Episode 132: Requested Replay: Paving the Way for Your Associate

“You have to be honest with yourself, and establish standards and your practice philosophy early. Don’t just cross them, you have to have the hard conversations, because at the end of the day it’s going to make your life better.”  ~ Dr. Jonathan Ehlers

In this episode of the Investment Grade Practices podcast, your host Dr. Victoria Peterson is joined by a true trailblazer in the dental profession, Dr. Jonathan Ehlers, who leads Tiger Family Dental in Sedalia, Missouri. Dr. Ehlers is making a significant impact in his community of around 25,000 people, and his insights on building a durable dental practice and what he’s done to empower his associate will have you on the edge of your seat.

You will learn how Dr. Ehlers paved the way for his associate, Dr. Erin Coleman, highlighting the crucial steps he took to equip and empower her, helping her uncover her unique place in the practice’s service mix, and how their synergy is fueling Tiger Family Dental’s impressive expansion.

Discover the practical strategies that have not only transformed Tiger Family Dental, but can also empower you in your journey towards creating an Investment Grade Practice. As you listen to this episode, pay special attention to:

• How Dr. Ehlers paved the way for his associate
• What you can do to discover the passions of your associate, when you bring one on
• The importance of marketing toward your associate’s service mix

EPISODE TRANSCRIPT

Dr. Jonathan Ehlers
It’s not, it’s not all a straight line to success type of relationship, there are going to be challenges with an associate but I think at the end of the day, it’s so worth it because you get to see that young dogs grow in their confidence level and, and how they’re taking, you know, taking ownership of a treatment plans and they’re caring for your patients, you know, so I think you just have to realize that with any good thing in life, there come sacrifices, but in the end, it’s worth it and you’re gonna be, you’re gonna be blessed beyond measure by just making that job.

Announcer
Welcome to the Investment Grade Practices podcast where we believe private practice dentists deserve to get the lifestyle today while building an asset for tomorrow. Join your host Victoria Peterson who designed the practice of your dreams and secure your financial independence. Let’s get started.

Victoria Peterson
Welcome to another episode of Investment Grade Practices today I am here with the not yet but soon to be famous Dr. Jonathan Ehlers, John, welcome to Investment Grade Practice podcast.

Dr. Jonathan Ehlers
Thanks for having me on. I’m excited to be here.

Victoria Peterson
We have been working together for a year or so with our team you have Tiger Family Dental in Sedalia, Missouri. What is Sedalia like? Am I saying that right?

Dr. Jonathan Ehlers 
Yeah, Sedalia. Yeah, it’s it’s a metropolis of 25,000 people. So you know, we are, our call to fame is the Missouri state fairs in our town. You know, it’s a very blue-collar community. Like I said, about 25,000 people made up of a lot of farming, folk and some industry, but really just, you know, salt of the earth people. I grew up about 20 minutes south of Sedalia, so I’ve always called Sedalia home as well and we’re about an hour and a half east of Kansas City. So not too far from a metro area, but again, pretty a pretty rural area. I love it.

Victoria Peterson
And you’re part of our Investment Grade Practice Coaching Program and just a couple of weeks ago, I had you on our panel for the IGP Summit and the topic was all around associates, like how to build a million-dollar associate and you were a panel of three to five doctors out there and I loved your topic so much that I had to have you on the podcast. So let’s dive into that if, if you are thinking of hiring an associate, if you have an associate now and it’s not working out so great, if you if you want to improve your relationship with the podcast, get on the edge of your seat, turn up the volume on your treadmill, because John’s gonna throw down some nuggets of knowledge here. So first of all, tell us a little bit about the landscape of your practice, like what is your service mix? Who do you serve? Why did you bring on an associate those sort of things?

