Episode 104 – The Secret to Practice Growth with Dr. Dwight Peccora

“The secret to our growth is we focused on building an incredible team, who just happens to do dentistry,” says Dr. Dwight Peccora. Tune in for a heartfelt chat about boosting your growth by:

• Thinking outside the box when seeking coaching and training
• Creating and nurturing mature, highly productive dental teams
• Getting out of your team’s way so they can take ownership and craft solutions

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About Dr. Dwight Peccora

Dwight Peccora graduate from UT School of Dentistry in 2010 and partnered at the existing Fort Bend Dental in Missouri City, Texas (south west side of Houston, Texas). Dwight had a dream of developing a group practice that prioritized quality comprehensive care with all general and specialty care under one roof.

Over the Last 6 years, Dwight has developed one mega practice in Missouri City of 10,000 squarefeet (which includes a CE facility), with three other locations throughout the Houston, Texas area to bring about access to this level of care for the Greater Houston area.

His greatest joy of practicing this way is the chance to collaborate among a team of doctors to find new and progressive ways to serve his patients. He has taken the original Fort Bend Dental from $1.7 million to just surpassing $9 million among all locations as they onboard their 4th location this winter in the “hub and spoke model” of practices.

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EPISODE TRANSCRIPT

00:48

CHAD: Hey, everybody, it’s Chad Johnson. We’re about ready to interview our guest on Everyday Practices here. Dr. Dwight Peccora. Dr. Dwight has graduated from the UT School of Dentistry in 2010 and partnered at the existing Fort Bend Dental in Missouri City, Texas outside of Houston. Dwight had a dream of developing a group practice that prioritizes quality, comprehensive care with all general and specialty care under one roof. Over the last six years, Dwight has developed one mega practice in Missouri City with 10,000 square feet with three other locations throughout the Houston Texas area to bring about access to this level of care for the Greater Houston area. He has taken the original Fort Bend dental from $1.7 million, just surpassing $9 million among all locations as they onboard their fourth location this winter in the hub and spoke model of practices. Let’s get started on the podcast. Dr. Dwight Peccora today. Doctor, how you doing?

01:38

DWIGHT: Doing amazing. Thank you for having me.

01:40

CHAD: Right on so you are down in Texas and how many docs right now are you at and like tell us kind of your background on like how many offices you have, like give us some stats? Yeah, yeah, so that way everyone can feel inferior. You know?

01:57

DWIGHT: Yeah, absolutely. I’m in the Southwest side of Houston. Well in Houston, Texas. Our main headquarters is in Missouri City, which is a part of Fort Bend County, one of the fastest growing counties in the nation. Fort Bend Dental is the fourth name we’ve got. Missouri City is a 10,000 square foot 16 operatory headquartered facility and I say headquartered because it’s primarily patient care, private practice. It also has a wing that specifically for support services for operations and accounting and HR and all these other support items for other for this location, for our other locations. And it also has a CE facility within it. The other location is in Richmond, Texas, which is also within Fort Bend County. That location is we’ve had it for a few years and has been growing and expanding as well. It’s not quite as large it’s probably about 4000 square feet. And then we have one in Houston, Texas, different name but a different brand, but has been there now for, we’ve had that since 2011. So I started with just I came out to Fort Bend Dental, which was already established since 1987. I came out here to the Missouri City original location in 2010. Right when I graduated dental school, actually. And-

03:25

REGAN: I’m glad you said that 2010 was your graduation year because I know our listeners can’t see you but you were like a baby then. How did you do that?

03:35

DWIGHT: I was super blessed to be able to like come out of dental school and go have heads to talk to right because all of this if you know if you see dental school is kind of the you know, as y’all like to say you see it as the finish line, you’re in trouble. You get to see it as a starting line when you’re finished dental school. And so I came out and got it. I was looking for a group practice, I wanted to be able to ask questions and kind of see where we’re going.

And then as I came in, it was it was a smaller size practice for sure. But there were there were three, total docs at that time. And it was a very well connected, original old school practice of just like, Hey, we’re here for a community, we live in our community and we’re here for them 24/7, and we’re just super entangled in communion and there was just my most important things were good quality, dentistry, camaraderie and belief in that that’s the purpose why we’re here is to serve the computing community not to build off of revenue.

