reSource Minute Videos

The reSource Minute – August 2025

Video Transcript:

Hi, this is Chris Bentson, and it's time for another reSource Minute. Today's topic: Transitions Available to Orthodontic Buyers and Sellers.

The way we're going to look at this is by practice size. There are a lot of practices out there that collect plus or minus $1 million a year. Almost always, whether you're buying or selling this practice, it's a doctor-to-doctor transaction - not a corporate transaction, simply due to the size.

Once you get to about $2 million, you have a few options. You can do a doctor-to-doctor sale of the entire practice, and about 20% of $2 million-and-up practices will consider a partnership. It's a little bit on the small side for a full partnership where both doctors are working four days a week - but if you're a senior doctor and willing to trade time for money, this is often how these pan out.

About 20% of $2 million-and-up practices will at least consider selling to corporate, just to see what they can get for the practice, since corporates are interested in that size.

If you are a $3 million practice or larger, very few of these are 100% doctor-to-doctor sales, because buyers have trouble coming up with the full purchase price. Most are partnerships, about 50%, where you’re buying into an existing partner’s practice. And about 50% of $3 million-plus practices will at least consider corporate to see what they could get for the practice and then work back for the corporation for a period of years.

All these strategies can work for either buyers or sellers. So, what’s your practice going to trade at? If you look at rules of thumb for valuations, generally speaking, practices will transact doctor-to-doctor at about 80% of the trailing 12 months of collections. If you’re collecting $1 million, that’s about $800,000, and so forth.

However, using that average as your benchmark can be very risky because the range of values is 45% to 100%. That’s why we always recommend getting an independent valuation to see where you fall in that range.

If you look at how that relates to profit, it’s usually 1.85 times one year’s net income. But again, that range is from 140% to 200%. These are just averages - the middle of the road.

If you’re looking at corporate, there’s a whole new term you need to learn. They typically pay five to seven times EBITDA - earnings before interest, taxes, depreciation, and amortization. We can explain more about that over a phone call if you’re interested. This is what’s out there in the market and how these practices transact, whether you’re a buyer or a seller.

That’s the reSource Minute. We thought you’d like to know.

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Chapters:
0:00 Introduction
0:15 Transitions Available to Orthodontic Buyers and Sellers
0:28 $1 Million Practices: Doctor-to-Doctor Transactions
0:44 $2 Million Practices: Options for Sale or Partnership
1:19 $3 Million+ Practices: Partnerships vs. Corporate Sales
1:54 Valuation Rules of Thumb
2:08 Risks of Using Averages: Independent Valuations
2:24 Percent of Adjusted Profits
2:38 Corporate Valuation: 5–7x EBITDA
3:01 Closing Outro

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Website: www.bcp-advisors.com

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The reSource Minute –July 2025

Video Transcript:

Hi, this is Chris Bentson, and it's time for another reSource Minute. Today, we would like to review a mid-year orthodontic update.

How are we doing halfway through 2025? In order to do that, I want to look at three key metrics: net production, net collections, and total starts - and this number is for Gaidge's United States-based practices. I think it's always good to look historically at where we've been before we look at where we are, because it gives us great perspective. So, let's start in that pandemic year, and boy, that was a down year, but when you really think about it, it could have been a lot worse. You guys did fantastically in the last half of that year. But that's where we ended up on production, collections, and starts in 2020.

2021 is a year that I'm not sure we'll ever see again. I call it the once-in-a-hundred-year flood positive year, but up double digits in everything. And a lot of money was swimming around, a lot of people were working from home, adults were huge, and that was a great year.

So, what did we get in 2022? Hard to beat that year, but we came off of those numbers a little bit. 2022 was tough, kinda flat on collections because we were collecting what we produced in 2021, but down pretty good in production and starts.

Here comes 2023, down a little bit, not as much as 2022, flat on production, flat on cash, but down in starts.

