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Episode 8 – Is Your Dental Practice a Hobby or a Business? with Dr. Josh Brower

“Without your patients you have no reason to be there. First you have to value your patients and what you do for them and that they are coming to see you, not someone else.”

To build an Investment Grade PracticeTM, you have to get out of the cash-flow rat race and into building a valuable asset. Dr. Josh Brower joins me today to delve into his unique tips and tricks about building value in your Investment Grade PracticeTM including:

  • Building value through exceptional customer service
  • Advice anyone can use to make their business better
  • How to not treat your career like a hobby


VICTORIA: Josh, how are you doing today?

JOSH: I’m great, Victoria, thank you for the invitation. appreciate being here.

VICTORIA: You and I got to know each other in April, during the dental tank where we got to preview young startup companies and think about being advisors and investors. And it was such a pleasure getting to know you there.

JOSH: Thank you, I really enjoyed meeting you and a bunch of the other, you know, Shark Tank people that were there’s kind of investors and evaluators of businesses. And of course, you know, you click a little more with some people than others. And I definitely clicked with you. So I appreciate the opportunity to keep meeting you and talking with you over time.

VICTORIA: Well, I love it. Thank you for being a guest here today, you are so interesting as a dentist as a clinician, but also a business person and an entrepreneur. And here on investment grade practices, what I love to bring our audiences are just one or two amazing things that they do to kind of get out of the cashflow, rat race and into the position that they’re building a valuable asset. And you have so many pearls, I think I’m gonna have to have you on two or three times.

JOSH: Well, thank you, I appreciate that. You know, my history is I’m about 25 years in practice. And I’ve had, I’m licensed in three states, I’ve got one practice in one state now. And I used to have three practices and two states with different associates in each of the practices. And I did that and I kind of made myself a little triangle. And I just did the specialty work in each of those practices for probably about maybe a decade or so. And I really enjoyed the challenge. But at some point, you know, you have to look at there’s plenty of cash flow and not enough life flow. And so I decided to change things up a bit and reorient what I wanted to do with the future. So

VICTORIA: I love that I have never heard it put that way before there’s cash flow and there’s life flow. Do you like the cash flow versus like, dude, did you coin that?

JOSH: I just coined it as we spoke, and you’re welcome to you know, use it anytime you wish.

VICTORIA: Okay, we’re trademarking that right now to Dr. Josh. So that is perfect. Because building an investment grade practice means you do find that balance and you’re living the life that you love now, and you’re not sacrificing cash flow. It may be that drops a little bit, but what you’re really doing is building value over time. So what changed for you? And, and and how do you see value being baked into your company into your practices?

JOSH: Well, I think there’s a lot of ways that you can build value. I think, you know, first and foremost, you have to value your patients. Without your patients, you have no practice, you have no reason to be there, you have no reason to hire staff, you have no reason to pay rent. So first you have to value the patients and what you do for them. So be grateful every day that you go in that you get to go in, and that those patients are there and want to see you and not someone else. I had a friend one time told me that he could look out his door and see seven other dental offices, and that he would frequently get patients that had fired their dentist from across the parking lot for basically for customer service. So I think value is something that you can really provide through customer service. It’s a free thing, which is really nice. It just takes a smile some time and some thought and it adds a lot of value to your practice costing your practice a lot. I think that, you know, people willing to pay a lot more for Apple products because the customer experience is a much better one than with a PC or an Android product. And I think for that reason, you see Apple still thriving, and I think they’ll continue to do that. So I think Customer service is definitely something that is undervalued and under focused on

VICTORIA: I love that. And I think in my monologue, afterwards, I’m going to really highlight that, you know, what are the nuances between customer service and customer experience? I’m really glad you brought that to the forefront.