And so I wanted to join that and be a part of that. And so I did in 2010, I came out was an associate for a couple years and then it was about like a $1.6 million practice. Nothing crazy. It was very simple bread and butter dentistry. Today, we over the over the last 10 years, I’d simply say that what we did was I focused on becoming managing partner in about 2012/2013 right in that timeframe. Mostly because I wanted to help develop a model that allowed us to give more access to care to patients, and to increase the comprehensive nature of care, right, so we kind of took it to change the model into into a sense of high level of education.

Now that it was more readily available, you could go and learn and have fellowships, Master ships and diplomats in all areas of specialty care, dentistry, and general dentistry. And that facility or that practice now sits in this 10,000 square foot facility where we do all General Dentistry and all specialty care under one roof.

In 2012, we took on the Richmond location 2011, we took on a Houston location. And it was something that continued to develop based on a sense of camaraderie amongst the doctors that say, Hey, we want to grow together, we want to hold each other accountable, while at the same time bringing in the team and saying at the end of the day, if we focus on being kind of the best possible team for dentistry, we know that the rest will come. And so-

05:57

CHAD: Are you 100%, CEO, like owner over everything? Like define kind of how that looks? Or do you have like heard some of that? Have some of the associates bought in? Or like how does that work for your structure?

06:11

DWIGHT: Yeah, so right now, as a managing partner, I help run the management piece of all those practices. And under the separate holding company, where the individual practices are, all doctors have a chance to buy in and become owners, we believe that the doctor who owns a part of the doorframe that they walk under every day to serve patients is going to do a higher level of quality of patient care just by nature of believing that they’re an owner and part of it.

And so we do create that track in that model. There’s currently actually five partners now, which is exciting. And we are all minority shareholders in the process, we do that on purpose, because we believe that, you know, you don’t want to create this structure where you’re kind of chasing how to how to maintain it. And we just believe that together, we can do more and serve more patients, and kind of impact more lives and go through it that way than just being Hey, I’m the main owner. And you’ll do what I want to do, we create tracks for partnership for everybody. And there’s everything from 30%, owner to 5% owner and everything kind of in between. And so we kind of built it that way to be able to do that. And, and today we’re nearing our we’re passing our 8 million mark annually, and we’re blessed to continue to kind of reach that we’re on par.

This year, we’ve done we’ve recovered really, really well. And we’re blessed to do it. So we’re hoping to kind of get close to the nine this year and go from there. So it’s been a tough year too. It has been a tough year. And as of next month, we are actually opening another location nearby and Grand Parkway Area of this county. And so we’ll be adding another location in the meantime as well.

07:50

CHAD: Very cool. I have one more question and then I’ll back off from hogging this conversation. But But you know, I was kind of curious with the structure setup and everything like that has to do the dentist entrepreneur organization, has that helped you form, how you are and who you are and everything like that? Or did you? Are you kind of walking into that going, guys, I got this but you know, like I’m still learning from you. I mean, how much of this was a, you know, efficiently structured by DEO mastermind, you know, bouncing that off of off of, you know, fellow, do people versus like, no, I already kind of had that figured out. How’s that look for you?

08:32

DWIGHT: So, background wise, I owned, I’ve owned and built computer programming companies to outsourcing companies, a couple dental labs. So I had some business background, yes. But I was truly blessed in that I came into dentistry at a time where people believed in like you all, podcasts, making themselves vulnerable, believing that we can do better in dentistry. I like to say that dentistry was like in the Medieval Ages, like 10 years ago, 15 years ago, like it’s progressed so much. And it’s because others have been willing to say, I did it this way. You did it that way. We shouldn’t each have to reinvent the wheel. So I’m real big on collecting thoughts. So yes, the DEO was a great influencer for me sitting and working with them. I’ve worked just more so in knowing so many different types of models. And realizing that this red ocean of competitiveness is actually not that red, it’s actually relatively blue. And it’s just a matter of finding your avatar of type of patient you want to see and serve., focusing on that.