Then last year, how did we do? We were actually up 2% in production, up about a percent in collections, but still slightly down. We'll call it flat on starts. Where are we six months into the year? Boy, almost up 4% in production, almost 3% in collections, and 2% in starts. That's as well as we've done since that 2021 year. I'm encouraged.

Everybody wants to know, is this going to continue through the back half? Well, we're into the summer months, which are busy. And so I'm encouraged that we're going to have a strong summer. And then it's just going to be, how do we finish out that last quarter of the year? Keep your foot on the gas. Have fun.

That's the resource Minute. We thought you'd want to know.

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Chapters:
0:00 Introduction
0:16 The Three Key Metrics: Net Production, Net Collections, Total Starts
0:44 Pandemic Effect: Looking Back at 2020
0:58 The Boom Year: 2021’s Unique Growth
1:14 Adjustments in 2022: A Tougher Year
1:29 Trends in 2023: Mostly Flat with Declines in Starts
1:37 2024 Recap: Modest Growth, Starts Flat
1:45 2025 Mid-Year Metrics: Encouraging Results
2:14 Closing Outro

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Website: www.bcp-advisors.com

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The reSource Minute – June 2025

Video Transcript:

Hello, this is Chris Bentson and it's time for another reSource Minute. Today's topic, "Why aren't you raising your fees?"

It's a good question, one I want you to consider. To look at that, I want to give you some perspective, a wide-angle look, at a lot of the things that we buy every day that we talk about in the news, and then we'll talk about your fees.

We talk a lot about eggs in the news and you can see that over the last 10 years, the price of eggs has roughly doubled.

We talk a lot about a 30-year fixed rate, what it costs to get into a home if you're going to have a mortgage for 30 years - that has almost doubled, not quite over the last 10 years.

We talk a lot about oil prices and while they've been volatile, as you can see on this graph, on balance over the last 10 years - they've doubled.

And lastly, we talk about the national debt a lot in the news and it has almost exactly doubled over the last 10 years.

What about your orthodontic fees done for a full-phase adolescent case? Well, this is self-reported data from the Journal of Clinical Orthodontics (JCO) Biannual Practice Studies. You'll see that 10 years ago you were charging $5,500. It's gradually gone up, but only to $6,000; so, that's not even close to a double.

How does this look when you look at it on a compounded year-over-year interest rate? Well, when we look at eggs, mortgage rates, crude oil, and national debt, you can see that it's ranging from 5% to almost 9% year-over-year compounding.

What does it mean when you go from $5,500 to $6,000 for your full phase fee on average in 10 years? Less than 1% compounding. Why is that? I think it's because you're scared no one's going to come see you. I know it's more competitive out there, but I want you to consider raising your rates. Being more flexible on financing is an antidote to getting to yes, still at the same rate you have been. But you need to raise your rates - everything else is costing you more.

That's the reSource Minute we thought you'd like to know.

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Chapters:
0:00 Introduction
0:16 – Why Aren't You Raising Your Fees?
0:27 – Everyday Costs Are Rising
0:38 –Price of Eggs
0:46 – 30-Year Fixed Mortgage Rates
0:58 – Oil Prices
1:09 – The National Debt
1:15 – Orthodontic Fees: Minimal Increase Over 10 Years
1:34 – Compound Growth Comparison
1:55 – The Real Issue & Call to Action
2:20 Closing Outro
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Connect with Bentson Copple Patterson & Associates: https://www.instagram.com/bentsoncopplepatterson https://www.facebook.com/BentsonCopplePattersonAssociates https://www.linkedin.com/company/bentsoncopplepattersonassociates/
Website: www.bcp-advisors.com

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The reSource Minute – May 2025

Video Transcript:

Hello, this is Chris Bentson, and it's time for another reSource Minute. Today, we look at case starts and how do you differentiate yourself in this very busy and complex world.

