The Dental Insurance Trap (E.168)

“You don’t have to go all the way to fee for service to significantly improve your practice. Every time you successfully resign from a plan, you have improved your practice.” – Gary Takacs

Brief Overview of the Episode

Gary Takacs has spent decades helping dentists build healthier, more profitable practices. In this conversation with Victoria Peterson, he brings both the consultant’s perspective and the owner’s perspective.

Together, they look at what happens when insurance stops being a tool and starts becoming the filter through which patients, teams, and doctors make decisions.

This conversation moves beyond the simple question of “fee for service or PPO” and gets to the real issue: restriction.

Gary and Victoria explore what it means to build a practice around stewardship, purpose, patient value, and long-term options instead of building everything around production volume or insurance limitations.

What This Episode Reveals

• Insurance dependence does not just affect reimbursement. It affects how patients think, how teams talk, and how doctors lead.
• Patients may want better care, but many have been trained to reject anything that does not feel “covered.”
• Going unrestricted is not an overnight move. It requires systems, communication, leadership, and a team that understands value.
• An investment grade practice is not built for a finish line. It is built to give the owner better options, more purpose, and a business that can keep getting stronger.

What You’ll Learn

• How insurance restrictions quietly shape patient behavior
• Why reducing insurance dependence can improve a practice without going fully fee for service
• How to talk about affordability and value without letting insurance control the conversation
• Why stewardship matters when building a practice that can run beyond the owner
• How purpose, team culture, and long-term ownership connect to practice value
• Why the future of private practice depends on doctors reclaiming clinical and business clarity

If This Sounds Familiar

• You feel like your best dentistry keeps getting filtered through insurance limitations.
• You may be producing, but still feel restricted.
• You may have patients who need care, but only ask what their plan covers.
• You may have a team that wants to help, but does not yet know how to communicate value.
• You may be thinking about the future of your practice, but still feel trapped by the model you built years ago.

This episode gives language to the problem and a clearer way to start thinking differently.

Next Steps

If you want to build a practice with more options, less restriction, and stronger long-term value, start by looking honestly at where insurance is shaping your decisions.

Book a 30-minute clarity call with Victoria and begin identifying where your practice may be ready for a more unrestricted model.

Visit: InvestmentGradePractice.com

---

TRANSCRIPT

[00:00:09] Victoria Peterson: Well, welcome back to another episode of Investment Great Practice podcast. I’m your host, Victoria Peterson, and if you hear me laughing, it is because I have been in the green room here with my very good friend Gary TAUs, and, uh, we have been sharing stories and laughing and reminiscing about our journeys, uh, where we’ve intersected and all the fun things that we’ve seen.

[00:00:32] Victoria Peterson: So Gary, welcome, welcome, welcome. 

[00:00:34] Gary Takacs: Thank you, Victoria. It’s such a pleasure to be with you, uh, on your podcast today. I’m excited about our discussion today. 

[00:00:41] Victoria Peterson: So we are, we’re gonna kind of go off script here today. Some of the things that Gary and I have in common, uh, we’ve both owned dental practices and been partners in living entities.

[00:00:53] Victoria Peterson: So our consulting work is grounded in, maybe not truth for everyone, but truth about what works in [00:01:00] our hands in a real life living laboratory. And I think that’s really important. Uh, we both once upon a time, loved motorcycles and I really enjoyed, uh, the, the creative continuing education programs that you put on.

[00:01:16] Victoria Peterson: Uh, you have been one of the best, you have been a trailblazer and excited to be with you here today. 

[00:01:22] Gary Takacs: Those trips were fun. It was great having you on, uh, uh, on our ride and learn trips and, uh, being able to be with some awesome dentists and seeing gorgeous parts of our country. So much fun. I always, yeah.

[00:01:34] Gary Takacs: When you make, when you make learning fun, uh, the learning sticks. Uh, that’s 

[00:01:39] Victoria Peterson: right. 

[00:01:39] Gary Takacs: And I think, uh, 

[00:01:40] Victoria Peterson: oh. I have to say I don’t really remember what we talked about on the CE part, but I remember, I remember the motorcycle rides and I remember going to Dr. Hammond’s office. Now, give us a date line on this.

[00:01:54] Victoria Peterson: We’ll come back into today’s time in frame, but this was in maybe [00:02:00] 2003. 

[00:02:00] Gary Takacs: Yeah, it was in the early two thousands. 

[00:02:02] Victoria Peterson: Yeah, and they had a front desk list concept that worked so well, like 20 years ahead of their time. 

[00:02:11] Gary Takacs: Roy. Roy Hammond was a, a huge, uh, follower of Dr. Er Reed. You remember Dr. Reed? Yeah. And Omer taught the concept of a front desk-less office.

[00:02:21] Gary Takacs: And, uh, uh, Dr. Hammond Roy Hammond, uh, thought, well, you know, I’m gonna put that in place here. And that’s what we saw, uh, a, a dental office without a front desk. And the concept when, when Omer taught that con Omer taught by parable. Uh, 

[00:02:35] Victoria Peterson: yeah. 

[00:02:36] Gary Takacs: And the concept of the front desk assist was not so much about eliminating the desk, but he did in his own office.

[00:02:42] Gary Takacs: Dr. Reed did because he wanted to show that it could be done, but it was more about, um, removing the barrier between patients and the doctor and team. And, you know, for our silver haired, uh, listeners and no haired listeners, uh, they might remember when [00:03:00] dental offices had those little tiny windows.

[00:03:03] Gary Takacs: Remember the little slider window. Uh, that separated, uh, you know, the, the patients from, from the team, and Dr. Reed wanted to be more open. 

[00:03:13] Victoria Peterson: Doctor will see you now. 

[00:03:15] Gary Takacs: That’s right. Uh, in, in hushed tones. Right, right. 

[00:03:21] Victoria Peterson: Yeah. Like, like you’re being scolded by a, a, a librarian. 

[00:03:25] Gary Takacs: That’s right. And so the concept of a desk’s office was to humanize the practice and, uh.

[00:03:30] Gary Takacs: And really connect with, uh, patients. Dr. Reed also was either famous or infamous for the 92nd Crown Prep. 

[00:03:36] Victoria Peterson: Yes. 

