Episode 110 – Requested Replay: Your Best Retirement Options

“We are moving from the short-term am I profitable, to the long term of does someone else see the value of the practice.”
– Christine Uhen

It sounds simple. It sounds assumed.

“Of course I own my dental practice,” you say. “Of course its an asset.”

But to this day 9 out of 10 doctors still can’t retire and maintain their lifestyle.

We get heartbreaking phone calls all the time from doctors realizing their practices aren’t worth what they need for retirement. The sad reality in today’s market is you can’t assume just because you’ve been in business for 20 or 30 years that you own a sellable asset.

So let’s change that.

Today, Investment Grade Practice Business Advisor Christine Uhen joins me today to share the strategies that put you at financial choice and in control of your future as we as we explore:

• What is possible when you view your business as an investment
• The lifestyle, financial, and legacy options available to you
• Real-life success stories from the offices of entrepreneurs building their Investment Grade Practices

Want to know if you have an Investment Grade Practice? Click here to use the completely free Investment Grade Practice calculator: What’s my IgP Freedom Number?

Want to have a conversation about your Investment Grade PracticeTM? Contact Brent at brent@productivedentist.com.
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EPISODE TRANSCRIPT

Victoria Peterson 1:21
I am here today with one of the most amazing people on the planet. Miss Christine Uhen. She’s in San Diego, California, Christina and I have known each other for at least 18 years and when Bruce and I founded Productive Dentist Academy, we knew one thing for sure. We didn’t want to be the ones getting on a plane and going to the office with clients and we have a philosophy that you only delegate to someone who will do the job as well or better than you could do it yourself. Christine, welcome to Investment Grade Practices podcast. So great to have you here today.

Christine Uhen 1:58
Always good to spend time with you, Victoria, thank you for that and thank you for the million miler club that I’ve earned on Delta.

Victoria Peterson 2:06
You are welcome. Did you get the really groovy luggage or Tiffany’s? What did you choose?

Christine Uhen 2:13
I did get some lovely accouterment, some lovely, the little travel bag that I did get from Delta. Yes, so still have it.

Victoria Peterson 2:20
I chose the same thing. I chose the same thing. Alright, so this podcast is all about building Investment Grade Practices, and sometimes it’s worth repeating. What does that mean to have an Investment-Grade Practice and what does it take to build an investment-grade practice? So that’s why I wanted to have you on here today. Our process, which you know, we’ve trademarked our process, we’ve trademarked the name, Investment Grade Practice, and you sit right in the middle of it. So what is an investment-grade practice? We’ll just start there.

Christine Uhen 3:03
Yes, and again, I just love that we’ve developed this as an experiential note as a need of the marketplace and as things have changed, it’s about creating a practice that creates a lifestyle now for the owners. It is a good, viable, successful business that sustains a lifestyle now, but also looks ahead and becomes an asset that has value for the future and that really is something that is sustainable, repeatable, and durable, that we have something that is predictable, whether the doctor is there or not and that also, you know, has longevity. So we’re really moving from the shorter vision of can I be profitable too? Is it something that someone else sees as the value in terms of the long-term future for the dentist?

Victoria Peterson 3:54
I’m so glad you pointed that out. It sounds simple and it sounds almost assumed that of course, I own my practice, of course, it’s an asset, however, the statistic that nine out of 10 dentists can’t retire and maintain their lifestyle still prevails and so I don’t think we can assume that just because you’ve been in practice 20 years or 40 years, that it’s a sellable asset.

Christine Uhen 4:24
And there’s, there are heartbreaking stories about that when some clients come to us from fear and short on time off I need to retire in five years and I need to double my practice because I’ve been told, it’s not worth what my financial planner has told me I need to sell it for these are heartbreaking stories, but then we get those calls way too often and they are, they’re hard to do have those conversations well time is short, let’s get to work.

Victoria Peterson 4:57
Yeah, and then the good news is, is that a lot of times we can help practitioners in that situation, and sometimes we can’t. It’s in all transparency, PDA got its first negative review in 18 years on Google and it was a one-star said, “I met you at a dental conference, not one of our conferences, and then when I followed up was told that PDA couldn’t help them,” but the reality is for that dentists and I did meet with that dentist is that she was underwater and on her way to bankruptcy and so it was not appropriate for us to come in and charge consulting fees, because we don’t specialize in that type of consulting but for the top 5%, 10%, which is my goal that what we do with clients become the standard, there’s no reason that 95% of dentist wouldn’t successfully build an asset and build generational wealth. So let’s talk about how we do that today. You said that we evolved as the marketplace has evolved and really what has evolved is the way practices are bought and sold.