If you want to get an idea of how many case starts are being done in the globe, it's a very hard number to find. I did find a Stifel analysis report that showed the following data. They claimed, in their research, that there are just under 23 million total orthodontic case starts worldwide. Wow, what a big number. How many of those are in North America? This is the United States and Canada, about 30%, just underneath that number with the balance coming from outside North America.

A couple of things to mention. One is 10 years ago, about half the orthodontics cases were being done in North America, about half outside. The big growth in orthodontics has been as other nations adopt orthodontics at a faster pace. So outside of North America, now we're growing faster than inside North America.

If you look at the aligner space, this analysis showed that of the 6 million and change cases they thought were being done in North America, about 10% of those were with aligners. I think that number is actually a little larger. And internationally, about 7% of those 16 million cases are with aligners. If you look at the Align data as of the end of 2024, they claimed to have shipped a few more cases than are shown in this analysis, but directionally, this is pretty accurate.

So a lot of cases, and you're trying to think about, does this mean anything to my practice? Well, let's look at the middle practice in the road - according to the data that we have, and it jives closely with the biannual JCO (The Journal of Clinical Orthodontics) Practice Study, the average practice in America that's independently owned is doing about 400 case a year. How do you look different when you're comparing that against the 22 million in change or the 6 million in change that are being done in North America? It's very hard.

So the question is - how do you differentiate yourself? And that's the question I want you to be thinking about as you think about your practice, your marketing, your messaging - because there are different ways to skin the cat. We've seen in our experience that you can be the insurance-driven practice, you can be the online or centric practice, you can be the digital practice, and you can be the low-cost to get in practice. There are a lot of ways to do this, but you need to decide what your way is to differentiate yourself in this very noisy world and then message that stronger to your drawing area in order to grow.

That's the reSource Minute we thought you'd want to know.

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Chapters:
0:00 Introduction
00:27 Global Orthodontic Case Start Numbers
00:43 North America vs. International Trends
00:55 Growth Outside North America
01:16 Aligner Usage in North America & Globally
01:41 Average Case Starts for U.S. Practices
02:10 The Challenge & Strategies of Standing Out
02:47 Closing Outro
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Connect with Bentson Copple Patterson & Associates: https://www.instagram.com/bentsoncopplepatterson https://www.facebook.com/BentsonCopplePattersonAssociates https://www.linkedin.com/company/bentsoncopplepattersonassociates/
Website: www.bcp-advisors.com

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The reSource Minute – April 2024

Video Transcript:

Hi, this is Chris Bentson, and it's time for another reSource Minute.

Today's topic is the importance of tracking Revenue per FTE. Let's begin by defining what an FTE is. Basically, it's the number of employees you have in your practice. You would take your annual revenue, in this example, $1.8 million, if you have 10 employees, then you divide 10 into $1.8 million, and you have $180,000 worth of revenue per full-time equivalent in your practice.

I want you to start tracking this number because you need to manage it as you go more and more into digital. You're supposed to receive efficiencies on digital, fewer appointments - that should mean fewer staff people, so it should mean greater revenue for FTE. And that's what we're seeing if you really pay attention to this.,

As an example, I asked our team to pull the last five valuations that left our office, and here's the data on that. You see practice one through five and show you what they collected in this chart, the number of doctors they had, and their overhead that I wanted you to pay attention to. You can see a low of 40% to a high of 78% - that's a big, big range.

Your digital Share of Chair, what is that? That's out of all your comprehensive starts, how many of those have a lab fee, which is either with aligners or digital braces. You can see that that varies in this data set from 10% to 62%. And then finally, the number we're talking about today, and then I want you to focus on is your Revenue per FTE. Big variance here.

It's all the way from $98,000, not so great, to $414,000, the center of the bullseye. What you need to know first is, what is my Revenue per FTE? Go find that out if you don't know it. And then, as you're If your digital share of share is wherever it is today and migrates up or down, you can titrate where your Revenue per FTE needs to be to keep your overhead at historical norms, which are about 60%.