[00:03:38] Gary Takacs: And the 92nd Crown prep, which he was, he was either praised or vilified for it. But the concept was that, um, if you know what you’re going to do with the prep in your mind, you know exactly what you’re gonna do.

[00:03:50] Gary Takacs: You have it all figured out. Uh, you know exactly what, what you’re gonna do, then. Press your foot on the rheostat all the way down and get it done now. 

[00:03:57] Victoria Peterson: Yep. 

[00:03:57] Gary Takacs: Victoria, here’s something that I, I don’t think [00:04:00] you and I have ever talked about. So, uh, uh, 7, 8, 9, and 10. Uh, my upper four anterior teeth are porcelain veneers that Dr.

[00:04:10] Gary Takacs: Reed did for me in 1987. 1987. I had a diastema between my centrals, little tiny peg laterals, and I was just starting to speak, you know, in programs and I thought I needed to represent good dentistry. Uh, and uh, I asked Dr. Reed if he would, uh, help me correct that, that gap between my front teeth and the little tiny pegs.

[00:04:32] Gary Takacs: He said, sure. He said, in fact, you know, I do some over the shoulder courses. Would you be a patient? He had a, one of his operatories was normal size where doctors could, could watch, and I’m sitting in the chair and Dr. Reed says, Hey guys, there was probably, uh. Eight, eight or nine doctors, he said, Hey, you’ve heard me talk about the um, 92nd Crown prep.

[00:04:52] Gary Takacs: You wanna see the 92nd veneer prep? And everyone said, yeah. And Elmer said, well, wait a minute, wait a minute, wait a minute. I forgot to ask Gary. [00:05:00] He’s the patient. I guess we should ask him. And he turned to me and he said, uh. Gary, would it, would it be okay if I, uh, prepped those teeth with a 92nd veneer prep?

[00:05:08] Gary Takacs: I said, Noer, you’re the boss. Absolutely. Uh, anyway, anyway, these veneers were prepped in 1987 with Dr. Ray demonstrating the 92nd, uh, veneer prep. Were almost at 40 years next year. How, how have those veneers held up? 

[00:05:25] Victoria Peterson: Wow. They’re gorgeous. They’re gorgeous. And you know what that was? Veneer prep technique wasn’t really being taught back then.

[00:05:35] Victoria Peterson: I mean, that was, Nope, 1987. That was still probably a decade before mainstream. 

[00:05:41] Gary Takacs: That’s right. But he did those four teeth with me as a patient and perfectly comfortable. I was, I’m was, I’m a good patient, but I, I was comfortable. But his whole point was, you know, know what you’re going to do. Um, press that wrist stat all the way down and do it.

[00:05:58] Gary Takacs: Uh, I, you know, [00:06:00] I miss Omer. Uh, Omer had, uh, such an influence on, on my life in so many ways, not the least of which is how, uh, uh, every one of his courses was tag lined underneath whatever the title was. It was Dentistry, the People Game. Um, and so whatever the title of the course was, it was subtitle, dentistry, the People Game, and, uh, uh, that has influenced you and I, that concept has been a thread throughout our entire careers.

[00:06:28] Victoria Peterson: We’ve just spent 30 minutes talking about the people side. I love it. And you know what we were also talking about was how the people get lost in the numbers sometimes. Or the numbers, the numbers kind of restrict our viewpoint. Um, uh, let me wrap up with the, the concept of, of productivity in the 92nd prep.

[00:06:51] Victoria Peterson: Uh, Bruce said the same thing. He said, I’m not here to teach you the 92nd prep. But what I am gonna teach you is that you need to get in and [00:07:00] outta there as quick as you can. Right. And I remember he and Jackson Bean, if you ever interview Jackson Bean, he’ll tell you the story that he was a young associate and Bruce used electric handpieces with no water, which was just.

[00:07:14] Victoria Peterson: Revolutionary. I still think most prep with water, but he’s like, why you’re not building up heat? You, you’re fine. Don’t put the patient through it. And so he puts Jackson to work prepping out a quadrant, and about an hour and a half later he comes back and Jackson’s like on a second tooth. He’s like, well, Jackson buddy, what are you doing?

[00:07:33] Victoria Peterson: And he goes, well, you know, it’s the first time I use an electric handpiece. And he goes, well, show me what you’re doing. And he’s still trying to use it like an air driven, and he is being really light. And he’s like, oh, let me sit down. You know, this baby’s got torque and he preps out the next four teeth in about five minutes.

[00:07:48] Victoria Peterson: And, and Jackson was like, uh, so you, there is something about productive dentists that really. Uh, it’s like that origami thing where you [00:08:00] fold the paper and you put a hole in it and you open it up and there’s a butterfly, like they can see the end and they get really clear about the outcome before they start.

[00:08:10] Victoria Peterson: I mean, it’s a very artistic eye, you know, it’s the sculptor knowing how to take the stone away to reveal the statue. I, that’s, it’s fun to watch dentists like that in their flow. 

[00:08:23] Gary Takacs: Victoria, this goes back to where you and I first met, uh, at Pac Life way back when. 

[00:08:28] Victoria Peterson: Yes. 

[00:08:29] Gary Takacs: And, uh, you’ll, you’ll remember Dr. Brian McKay.

[00:08:32] Victoria Peterson: Yep. 

[00:08:33] Gary Takacs: Uh, and I always appreciated his, uh, humor because it was witty humor. You had to think. Um, and just a, a wonderful, wonderful dentist and a, and a great person and, uh, you know, this was in clinic. And of course the doctors are learning how to do veneers, you know, in Dr. Hornbrook’s, uh, lectures. And then they’re in clinic with the instructors actually doing a 10 unit upper anterior por [00:09:00] of veneer case.

[00:09:01] Gary Takacs: And I would observe in clinic, uh, just right. And I was sitting on a bench just observing. And, and, and Brian, uh, taps me, uh, on the shoulder. He goes, watch this. And he had my attention at this point. And, uh, there was a, a dentist that was taking the course beginning to start to, to prep, uh, his patient on a tenured upper anterior por vere case.