Dr. Jonathan Ehlers
Yeah, so I think, going back a little bit. So I started the practice in 2016, straight startup, and you know, with a, with a strong marketing budget from the get go, we’ve been able to grow the practice from you know, back then about 1300 square foot practice with three operatories to now we’re a 4000 square foot office within operatories and then next year, we’re planning another 10, another four operatories, and a dedicated surgical suite. So, you know, the trajectory of the practice has been quite steep and pretty quickly in the process, I realized that I just couldn’t, I couldn’t manage that many patients. You know, we’ve been averaging about 100 to 150 new patients per month since the start of our practice and so I realized pretty quickly again, yeah, let’s find someone that can help and, you know, when, when everyone has a slightly different philosophy, when we’re talking about adding associate. The way that I approached it was okay, this is the, this is the service mix that I want to provide, how can I add someone to basically work synergistically? You know, kind of kind of take some of the areas of practice that maybe I didn’t want to take care of and we can coalesce together and if you grow our service mix and so, you know, my practice is the way I practice is pretty surgically focused a lot on X, you know, a lot of implants and different things like that. And so when I found Dr. Erin, she didn’t like that, you know, and she wanted to focus on cosmetics and Family Dentistry and so she was the perfect addition to my practice where we can still serve that area, because it is a big need nurse still, but then I can still focus on the type of dentistry that I want to provide.

Victoria Peterson
Okay, you said a lot right there. We had a strong marketing budget from the get go, I was scratch start, we grew 100 patients per month, if you’ve been following Investment Grade Practices, you know, that what you just described on was the viability stage. Right and it sounds like you skyrocketed through that pretty quickly. And bringing on the associate helps you not only meet the demand, but open up a whole new market.

Dr. Jonathan Ehlers
Absolutely, absolutely and I think, you know, the one thing that I would, I would urge, you know, newer dentists that are kind of on this path, to take a step back and, you know, as my practice was growing, I didn’t, I didn’t really adopt coaching early on. I was so focused on we got all these patients coming in, you know, we’re producing all this dentistry, everybody’s happy and then you had for, you know, for new team members with different personalities, and all sudden, you’re like, “Oh, we don’t have systems in place,” and so, for us, it was like, we had to go through some some bumpy roads and, and so I would tell, you know, get the coaching on board early, you know, and, and honestly, get some guidance with your marketing, because, again, you can spend, you know, a healthy 8% of your collections on marketing and do pretty well but if you’re not focused, if you’re not focusing that marketing on the, on the type of dentistry you want, you can be leaving some money on the table.

Victoria Peterson 
Just a little bit more background and color, what is the quality of revenues in your practice? Are you on eight IOPs, PPOs, out of network, in network? How does that work?

Dr. Jonathan Ehlers
So we we have a direct contract with Delta and then we contract with kind of some third-party groups that will kind of get us into something that works but we don’t do a lot of direct. We don’t have direct contracts with insurance as we do we use Carrington and so that gets us into the majority of insurance groups in our area and so, you know, we are a PPO office. I mean, we see a lot I’d say we’re probably 70, 75%. PPO and but again, I think adding the full arch niche into the practice that’s kind of grown are outside of the PPO environment, you know, because again, it’s just when you’re talking treatment plans, those dollars and cents. Insurance becomes kind of obsolete in that discussion, you know, you’re selling dentistry, not necessarily an insurance plan and again, my goal is to slowly get ourselves out of that PPO environment and again, that’s just that’s a, that is a fine line, you gotta walk, you know, to make that transition.

Victoria Peterson
Well, yeah, especially, you know, all the teachers union and everybody, you know, your mother’s gonna get mad at you in a small town, if you have friends.

Dr. Jonathan Ehlers 
That is a real issue in my area, they’re gonna call me on my cell phone, like, “Why don’t you take my insurance?”

Victoria Peterson 
Right? Oh, my goodness. So I mean, again, you are not to throw out a lot of numbers and things like that but if you know, we just do some rough math of 10, operatories, probably 40,000 per operatory, you can get a sense of the size of your practice, and very profitable, your EBITA is well north of 15%. So you know, a lot of times there is a lot of talk of get off the PPOs but I would say that aren’t  80% of the doctors we work with still have some type of insurance reimbursement, but it sounds like you are modeling, the philosophy of insurance is a form of payment, it’s not a form of treatment planning.