We tend to as dentists being very hypersensitive to wanting to do a little bit of everything and that focus was driven there and they did a great job of kind of helping with that. I worked with other big groups, Productive Dentist Academy y’all have been incredible and making sure in the training and development. I try to talk about Productive Dentist Academy as saying You help my team mature in their thinking, even though they may not mature because it takes time to mature and through experience, but you mature in their thinking they think about others. And the whole team, as opposed to thinking about themselves now is something.

And you know, other groups that I’ve worked with, I mean, even before them, we’ve worked with a living group we worked with, the truth is I’ve done a lot of getting out of dental school and believing that I need a coach. And I believe that everybody on my team needs a coach. And that’s been a big trigger of success. And I would say that a lot of the time, I don’t do a lot of my training in dental, right, I do a lot of my training outside of dental and regular business training and working with people like Alex Scharffen, who has become a close friend. I’ve worked with him for a long time. Some of these big thinkers that help you kind of get out of the box that we get forced into.

And I think that there’s a lot of pride, an obsessive nature of control that dentists take in their profession. And so we try to box each other in. And the truth is, is we, a lot of us have incredible practices. And it all comes down to what our patients say about us and our team. And so that’s really the crux of how we’ve been able to grow. We’ve absolutely focused on we focused on building an incredible team that loves to get up every day and go to work. And that is not easy as the hardest thing we do. But then we also happen to do dentistry. And so we focused on building a team not so much on building a dental office.

11:30

CHAD: Well, honestly, it sounds like dentistry is your side shuffle.

11:36

DWIGHT: I’m blessed to be able to build teams, man, because it is my joy. That’s what gets me up every day. There’s no doubt about it. But dentistry is bought on the side. But I agree, right?

11:43

CHAD: I know. It’s like It’s like he’s a he’s a hustler. And this dentistry is a side hustle here, you’re just like, yo, yeah, I’ve been doing you know, these other companies helped me out though, who’s Alex Scharffen, or whatever. I don’t know that.

11:55

DWIGHT: Alex is a great, so he’s a big thinker when it comes to he writes a book called the Entrepreneur Personality Type. And his EPT structure. And he’s in charge of something called it’s it’s a it’s a stressful name for those who are not in who are in healthcare and where they’re, they’re hard on the wrist, it’s actually the billionaire code, because people think that it’s about becoming a billionaire. It’s not, it’s about all the stresses and strains that your business takes in being a $1 million, company, one to 2,000,002 to five, five to 10, and all the way up to billion and how you work on different portions of your company in different times to be able to stage it out.

As I’m always saying do not build an elephant on giraffe legs. And I’m always quoted as saying that because I’m obsessive about infrastructure, because your team needs to know. I mean, at the top of the board behind me, it always says is the business safe and okay. Because at the end of the day, it’s about the people that live their livelihood off of this company. And if we don’t know how to build infrastructure, as you grow, you end up creating a tremendous amount of risk for people, which I think most of society has definitely learned in 2020 with COVID and it’s one of those impacts that we really need to hyper focus on and be prepared for.

So that’s, that’s why I’ve worked with people like Alex, a huge influence. For me and great dude.

CHAD: On a small level, he sounds a lot like the the one minute crown prep, where it’s not so much about the one minute crown prep, it’s about the idea of efficiency. And when you said the billionaire code, it scares you, because it’s not about the billion. It’s about the mindset of logarithmic growth and how to build a structure around that. When I hear people you know, knock on the minute crown prep kind of stuff. It’s like, well, if I’ve heard him on YouTube himself, say, it doesn’t matter. If you like, however long you take, you can take as long as you want. That’s not the point. It’s like, Are you being efficient in how you rock it out? So I’m done hogging Reagan.

14:03

REGAN: This is going to be probably a two or three part series. I’m gonna call it right now. I bet there’s so much to unpack with what you just said Dwight. There’s I mean, this is this is it’s enormous. I can relate personally. Absolutely. To what you’re saying with the scalability. I can’t wait to read that book. I know that PDA we’ve lived through it.

I’ve been in dentistry since 2011. So I seen that big expansion and you like you just took a stake and put it right in the heart so Dwight, you water the roots I can see the growth right away you water the roots by looking at community and relationships and your team your team love just came like shouting through like a ray of sunshine. So he’s you’re watering the roots down there and that’s what ends up getting you this grow.

