Episode 72 – The Dental Business Accounting Playbook

“Accounting doesn’t matter…until it matters.” -Chris Sands

So when does accounting matter?

The simple answer is when there’s a significant exchange of money.

It matters if you grew you and made money and have a big tax bill. If you’re buying anything or applying for a loan, accounting matters and the biggest time accounting matters for any independent dental practice owner is when you’re selling your practice.

All too often, accounting gets downplayed an entire career – maybe even ignored – until you get to that point of sale and you are pleasantly surprised, or disappointed.

Understanding your accounting and finances are vital parts of building an Investment Grade PracticeTM and I promise that today we make taxes and accounting exciting!

An Investment Grade Practice should be within the reach of every independent dental practice owner. The finances Chris Sands from ProFi 20/20 joins me for a conversation about finding a financial team that can support you as you build your Investment Grade Practice:

• What you need to know about your accounts
• How to vet a CPA
• The importance of organization

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.

EPISODE TRANSCRIPT

Victoria Peterson
Accounting doesn’t matter until it matters, says my next guest Chris Sands from ProFi 2020. American and North American I think you’re beyond US, North American CPA firm. Welcome, Chris.

Chris Sands
Thank you, Victoria so glad to be here. It’s an honor and looking forward to some exciting discussions if we can make tax and accounting exciting today.

Victoria Peterson
Well, we’ll get to this in a minute but given that you and I are both UGA grads from the University of Georgia, Go Dawgs, this will be fine. So we got to do the whole thing, go dogs, single

Chris Sands
football, college football national champions, we have to soak it in once every 40 years.

Victoria Peterson
And yeah, we’ll just dive into this right now. So I was there when Herschel Walker was the Heisman Trophy winner and REM was just getting started as a band and you know, all that kind of cool, groovy, time back in the early 80s. You graduated from UGA in?

Chris Sands
In 2008

Victoria Peterson
We have a 20-year difference in our experiences there so at the end of the show will tell you the true difference and what it meant to be on campus in the 1980s versus the 2000s but Chris, I want to dive into accounting doesn’t matter until it matters, so when does accounting matter?

Chris Sands
You know, accounting doesn’t matter until there’s a significant exchange of money and that’s what matters and you know, that can happen annually. It could be that you got a tax surprise, you grew you made more money and you had a big tax bill, and all of a sudden the accounting mattered it was ignored and maybe too late, and then you had that pain point. You know, the other times there’s when you’re typically buying or selling something, and the biggest one for any doctor in their careers when they’re selling their practice so a lot of times accounting gets downplayed and ignored for someone’s entire career and then they get to that point of sale and they’re either pleasantly surprised are very disappointed and that’s when it really, really matters and you know, that is there are the times too if you’re asking for money, and if you’re asking lenders for money, whenever it, whenever there’s a significant exchange of money, is when it matters.

Victoria Peterson
It’s almost like your credit, your credit score doesn’t matter till it matters, right? It sits quietly in the background, and then you get a mortgage and you don’t qualify or that car loan, they charge you 2% more, because you can’t qualify because of your credit score.

Chris Sands
That’s right. That’s right.

Victoria Peterson
I love that and I’ve, I’ve worked with so many clients who have foreign partnerships, or they’re buying or they’re selling, and, you know, they go, Okay, I’m selling, I’m putting my practice on the market and that’s kind of the old school way of thinking of things is like listing a house, I’m now putting it on the market and within six to 12 months, I’m wiping my hands of this, I promised myself when I was one of the practices I bought in Wisconsin, he said, “I promised myself when I turned 62, I would no longer own the business.” So we started when he was like 61 to look for a buyer and he got so angry and upset, there were things we needed from him that were holding up the loan, that they just hadn’t gotten back and the date of the closing date was going to fall the day after his birthday, and because he had promised himself 62, I thought he was going to have a coronary. So we talked to him and we talked to the banks and we talked to the closing agent said let’s close today, and let’s fund tomorrow so he got to learn that funding date could be different than the closing date and then I swear he called me every 10 minutes to see if the wire transfer had gone through. It was like you know those take time so, it, you get really funny about money, people get really funny about money. Now you’re not actually a CPA, but you own one of what I think is one of the most progressive CPA firms in the nation so tell us a little bit about your background, and why you love the space.