[00:09:23] Gary Takacs: Um, and Brian Wa Ryan was the instructor that was rotating through the clinic then kind of keeping everything going. And he watched for a few minutes and he walked up to him and he said, doctor, you can rub that tooth as long as you want with that burn, and Jamie’s not gonna come out of there. And then he turned around and walked away and I, I was on the floor laughing, uh, because I knew the humor in that it was a delayed response from the doctor.

[00:09:51] Gary Takacs: The doctor looked over at, at Brian about 30 seconds later, and then he said, oh, I just got that. [00:10:00] He said you could rub that tooth with the burr as long as you want. And a genie is, 

[00:10:04] Victoria Peterson: but you really, you need to turn it on. Yeah. Turn it on and get going here. Oh, I love it. Well, I had the pleasure of being on your podcast, uh, which coincidentally is you just told me it’s coming out today as we’re recording.

[00:10:19] Gary Takacs: Recording, yeah. 

[00:10:20] Victoria Peterson: I, I love keeping this going and you gave me one of those moments we were talking about insurance participation. From the viewpoint of how it limits or restricts the doctor’s thinking it, the clinical choice, you just get, I don’t know, grounded down into right complacency because you know it’s gonna be rejected.

[00:10:45] Victoria Peterson: Like it’s built into the language of the plan to make it difficult for the patient to say yes. And so you start to comply and you shared the story of one of the teams that you had. Look at this. They were going outta network and they [00:11:00] ran a detailed, uh, report and shared that 95% of insurance utilization was for preventative care and only 5% utilization.

[00:11:11] Victoria Peterson: On restorative. So retell that. So making sure I’m getting the details right. That was, 

[00:11:16] Gary Takacs: this was fascinating to me. Uh, you know, I, I love our work that we get to do. You get to do, I get to do. Our teams. Get to do Because we learn every, every, yeah. We’re constantly learning. It’s, it’s a, a moving target. We’re constantly learning things and, um.

[00:11:32] Gary Takacs: A, a client of mine, uh, a wonderful husband and life doctor, doctor team. Just a really great practice. Um, really, uh, I would absolutely call it an investment grade practice. I, I, I love your terminology with that. Um, this is an investment grade practice and, uh, we had worked their way, uh, out of a network to become an un unrestricted provider.

[00:11:54] Gary Takacs: This is an area where, uh, insurance is, uh, rampant. Um, [00:12:00] and it just didn’t fit their model and over time didn’t happen overnight, but over time they successfully resigned from all the plants. And, um, the, one of the, one of the doctors, uh, said to me, you know, Gary, I was interested in doing, as we were preparing to do this, I wanted to go into our database and see if patients that have insurance.

[00:12:20] Gary Takacs: Whether they were likely to accept more complex restorative care, what I like to call high value services. Um, and she said, I went into the data and she’s a, a, a very, uh, data-centric person, uh, has command of data. And she said, here’s what I found. Um, she said, uh. When it came to elective or higher value services, our patients that were in network only 5% of the time were they accepting that that treatment, they only wanted what was covered by their insurance.

[00:12:53] Gary Takacs: She said, I thought it would be a small amount that, uh, did, but I didn’t think it’d be that low. Uh, and she [00:13:00] said, that just reinforced my decision to go out of network. Because if you think about how they come into the practice, that patient comes into the practice looking for someone that takes their insurance.

[00:13:10] Gary Takacs: That’s the license that patients use. And so in a way, they’re sort of self-selecting. And it, it isn’t that you can’t get a good patient from, I won’t name an insurance company, but name anyone we want. Can you get a good patient from fill in the blank insurance company? Uh, and the answer is yes. You, you, you can.

[00:13:27] Gary Takacs: However, oftentimes they arrive with baggage and the baggage they arrive with is I’m only interested in having things that are done that are covered by my insurance. And that research one practice doesn’t make a universe of data. But I’ve since now dug into that in my client database, and it’s very similar.

[00:13:48] Victoria Peterson: I did the same thing. I, I, I put a Slack message in our coaching channel and I said, pull a dozen clients by the end of the week. I wanna know what the pattern is. And they were like, oh my gosh. And I started [00:14:00] looking at the reports and it was like, uh, you know, um, the patient accounts, we, you know, uh. We took out all that for HIPAA compliance and things like that, but account after account after account, it was like utilization last year, $400, 3 50, 4 25 for preventative, and then you would go restorative 0 0 0 0 2 50 0 0 0 1200 0 0 0 800.

[00:14:27] Victoria Peterson: And what was fascinating was that the zeros were both in the treatment planned. Treatment accepted or, or acted upon. And so I wanna dig into that. So this is not theory, like you can chat GPT, you can go online, you can do the research, and you’ll say, the ADA’s commission on this says utilization is that.

[00:14:50] Victoria Peterson: And you get the stats and you read it. And I know you and I have both quoted it, we lean into it, you know, for benchmarking, things like that. But to see [00:15:00] the benchmark. Like literally come in your windshield, you’re like, okay, this is un undeniable. So if it had just, well, not from, if it had just come from you or me, it would be anecdotal.

[00:15:14] Victoria Peterson: But when it’s a national phenomenon that everybody knows. Then you start validating it through two of the top consulting firms in the country and, and we, between the two of us, we now have a data set of over 30 and we haven’t even scratched the surface. We’re starting to get statistically valid that this might be a pattern and I’m wondering if it’s pattern that could help doctors.

[00:15:41] Victoria Peterson: Open up their mindset just a bit in the space of how restricting it becomes and what unre, how they can become unrestricted without. Without crashing you, you don’t just wake up one morning and say, screw insurance, I’m getting off. Right. [00:16:00] 

[00:16:00] Gary Takacs: Well, let me reinforce that with some data that I learned in the last six months.

[00:16:04] Gary Takacs: Um, I, you know how we have our associations, uh, Victoria, you know, we, we have Yep. A DA, we’ve got our state associations hygiene association, you know, we’ve got association. Well, there is such a thing as an association of dental insurance plan executives. 

[00:16:20] Victoria Peterson: Right. 

[00:16:21] Gary Takacs: And here’s the data from them. Um, now when we look at annual awards with insurance, the annual limit, um, what do you usually see, you know, in, in, as we’re recording this, in this timeline, what are you seeing in terms of annual, uh, limits?

[00:16:38] Gary Takacs: What, what kind of numbers do you see for an annual award for mojo? 