So it’s not it’s not about the billions but you put the behaviors towards what you really want to go for in the billions just sort of they appear. And what an interesting background to because Chad, we just interviewed doctors Eddie and Richard Lee, and they had they blew my mind their background, Dwight was in production of a magic show a television show, a magic television show online producers which they  mocked up in their artistic way, a whole new logo for us..

15:17

CHAD: It was Eddie, that managed the GAP.

15:29

Yes, Eddie manage the GAP. And he dealt with stock flow and all of that. So he they developed their own sense that they play they have in Park Slope dental as part of the experience. And it’s just as brilliant little hacks like that. But it’s based off their background. So Dwight, to hear your background. Did you? Did I hear you right? You built a company previous to dentistry? Totally.

15:50

DWIGHT: Yeah. So I was I so I ran an outsourcing company called Premier Outsourcing International out of South America, my family’s originally from Argentina. And I, I spent a lot of my upbringing going back and forth. And I ended up here, my father came here to the states to Duke medical school and to training there. And that’s what brought our family up here. But I had a lot of good contacts, and really relationships. And in college in particular, I spent a lot of time developing a connections, right, it was about people needing other people and being able to create that scenario.

And back in the day, I mean, it was about time zones, and the complexity of time zones and having high levels of education. So I come from an area in Argentina, where there’s a high level of education. And just like, you know, groups like clear aligner groups like Invisalign, and things like that, go down to Costa Rica and find a team to be able to support them with good education, good English. And then on top of that, having the capacity to do it, we did that out of an area called Cordova in Argentina. And that’s where my family’s from.

And so we create a lot of relationships and a lot of building of programming that companies in the US needed that level of support. And I remember being told by a professor mind as I was, I was bloodshot coming in eyes, bloodshot coming in, early in the morning, to take a blood biochemistry exam. And it was it was Monday morning, I just flown in from one of the site is, you know, and and I had flown in and gotten in at five, and I was taking the exam and, and I was like, let’s go, let’s do, what do we need to do? And the professor was like, What is wrong with you, you need to sleep or what’s going on? You know what, I’m a little worried about you. And then of course, my buddy next door, who was like messing with me said, No, he just flew in from South America. And he’s like, and he looked at me, he’s like, you got to take care of yourself seriously, and take your patients seriously and take care of it.

I was like, I love dental school. I mean, I was able to study the whole flight, there is no problem. But I think to me, it was more about I loved my team there and my team was there. And so whatever it is that I chose to do, I wanted to make sure that we built it around a sense of team because you can literally do anything. And any good company develops and has longevity based on building teams in a way that they they want to support each other.

And so I was very passionate about doing that early on, I didn’t really matter what I was doing. And so I decided to sell off and be done with some of that, and then focus on building some other areas. And so in dental school, we ended up with some problems with dental labs. And so we did an outsource to Costa Rica for dental labs. And so I built a one to allow us to help the senior class and the junior class when I was in dental school, be able to send our stuff out. So we built a contract with UT and did all that. And it was about, again, building connections between people.

And I didn’t realize how intimate those connections would be in the healthcare industry and in dentistry. And so that’s why we’ve been able to kind of scale the process of building the business and the practices. And so I’ve really come to enjoy that I’ve come to enjoy that on the patient care level. So I do practice and now two and a half days a week, I would say max clinically and the rest of the time I’m supporting my team from just an organizational standpoint.

19:05

REGAN: Wow. Wow. I, it sounds to me like you’ve really you want to or have or continue to master the inversion of the pyramid?

19:14

DWIGHT: Yeah, it’s really important to be I what I believe is decentralization of decision making. So there’s no reason that that me as managing partner of a Dental Group should be involved in the decisions specifically of how hygiene is managing their periodontal program, right. So we have a we have a leadership team within our system that hyper focuses on saying, Hey, here’s your hygiene liaison, your admin, clinical admin liaison, your your surgical liaison, all these teams, and that team has their team and they’re in the trenches, they’re helping make decisions because their team is going to be hyper affected by it.