Dr. Jonathan Ehlers 
Exactly. Right and I think that’s that’s the point that you have to make. It’s, you know, your initial consultation, comprehensive exam, you set the stage right there, you know, insurance is a way that you’re going to get some, some payment there but that’s not how we’re going to operate your treatment plan. You know, you’re gonna you’re coming to Tiger Family Dental because we’re going to, we’re going to treat you comprehensively we’re going to diagnose you and we’re going to, we’re going to recommend treatment that you need, not necessarily what insurance is gonna pay amd so that that right there allows the patient to have some insurance benefits, but we’ve already had the conversation and, you know, we see it all the time.” So and so do you need a pre-authorization for this crown”? They’re gonna say,” Oh, well, I’ll just sign I was assigned the pre-refusal, you know, because we, you told me I needed a crown, we have that relationship, let’s do the crown, you know.” So insurance can be an addition to the service you can provide but let’s not let it dictate how we practice. Yeah,

Victoria Peterson
I think that’s the number one conversations, if doctors can get comfortable having that conversation, it overcomes so many barriers for the team. Let’s talk about your associate, because one of the things you really put a fine point on at the conference was empowering your associate a supporting giving resources to marketing for it, I’ll have to say, I know it seems very common sense to you but I see it is very rare, particularly in a PPO office, like the primary doctor wants to do all the great cases that I’m going to give all the composites and the kids to the SEC, you didn’t take that approach?

Dr. Jonathan Ehlers
No, well, I will say to in my area to attract an associate period is a challenge and so I approached it from a standpoint is, if I’ve found the right person, I’m going to do everything I can to keep them in my practice and keep them happy and so Dr. Erin, you know, and she, I mean, she’s just slightly a unicorn, I have to say it, you know, she, she owned a practice in Indiana, for, you know, four or five years relocated, because her husband moved down here, didn’t want to own her practice and so, you know, she, she came in there, and it was, it was a perfect fit and she had that production history already and so, you know, whenever, whenever we were talking, and she’s like, “This is the type of dentistry I want to produce.” My immediate, I’m like, “Okay, let’s, let’s find the things that are going to make you successful.” Because at the end of the day, when you’re associated success, successful, your practice successful, and that comes back to you and that goes back to our marketing discussion. It’s like, you know, if, if you don’t have the patient mix, that’s going to provide quality production capability for your associate, then you do something else, you know, you need to figure out how we’re going to get those patients in here and that’s where marketing also comes in. Now, it’s not just part of the associate and just let’s just sit down and hope that we can fill your schedule. No, you know, it doesn’t just happen. You have to, you have to have a strategy to attack that and make it happen in marketing is a big piece there.

Victoria Peterson 
I love that Tony Robbins often says that, “Hope is not a strategy.”

Dr. Jonathan Ehlers 
Yeah, that’s

Victoria Peterson 
still, how did you market it for her?

Dr. Jonathan Ehlers 
I think it starts with, well, before they even stepped foot in your practice. On day one. I’ve seen patients, you know, you need to have a strategy that goes back a month, I think I think we marketed Aaron for two months before she even came in. You know, we put fliers out in our local community, we talked to the chamber, we actually had her do a radio interview and say, “Hey, this is who I am.” She didn’t even really talk about ministry. She’s like, you know, “These are my kids. These are my interests. This is why we’re coming here to civilian,” and you know, I think given a well-rounded description of who this person is an excerpt this way everywhere, but in particular, small towns, who you are, you know, people care about the relationship. They want to know who your husband is, who you’re married to, your wife is who your kids are, where are you going to church if you don’t go to church, what are your interests, you know, and so that’s how I, that’s how I approached it, I wanted, I wanted my community to know, this is the person that I’m trusting their dental care with and that was day one, that was, that was the first step for us, you know, and then I asked, “You know, what, let’s see some of your work, you know, you have some work in your previous practice, or what are your interests?” And then we specifically marketed those skills for her and so, you know, by the time here and started seeing patients, you know, patients already asked her questions about you know, “Hey, I heard about this. Can you talk about that, you know,” so just really organic conversation starters last year, I think that’s a great way to start the growth of your associate.

