reSource Minute Videos

The reSource Minute - September 2024

Video Transcript:

Hello, this is Chris Benson, and it's time for another reSource Minute.

Today's reSource Minute is about Innovation. I chose it because something really cool happened for the entire world this month, in early September, and it had to do with innovation, so I thought it might be nice to talk about it. When I think of innovation and what it means, really in a nutshell, for me, it means to dream, to dream of making a process better, a product better, an idea better. Who of us, when we weren't small, might not have had this dream, "I want to be an astronaut when I grow up", or whatever it was that was outlandish at the time? This perhaps was one of your dreams, and in fact, on September 24 - it came true. You could actually book a ticket on a rocket ship and venture out, not only up into space, but out into space with the first spacewalk by a consumer. I think that's some crazy cool innovation, and we're alive to see it. It's pretty cool stuff.

When I think about where this all started - how did we get to space? It all really started with transportation and when Henry Ford started designing, the first way for us to get around on this Earth was in a motorized vehicle with the Model T.

And he famously said that if he had asked, as he was designing the Model T, consumers about what they thought they might want. He said, they probably would have told me faster horses. We tend to not have the bigger vision that some of our innovators and scientists have, and I think that's very true.

So, to bring it to orthodontics, I wanted to just say a few words about some of the innovations over the last years in business and in clinical. When you think about what we've achieved in business innovation over the last 20 years or so, we now have products like Gaidge, OrthoFi, and OrthoBanc. We have virtual employees that we can hire. We have revenue cycle management that we can employ, and of course, we have corporations that are learning how to do this on steroids level, as well.

On the clinical side, for 25 years, we've had aligners now in our space. We now have direct printed brackets. We're probably going to go to direct print of metal brackets someday. There’re all kinds of research being done around the globe that's going to bring enormous innovation to the specialty.

So, I think it's a good month to celebrate innovation. I think it's good to reflect back on how much better orthodontics is today than it used to be because of innovation. And I'm encouraged to think about all of the science and the researchers that are doing innovation for you, the specialist, to make your lives and the lives of your patients better. As they say in space, "To infinity and beyond!"

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

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Innovation (September 2024) - The reSource Minute

Bentson Copple Patterson & Associates September 27, 2024 4:00 am

reSource Minute Videos

The reSource Minute - August 2024

Video Transcript:
This is Chris Benson, and it's time for another reSource Minute.

Today's topic is Profit and Loss Expense Guidelines for the Balance of This Year and Next. I want to dig into your profit and loss statement. If you were to send me your profit and loss statement for a valuation, we would force every line on your P&L into the form that you see on the screen.

On average, we're seeing practices operating in the United States at around 60% of collections. We break it down by line item, and I want to review those for you. So, let's make it a little bit bigger, and a little bit easier to see, and start with the four biggest expense items that you spend money on in your practice.

As has been the case for decades, people (staff expense) are the largest investment that you have - and those W-2 wages are averaging 20% right now. The next biggest expense right now in catching up to people is your lab expenses, primarily these days with aligners. After that, we've got marketing, and that can vary widely - we'll talk a little bit more about that in a minute. And then lastly, the fourth biggest expense is your rent or the mortgage you're paying yourself if you own your own building.

These are the four biggest expense items that you have on your P&L Statement. Let's focus on these a little bit deeper. First, let's go back up to the top and look at your people cost - two things to point out. One is you can't just look at your W-2 wages and say, “That’s my people cost," because there are other expenses involved, and you see those itemized there. So, all in on people, we're now seeing about 24.5%. This number has got to be titrated down over time because as you get deeper into digital, which every practice will, in my opinion, you're going to spend more on the next item, which is lab expenses.

And lab expenses (orthodontic expenses) are going to expand from not just aligners, like we've been used to the last 25 years, but also digital braces and monitoring fees. If you're doing any digital braces, with LightForce, KLOwen, and something like that, and if you're doing any monitoring fees like DentalMonitoring, Grin, or something like that, I want to encourage you to add that as a separate line item so you can track these expenses separately and get a better feel for your digital expense versus your brackets, bands, ligatures, and wires.

When we look at marketing, it's at 3.2%, on average, in the practices we value. Realize that most practices that find their way to us are looking for a partner or are looking to exit - they're more mature practices. When you're younger, you're probably going to spend more, but on average, 3.2%. If it goes a little higher or if you have it a little bit lower, don't worry about it, but it's a significant expense in your practice and one that you need to continue to have to speak to the consumer.

And lastly, occupancy expense or rent. I believe that footprints in orthodontic offices will shrink incrementally year-over-year going forward - so that 7% may go down to six, even five. And it's one of the few fixed expenses you have in orthodontics, so you want to watch that. But when you're building a new office or looking to start up, I think you can do quite a bit of production out of a four-chair office these days if you utilize digital products.