Chris Sands
Yeah, you know, I never thought I would be in accounting. They were not my favorite classes and undergraduate school. I also never thought I would be in the, in the line of, business line of dentistry. I’m not a dentist, I’m not a CPA, and I’ve worked in both of those business models and if you’re on this podcast, and you’re somebody who knows the business of dentistry, I will tell you that the business of accounting is very similar in terms of the makeup, you know, the dentist is just like the CPA, every dentist has dental assistants, CPAs have tax assistants, and the hygiene department that’s like our bookkeeping and accounting department. I just, I look for similarities, you know, I happened to stumble my way into dentistry and then saw this problem and accounting to create this firm, and then I learned that they’re the same exact business model but my story is that I came out of school with a desire to work with people, I didn’t know exactly what I wanted to do. I had a degree in risk management and that kind of made me analyze businesses, I was part of the workload that we had in undergrad and got introduced to a dentist early on and asked him if I even it was the first practice he was buying, asked him if I could come to sit in his dental office one day a month and observe and learn, kind of on the side as I was doing a full-time job and it turned into a three-year relationship where we grew, you know, 600,000 collections to 1.7million in four chairs with one doctor and then I could tell we were out of space and he’s since grown the enterprise to three locations but during those three years, I did everything but the clinical dentistry and I really didn’t, I didn’t deal too much with any of the insurance companies but during that time, I primarily focused on the financials and I had relationships with the CPAs we had three different CPAs and those three years because I fired them every year. Two out of the three were dental CPAs and I learned fairly quickly that they knew accounting and did accounting for a lot of dental practices, but they didn’t know the business of dentistry and you know at the time, I thought I wanted to maybe do what you do Victoria, but I wanted to be a practice management coach or consultant and just saw that I just had this huge pain point dealing with the CPAs because I could not get the data on time.

I could not get our financial reports every single month and then I couldn’t get any of that business advice, so I learned enough of the have, you know business and dental practice management to be dangerous and I found finally found a CPA one day that spoke my language, told him, shared with him the void that was in the space and I said, we have to create something that doesn’t exist and we wanted to create a firm that, you know, would deliver financials every single month guaranteed and that would be proactive, and it’s advice and that would have, you know, a little bit of coaching involved to explain financials to doctors, I think one of the most common comments that I’ve received from doctors is that they’re scared of the numbers and that’s okay to be a dentist and be scared of the numbers, it’s not okay to be a business owner and to be scared of the numbers so it’s our mission really, is to fill the entrepreneurial void that’s in the accounting space for dentists and as I said, in the beginning, they’re the same business model, believe it or not, many CPAs are not great business owners.

Victoria Peterson
Oh, I’ve got a statistic on that so I’m not going to be able to give you a link and a reference to it but when I was researching years ago, the American Dental Association says that 95% of dentists can retire and maintain their lifestyle and the other, the correlation to that is 96%, oh no, 95%, cannot retire, maintain their lifestyle, the corollary to that for CPAs is 94% cannot retire and maintain the lifestyle so I like this huge light bulb went off early, my career’s like, oh my god, CPAs are only 1% better than the dentist that they collaborate with this. There, no one is focused on the future and you and I have talked about this a couple of times, there’s a very big life-changing generational wealth-changing difference between working with a financial team that is proactive, versus reactive and I want to dive into that just a bit. On your,

Chris Sands
yeah. Quick up, I’ll tell you, before I got into this, I used to beat up CPAs pretty bad and I’d say you know, they come in and count the bodies after the war is over and the other thing I sometimes would accuse them of is knowing the cost of everything and the value of nothing and I think those are similarities, again, amongst dentists and accountants is that they’re just it’s very, it’s an analytical occupation by nature. Yeah and you tend to be, you know, in the weeds, in the job, in the chair and most of them, even the CPAs, I’ll tell you how we’ve, we’ve made one acquisition, so far in our first five years, and I found that most CPAs, even though they see there, they’re even the dental CPAs and see their dental clients selling and transitioning their businesses, and they don’t even plan their own, plan for that for themselves and their own business.