We built a chart to help you with this, and this is a good one to take a picture of. Basically, this shows you as your Share of Chair migrates from 15% to 70%, and again, Share of Chair is the digital number of starts that have a lab fee that's usually in aligners or digital braces, where should your revenue per FTE track in order to keep your overhead about the same?

So this is, I hope, good information for you to know. Go find out what your Revenue per FTE is. That's the reSource Minute we thought you'd want to know.

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Chapters:
0:00 Introduction
0:17 What is Revenue per Full-Time Equivalent (FTE)
0:45 Why You Should Track Revenue per FTE
1:03 Valuation Data from Orthodontic Practices
1:16 Overhead Ranges Across Practices
1:23 Understanding Digital Share of Chair
1:38 Revenue per FTE: Range and Importance
2:11 Target for Revenue per FTE Based on Share of Chair
2:42 Closing Outro
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Connect with Bentson Copple Patterson & Associates: https://www.instagram.com/bentsoncopplepatterson https://www.facebook.com/BentsonCopplePattersonAssociates https://www.linkedin.com/company/bentsoncopplepattersonassociates/
Website: www.bcp-advisors.com

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The reSource Minute – March 2025

Video Transcript:
Hello, this is Chris Bentson, and it's time for another reSource Minute. Today's topic, DSO versus Independent Practice Ownership.

What does the data say? Where are we? How's it trending? And what's the future look like? If you look at information from the ADA, they have in general dentistry and all the specialties in dentistry, how penetrated the DSO market is. All the way to the right is the tallest graph; this is the orthodontic specialty. That's no big surprise because our margins are good, and the DSOs have been very attracted to your space for a long time, but about 18%.

I get asked all the time, "Will this grow and where does it stop?" The answer is, in my opinion, it will grow incrementally year over year. A couple of slow growth years in the last two, but it'll continue to grow, and then it probably caps out at 25% to 30% - so I think that's where we're headed.

When we talk to young doctors, and our shop talks to a lot of them, specifically the residents, we ask them, "How do you feel about DSOs in orthodontics?" And surprisingly, 14% say, That's a great idea. I've got a lot of debt, and I can make more money there than I can working for an independent doctor owner or borrow a bunch of money to start or buy a practice. So a small portion say it's great. Eighty-six percent (86%), however, say, It's good for a job, but it's not what I want to do long term.

When we think about the long-term impact of DSOs, will they be around? Yes. Will they cap out at 25% to 30%? Yes. But will there always be a place for independent practice ownership in orthodontics? Yes to that as well.

That's the reSource Minute we thought you'd like to know.

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Chapters:
0:00 Introduction
0:15 DSO versus Independent Practice Ownership
0:31 Current DSO Market Penetration
0:53 DSO Growth Trends & Future Projections
1:09 Young Doctors' & Orthodontic Residents' Perspectives of DSOs
1:39 Long-Term Outlook of DSOs & Orthodontic Practice Ownership
1:56 Closing Outro
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Connect with Bentson Copple Patterson & Associates: https://www.instagram.com/bentsoncopplepatterson https://www.facebook.com/BentsonCopplePattersonAssociates https://www.linkedin.com/company/bentsoncopplepattersonassociates/
Website: www.bcp-advisors.com

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The reSource Minute - February 2025

Hi, this is Chris Benson, and it's time for another reSource Minute. Today's topic, "Where Does It Hurt?" It sounds like you're going to the doctor, but this is you - doctors, orthodontists, telling us where it hurts for you as a practice owner. And interestingly enough, it's not in diagnosing and treating. That's the least problem you have, but it's more the softer skills that you may not be well-trained in out of school and, those are the more difficult pieces of running your business.

So let's take a look at each of these and I've added my own language to the top. This is a study that was done by an independent group called Ipso, for North American orthodontists and it was sponsored by DentalMonitoring. It was done last year. But it's no surprise that the number one problem you tell us you're having is with staff turnover and staff training. So let's walk through each of these with some ideas on '25. If that's your number one problem that you'd like to lessen, what are some ideas around there? One solution, I think, would be to engage with a consultant. They've seen staffs of all shapes, all sizes, large, and small.