JOSH: Yeah, one little simple thing I do is, I do a lot of surgery, that’s kind of my background, and I have my business card, and my business card has the email on it, that goes to my cell phone. And I always go up to them, I asked them if they have any questions at the end, before we dismiss them. And I hand in my card and I say, the card doesn’t matter. The only thing that matters is this email right here, it goes to the cell phone, I put my cell phone I showed him, I say that email goes to this cell phone, do not call the front desk, just contact me and I’ll take care of any problem you have. Just know that I’m here for you. And I thank him and I let him go. Wow.

VICTORIA: That’s amazing. And how often do they reach out to you?

JOSH: I probably get at least five emails a week, I would say, because they keep that email. And sometimes they’ll ask things later, you know, might not be initially after the surgery, sometimes it’ll be later. The trick of it is that sometimes they’ll send me a scheduling question. And then I just simply forward it to the front desk. And so I only respond to the ones that are doctor specific. But I think it’s a small price to pay for not having them know that, you know, I’m there for them. And they’re not going to call the front desk and get told the doctor will get the message and they may or may not get responded to.

And it also gives me a written dialogue of what they’ve said to me and what I’ve said to them. So it’s a nice way to legally reinforce all the things that I told them during the surgery. And before that we went through the consent forms. That’s amazing. Do your associate doctors do the same thing? Well, at this stage, I don’t have any associate doctors because I’ve been tapering things down. But when I had them, No, they didn’t. In fact, most of them would simply kind of dodge the patients, you know, tell them to come in for an exam and they would see them. But none of them ever gave out their own personal contact information or asked the patients to contact them directly if they would all the patients for though then had to go through the front desk.

And I think there’s a certain amount of, you know, feeling that I wanted them to act like I did. But I also feel like you can micromanage. And, you know, maybe give them some problems with you taking away their value in your practice. So although I wanted them to do some things, sometimes you just have to let them do what makes them comfortable. Otherwise, there’s not enough value in the practice for them to stay.

VICTORIA: So True enough to enough. So you lecture internationally, you’re everywhere. Are you excited to get back on the road now that COVID is restrictions are lifting.

JOSH: I am I should be I’m going to actually Iceland has opened up. So I’m going to be going there over the Fourth of July, which is kind of nice. I here’s a little value tip. I tracked it for over 10 years. And the first week of July was the worst week of the year, every year. And we were always full. The schedule never ever wasn’t for people get excited, I have time off, you’re going to be open, I’m going to get it all done. And we had the highest cancellation and failure rate of any week of the entire year. And it was always last minute, they’d call I’m sorry, my spouse said that, you know, we’re going to go to the lake and I’m not going to get in trouble with my spouse. So you know, I’ll pay your missed appointment fee or whatever it is.

But I’m going to go do that. And so they chose their life flow over their workflow. And I just decided, you know what I should be living life like they are and take that time off. So I’ve always taken the first week of July off since I finally did that math and figured that out. And my staff appreciated my patients rarely want to come in. So it’s a good time not to be missed. And that’s why I’m going to get to go to Iceland since they’ve opened up to vaccinated people. And then as far as the lecturing goes, the Indian dental implant Association meeting was cancelled for COVID. And that’s been rescheduled September. So I’m looking forward to going over there. And right now, they’ve had some COVID spikes, but I expect those to be kind of tapered down with September. So yeah, I’m really excited to get back out there.

VICTORIA: That’s great. And as you’re lecturing and you’re talking to Dennis about, you know, being a smart business owner and growing, what’s one great piece of advice that almost anyone could use to make their business better?

JOSH: Well, just don’t overspend where you don’t have to, you know, there are certain things that you want to spend money on, and my philosophy and what I’ve told people because I’ve done a lot of mentoring and business coaching is very simple. Like, I’m not going to tell you not to not spend money. You know, if I want to buy a big speaker system, I don’t want anybody to tell me that doesn’t have value, because maybe it was to me. But what you really need to look at is, you know, somewhat of a farmer perspective, since I’m from South Dakota, that they don’t spend money unless it can make them money.