Victoria Peterson
Yeah, I have a lot of compassion for CBT, I almost became a CPA and then I realized that so I got a degree in hygiene and then I went back and started working on a degree in business and I loved accounting. I don’t like math, but I love accounting. It’s a really, it’s a different, different part of your numerical brain and I thought, oh, and I would visit some CPAs and they all back in the day, because from back in the day, they all had that dark paneled office with this little desk and I thought I just can’t live like, like picture Bob Newhart, right with the Naugahyde and I thought, “Oh, I just can’t I can’t work in such a dreary environment,” so I stayed in dentistry and didn’t go into accounting, but one of the things that I think were proactive versus reactive really shows up is in recommendations about benchmarks and spending, like lab costs, labor costs, marketing costs, all of these things, so many, and there are, I know, you’re not the only great CPA firm out there, there are many great CPAs but as a trend line, a lot of CPAs will say my clients tend to spend this and so because it’s common, they make it a benchmark, I call that like reactive. They just as you said, counted the bodies and said, “This is what most of my clients do,” but then they package it as advice, “This is what you should do.”

Chris Sands
It was most sad about what you just said is that they’re driving all of their clients to be average, like the rest of the ones. Right. You know, it’s like, right, going back into the pool of mediocrity and I think that is Yeah, that’s a huge point. I think that you know, statistics are put out on what the averages are, you know, in different occupations, you know, what the averages are for expenses and dentistry, and I don’t want to be average, I don’t want to work with people that want to be average. We’ve got to you got to push to see you know, if there’s a top 1% That means that they’re doing the opposite of the other 99%.

Victoria Peterson
Or one or two things different that really leveraged it and that’s what I say, building an Investment Grade Practice should not be out of the reach of every dentist in America, like I’m on a mission for this and I want to level the playing field for the DSO impact. I think private practice and independent practice is alive and well and will be alive and well, 10, 20, 30, 40 years from now, but how do you really gain that discernment on who you surround yourself with? You’ve got to have a great board of advisors so when it comes to marketing, you know, the average typical dentist spends one to 2%, but the typical dentist will never be able to retire and maintain their lifestyle so what is a proactive budget for I’m just taking marketing as an example.

Chris Sands
You know, if this statistic has been put out, I think goes back in 2017, that the DSOs, on average, were spending six to 8% in marketing and so you’ve got this wide spectrum of one statistic of private practices doing one to 2% and then there’s the DSOs, doing six to eight. I think if you just look at it, I think it’s pretty intuitive that most DSOs have a little bit harder time with retention than private practices. Private Practice can put a little special touch on things and should have a better job with retention but they’ve got to invite more people to the party, if you have that knowledge and no, no that the DSOs who typically are larger revenues than a single location, private practice.

They’re reinvesting not only a higher percentage but more dollars, right, to invite more people to the party and that is part of the equation. I think, in your world Victoria of practice management, I think that there’s a spectrum of people to give advice on, you know, focusing all on new patients and people that focus all on stopping the leaks and the buckets. I’m of the opinion, you know, the middle do both. It conversion all, you know, but the, unfortunately, I think private practice, the small business owner, who sometimes uses the business as a personal piggy bank, or who you know, just doesn’t there, they feel like they’re better off taking the money home than they are reinvesting in their business. That’s the opposite of what private equity is doing. They could be investing their money somewhere else, they’re choosing to invest it into the dental business.

Victoria Peterson 17:36
Why is that? Why is private equity investing so much in dentistry right now?