[00:16:42] Victoria Peterson: With the exception of some outliers, it’s the same as it was in 1987 when it came in a thousand, $1,500. Occasionally there’s 2000, 

[00:16:52] Gary Takacs: right? Exactly. It might be a thousand, it could be 1250, maybe better plan might be at 1500, and occasionally there might be a really, really, really [00:17:00] good outlier plan that has $2,000 a year.

[00:17:02] Gary Takacs: Well, according this is their data, the Association, association of Dental Insurance Plan Executives. What percent of the people that have dental insurance use their annual maximum? Do you think that’s a high, high number or low number? I you, just for the record, we haven’t talked about this ahead of time.

[00:17:20] Gary Takacs: This is impromptu. 

[00:17:22] Victoria Peterson: I’ll take, I’ll take low number for 500 please, Gary. 

[00:17:25] Gary Takacs: Okay? Yes, yes, yes. Let me tell you what it is. Uh, it is drum roll please. 2.8% of paying who have dental insurers use their annual maximum. 2.8%. So you thought it was low, but you didn’t think it was that low, did you? 

[00:17:43] Victoria Peterson: I didn’t think it was 2.8, 

[00:17:44] Gary Takacs: no.

[00:17:45] Gary Takacs: I thought it, like you, I thought that number would be low. I thought it might be, you know, maybe 20 a quarter to a third of the population by, no, it’s 2.2 0.8%. That’s why they have no reason to raise the annual. There’s no [00:18:00] reason to raise them because the, the people that have it don’t use it. And what that does tell is the two points that use it is basically using it for their free hygiene appointment.

[00:18:11] Gary Takacs: That’s where it being used. And then so when you’re there talking to ’em about other ways you can help your patient. Uh, you know, have optimal oral health. There, there’s a, a, a, a mental block and, uh, you know, kind of a disinterest there. It’s restricted. It’s, it’s done what plans have done with restrictions.

[00:18:31] Gary Takacs: They’ve succeeded in getting the patient to think in terms of restrictions. I only want what’s covered by my insurance. 

[00:18:38] Victoria Peterson: Right. 

[00:18:39] Gary Takacs: And I think that’s where dentists have so much, um. You know, frustration, right? They know how they can help patients. They know how they can help improve not only their oral health, but their overall health.

[00:18:51] Gary Takacs: And, and yet the patient is the mindset. I only wanna have it done if it’s covered by insurance. I think that might be there. There’s plenty of ills with the whole insurance design. [00:19:00] Uh, 

[00:19:00] Victoria Peterson: yeah. 

[00:19:01] Gary Takacs: But that might be one of the biggest ills because you’re dealing with people that don’t want, that. They don’t want what you can help them with.

[00:19:09] Gary Takacs: And that’s, that leads to right client frustration. 

[00:19:13] Victoria Peterson: Well, they, I think they do want it because they’re walking in the door. However, they have been subconsciously programmed to automatically reject. Um, and, uh, we were talking off camera earlier. Thank you so much for agreeing to be a book reviewer for me, uh, uh, for the investment grade practice book because there is a new framework.

[00:19:34] Victoria Peterson: For long-term business ownership. You know, we’re going into a time of, we’re still consolidating, consolidating efforts cooled a little bit in the last couple of years because interest rates are rising. Money’s not cheaper free. So private equity’s thinking twice. However, you know, consolidation continues, but there’s still gonna be.

[00:19:53] Victoria Peterson: Part of the marketplace, 30% or more that are going to be independently run [00:20:00] practices into the near future. But how do you stay competitive? How do you, how do you slice the truth from what you’re being told by insurance companies, by equity, by everybody else to be true by marketers? And you know, the.

[00:20:18] Victoria Peterson: There’s so much jargon. It’s really hard. I wanna say BS, but I don’t wanna say that on air. It’s hard to cut through the noise. It’s hard to cut through the noise. And so this is one of the noises piece, and there’s a chapter in there and there’s three different scenarios. One was a client, Dr. Uh, Daniel Hawes, who said, you know, I love PDA.

[00:20:41] Victoria Peterson: And if I could give you one piece of advice, a lot of the doctors you showcase are fee for service. And I’ve had success with you and I remained in network and you know, US grinders that are in network, we make up a big part of the world. And I said thank you for that feedback. Right. [00:21:00] Another one, uh, Dr.

[00:21:01] Victoria Peterson: Justin Vine. Came to us after he went off half of his plans with no communication plan, no marketing plan, no differentiator with the team on how we talk about things. And he quickly learned like there’s a system for developing a fee for service. Practice that’s different than an insurance practice. He thought he had a marketing problem.

[00:21:25] Victoria Peterson: Thank goodness Sarah Hansen said first we build the system within the practice and get your team on board. Then we do the marketing. So that turned around really quickly. And then a third story, like many of your stories where uh, doctors made the choice to go completely outta network over time. And the interesting variable, ’cause all three are successful.

[00:21:46] Victoria Peterson: You know, 80% participation, uh, 50% or less, and zero, like at every stratus there’s success, but it comes down to this piece of restriction [00:22:00] and being able to say to the patient, here’s everything I see. Here’s what I know. And I, I understand, you know. If insurance and coverage is a concern for you, nine times outta 10, our team can help you with the copays.

[00:22:17] Victoria Peterson: We can make this affordable. So it really is the conversation about affordability and value, even within an insurance network if you’re not talking about value, risk factors, lifestyle prevention. The patient has no real reason to go forward, I don’t think. I mean, that’s what I’m observing. You have to, you have to help ’em see how it benefits their life.

[00:22:45] Victoria Peterson: Like Bruce used to say, what did, what was Bruce’s I’ll, I’m gonna let you jump in here. Bruce used to say, Mary, uh, you have gum disease, and I wanna let you tell, I wanna let you know that that’s an infection in the gum. And a lot of patients say, well doc, can you save my [00:23:00] teeth? He goes, I’m not worried about saving your teeth.

[00:23:02] Victoria Peterson: I know I can do that. I’m worried about saving your life. When you make, when you’re, when you’re that strong in your core belief about what health is. Insurance is not the variable. Right. 