So that's a look at your profit and loss statement. If you want to get a copy of this so that you can look at this a little bit more closely and with more time, please take a picture of this QR code or take a picture of this screen and just go ahead and type in the information you see at the bottom, and that will get you to that form so you can have it and translate your P&L to that.

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

Download Bentson Copple & Associates' Sample Profit & Loss Statement Here: https://www.bentsoncopple.com/uploads/SampleP&L2024.pdf

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Profit & Loss Expense Guidelines for 2024 & 2025 (August 2024) - The reSource Minute

Bentson Copple Patterson & Associates August 27, 2024 5:34 pm

reSource Minute Videos

The reSource Minute - July 2024

Video Transcript:
Hello, this is Chris Benson, and it's time for another reSource Minute. Today's topic, Better Together.

What do we mean by that? It's often said that in entrepreneurship, it's a lonely, lonely space. I think that's true for a lot of independent orthodontic owners. Who can you surround yourself with to help improve your performance? And that's the topic today, and I want to go around this virtual boardroom table. You’re at the head of it, but who should you surround yourself with to get the best results in your career?

We'll start with an Orthodontic Mentor. Maybe somebody you went to school with, maybe a professor, but another orthodontist, not to just talk over cases with, but to also talk through some of the business decisions that you need to make.

- I've got an HR problem.
- I'm thinking about this piece of equipment.
- Who are you using for this or for that?

This is an important person in your life, and it's one or two key people who can help you who are like-minded and are doing what you are doing.

Probably the most important person, professionally, that you'll hire, certainly earlier in your career and throughout, is your CPA. We think this should be somebody who understands dentistry. They don't have to be siloed in orthodontics. We don't think necessarily that you have to hire the senior partner in the CPA firm, but somebody who understands your world, that's done tax work for them, understands how you're structured, and is trying to work with you to keep as much money from the taxman as possible. Ideally, somebody can meet face to face with.

An Insurance Advisor is needed from time to time. There are certain insurance products you must have as an orthodontist. And some are nice to have or you can have, and they're elective. We think you should investigate the whole cadre of insurance products. You need somebody smart who understands that what you're your income level is and what your risks are. Don't forget disability insurance - that's an important one. We get that call once a quarter of somebody that's having a problem that doesn't have disability insurance and sure wishes they did - so take a look at that one for sure.

An Attorney. You don't need an attorney in your life every year, but anytime you're signing a contract, we think it's great advice to have an attorney look at that for you. Certainly, when you're entering into a practice, when you're entering into a lease, when you're buying a piece of real estate, when you're bringing a partner in, or transitioning out of your practice, you need a good contract attorney - make sure you have one of those in your life.

A Local Banker/Lender. Most of you do your banking online. We understand that. But if you live in a suburban or rural area, it's sure nice to walk into the bank and know the President and who's working there in the bank. And you won't need a lender because you're going to borrow money for all kinds of things from time to time. Make sure you establish a relationship with somebody who understands your financial situation and can get you answers quickly on the lending side.

A Practice Consultant. I want to emphasize this one because so few of you use a practice consultant. The data over the last 35 years in my career has been very consistent in that only 20% of you will ever engage with a practice consultant. I find that surprising because as we value your businesses and your practices, we find that if you do use a practice consultant you almost always outperform those that do not on every operational and financial metric. They really do help. Do you have to have one every year; maybe not, but every two or three years, bring a practice consultant in. A checkup from the neck up is a good idea.

Where Wealth Managers are concerned, you're going to have the opportunity to accumulate a lot of wealth as an orthodontist. And orthodontists are renowned for making unwise decisions with that wealth. Find somebody who can keep you out of the ditch and helps you save and grow the money that you're going to earn.

A Transition Advisor. Certainly, you don't need one of those in your life all the time, but any time that you're going to enter into a practice, you're going to hire an associate that might lead a partnership, or that you're going to exit a practice, do not do a for-sale-by-owner. I'm not the only ones that do this - so call the AAO they can give you a list of transition advisors that you can choose and vet.

Social Media Marketing Partner. These days, if you're not good at this, you're not going to compete, you're not going to be relevant. You need somebody, even though you may be native and have grown up knowing how to do this yourself, it just gets to be too much. Find a good partner that can drive your social media and your marketing. You find so many of your new patients this way, and that will increase incrementally over time....

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Better Together (July 2024) - The reSource Minute

Bentson Copple Patterson & Associates July 25, 2024 2:56 pm

reSource Minute Videos

The reSource Minute - June 2024

Video Transcript:

Hi, this is Chris Benson, and it's time for another reSource Minute. Today's topic is The Gift of Time.

Specifically, I want to talk about time-saving in the digital practice versus the analog practice. When I say digital, I mean you're using either digital aligner treatment or digital braces treatment - both of those are proven to save time. We talked a lot about that, but I have some information that I saw from InsightZ who directionally are very accurate.