Chris Sands
That I think a simple way of answering that is that it is a sleepy industry and occupation of people who own their own business but did not pay attention to it did not do things like invest in it did not know their metrics and when you start to learn the metrics of dentistry, it’s very consistent and repeatable. redundant, it’s recession-proof and crisis-proof and predictable return and if you could just get you to know, 10% margin or return in a dental practice on your investment, that’s, that’s, you know, it’s consistent like that, that’s way better than the stock market that goes up and down. You know dentistry is shining right now, in a time where the market goes down but even when the markets are high, I mean, I will argue, till I lose my breath, that dentistry is a better bet than Wall Street. If that wasn’t so people with plenty more money than a lot of the doctors out there, they’d be putting their money in the stock market rather than dental practices, but they’re not.

Victoria Peterson
Now when Heartland sold to the Teachers Retirement System of Canada, you know, 15, 10, 15 years ago, that type of investor is the most conservative investor there is, you know, when teachers retirement systems invest in something, it’s because of steady, predictable returns, nothing crazy is going to happen when the market goes up or down so I think there’s a lot of validity to what you’re saying that, but treating it like the business. So give us some pros and cons of what to look for, I know you do what you call, like, do you call it attacks X-ray, which I love and so many of our clients have gone through that and a lot of times you say, “Man, your CPA has been doing a great job and here are some things that you might think about, or your CPA has not set up your company very well so at time of sale, it’s going to cost you a lot more in taxes, here are some things that you should have been doing or could be doing.” You know, you’re finding all kinds of things so, if you’re vetting a CPA, what do you look for?

Chris Sands
You know, what’s the old saying that You know, that diagnosis without an x-ray is malpractice or without an exam is malpractice? It’s the same thing in a lot of businesses, but certainly in tax and accounting. I mean, I think we get a lot of questions people ask I think similar questions they asked for a dental office, you know, what are your fees on certain things and without seeing, you have to see the full scope of the work, you have to see the full picture and you got to get an update, you know, we call it a financial X-ray and that’s the same thing that you do, every time you go through getting a loan, or again, selling your practice, anytime there’s a big transaction of money, it’s always looking at the last three years. So we want to see three years of tax returns a full year, a profit and loss statement, and a balance sheet, and the balance sheet is important.

It’s one thing I think gets left out, most business owners don’t look at, understand or use their balance sheet but, to see that full picture to see not only just the business, your personal, but any other side gigs, you might have those 11 rental properties or whatever you might be doing, in order to be able to fully give any kind of treatment plan, you know, and that’s what we do on every console we do, just like a doctor may offer a free exam and X-ray, we do the same thing. If you will provide all of your documents, we’ll tell you what we see, we’ll see if there’s any low-hanging fruit or any free money you can get and they will tell you what we would do differently and how we would improve the situation. If you don’t do that, and all you do is have a discussion around, “Well, every year we How many returns Do you have? We’ll file those.”

You know, you’re getting transactional advice and I hope that I know that I seek out transformational relationships and I hope for everyone that’s in business that they seek out transformational relationships but

what does that mean?

Cjris Sands
Well, I mean, how is aligning yourself with the CPA going to positively impact your life? Is it just going to report data and file paperwork for you, or is it going to be something that gives you strategies that could help you, you know, save so much money in taxes one year that you pay off your home mortgage, as an example? Is there going to be someone who is not just a minimalist telling you where you can cut expenses? That’s really the easy part but a lot of times accounting doesn’t have a focus on revenue doesn’t that certainly doesn’t create revenue for you, but is it, is that relationship going to help you interpret and explain your financial picture and give you the advice to push you outside of your box? You know, to a new level?

You know, there’s a there’s an important concept I think that when people are meeting with accountants and interviewing them there are a lot of times I get this feeling they’re looking for this like magical LLC strategy that they can open up, and I can I move my money over there and then move it back and move it around and is that going to save me on taxes? And there’s plenty of schemes out there used to sell products but you know, Victoria, if I was to give like some, some hard advice to someone in terms of when they’re talking about just minimizing taxes, I think it’s, you know, the more income you make, the more taxes you pay, okay, the more assets that you buy, the less taxes you pay and the government wants the government are IRS code incentivizes you the most, when you make big moves to do things that our government views as improving our economy, and that traditionally has to do with businesses like buying businesses, or commercial real estate that house businesses and the vast majority, not the 99% of people don’t own those things and so they can’t participate in those things and sometimes it takes growing someone and pushing them outside of their box to get them to realize that, “Hey, if you really have this desire to work hard, and to keep more of what you make, pay less in taxes, you’re going to have to do more, you can’t just sit still, you know, the government wants you to buy assets and they’re going to penalize you for earning income.”

