Ryan Isaac of Dentist Advisors returns to continue his discussion with Kiera about the future of dentistry, including options aside from DSOs. The question a practice owner should ask themself, Kiera and Ryan say, is what that individual wants out of their life — then consider the best platform to get you there. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:00) Hello, Dental A Team listeners, this is Kiera, and this is going to be part two of mine and Ryan Isaac's conversation where we're digging into DSOs to sell to not to sell, all of that. And I truly am so excited for you guys here, part two. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast. Kiera Dent (00:17) why don't we take a pause and just think of like, what's the future of dentistry as now the future pioneers of dentistry? And what are we going to do to our profession? Yes, there's top dollar. Yes, there's things about it, but is there a way to influence? and make sure that the integrity of dentistry can maintain long-term. I have no answer to that, but again, this is Kiera Dent sitting on my podcast where I think that there is a voice and an influence and like on Dentist Advisors podcast, is there a way that we can influence our industry in ways that will protect and still pay out? Because I'm like, even if you don't get the 10X EBITDA, you still can get a freaking great payout if you do your life right to where you can be financially set up. Ryan Isaac (00:33) Mm-hmm. ⁓ Kiera Dent (00:58) still be able to sell your practice, not have to sell it in ways that could potentially hurt the industry. I'm not saying one's the right answer or the wrong answer. There's no judgment on my side. It's just, let's maybe think and consider how it could influence. Can we get people that could be private equity higher up that could help protect it? Those are things that, and again, I'm just Kiera Dent here in Reno, Nevada. Ryan Isaac (01:03) Mm-hmm. Yeah. Same, okay. Okay. Yes. No, these are the questions. You're totally influential. I think it's just in the opposite direction. ⁓ I don't think we can influence private equity. Private equity is ruthless in every industry. They don't. It feels dirty. It feels dirty. And I have a question for you, but I just want to say really fast. ⁓ I do feel like, yes. Kiera Dent (01:30) It's dirty. It's dirty. Is there a way though, Brian, you don't finance better than me. Is there a way that there could become dentists that could become in private equity where they own it? Because once you, there's no way to insulate, you don't think. Because once you get to that level, you just, I mean, I've had. Ryan Isaac (01:44) Yeah, but they'll do the same thing. I mean, they'll want the same thing. Now, money's money. It's why capitalism runs the world. mean, that's why, you know, it's like why it influences politics and money and business runs the world, you know? ⁓ Okay, hold on. There's so many good things here. Number one would be not every group will be a DSO, private equity backed DSO. And you know, many, many ⁓ clients and just dentists around the country who will end up being owners of Kiera Dent (02:05) Okay. Ryan Isaac (02:19) 20, 50, 100 group practices that will stay privately held and ran by owner doctors. That will be a chunk of this ⁓ group practice ⁓ takeover. So in that space, the influence can still be huge. ⁓ I think the chance to influence the integrity of private practice is in those who don't sell to DSOs. I think it's in the industry, educated in influencing the industry for people who aren't going to sell and who are going to maintain control. Now, I do think that in the future, more and more dentists will be in a group. ⁓ are probably, yeah, be fewer and I can see why it would make sense to do that. There would probably be fewer and fewer people with just solo doc, solo location practices. know, some towns and rural places, that would be hard to do. Kiera Dent (02:47) Mm-hmm. I do too. Ryan Isaac (03:15) So I think you're Dorothy, is that what you said? I'm Dorothy. I think that is possible, not with private equity, but with still the owner doctors that still exist and the group practices that are ran by dentists, not private equity back. I think the influence is still gonna be, I mean, if you took the projections of what will stay private, Kiera Dent (03:20) Yeah, hi. I agree. Ryan Isaac (03:40) and then the chunk of the group stuff that'll be non DSO non-corporate, that's still got to be 40, 50 % of the industry eventually. Kiera Dent (03:49) I would think so. I mean, look at it right now. There's corporate dentistry within. And again, there's nothing wrong with any, because I have clients that are in corporate dentistry that run their practices like private. They take care of their teams. So it's one of those things I still think, like even if you are, and that's another way that we can influence this, if you are part of a private equity-backed DSO, you can still influence your practice. You're still the dentist working in the practice. You can still run culture. You can still run change. Ryan Isaac (03:59) Totally. Absolutely. Yes. and hit it. Kiera Dent (04:16) ⁓ I know the doctors I have, they're part of a very large group corporate and things that we have done together, like I work with them, they're my only corporate practice that I work with, but we have literally influenced the top tier CEO. They've asked what these offices are doing differently. They're taking things that I've helped bring into the practice and they've asked like, what's changed in your practice? Like we hired this girl who teaches us to run it like private practice. Their culture's incredible. We're even right now petitioning up to the top people because they're writing off things that you can actually bill out to insurance that they're making them write off when it's like, actually, no, we can bill it as a non covered service and actually have the patients cover. So I'm like, I do still think whether you're in private equity, but I think you've got to be a strong enough doctor where you advocate for the rights of your patients and the rights of your practice. And I'm super proud of my client who does this because her and her husband, they go to bat and they're like, they write some pretty direct emails to the CEO of this and say like, hey, and they're a big enough force. Cause I mean, Ryan Isaac (04:55) Mm. Yes. huh. Kiera Dent (05:15) They're the top tier practice in their area. have them making like, we are adding multiple millions to their offices every single year. But I'm like, I think that's also how dentists, even if you're in private equity, even if you're in group practices, I think at the end of the day, are clinicians and clinic, like you are, you are the product. And I think that they have, I think dentists have more say than they might realize that they do to influence the industry and keep it more positive and more ethical than it could be otherwise. Ryan Isaac (05:38) Yeah. Yeah, I totally agree. I totally agree with that. We all know people who are in those group models that are still running like amazing, almost privately held practices. The other thing that's interesting that's different than med...