They know how to coach you on how to interview. They know how to coach you on how to pay. They know how to coach you on how to incent. They can write job descriptions, and they can keep your staff monitored, if you will, better than you can. And so I think a consultant is a good idea if that's your number one struggle.

The second one, practice growth and optimization, I think is around new patients, differentiation, or workflow optimization. There are three big problems there. But if new patients and making the phone ring more is what you need, then I think you need to investigate what marketing ideas or company or help will make that phone ring more and translate into more starts.

Differentiation, I think, is largely around digital. I think the consumer is ready for that. I think this is a problem that my generation probably doesn't embrace so much, but the younger ones do, and those are the practices anecdotally, I can tell you, that grew last year. So where are you on the digital scale with regards to not just aligners, but also digital braces And the third leg of digital, which is remote monitoring, I think is very important. You might want to go deeper into any of those three categories.

And workflow optimization is just once you get all these digital things working in your practice, there's a lot of software and so forth, but maybe some project management training, some great products out there for that that you want to investigate. I think Dr. Heather Hopkins has a great one called Asana Project Management that gives assignments to your team, to you. It seems to streamline these events.

Patient management is about patient compliance. I don't think I'm any help to you there or don't have any great ideas. It is what it is. But patient engagement, I think, is largely centered, for me, around this idea of remote monitoring or some other ideas that you can have around communicating with your patients digitally. The consumer is ready for that. Practices that are doing this seem to have more engaged patients, the studies show. So, I think you really want to look at remote monitoring and your implementation of that as a way to engage your patient base. Even though you're seeing them less, they feel like you're seeing them more and you're communicating with them more clearly through pictures and text back and forth - so very important.

And lastly, the least problem that you have is around clinical challenges and control over treatment. Your reps can help you with that. But onboarding digital technology is a real thing. And again, I just circled back to the consultants here because they see everything and they can really help you decide what to onboard next, how to pace that through your practice, and how hard to go at that.

Some ideas for '25 - I'd suggest that you pinpoint where the biggest pain point is that you want to solve and then use some of these ideas or others that you hear someplace else and try to solve one. Don't try to solve them all this year. Try to solve one at least the first six months. You'll have a more profitable year.

That's the reSource Minute we thought you'd like to know.

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Chapters:
0:00 Introduction
0:17 Where Does It Hurt?" Overview
0:31 ISPO Survey Results
1:01 Issue #1: Staff Turnover & Training
1:14 Solution: Engaging a Consultant
1:36 Issue #2: Practice Growth & Optimization
1:46 New Patients & Marketing Solutions
1:56 Digital Differentiation in Orthodontics
2:22 Workflow Optimization Solutions
2:45 Issue #3: Patient Management & Engagement
2:55 The Importance of Remote Monitoring
3:26 Issue #4: Clinical Challenges & Treatment Control
3:34 Onboarding Digital Technology & Clinical Onboarding
3:47 2025 Goal Setting & Focus
4:07 Closing Outro
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Visit Bentson Copple Patterson & Associates: www.bcp-advisors.com

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The reSource Minute - January 2025

Video Transcript:

Hi, this is Chris Bentson, and it's time for another reSource Minute. Today's topic, a complex one, is the evolution of dental service organizations or DSOs or OSOs, as you know them - orthodontic service organizations.

Most people don't know that they've been around for about 30 years. The first DSO 1. 0 that you see here was very top-down driven. It's where the term corporate dentistry came from, and it was not viewed by dentists, or orthodontists, as a very positive experience. You heard the term quotas, and they mandated clinical processes and things like that. That didn't last too long.

Then they evolved to a kinder and gentler model, with less top-down management. Dentists were still employees, but this reduction in mandates allowed you to diagnose and treat like you wanted to. The culture was improving, but it was still very corporate.