Victoria PetersonRight

Chris Sands
And this took a while for me to for this to register as well and I basically am now in this game myself whereas I am trying to constantly earn more income. I’m then taking that income as much as I can and converting it into assets, they don’t have to be hard assets, but I like hard assets that provide passive income and they don’t all have to be rental income but I like passive rental income from dental office buildings, right? I have worked in the dental practice, I don’t necessarily want to go into ownership of the dental practice with all the people involved but I sure would like to own the majority of the offices that Heartland pays rent to,

Victoria Peterson
Wouldn’t that be great? What a steady client, what is it,

Chris Sands
it’s like you what I’m learning is, you know, as you first you should do this in your own business, I own the building for our CPA practice but then I went out and bought a dental office building and as you start making income, you keep buying, I keep my plan is I’m gonna keep buying these dental office buildings and every time I buy one, it comes with depreciation, you know, on that real estate, and that offsets the taxable income from the other building, and some from my business so it’s, it’s a constant game of never stop growing and I think that’s another thing, Victoria, that it’s a something to overcome for people that are early in their career, sometimes even later in the careers they like, you know, “What if I don’t want to grow? What if I just want to sit still?

Victoria Peterson
You are never sitting still,

Chris Sands
That’s saying you’re either growing or you’re dying, right? So I mean, that’s a choice, you can sit still, but you’re not going to win at the game.

Victoria Peterson
Well, you’ve just highlighted so many principles that I believe in, and that we’re teaching doctors as they build Investment Grade Practices, it’s about building assets so the cash flow and the patient base of your practice, that’s asset number one, the building’s asset number two, build a comprehensive finance patient finance portfolio, that’s asset number three it out, bring in the house a lab or do your own printing, you’re starting to shift line items on your P&L into, I don’t know who told this meat to me, it was an early mentor, he said, the more times you can flip a coin, before it leaves your hands, the richer you will become and I thought what is flipping a coin have to do with anything. So is like you flip it and you catch it. Now you put it back to you so if I take my revenue from the practice, instead of paying rent, I buy the asset, now I kept that money, I flipped the coin and I kept the coin and then I decide to I’ve got open time in my schedule so I trade that time for a patient loan, which I collect interest on. Now I flipped that coin again, I took my time and I kept that coin in my hand, and it grows exponentially. Once you start doing that, so many great things. You brought up also a great point when you said you’ve got to know how to be organized so accounting doesn’t matter till it matters and the thing that matters most when it matters is how organized are you I know one practice, I got approved, start to finish like I met the banker was funded nine days later. Now that doesn’t happen very often but I said, “I don’t like the funding and the offers that I’ve gotten.” I got right up to closure on one practice that I was buying and in the fine print they wanted certified financials every year and audited financials every year, not just GAAP financials but the bank itself needed to audit my financials and they were going to charge me $5,000 per location, I have five locations so for an extra $25,000 a year, I could get this incredibly low-interest rate on my practice loan and I was like, and I did the math and it was like ridiculous, how much more interest they were charging me through this audit fee and I don’t like things like that so I immediately went shopping for it. Oh, that was a might have been the one that I came in a day late and yeah, PNC Bank was great with me and I said, “What do you need?” They told me and I just opened up my Dropbox, share them with the box, everything they needed was there so within 30 minutes, I had everything they needed and they looked at that they looked at me, they interviewed others and they said, “Yeah, you’re good to go,” and filled out the paperwork and when that wasn’t the case, on the first loan I did where I’m like, “You need what?” and so it can take years to get in that shape.

