sell to a DSO. Again, nothing wrong with that. But saying, ‘I just sold to a DSO, and I'm having more fun practicing as a dentist in the same practice that used to be mine,’ that's something that I usually don't hear.” (35:10—35:54) -Dr. Coachman

“Dentists are generally extremely ethical. They're like, ‘I want to use the best, period. I want to use the best. I want to do the best. I have fun. I'm proud. I bought this equipment brand-new. It was three times more expensive than the second one that was pretty good, but this one is better, and I bought the best.’ These are dentists when they own their practice. They're buying the best because it's fun. They love it, and they love to do their best. That's what you lose when you're not in charge anymore.” (38:17—38:49) -Dr. Coachman

“Another big one is choosing your own lab. So, you have a relationship with your lab for 15 years. The lab is expensive, but you have an amazing workflow, and they deliver great quality. It's a problem. Once corporate comes in, they're like, ‘Why? There's one in town here 30% cheaper.’ That's it. You have to adapt. ‘It's a little bit worse.’ ‘No, we're going to make that work.’ Then, suddenly, you lose that relationship with the lab that you preciously built the communication process with, the back and forth, and you know the details on how to make the case work better because of that collaboration. Suddenly, you don't have that freedom anymore.” (39:32—40:20) -Dr. Coachman

“There are competitive advantages [of being owned by a corporation], and we need to acknowledge it. If you want to be more competitive, if you want to survive, you need to understand what you're competing with, and you need to understand what are the things that they have that you don't. But also, you need to understand what are the advantages that you have as an independent, great dentist — things that, it doesn't matter how much money a corporation has, they will never have the same way you have. Instead of trying to compete on the things that they are much better at than us, it's much smarter to empower, leverage, and amplify the things that we are much better at than them. This is a smart way to compete. David and Goliath. You need to focus on those things that you are better at, and make sure that your community sees that.” (40:58—41:58) -Dr. Coachman

“When you talk about successful, independent, great dentists, what are the things that I feel like as soon as you own more than three practices, all the way to 500 practices, you lose these advantages? Relationships with patients. There's no way it's the same, period. Done. Over. And you need to empower that. You need to leverage that. You need to promote that. You need to make it so clear that you can go to an amazing restaurant that is part of a chain, but you will never get a three-star Michelin experience. Three-star Michelin restaurants are not chain restaurants. They cannot even open a second location. Why? Because Michelin knows that when you open the second, you're not going to keep the stars. You're going to drop the quality. It's exactly the same in dentistry.” (43:44—44:33) -Dr. Coachman

“Independent dentists can compete on customer service. I think sometimes we are doing a better job than the DSOs, and maybe part of that comes from the part where we retain our staff if we have all the systems in place that we should. I think we do a better job at retaining staff and customer service than a DSO because they have a revolving door of dentists. You might see a different dentist every time you come in.” (46:09—46:36) -Dr. Tanzi

Snippets:

0:00 Introduction.

4:30 Dr. Tanzi’s background.

5:24 Why this is an important topic.

7:23 Learning from trends in medicine.

8:59 The need to center patients.

14:48 Quality dentistry is not scalable.

16:44 You have choices in dentistry.

19:22 What makes dentists want to sell their practice?

20:19 How Alliance of Independent Dentists can help.

27:12 The benefits of practice ownership.

30:19 Set yourself up for success.

33:28 Are dentists happier after selling their practice?

38:50 Do things your way.

40:22 Final thoughts.

47:32 More about Alliance of Independent Dentists.

Dr. Christian Coachman Bio:

Combining his advanced skills, experience, and technology solutions, Dr. Christian Coachman pioneered the Digital Smile Design methodology and founded Digital Smile Design company (DSD). Since its inception, thousands of dentists worldwide have attended DSD courses and workshops, such as the renowned DSD Residency program.

Dr. Coachman is the developer of worldwide, well-known concepts such as the Digital Smile Design, the Pink Hybrid Implant Restoration, the Digital Planning Center, Emotional Dentistry, Interdisciplinary Treatment Simulation, and Digital Smile Donator. He regularly consults for dental industry companies, developing products, implementing concepts, and marketing strategies, such as the Facially Driven Digital Orthodontic Workflow developed in collaboration with Invisalign, Align Technology.

Dr. Jill Tanzi Bio:

Dr. Jill A. Tanzi originates from Oxford, Massachusetts, where she graduated valedictorian from Oxford High School. She obtained a BA cum laude in biology from the University of Rochester and a DDS from the University of Maryland, also with honors. During dental school, Dr. Tanzi performed research on salivary glands at the National Institute of Dental Research in Bethesda, Maryland. After graduation, she worked in private practice for three years in the Philadelphia area before returning to Massachusetts to open The Dentist at Hopkinton in 2003.

Dr. Tanzi is committed to continuing education and learning advanced dental procedures. She has taken classes at The Dawson Academy as well as The Spear Institute and attends a monthly Spear Education study club. In addition, she has completed the Midwest Implant Institute Surgical Implant Externship in Columbus, Ohio.
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