[00:23:16] Gary Takacs: Right. Well, I wanna amplify what you said a little bit ago, and that is that, uh, there, it’s not a one size fits all in terms of an insurance profile that works.

[00:23:27] Gary Takacs: Uh, and you’re absolutely right. We’ve, you’ve worked with them, we’ve worked with them. PDA has seen, uh, a cross section, a wonderful cross section of our profession, but I deliberately use the language, uh, reduced insurance dependence. 

[00:23:41] Victoria Peterson: There you go. There you go. 

[00:23:42] Gary Takacs: Because you don’t have to go all the way to fee for service to significantly improve your practice.

[00:23:47] Gary Takacs: Every time you successfully resign from a plan, you have improved your practice. And if you choose to stop along the way for whatever reason, there, there could be good reasons to do that. Uh, then I’m in favor [00:24:00] of it, but I, and I always do tell my clients, but if your goal is to go all the way to fee for service.

[00:24:04] Gary Takacs: I’ll be your biggest cheerleader. You don’t have to do that, but I’ll be your biggest cheerleader because that is truly the way to be completely unrestricted. Uh, yeah. But it’s not necessarily for everybody, and it isn’t the model that everyone should follow. 

[00:24:19] Victoria Peterson: Well, once you do that, then you just have another set of variables to manage.

[00:24:22] Victoria Peterson: Right. 

[00:24:22] Gary Takacs: Right, right. Uh, but you know, I, I, back to PDA, uh, just love the foundational work that, uh, you guys have done for so long at, at, at PDA to help, uh, doctors understand, uh, how to tr truly, uh, d uh, take care of their patients. Um, you know, and, and you know, we were talking a little bit earlier about, um, uh, things like leadership.

[00:24:48] Gary Takacs: Um, yeah. And one of the things, and you, you’ve, uh, you’ve given me a glimpse into this, uh, and it’s a glimpse that we need to explore, explore a little bit more. Um, there’s [00:25:00] all kinds of different leadership styles. There’s, uh, different, uh, ways to, uh, you know, manifest good, uh, good leadership. But you introduced the term to me that, uh, I hadn’t thought of in this context, but it’s so appropriate.

[00:25:13] Gary Takacs: And that’s the idea of stewardship, stewardship. Um, and I think that’s a, a, a term that’s gonna resonate with so many dentists. Uh, the idea of stewardship. They’re stewards of their families, they’re stewards of their, um, patients, of their teen. Um, and really what a, what a model of, um, you know, to incorporate into the practice the concept of stewardship.

[00:25:45] Gary Takacs: Uh. I think it, it, it, it kind of paves a way forward. You know, you, you’d have to be, um, you know, living under a rock in the last, uh, number of years to realize that, uh, staffing today in dentistry is, is [00:26:00] hard. Staffing in any business is hard. Um, right. You know, it’s not just dentistry. It’s, it’s finding people that really want, uh, you know, want great jobs.

[00:26:10] Gary Takacs: It, it’s harder than effort. You. And I remember a time when if you were looking for a hygienist, you back then we’d put an ad in the newspaper going way back when, and by the end of the day you might have, uh, seven or eight really good applications. That was a different time, right? Uh, but today I think, uh, more and more, uh, people that are in the workforce are wanting to work in a place where they feel that they can put their heart and soul into it, uh, and, uh, you know, have purpose beyond whatever it is the job that they’re doing.

[00:26:40] Gary Takacs: And I think that the answer to that is, is, is a stewardship model. 

[00:26:45] Victoria Peterson: I love that you brought that up. Yeah. The investment. Great practice book. Uh, we’re actually gonna create a bookmark that has some of these terms because they’re very intentional. The word investment is intentional. Um, it yields a [00:27:00] financial return, but it really comes from vestment, you know, like the sacred, uh, you know, in ceremony and religion and, and, uh.

[00:27:08] Victoria Peterson: You, you vest yourself, 

[00:27:10] Gary Takacs: right? 

[00:27:10] Victoria Peterson: And you clothe yourself in this responsibility, in this purpose. So coming back to like really living your purpose and investing in your team, investing in yourself, and then the concept of stewardship came along because. Uh, I know you’re probably working with this, this too. A lot of doctors are preparing to transact.

[00:27:30] Victoria Peterson: I think there’s an estimate 34,000 dentists will transact in the next four or five years. Uh, that’s huge and I’m gonna ask you a question about that for a minute, but it’s been my experience over these years that many entrepreneurial dentists build lifestyle practices. And everything centers around the doctor.

[00:27:56] Victoria Peterson: And that’s really good. In the beginning, I’m the boss, [00:28:00] I’m autonomous. You can’t tell me what to do. This is the way it’s gonna go. Then you find out it’s something of a bear trap. Oh wait, no one’s gonna do anything until I tell them to because they build it all around me. And now you’re trying to look at how to escape.

[00:28:14] Victoria Peterson: So I call that kind of a command and control model. And it, it works really well when you like being the center, but when you start thinking about transitioning and succession planning is, I think it’s the same conversation as reducing your dependence on an influence of insurance restrictions. It’s not an overnight process done well.

[00:28:35] Victoria Peterson: It’ll take a year or two to really get ready, and I, that’s where the word stewardship comes in. When you shift your mindset from, I. Own this to, I’m stewarding it and building it so that it runs without me. Like I want a legacy for my team. I want a legacy for my patients. I want this practice to continue to be like a beacon of health and a [00:29:00] beacon of hope for my patients.

[00:29:01] Victoria Peterson: That stewardship model changes everything. 

[00:29:04] Gary Takacs: Yeah. And I think that model also, um, provides an opportunity, uh, to really attract. Team members, you know, to the practice that, that resonates deeply with them. 

[00:29:18] Victoria Peterson: What are team members looking for today, Gary? 

[00:29:21] Gary Takacs: Well, so you and I have done work with, um, understanding different generations.

[00:29:27] Gary Takacs: Uh, you know, it, it, it, it really does make a lot of sense, you know, when you look at, uh, you know, the different, uh, mindsets of different generations. And one, one of the things we’re seeing today with, um. It, it started with Gen X and in younger generations, um, is that they wanna be involved in something that’s bigger than themselves.