Christine Uhen 6:14
That is a huge change that’s happened in the last, you know, several years in the dental industry but we really think about when you hire, when you call a coach, and what are you looking to have a consultant or a coach do. Generally, there are some pain points, there is some sort of stressor that is causing the dentist to reach out for help. Everything from you know, “I’m struggling with HMOs or BPOS, I’m struggling with the team, I don’t have enough new patients,” there’s something that prompts that call and that is the very traditional type of consulting, and coaching that we have provided and still do because whatever stresses out a doctor will kill their productivity that’s the number one killer of productivity. So moving, anybody in our world dentists away from their stressors, will make them better. Clinicians, leaders, business owners, so that’s always level one is to move away from the, “Oh, I don’t have something to you that scarcity mentality,” to “Okay, now I’m comfortable. I’m distressed, I’m getting a little more predictable,” but the reality of that is that’s a whole nother level of coaching opportunities, the challenges of abundance, we grow practices, that’s what we do. We’ve been very successful at that, growing productivity, growing profitability, creating more value, and a good successful business but now what’s phase two, what’s next after that, and many individuals or firms don’t know what to do with that challenge of abundance.

Christine Uhen 7:48
So now this is where again, our methodology of looking at this more comprehensively looks at the practice globally. Now that I’m out of stress, what is next? Well, what is next is not something small, usually, and in this environment, the sooner the conversation happens, go back to that one dentist is asking him, you know, a few years to retire let’s make more money. Well, why don’t we have that conversation sooner than later? I’ve heard it said it’s never too early to talk about your exit strategy, whether that’s 5, 10 or 20 years, I don’t think anybody plans on retiring with a drill in their hand or with, you know, passing away with a drill in their hand, that’s what gets into my coffin with my kind of thing, get it on, you know, I can’t pull it out of their hand, because we all want to have that retirement we enjoy. Well, if we could have that happen sooner than later. Why wouldn’t we have that dream? And so,

Victoria Peterson 8:46
I’m seeing more people retire in practice if you will,

Christine Uhen 8:49
Yes and so again, that putting people at financial choice where work becomes an option, work becomes the choice that I make and even if it’s choosing different pieces of dentistry, maybe I only want to narrow my focus to a certain service mix but then I also still want to service my patients who are, you know, an extension of my family. So now we’re talking growth and expansion, and transitions of adding providers adding service mix, adding hygiene, adding operatories cutting locations, the very exciting conversations that we are having with our clients now of not what do you want to be in 2023, where do you want to be in 2028? Right, think bigger and can I share a story with you?

Victoria Peterson 9:40
Yeah sure, sure

Christine Uhen 9:41
Because this just happened recently while we were talking to one of our clients? So we’ve had them as a client for three and a half years, and we have been able to grow her successfully. Partnership, through the pandemic, I mean, record months record quarters, the best year ever, right in 2022, on track to break every record and I literally got to have a conversation with her about, “So where do we go from here? You have opportunities to grow bigger, how big do you want to go, right?” So literally, she shared with me a number that she wanted to earn in five years. She had a check that she wanted to write to herself for a certain dollar number, and literally when she and I sat down, we were able to calculate profitability, cash flow, take-home money over the next five years, and what that value of her practice would be, in five years, I kid you not, it was just over $10 million. Wow, it was almost to the penny to the day that we could actually say we can help you do that. We have the strategies, the methods, and the team of advisors that would support her and her team to have that happen. We’re about nearly in tears about this, just the joy I had not known that was her goal but we had created this strategy, just thinking outside the box of what if and why not? Those are some great questions to ask doctors. What if and why not?

Victoria Peterson 11:19
What if and why not? I love that and I want to break this down so it doesn’t sound so mystical, right? Like Christine Uhen has a crystal ball and it matches up with my big dream

Christine Uhen 11:34
I don’t know about you, Victoria mine broke in 1989, my crystal ball broke in that era.