Victoria Peterson 
Amazing, amazing. I hope you’re all picking up these nuggets that he’s putting down because your market before they come on, get to know them as a person, let the community get to know them as a person, amazing stuff. How did you help the team get ready for an associate? That’s not always you know, easy

Dr. Jonathan Ehlers
Yeah, it’s just a rule of thumb in our office, the new person, any person that comes in our practice, it’s like, they have to go through the gauntlet of questions and, “Oh, I don’t know if we like her, or you know, they don’t they do it differently.” You know. So, we, we kind of set up meetings where she would come into our team meetings, again, because she is already in the area before she started seeing patients and, and we just had them, you know, we did some lunches, we just introduced again to meet who she was and as the, the dentist in the practice, but just as, you know, and so I think that’s important, getting your staff to realize that, okay, this is not a person that’s coming to challenge, who we are as a practice, we’re bringing them in to be an asset. Yeah, in addition to our practice, so I think it’s just, you know, again, it’s the conversations you have to have, and when I, when I talked about empowerment, you know, right off the bat, I told my staff, she’s an extension of me, you know, on on the door, it’s not just mine now, it’s ours, you know, and she may be associated, she may not have equity in the practice, which, but let’s be both be real, she’s a, she is a authority figure in the practice, she has ownership in the practice, she’s caring for our patients, just like we are and if you set that standard from day one, I think your staff will choose to fall in line with that ideology, or they might just go somewhere else and you know, if they’re not willing to support you in that decision, that probably not the right fit anyways.

Victoria Peterson
You know, you have I don’t know if you’ve even recognized this as a pattern, but you said, set the standard from day one, about three times, you know, set the standard with your patients,  set the standard with your team, set the standard with the associate, how did you discover what your standards were?

Dr. Jonathan Ehlers 
Well, I think it takes some failure along the way, you know, it’s, patient comes in, they’re pushing you to do a, you know, less than quality restoration, because they don’t want to pay for it, because the insurance is paying so and so and early in your career, you say, “Okay, I’ll do it,” and then you pay for it every year from that, or you haven’t, you know, you bring in a team member that has all these demands, that doesn’t really fit, you know, the philosophy of your practice, you know, like, I really need an assistant right now. So okay, we’ll hire, and it’s just a headache from the get go, you know, or, or it’s just like, all those things. When I found in my experiences, they were failures, because I didn’t realize that I did have a standard, I didn’t have a, I didn’t realize that I did have a practice philosophy, and how we’re going to treat our patients and how we’re going to treat our staff and our associates and so when I found there’s just you have to, you have to be honest with yourself, establish those things early and don’t, don’t know, don’t cross them. You just use your data, you know, have the hard conversations, because at the end of the day, it’s gonna make your life better in the end.

Victoria Peterson
I love it. Yeah, Bruce often says with integrity, nothing else matters without integrity, nothing else matters and sometimes we think about that as being, you know, on the side of honesty and truthfulness and things like that but integrity really is, does this coffee cup have integrity? Making coffee the other day of this, a friend gave me a coffee mug, love this coffee mug but the handle broke off, it just came off immediately. So I had my husband who’s a contractor, he’s got all the heavy-duty glues and stuff. So he glued it back and it worked for a year and I’m literally on a call and my coffee cup starts falling this way and filling over me because that handle lost its integrity, the glue stopped working. So this glue of was so so powerful, set the standard and then stick with it no matter what the pain of a crucial conversation is going to be minimal compared to breaking your standards.