[00:29:53] Gary Takacs: They wanna have some, they wanna make a difference. Um, and they, they have a [00:30:00] strong drive to, to do that, and they wanna be, uh, sure income is important, you know, for, at some level, you know, in terms of just being able to, uh, you know, survive. Uh, but. Uh, perhaps what’s even a bigger driver is being involved in something, uh, that they know they’re making a, a difference.

[00:30:18] Gary Takacs: If, if you notice of what’s going on in the, in the volunteer world today, you know, the people that, uh, that carve out a certain amount of their time where they give back through, through volunteering, they get a tre. It’s like they get a tremendous ratification. For volunteering in this organization because it, it’s something that they feel like they’re not getting at work.

[00:30:42] Gary Takacs: You know? They’re not getting that. So I’ve gotta get, I’ve gotta nourish my soul somewhere. Uh, so, and, you know, uh, I’m, I’m, I’m thinking of a, a particular, uh, team member that comes to mind, uh, that I met through a client office. And, uh, her world is, she loves volunteering [00:31:00] in these pet rescue organizations where they adopt, uh, you know, puppies and, and find good homes for puppies.

[00:31:07] Gary Takacs: And it, it’s her, it, it literally is what feeds her soul. Um, and it, it brought up to me. The idea of introducing to her doctor, how could the workplace in the dental practice also feed her soul? Uh, it’s like, well, I go to work here and she loves her job. I go to work, I do this, but I, I have to have my time where I can volunteer, uh, you know, to do that.

[00:31:35] Gary Takacs: And I think that’s just one example of how, um, part of the workforce today really wants to be involved in something that’s bigger than themself. 

[00:31:45] Victoria Peterson: I love it. Yeah. My daughter, uh, my daughter has volunteered at Noah. Um, you might know this, it’s on, uh, I five as you’re going between Seattle and Bellingham.

[00:31:56] Victoria Peterson: It’s beautiful. It looks like a big log cabin. She has volunteered [00:32:00] there, I wanna say almost 15 years, every Saturday to work with kittens. And she has been highly allergic to cats since she was a baby. So she takes extra Zyrtec every Saturday so she can go and work with kittens. ’cause they just, she loves little kitty cats.

[00:32:18] Victoria Peterson: And you’re right. Um, I think the more digital we go, the more analog people are trying to get. Like, I, I wanna garden, I wanna be in nature, I want to be with animals. And uh, I love this new generation for that. Um, and yeah. Attracting, attracting talent. Uh, back to Omar Reed, I think, I think we may need to adopt some of these front desk list techniques because it’s hard to find administrators, you know, and, uh, he did it well.

[00:32:48] Victoria Peterson: Like Roy Hammond. I remember like when I walked through the doors, someone magically appeared. Like, hello Victoria. How are you? It’s great to see you, because they had security cameras at the end [00:33:00] of the sidewalk, so they knew and it, it tripped along. Like there’s a system to everything I think. I think that’s what I’m discovering as we go deeper and deeper into this concept of building an investment grade practice.

[00:33:13] Victoria Peterson: One that, like you said, attracts and feeds the soul of you and your team today, but is then positioned well for options. Like I’m hearing more doctors. I’m curious to see what you’re hearing. I’m not hearing. Mm. Like in the pandemic, go back to 2021. Right. So we survived the pandemic in 2022. It lingered into 2021.

[00:33:38] Victoria Peterson: Uh, some doctors just were closed to retirement, turned into keys and walked away. Some doctors said, this is far too much stress. And they sold, uh, a lot of transactions happened in 2122. Um. Doctors were it, it was, it was crazy. I don’t see [00:34:00] this as much, but you’re just going through your mail and you’re getting unsolicited offers.

[00:34:04] Victoria Peterson: Hey, I got an offer from my practice. I think I’m gonna say yes. What do you think? I was like, if somebody rang your doorbell and said, love your house, could you move out in 30 days? Would you not? Get your house appraised, would you not try to find multiple? If it’s that desirable, wouldn’t you want multiple people looking at it for the best offer?

[00:34:23] Victoria Peterson: So we went through that phase. Uh, so I wanna check the temperature with you. I’m feeling like we’re at a phase now where doctors aren’t wanting a quick sale. They’re wanting options. They wanna know that I have the option to be here. Maybe cut back my days and know that the practice will run well. I want the option to partner with my associate.

[00:34:46] Victoria Peterson: I want the option to maybe partner in a private group. I’d like to see the option on A DSO, but it, it was binary for a while. Sell to an associate, sell to A DSO. It seems like it’s, there’s [00:35:00] multiple choices, so what advice do you have for doctors in understanding. How to create options so they know the data, they know how to, how to think about the options.

[00:35:13] Gary Takacs: Yeah, you’re absolutely right, Victoria. If you look at the, the history and evolution of practice transitions for, for a, for a long time, it was just a single lane road. Uh, you know, you developed your practice, uh, you got to a point where you’re nearing retirement age, um, and you find a broker and sell it.

[00:35:34] Gary Takacs: That was, or you know, that was one path that was the dominant path. Uh, but then it started, we started to see more and more, uh, the idea of uh, multi-doctor practices, associate or associates, and the idea that you might pass it along to an, to an associate doctor. Um, you know, might be, you know, another path.

[00:35:55] Gary Takacs: And, and then of course, as groups developed, you know, we now had another [00:36:00] option with the idea of, uh, part of selling, you know, to, to a group or partnering, uh, with a group, DSOs and DPOs. So dental service organization or dental partner organizations became, you know, part of that mix. But it, it’s, it’s kind of the, the flaw that I think that has been.

[00:36:18] Gary Takacs: Evident in all these different options was you were working towards a finish line and the finish line was the endpoint. Um, and, and, and then, then what, then what exactly And, and it’s interesting, I’ve, I’ve asked that, that question, you know, to, to then what, and then a lot of times they have the answer initially, like, well, I’m gonna, I’m gonna travel more.

[00:36:43] Gary Takacs: I, I’m, I’m gonna play golf, or I play more golf. I’ve always wanted to do X, Y, Z, and now it’s gonna gimme a chance to do that. And then I, I, I took it further. I had a good mentor on this. Uh, you, you might remember, uh, Mercer, uh, 

[00:36:58] Victoria Peterson: Mt. S 

[00:36:59] Gary Takacs: Yeah, [00:37:00] mts, but before, uh, mts, uh, uh, it was Rick Mercer and that’s where I started in, in, in my career.