And I would tell them that if they’re going to spend money first look at will it make you money? And if it won’t, that’s fine. But then you have to look at, am I buying this? Because I want to buy it, and not because I need it. And that’s fine as well. But then you have to look at Do I have the cash flow to buy things I want, that I don’t need. So I know I’m not going to make money, I want it. But do I have the money to spend knowing that it’s not going to help? Sometimes you can just, you know, say, Well, I want to have this laser, my practice, and I’m going to market the laser. And it’s going to bring in patients for other reasons. And it’s going to cross sell into procedures. And I’m going to upsell my cleanings.

And, you know, with this laser treatment, and maybe you can say that, but I have found many times over decades of practice that very few of the high end we’re talking 50 plus $1,000 pieces of equipment are going to really generate long term cash flow for me directly. So could I say indirectly through a lot of other things very much. So I would say the exception to that rule right now is a CAT scan machine. Because there’s so many billable codes for it, it’s useful in diagnosing so much more treatment. And it allows you to do procedures you couldn’t do before surgically at a much higher level of competency.

So that is probably my one exception to you know, make sure you own one if you don’t. And beyond that I you know, I always go with the hedgehog principle, if it’s what your focus is, then you should probably look at spending money there. If it’s not your focus, maybe you should try to talk yourself out of spending money. You know, if it’s not what you do, you know, I don’t do a lot of full mouth rehab with veneer cases. So it would be hard for me to you know, invest in a lot of systems that would help me do that. But I do do a lot of surgeries. So, you know, I have two CAT scan machines in my office and I think they’re it’s a good value have to, we can always use you know, more more chairs and more CAT scans, it’s just seems like something I know that will always generate the income. So I like that method of spend the money or I’m going to make the money.

VICTORIA: I love that and use you have a real clear sense of your revenue drivers and I can hear in your voice and in your language, you’re not easily persuaded to come out of that. And it has nothing to do with abundance or scarcity and the wild misuse of both of those words. It’s about knowing your core values and your strengths and where you want to play. And I love that you don’t seem too easily distracted.

JOSH: No, I am easily distracted, like any dentist if it’s interesting or neat. But now when it comes to business, you know, I attended a meeting maybe 15 years ago. And Victoria, you’ve been in the industry a long time, maybe you were one of the people there too. But this was a meeting for people who were struggling in their business and I happened to be walking by. And I tucked my head in the room. And the room was really full. And that kind of surprised me. And the lecture had one thing that he said that I kind of took away the pearls because I heard him say he goes, raise your hand if you do dentistry as a hobby.

And of course, nobody raises their hand. And then the next question we had was, Why are you treating this like a hobby then, and not a business? And so I think that that’s a factor that people get into, especially the farther you go into your career, you know, at what, where do you draw the line on? Is this making money? Or is it just something I want to do? And, you know, everybody has their line in the sand. But I feel that like the earlier you are in your career path, you may have some debt you may have, you know, other things that require your cash flow.

And so maybe you should be a little more business focused, especially earlier in the business because that’s probably where you’re going to make it or break it for your whole career. Because if you don’t get that money, you know, saved early or paid down early. You’re going to be losing compounded interest or gaining compounded interest for decades. And that’s really going to make it so you can retire or not retire.

VICTORIA: I love it. Well thank you for spending time with me today. Dr. Brower, you have been I’ve got so many pearls. I think we may title this one. Is it a hobby or a true business? clarity on that? No, that’s great. And thank you so much for having me, Victor. I appreciate it. You’re welcome. How can people get in touch with you if they want to book you in their study, club or recommend do to a conference or other things that you do? Sure. I run a bunch of different Facebook groups. But I also have a website called get dental training calm. And there’s a Facebook group that’s through there.

JOSH: So you can contact me through the website or through any of the Facebook groups. And if you’re on Facebook, you can message me directly, or just reach out and ask for some help. And I’ll give it to you.

VICTORIA: I love it. Well, we’ll get all of that in the show notes. Thank you so much for joining us here on investment grade practices where we’re helping dentists love the life that they’re living today and building an asset for tomorrow.

JOSH: Thank you so much for having me.

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