Where we are right now for most DSOs is this 3.0 model, and we've been here for the last 13 years or so. A much more professional C-suite that understands orthodontics better, the industry better. We still see dentists as employees, but you'll increasingly hear the term "partner". They see you as a partner. The idea of quotas has largely gone away, which is a good thing.

A lot of autonomy for you and how you want to treat and diagnose. The cultures are still varied, but they're improving. And most of the sales to these groups are still driven by brokers and some doctor referrals. Where is the DSO/OSO world, headed? And where are some of these shops right now?

I'll call this Evolution 4.0, and it's a much more pleasant place to be. This is a best-in-class C-suite management team at the corporate DSO level. Their business models are designed to make you a partner, and they're also sharing equity with you. So, it used to be they buy 100% of your profit and then they pay you a salary.

Now they'd like you to keep an ownership interest, as well. You'll hear the term JV model thrown around a lot, but that's allowing you to keep some equity after you sell to the DSO and make some more money while you work for them. They think that sticks you closer to them over the long term. Total clinical autonomy in most places, with some exceptions - but very few. The cultures are much better for your staff, have upward staff mobility, and great benefits, and are no longer really driven primarily by brokers, but by this internal cohort of referrals of doctor partners.

It's a better place to live. The conclusion - it's complex and it's evolving. If you're going to go this route, or if you're thinking about going this route, give someone like us a call so we can help you understand who you're talking to, where they are in this evolution, and what experience you might expect from them.

That's the reSource Minute we thought you'd like to know.

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Chapters:
0:00 Introduction
0:16 Evolution of Dental Service Organizations Overview
0:30 DSO 1.0: The Early Days/Top-Down Corporate Approach
0:57 - DSO 2.0: A Kinder Approach
1:16 - DSO 3.0: Increased Professionalism
1:55 - DSO 4.0: The Future
3:05 - Guidance & Navigating the DSO/OSO Landscape
3:24 - Closing Outro
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Connect with Bentson Copple Patterson & Associates:
https://www.instagram.com/bentsoncopplepatterson
https://www.facebook.com/BentsonCopplePattersonAssociates
https://www.linkedin.com/company/bentsoncopplepattersonassociates/
Website: www.bcp-advisors.com

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The reSource Minute - December 2024

Video Transcript:

Hi, this is Chris Bentson and it's time for another reSource Minute. Today's topic is affordability, which, if you look at surveys, seems to be the number one concern of patients who are seeking orthodontic treatment.

What do we know about affordability? Some general guidelines from data from '24 that's been gathered from Gaidge, OrthoFi, and our shop, as well, as we do valuations. What we see is that the average monthly payment for orthodontic treatment is plus or minus $220 a month on average.

The average down payment has a range from 7% to 12%. How does that translate? Well, let's take an example. If you look at a full phase adolescent fee of $5,500 and you get the upper range of the down payment of 12%, that's $660. And that would translate to 22 equal payments of $220.

You can titrate this up or down to kind of fit your needs - but, we think as you look to ‘25, that if you're outside of these ranges by a significant factor, you're probably leaving some starts on the ground and they're going to your competitors.

Offering affordable payment options will help, we think, attract new patients. It will yield higher conversions, and when you get those two things together, that equals growth. That's our wish for you in ‘25.

That's the reSource Minute. We thought you'd like to know.

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0:00 Introduction
0:16 Importance of Orthodontic Treatment Affordability
0:31 Average Monthly Payment for Orthodontic Treatment
0:46 Average Down Payment Range for Orthodontic Treatment
0:50 Example Payment Breakdown
1:19 Offering Affordable Payment Options
1:33 Closing Outro
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Connect with Bentson Copple Patterson & Associates:
https://www.instagram.com/bentsoncopplepatterson
https://www.facebook.com/BentsonCopplePattersonAssociates
https://www.linkedin.com/company/bentsoncopplepattersonassociates/
Website: www.bcp-advisors.com

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