Victoria Peterson 11:40
Mine’s a little dusty but what we did do is when Dr. David Porritt came on board, you and David, and I, pored through 20 years of consulting data and we looked at how to practices that are intentional on optimizing their marketing, optimizing your team optimizing your time, and it’s not about being bigger or busier. In fact, being productive is the exact opposite of being busy. So when you become productive, and you’re focused on optimizing the systems around it, so there’s no wasted effort and a lot of busyness. We’ve noticed that doctors have time and space for more clinical education and everything rises because of that but here’s the cool thing that happened with that research. We saw a predictable trend and a predictable pattern where doctors would grow on average 25 to 30% in the first year with PDA, and an additional 20 to 30% in the second year, and they sustain that 15 to 20%. growth year over year over year over year. Bruce was growing $300 an hour. I don’t even for 15 years in a row. He went from 800 an hour to 1250 Blah, blah, blah. He retired at 4000 an hour or plus not because he was working hard or he was working two days a week but because he brought his team with him, he uplevel their skills delegated to the max, and had a marketing machine that was optimized to bring in the ideal patient. So you now have because of the research that our team did, and David created this amazing crystal ball, right? So with the simple number of what you collect today, you can predict with some pretty darn great accuracy, not based on a 20% growth model or a 30%, but on a 12%, like, a half or a third of what we know doctors can, how they change and evolve when they optimize using 12% for three years and 7%. Like, compare that to the standard, if you don’t know you’re listening to this standard growth is five to 7% a year for a dental practice, and the standard growth for DSOs is five to 7%. They want predictable, calm, stay in my comfort zone, and let me grow a little bit to overcome inflation but they don’t tap into the potential that’s there. So what do you see when you put numbers into that becasue you’re not just grabbing $10 million out of the air? How does that work?

Christine Uhen 14:37
Yeah, well, anyway, it was really it was eye-opening for both of us that we were that insane. That is what we’re looking at is you know, a healthy EBITA of 20% and looking at a very conservative growth exactly what you said 12% predictive over the next couple of years and even less after that to 7% growth. That literally being able to show the comparison between you know, selling now versus selling later selling to DSOs new owning it yourself cashflow over time. It is astounding that when you do look at your business as an investment, meaning I should be putting money back into it right there is what does it take to be an Investment Grade Practice means that I have focused on what is going to grow my business without overtaxing myself working harder overtaxing the team or overspending. So it’s very, it’s extremely conservative and manageable in the fact that our dreams aren’t. They aren’t in the crystal ball, they aren’t in the ethos this is due and it’s been done and we’ve done we’ve over exceeded those expectations in reality. So to be able to come to a client saying, “This is doable, and we’ve seen it happen,” is comforting to them. It’s confidence building in us as a team because we have that history already. This isn’t something we’ve thought we could do. There is no evidence that we have done it and done more of it.

Victoria Peterson 16:17
I love it

Christine Uhen 16:17
That but again, sometimes that is what a doctor needs to anybody that’s talking about investing needs some confidence so that the track record is a huge comfort to our clients as well as to us as advisors to know, this isn’t something we hope can be done. Hope is not a good business strategy. Right and so really being able to tie in real numbers, real history, real systems that we know, do create the efficiency, the optimization, and the results that we’re looking for, is a gift to be able to give to our clients to be that partner in that thinking. Yeah,

Victoria Peterson 16:55
Well, and I want to reiterate that we are in a unique period of time where the stock market’s going crazy, you know, depending on what the feds do with interest rates, oil and gas, and dependable things are going nuts with you know, civil wars and World Wars pending. So private equity investors are looking for secure ROI over time. So we are seeing that even a few years ago where you might have gotten five times your net profits or earnings before interest, taxes, depreciation, and amortization, affectionately known as EBITA. So if it was a three to five multiple then is six to eight multiple now there are different strategies that without doing a darn thing different in your practice, your practice could be worth more. So it’s a great time if you’ve not had to and this is the fun part too is the only time doctors get a valuation of their business is like six months before they want to sell it so right it’s almost like selling your house you can’t think about that. In that way, the average sale today is happening when you’re 41 years old.

Christine Uhen 18:17
Isn’t that incredible?

Victoria Peterson 18:17
It is incredible and I’m so glad that you are such a knowledge knowledgeable Business Advisor. I mean, before you came to PDA, you were with Mercer Group, and you’ve been studying finance and strategies with dentists for three decades. I mean, you know your stuff, and you help our doctors understand how to move along that path of the clinician, to entrepreneur to the investor and that’s a journey, that’s a path and imagine if you’re 40 years old, and you found a way to pull some of the equity off the table, pay off all of your debt, and then take the proceeds and put that back into commercial real estate or back into other investments, you’re debt-free, you’re stress-free, you’re living your life, you love your clinical skills, you still have ownership on part of the practice, and you’re leveraging that equity later, those strategies are now available, where they weren’t even three years ago and that’s the exciting part.