Dr. Jonathan Ehlers
Absolutely. Yeah, it’s hard. You know, I, my personality. I think that when, again, when you do introspection, as a practice owner, you have to have those conversations with yourself and I struggled with that, you know, I think naturally I’m a people pleaser, and having those tough conversations on the front end is so difficult, but it’s way more difficult dealing with the repercussions afterward, when you don’t just set that standard from the get-go. So, you know, I learned the hard way and so I’m trying to educate those to say, “Just just have that conversation.”

Victoria Peterson 
Practice with teddy bears in your living room first. All right. You know, I asked a question at the summit. You know, there’s three phases of business development. There’s the viability, which we talked about the race to revenue you, you described a great scenario there of having a healthy marketing budget, then get your systems really predictable. Its a mess trying to expand if you’re not predictable, and the durability question, do you remember that? Yeah. How long can you be away from your practice and not worry that it’s falling apart in your absence?

Dr. Jonathan Ehlers 
Yeah, I have a good example. We had twins and a year and a half ago, twin girls and I told my wife, you know, it’s like, “I want to be there,” you know, because we had our son, he’s almost four and took a week, maybe not even a week and I was back at it and I’m like, “You know what, let’s,” I think it took almost four weeks, longer three weeks off. Yeah and Aaron, I mean, in a team, they, they killed it. I mean, they, they, the office was humming, you know, they would send me screenshots of their production, you know, and, like having some really awesome days, you know, and so, I was sitting at home taking care of my girls, and my practice is doing great. So when you say durability, like, that was a lightbulb for me, it’s like, you know, what our practice is durable. We, we’ve built those systems snd it was just, it was a great, great feeling for me. So I think I can I can honestly say, yeah, about a month, two months, I could I could take off and our practice, I know our practice will be taken care of snd that feels amazing. I mean, it is, it’s the freedom that I think we all really want, you know, because they always say,”Being your own boss, it’s great,” but honestly, what happens is you quickly become a slave to your practice and, and so and that’s part of that durability conversation. And it’s part of I think, why so many try to find this associate because they’re like, “Oh, finally, I can just dump all this stress on them and I can go to two days a week and do all these great procedures just for myself, and let them kind of be the grunt of the practice,” and that doesn’t work but if you if you treat your associate, right, if you empower them, if you if you give them that ownership, then they will gladly. I mean, Erin saw that as an opportunity to number one, produce some really good dentistry, but also take that leadership role with our staff. I mean, when I came back, it was amazing how that that mindset shifted with her and the staff, you know, they respected her because she didn’t just scramble and have that stress on her face. She’s like, “No,” she’s she stood up and said, “We’re gonna, we’re gonna make this thing run, just like, you know, John John was here,” and it did. So it was great.

Victoria Peterson
And love it. Did you have to give up anything like there’s so many doctor, I just want to speak directly to the doctors who say, but I’m a curmudgeon, I know I can’t work with anybody else, partnerships don’t work, associates, chips don’t work, you know, my way or the highway. I mean, we’re so autonomous of times in leadership, if you had to give some bit of encouragement to doctors who feel a little overwhelmed, like I’m chained to the practice, and I can’t leave, what would they have to change about themselves to let someone in to help them?

Dr. Jonathan Ehlers 
I mean i think you, you do you have to give, you have to give up a little bit of that stranglehold on your practice but if you do that the stress level will exponentially go down by just giving up that little bit of a hole, you know, so? Yeah, I think it was, I’ve always had that idea that I want to work and collaborate with someone else, whether it’s Erin, that’s more of a peer or a young associate, that we’re getting ready to bring on a younger associate. So we might have had this conversation over the years. How that differs but so I always had that mindset but I guess if you’re, if you’re a doc, it’s been practicing for 30 years by yourself and I think you just have to take it from a, it’s like, if you can give someone if you can give something to the world, it always gets repaid to you, you know, tenfold I think you really have to approach that. It’s not it’s not all a straight line-to-success type of relationship, there are going to be challenges with an associate but I think at the end of the day, it’s so worth it because you get to see that young guy grow in their confidence level and, and how they’re taking, you know, taking ownership of their treatment plans, and they’re caring for your patients, you know, so I think you just have to realize that with any good thing in life, there come sacrifices, but in the end, it’s worth it and you’re gonna be you’re gonna be blessed beyond measure by just making that job.