[00:37:09] Gary Takacs: With, uh, with Bursa, and I remember, uh, Rick was a very, very kind mentor. Uh, to me. He would often bring me in, uh, uh, to participate in, uh, you know, client meetings with him, uh, where, uh, I was the scribe, you know, I was taking notes, uh, but he really had me in there. So, uh, I could learn. Uh, but you know, he would, he would talk to the doctor and, and say, well, you know, you’re thinking about, you know, you’re gonna be 65, you’re thinking about you’re selling your practice.

[00:37:39] Gary Takacs: Um, what are you gonna do? And then initially they’d have some answers. Um, and then he would say, then what? And they might have a few more answers. And then what? And it, it, it would get uncomfortably quiet. Yeah. And, and the, the really, uh, you know, reflective [00:38:00] doctors would say. I haven’t thought past the first two.

[00:38:04] Gary Takacs: Then what? I haven’t thought about it. And, and then he, you keep asking probing questions and one of the, it, it was a, it’s, it feels like this is now over, over 45 years ago, but it feel like it happened yesterday to me because it’s impacted me. The doctor turned to Rick and he said, I think what you’re telling me is maybe my life doesn’t get any better than it is right now.

[00:38:29] Victoria Peterson: Oh 

[00:38:31] Gary Takacs: wow. And you know what? I really do love what I do. I’d like to maybe do some things a little bit differently. Um, but I think what you’re telling me is that in terms of purpose, in terms of, um, you know, uh, helpful spirit helping others, maybe my life doesn’t get any better than it’s right now. Uh, and, uh.

[00:38:57] Gary Takacs: Ru would always answer a question with a question. He’d say, [00:39:00] what do you think? He said, I think you’re right that maybe it doesn’t get any better. But, and then he, he would ask the, the, the ultimate question, what would have to happen for you to feel a really, really, really good in every way about your practice?

[00:39:19] Gary Takacs: What would have to happen? And they could typically answer that question pretty quickly, this, this, this, and this. Uh, well, let’s put those wheels in motion and let’s live it now. So maybe it isn’t a finish line. I think, I think that’s maybe a flaw in the models that you and I have seen as prevalent, you know, transition models, it’s a finish line.

[00:39:42] Victoria Peterson: Yeah. 

[00:39:43] Gary Takacs: And when you’ve spent, you know, again, I’m, I’m, I’m addressing, I’m thinking about our senior doctors, but this can apply any place in the career, you know, early, mid, or late. When you’re a senior doctor that you know so much of your life has been [00:40:00] your practice, uh, it’s, it’s hard to successfully step away from that.

[00:40:05] Gary Takacs: I’m not talking transactional here. I I, I’m talking about emotional, uh, and, uh, you know, purpose, purposeful. It’s hard to what, what if you developed a practice that contain and you could participate in any way you want it, you know, as. Uh, you know, as an owner you can participate in that any way you choose, and all of a sudden the concept of retirement changes.

[00:40:29] Victoria Peterson: Exactly. And 

[00:40:33] Gary Takacs: I’ve had the privilege of working with quite a few doctors and taking them to, you know, a transition over the years. You, you have as well, and, and, you know, it’s mixed. Um, in, in many cases they’ve had a successful retirement and in other cases it, it was a disappointing. Retirement in terms of, uh, you know, purpose.

[00:40:56] Gary Takacs: And one of the things I’ve observed is that doctors, they have something to retire [00:41:00] to, will be much more successful in that than those are just retiring away from something. And, you know, successful dentists for a long time, uh, their world has been teeth, teeth, teeth, teeth and more teeth and teeth. And hopefully people, you know, if they’ve, 

[00:41:16] Victoria Peterson: Hey, okay, this is really bad, but that’s the tooth.

[00:41:22] Victoria Peterson: Hey, 

[00:41:22] Gary Takacs: waiting for that. I was, I was waiting for, that 

[00:41:25] Victoria Peterson: was corny. 

[00:41:26] Gary Takacs: But what if the, you know, what if the continuation, um, you know, be, becomes something that you can con, you know, you can engage in, you can get your purpose from, you can help others. Uh, you can lift up, you know, team members and young doctors and you can mentor and all that could be done within your practice.

[00:41:44] Gary Takacs: Then, I mean, I, I absolutely love your concept of an investment grade practice. So really it was a breakthrough for me. So I understand the concept of investment grade investment. I understand that. 

[00:41:55] Victoria Peterson: Yeah. 

[00:41:56] Gary Takacs: And when you introduce the concept of investment grade practice, it isn’t [00:42:00] about, you know, trying to squeeze every last nick lot of your practice.

[00:42:03] Gary Takacs: Uh, it, it, it it’s about, uh, you know, truly realizing the potential of your practice. And that’s a, you, there isn’t a finish line to that. It just gets better and better and better and better. 

[00:42:14] Victoria Peterson: I love that. Um, wow. Our, our time is flying as it always does with you. Um, so I’m, I’m, I’m writing over here furiously.

[00:42:25] Victoria Peterson: If you’ve seen my eyes darting, I’m like, I’ve gotta take some notes on this. Um. It’s a pleasure being in your world, Gary. You and I have actually, uh, shared clients together. Uh, Nikki Green says hello. Like, you know, we work on different sides of the equation and our philosophies are very compatible. And, you know, uh, I I pass along a, a, an expression that one of my mentors gave me, which is success requires support.

[00:42:52] Victoria Peterson: And I definitely see that owners are exhausted. As well, they should be. [00:43:00] Um, the world has changed a lot in the last five years. Uh, compliance, regulations, staff turnover, overhead, shrinking margins, all of those kinds of things. So, uh, not to paint that and everybody lives happily ever after, but there is, there is a framework.

[00:43:19] Victoria Peterson: Um, I was chatting with a doctor today and he said, well, I know consultants, so how are you different? I said, well, how do you know consultants? What do they do? He said, you know, you’re gonna gimme some dashboards. You’re gonna gimme some metrics. We’re gonna do some meetings and huddles, and people are gonna know what they’re accountable to.