Christine Uhen 19:24
I was gonna say there’s another story in there too about it, when we’re talking about growing and getting bigger, it’s also about the value of time and there are, you know when you think about like you were saying about taking equity off now, and using that money toward other things, getting stress free, reducing your time in the practice to be with family, whether that’s the young kids you have now, again, I was just these are so meaningful stories, I was on a call with another doctor who said, who is bringing on another associate a second associate, to be able to allow him as the owner, time away from the practice that can still maintain its profitability when he’s not there. He’s going to be at every one of his son’s football games. He’s committed that to his 10-year-old, you know, and so he’s a young owner, but I can say the entrepreneur who now realizes that it is worth reinvesting into another doctor in the practice, not to be more, more productive, but to have more time, which is just as valuable for him and his family. So I really appreciate it when you said it’s not just about getting bigger, you’re right. What is most important to the client is our focus, not what we think their business should be there. They are independent business owners, they’re entrepreneurs, and they’ve got a vision and for me as their business advisor to help them get clarity on that vision, I’m helping them polish their own crystal ball, right? This isn’t my vision for their practice or PDA’s vision, but being able to get them to say, “No, no, think bigger, behind us, give me something bigger. Let’s get juicier.” There’s one of Victoria, Jim, let’s get juicy here but we get to do that, and like you said, the strategies that are in place now from equity selling part of it, partnerships, multiple owners calls, such options are out there for our clients and we’re excited to be able to, to present these options to them and help guide them to the best choice for their lifestyle, financially, and possibly legacy.

Victoria Peterson 21:37
Well, I love that, I love that.I’m sitting here and listening to you with just a big smile on my face because nine times out of 10 When we tap into the vision with our doctors, it starts out as, “Oh, no, it’s impossible. I mean, I did you know, I started out thinking but nobody gets to do this and, you know, it’s all, it’s almost lost hope. You know, and secret dreams like I want to own a BMW X 6x Five? No, I tell that too because my neighborhood drives that, or I want a Ferrari,” or sometimes our tangible expression of what wealth is, can feel embarrassing, particularly to people in dentistry, because you come into this field with such compassion and humbleness that it can feel underserved, to be so lucky and that’s another one of those challenges of abundance is you can self-sabotage going, “I have enough think about all the people who are starving,” and all of this there. My experience is, is that the more financially secure you become, the more you are in a position to help. So getting that community connection and those heartfelt connections are all a part of that too. I am going to wrap up with one thing, if you don’t know if you haven’t noticed yet, Christine and I love to work together. We have these clients every week, we’re going through the portfolio and saying, “Well what if and what if?” So if you can discover you know where you want to go and why that’s important. Our team brainstorms behind the scenes on how do we get you there and another client we were working on this week is like, well, they want to bring in a partner, they want to transition out of all insurances, none of that and other than I was like, “Wait a minute, they want to get off Delta Dental. Cool. I’m cool with that but rather than that being reactive because I don’t have space in my schedule, how many patients is that and what’s it worth?” And they was like, “Oh, yeah, 1300 patients and $1.1 million.”

Victoria Peterson 23:47
That’s a whole nother business. Isn’t there a three-operatory space like down the road? Can we hire an associate? Can we somehow set up a whole entire business? And you’re like, “Oh, yeah, he already has a second location, we could probably move it there,” but it’s that kind of thinking because we’re not in the weeds, we get to see things differently than if we’re under the stress of it. I’m like, “Damn, I’m just tired of working with this insurance company, get rid of them but when I don’t know, McDonald’s makes billions of dollars a year, nine cents at a time, I could surely take a Delta Dental patient base generating a million bucks and set up a business plan where it was profitable and that owner doesn’t have to be delivering the service, right?”

Christine Uhen 24:34
Yeah, and again, that’s the creativity that we get to, you know, again, this is the value of a team to here this is you and I talking this is us talking with our marketing strategist, this is such talking with the team development coach of who will be put there. So it is, these are such honorable conversations to be having to put our minds to that kind of elevation of an opportunity for another doctor who might just go who might be just like you say in the middle of it and stressed about it, and just get rid of it and yet, I know in the heart of hearts, he also wants to take care of those patients. So we’re going to help find a way to reduce his stress and still take great care of those patients but that’s who we are to be able to help our clients do that for their patients.

Victoria Peterson 25:23
Christine, thank you so much for your creativity. Thank you for your dedication to the practices that we serve. You really are a terrific strategic thinking partner. So thank you for being here today.

Christine Uhen 25:35
I have enjoyed every moment anytime.

Narrator 25:40
Thank you for tuning in to this episode of Investment Grade Practices. If you find value in this episode, help us spread the word by passing it along to a dental friend, subscribe, and give us a Like on iTunes or Spotify. Learn more about building your Investment Grade Practice at productivedentist.com Today