Victoria Peterson
John has been such a blessing being with you today. We’re going to end here with another great nugget you just gave us though. I hope you heard it. You’re like, “Well, I’ll talk to you again in a year we’re about to bring on another associate,” and that’s another principle of growing investment great practices is that these stages are not linear. They’re like I go from viable to predictable and it’s always going to be predictable, and then it’s durable, and it’s always durable. You’re in durable now but you’re bringing in an associate. So you go back to stage one. Is this is this viable, you know, with this third element and you’ve got to it a ripple through the whole practice all the marketing and the team and relationships and the contracts and all that, so good for you. I will bring you back in a year maybe soon to see how that’s working.

Dr. Jonathan Ehlers 
Oh, great. I’ll look forward to it.

Victoria Peterson 
Alright, my last question for you. I am I should have asked you this a long time ago but I’m really curious, where did the name Tiger Family Dental come from?

Dr. Jonathan Ehlers 
So whenever I was thinking about creating this practice in our area, I wanted to I wanted to practice that the whole community could relate to and so from elementary school to our high school, the mascot was the Tigers and alsolso a diehard zoo Tiger fan. So that also is like perfect I can I can represent, you know, my favorite college, and then also my community. So that’s how Tiger Family Dental was born. Just with that mindset, because like, I remember talking to a guy and he’s like, “You know, don’t just say Jonathan Ehlers, DDS is your office like you have your practice name reflect the things that you care about,” and, and that’s really what it was. I’m a huge sports fan. I love my community. I mean, it’s I go to work and I expand technology, my practice, expand or practice patient flow, because I want Sedalia to have the best dentistry possible and so it was just natural for me to have a name like that rather than just a generic you know, my name so and this could this also can live on well beyond me. You know, Tiger Family Dental can be a staple in Sedalia even many years after I’m retired.

Victoria Peterson 
And love it. Well, that gives me another reason to bring you back for a podcast on authentic marketing. You are just one of my favorite people in this industry. You’re comprehensive, you’re compassionate, you’re empathetic to the needs of your team and your community. So authentic and genuine. You know, from the name of your practice to everything that you do and high tech, you’re the first person I know who has a robot in their office. So go Yomi. So would you come back and visit with us again, and let’s dive deeper into authentic marketing?

Dr. Jonathan Ehlers
I would love to you know, I anything that I can do for PDA and IGP it’s a, you guys have changed the trajectory of my practice and our ability to help patients so anything I can do to help and you know, spread the news, I’m here for

Victoria Peterson 
I love it if people want if Doc’s want to reach out and bend your ear, is there a way that they can do that?

Dr. Jonathan Ehlers 
Absolutely. Yeah. So you can reach out to me my email is jreoms2012@gmail.com. And you can you can reach out to the office to our office number 660-827-2405 and we can we can chat any questions you have I’ll be more than happy to help

Victoria Peterson 
all right, as I said before, the not yet famous but soon to be Dr. Jonathan Ehlers, Ian’s are Ehlers.

Dr. Jonathan Ehlers 
It’s ailleurs gamers. German so it’s it’s tough. You know, I, I don’t even I don’t even fight anymore. Anything you want to call me. That’s not profane, I’m fine.

Victoria Peterson 
I’m just so happy that this is your very first podcast because you’re about to turn to the industry upside down. You’re an influencer in the making. And if you do get a chance to spend some time with Jonathan, what a great guy. So thank you for all you do for your community. Thank you for what you’re doing for dentistry. We appreciate you.

Dr. Jonathan Ehlers
Absolutely. Thank you. You have a great weekend. It was great talking with you.

Announcer
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