Chris Sands
Well and you know, being organized is like an indicator, you know, for a bank of how organized are you going to be to make your payment on time, ya know, and having that where you like, you know, you’re ready to have basically financial nudity to anyone at any time because you have nothing to fear and that you’re, you know, you’re ready to present your documents in a clean organized format, that you have a good cat metric on your balance sheet and that you have cashflow profit on the bottom of your P&L, you know lenders are care first and foremost cashflow lenders, but they want to see are you a good financial steward? You know, if you’ve been in practice for a decade or more, they hope to see you have some savings so you’re a saver if you’re, if not, that’s, that’s a risk factor for them but yeah, being organized is the first, the first key step..

Victoria Peterson
I love it. Chris, you’re gonna be with us in September at our first ever IGP Summit and our doctors are so excited. This is our member-only, invitation-only event and we’re going to have you there because there’s so much happening in dentistry right now. That has changed so if you’re a current PDA client, I want you just to take all that in Christopher is going to be there to answer a lot of these more detailed questions about accounting and how it impacts finance and you’ll be there along with our friends at dentist advisors and professional transition services, I mean, it’s just going to be such a deep rich combination and I feel so lucky and blessed that you’re going to be there because getting all of you on a phone call is nearly impossible getting you in a room for two and a half days together. This is epic. This is unheard of outside a conference where you might be speaking for an hour, but then not really engaged, right, you just all of these topics coming together as one is gonna be epic,

Chris Sands
The full board of advisors, all there.

Victoria Peterson
The full board of advisors, plus our coaches plus some IGP doctors that have already walked this path. It’s like the real meal deal. Alright, before we wrap this up, we got to go back to the University of Georgia just reveal a little personal information and, and how times change. You know, I tell people I came into dentistry, when literally we had stone tablets and we were chiseling, you know, we were chiseling away so I graduated from Dental Hygiene school in 1982. Went from Jacksonville, Florida to Athens, Georgia, and went on campus with the University of Georgia, and if you’ve seen the campus, we have the arches, their iconic symbol,

Chris Sands
The state symbol

Victoria Peterson
It’s our state symbol, right? Well, it’d be hard to have an as a state so the folklore when I was there, 20 years before you was if you walk through the arches as a freshman, you will remain a virgin for the rest of your life so we always walked around the arches. It changed when you went to school there,

Chris Sands
Hey, I guess they watered it down. It became more PC. It was just if you walked through the arches before graduation day, then you would not graduate, so you always walked around but you know, there was there. I don’t know if you remember Lewis Broussard.

Victoria Peterson
I love Lewis Cozart.

Chris Sands
He was one of the best and he had a saying that he said, you know probably is probably said back in the 60s and then it’s still true today. I would think he said, you know, “They say that you can drive by the University of Georgia roll your window down in your car and they’ll throw a diploma in,” and that’s not true, you have to stop

Victoria Peterson
it’s so good to be with another Georgia native who kind of gets this Louis screws out. Do you know interestingly, Lewis Rezar died of an abscessed tooth? Did you know that?

Chris Sands
No, I did not know that.

Victoria Peterson
He had a wisdom tooth that was extracted became infected and he had had a heart valve replacement with a pig’s bow and I think the infection they are odd to check the date on that but I think the oral infection is what caused an infection in his valve and that’s what took them out.

Chris Sands
I knew it was definitely heart-related but the fact that we’re having this I brought up around this conversation is dental-related. That’s pretty interesting.

Victoria Peterson
All right, to wrap it up. If you don’t know Lewis bizarre, get the book, everything I needed to know. I learned in kindergarten and if you’re looking for an amazing proactive future-facing CPA firm, please check out ProFi 2020. Chris, do you want to give us some contact information?

Chris Sands
sure you check us out online at prophi2020.com That’s P R O phi 2020 .com and we’re on all forms of social media at prophi2020

Victoria Peterson
All right, you’re the best I can’t wait to see you in person in September.

Chris Sands
Same here, Victoria.

Narrator
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