[00:43:37] Victoria Peterson: I already have all that, so how is this different? And I said, oh, you were given the bones. Now it’s time to put some meat and a heartbeat. So I think it, it is kind of a, a, the subtitle of the book is, uh, helping dentists return to the work they Love, to the Career they Love. So somewhere along the way, I think that’s the opportunity is to get back [00:44:00] to, uh, give us the phrase that you gave us at the beginning.

[00:44:02] Victoria Peterson: Get back into the, to the business of people and get, 

[00:44:07] Gary Takacs: dentistry is a people game. It’s a, it’s a Corona game for sure, but it’s also a, a people game. I’ll share something with you, uh, Victoria, and also to our listeners. You know, uh, this happened, um, in the last six months and it, it has been, uh, one of these things that keeps me up at night in a good way, uh, in a good way.

[00:44:28] Gary Takacs: But this was a very large, uh, private Facebook group. I’ll leave them aimless, uh, for the purpose of the story, uh, but very, very large, uh, involving many tens of thousands of dentists. And, uh, one of the moderators asked the question, knowing what you know now, would you encourage your son or daughter to become a dentist?

[00:44:54] Gary Takacs: And it drew me in. I was, I was very, I wanted to see the results of that, and [00:45:00] it deeply saddened me. To see that the results, um, were about 70% no. And in some cases there was a figurative in front of the no, which I won’t say to keep your podcast, the g the the 

[00:45:16] Victoria Peterson: family friendly 

[00:45:17] Gary Takacs: mean lyrics rating. Um, so it was something, no.

[00:45:23] Gary Takacs: But 70%, it was no in caps and yelling at you. The other 30% were either, either yes or I think I’d, I’d I think so, but that, that deeply saddened me. When I, when I, when I, when I read the results of that, uh, that people are putting their heart and soul into what they’re doing now or, or really trying to make it work, and yet they wouldn’t guide, uh, you know, a family member to choose that same career path.

[00:45:51] Gary Takacs: And I, I, I understand there, there’s challenges, there’s, there’s certainly challenges to developing, uh, a, a successful practice, an investment grade [00:46:00] practice. Uh, absolutely. It’s, if it was easy, everyone would do it. Um, my grandmother taught me that. So, Gary, if it was easy, don’t go for easy. Go for worthwhile.

[00:46:08] Gary Takacs: Um, I think I’ve shared with you my grandmother, my maternal, uh, grandma, my mom’s mom. Uh, I’ve had the privilege of meeting some really brilliant people in my life, and I’m not sure I’ve met anyone as bright as my grandmother and she had an eighth grade education. Uh, but, uh, she, uh, had a PhD in life. Uh, and I have a lot of, uh, her saying etched in my mind, but said, you know, if every, if it was easy, everyone would do it.

[00:46:33] Gary Takacs: And, uh, don’t go for easy, go for worthwhile. Uh, and that’s really, uh, what I, I I think of that as, that’s what investment grade practices, it’s worthwhile. 

[00:46:45] Victoria Peterson: Yeah, 

[00:46:46] Gary Takacs: and it’s something that continues. It, it’s, it, it can continue in a lot of different formats and it, it can be something that you live in different ways at different seasons of your career.[00:47:00] 

[00:47:00] Victoria Peterson: I think that’s the mic drop right there. Gary, uh, thank you so much my friend for being on the show. As always, I look forward to every opportunity of engaging with you and pouring your wisdom into our communities. If people wanna reach out and connect with you, what’s the best way to do that? 

[00:47:18] Gary Takacs: Yeah, the, the best way to reach me.

[00:47:20] Gary Takacs: So, uh, I’m, I’m very, uh, transparent. Um, uh, I, I will do something that probably none of your guests have done. Uh, I’ll publish my cell number, okay. Text messaging works great for me, so 6 0 2 3 2, 1. 1, 7, 7, 8. That’s my personal cell. You, you’re seeing me hold up my phone. That’s the, the cell that’s pocket. But send me a text message, reach out to me.

[00:47:47] Gary Takacs: We’ll connect, uh, would love the opportunity to hear from your listeners. And Vicky, I wanna take a minute. Victoria. I want, I, so I, I still fall in the trap of, uh, we, we talked on my PO podcast about your name change. Yeah, [00:48:00] that was our opening, uh, comment that, uh, uh, so, uh, I knew you, uh, uh, be before the name change, uh, but Victoria, I wanna take a minute and, and just thank you and, and, uh, show my appreciation for all the amazing things that you do for our profession.

[00:48:18] Gary Takacs: Um, it’s, it’s so wonderful to see. I know, uh, we, we’ve, we’ve approached dentistry from different. Uh, uh, different backgrounds. Uh, but like you mentioned earlier, w we’re, uh, two non dentists that have owned practices. I, that’s not a big universe of people out there, but, uh, we share that in, in common, uh, for sure.

[00:48:38] Gary Takacs: But I sure appreciate, uh, all the ways, uh, that you contribute to our amazing profession. I, I truly believe that dentistry rocks, uh, I think dentistry rocks because, uh, we have the ability to change people’s lives every day. Uh, awesome. And it could be something we do, you know, clinically, it could be something we do behaviorally.

[00:48:56] Gary Takacs: It could be something we do structurally, you know, in your practice. [00:49:00] Uh, but we have the ability to make a deep impact on people’s lives. And I think, uh, with every ounce of my DNA, I believe the dentistry rocks and, uh, I love the work that you’re doing to see that come about. 

[00:49:12] Victoria Peterson: Thank you. Well, as long as good people like you, uh, remain in the profession, I still hold high hopes that.

[00:49:20] Victoria Peterson: We’re gonna start being recognized for the oral physicians we are, and medicine and the world. Our patients are gonna start recognizing that nearly 80% of chronic disease can be identified at the dental office. So I still have work to do. You still have work to do and I know all of our listeners here on this podcast have work to do.

[00:49:42] Victoria Peterson: Thank you so much for sticking with us, Gary. We’re gonna have you back for part three because this is just too good 

[00:49:48] Gary Takacs: count on it. Victoria, I’ll, I’ll, I’ll be there, but thanks so much for having me. 

[00:49:52] Victoria Peterson: All right. Mahalo my friend. 

[00:49:55] I.