So we take the problem that we just eliminated most leadership team and they come back with the solution. What they don’t need is somebody from the, you know, the top of the pyramid coming down and making a critical decision that affects them affects their team and affects their patients. And so we believe that that is the model to potentially scale within dentistry without losing the quality of patient care. And without losing control of that, that model.

20:17

CHAD: So you get out of the way of people being able to do their best. Yeah, absolutely. Very cool. Yeah, I’ve got the same thing where someone will call and say, Hey, can I do a lunch and learn with your admin team about this? And that, and I’m just like, well, it’s not up to me. Why are you like, and-

20:36

REGAN: You say that, you do say that!

20:38

CHAD: Yeah. Well, I am candid with people. Like they look at me, and I’m just like, no, it looks like I don’t know, like, what their, you know, their schedule for their meetings and stuff. I don’t know, their schedule, you know, it’s just like, and I don’t really want to know, and so Dwight, I’m kind of on the same page with you with that, as you know, someone will say, Hey, can I talk to your hygiene team, but I think they’re used to the dentist being the gatekeeper.

But they’ll say hey how would it be if I came and talk to you about this electric toothbrush? And I’m just like, no, you’d have to run it by them. It’s just like, why? Or, you know, like, Hey, we want to do this, you know, this online scheduling thing. I’m like, Well, you know, talk to the admin team about that. If, you can impress them, like, then is done, like I. What do I care, you know, and then after a couple months, I’ll just, I’ll say, is that working? And they’ll say no, and I’ll be like, Well, why don’t you get rid of it? If you’re OK with that, then just do it. You know, but Reagan, you know, me a little better. It’s just like, I, you know, just delegate that out. And so I’m glad to hear that that’s working really well for you.

21:43

DWIGHT: Yeah. And you, you know, you’re empowering your team. Chad. I think that’s, that’s right, exactly what what needs to happen is allowing them to have ownership of that process. I do believe that that’s what keeps you from the scary scaling and commercialization of your practice, especially if you end up in multiple locations.

We don’t believe that the purpose of us to grow is some revenue, sky high, hairy, audacious goal, like we actually believe that it’s based on the community you serve, we happen to be one of the fastest growing communities in the nation, you wouldn’t need that the truth is, is ever all of us have a tremendous amount of availability, if you you’re gonna call your patients, you build a relationship with your patients, you check on them, you, you do your part, your team passionately does theirs, we all own it. The truth is your practice is going to grow. Maher our model is is I’m I know that if I go to the Richmond location, I go to Houston, I go here, even the new Grand Parkway location, I know that when I walk in there, it’s going to have a feel of the convenience of the community it serves, it’s not going to have a Fort Bend Dental feel, there can be a brand, but it’s relatively irrelevant. It’s run by the team, they own it.

And when I tend to see problems, it’s because I we’re lacking a local leader or they’re lacking differently. It’s not because they don’t have access to the ability to make decisions. And so you have to give them resources and provide resources until they’re capable of it. None of this stuff we’re talking about is easy. It’s kind of like when people ask me Well, how do you manage the situation or not? It’s what Chad saying he doesn’t manage it. He coaches it. He coaches somebody to be successful, and gives them authority. Management is a super easy thing to do. Here’s a giant Handbook, do everything in this and never do anything outside of it.

Coaching is the hard stuff. Nothing we’re talking about is easy. But he’s he’s delegated because he’s built trust and relationships with the people he works with that they know they’re not going to bring somebody in that’s going to terrorize the company.

23:37

CHAD: You know what Dwight, though? It’s kind of funny. I say it the opposite way I go. It Ain’t Rocket Science. Like you want to talk electric toothbrushes with my hygienist? Asked my hygienist to find some time to meet with him, you know? So it’s funny because I almost say it the other way. It’s just like, why am I involved with this decision? Like, like, It Ain’t Rocket Science, just you know, like, we don’t need to have a meeting about whether we should have a meeting like

 

23:58

DWIGHT: That’s, that’s what’s used to that’s what our industry is used to right? Like, right? They’re expecting to go through that process. And then you’re going to make a decision that the whole team hates and then you’re gonna have to live through it and then go back and forth. And the truth is, you don’t want to be a part of it.