And I'm going to start with 100% analog practice, no digital at all in your practice. If this is you, you're not doing any aligners and you're not doing any digital braces - and 100% of your chair time, doctor time, and staff time is being used up.

As you move more into digital, you're told by me and others that you can save time - and most of you are at about 25% digital. That's the average in the country, and most of that is aligners, and some of that is digital braces. When you see the gauges move here, you'll see your total chair time is saved by about 10%, a little bit more in doctor time, and about 10% in staff time.

Some of your frustration of, "You told me to go digital, I went digital, but I feel like my overheads are going up", is because when you're at 25% digital and 75% analog, you can't really save any chair time, doctor time, or staff time that's meaningful.

As you go, however, up the digital scale and you become more digital at 50%, 75%, and ultimately 100% of your cases- which someday is where we're going to go, I think - watch what happens to each of these gages.

At 50% digital, you're really starting to save time. Over 22% in doctor time, about 1% in staff time, and about 18 % in chair time. So that's creating more opportunities for you to grow. Most of you don't have that problem right now, but we are going to start growing in '25, '26, and '27.

Look what happens at 75% digital practice, and look what happens at 100% digital practice compared to 100% analog. One doctor can do so much more. You can see so many more patients if you had them to see, or you can work less, open a satellite, or work on your practice to grow it, and you can do it with fewer staff.

I think this is the story of the future. This is an interesting way to look at it with regard to the time savings for chair time, doctor time, and staff time. The reSource Minute we thought you'd like to know.

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The Gift of Time (June 2024) - The reSource Minute

Bentson Copple Patterson & Associates June 28, 2024 1:46 pm

reSource Minute Videos

The reSource Minute - May 2024

Video Transcript:
Hi, this is Chris Benson, and it's time for another reSource minute. Today's topic is Perspective Informs Our Outlook.

What do I mean by that? One of the things I want to look at today is starts in orthodontics in the United States over the last 40 years. This is really interesting information, I think, for all of us to look at - it was put together by our friends at Orthodontic Partners with a number of resources cited.

What this shows is that from 1986 until last year (2023), you can see the number of starts that we've done per year in orthodontics in the US. You know, one of the headlines that might be over the last 40 years is "We treat double the number of people that we used to treat." The axis on the left is actually in millions; so, you get 1 million, 2 million, 3 million, and 4 million as you go up that chart. But you can also see a few trends here.

One thing I want to point out is that there have been three times in the last 40 years where we've had two down years in a row. We just finished that in '23, and we're in the midst almost halfway through '24.

How does this year pan out? I don't know, but if it ends up being slightly down from '23, it will be the first time in 40 years that we've had three down start years in a row in orthodontics. We've been talking a lot about it's hard to grow in this environment. The consumer is challenged and the economy is struggling.

I think after the election and some interest rate cuts from the Fed, things are going to get very good. And the historical information informs us that when the economy starts going again, this trend is not going to continue and we're in for what I think is going to be a pretty positive '25, '26, and '27. So good times ahead is one way to read this.

The other thing we've been talking a lot about is interest rates; so, if you overlay this chart with how the interest rates have gone for corporations over the last 40 years. What you can see is another trend - and that is this is the first time that we've had two down years in a row amidst rising interest rates. So, I think as interest rates go down, starts will go back up.

I think perspective is the right way to look at current events so we don't get overly concerned about "Is the sky falling?" It's not. Good times are ahead. I wanted to share this information with you.

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

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Perspective Informs Our Outlook (May 2024) - The reSource Minute

Bentson Copple Patterson & Associates May 28, 2024 1:54 pm

reSource Minute Videos

The reSource Minute - April 2024

Video Transcript:
Hello, this is Chris Benson, and it's time for another reSource Minute. Today's topic is Orthodontic Valuation Data Trends.

To look at that, we're going to look at the data from valuations that we did in 2023. A subset of that is on the screen in front of you 25 - we did about double that amount last year. Two things to point out in this subset of data - one is the overhead rate; I want you to notice that the variances practice-to-practice are large. And so here, when we just look at these 25, the low is 37, the high is 67, that's a 30-point variance. Overhead is super important because it dictates profit and value. When we look at value as a percentage of collections, we can see that the variance is almost double that, 62 percentage points.

And so, the takeaway here is if you’ve seen one practice, you've seen one practice. They're all different and that's why we do valuation studies when you want to sell one, when you want to buy one, and when you bring a partner in. Very important not to just use rules of thumb because somebody is going to get on the short end of the stick, usually, because there's so much difference practice-to-practice. So that's the takeaway from there.

If you want to just get a summary of what I just showed you, this is the average of the practices that came through Bentson Copple & Associates last year. You'll see on the far right that that average value as a percentage of collections was 83.5%, on just under $3 million in net collections.

A bit of information about multiple locations - because it's very much a myth, I think, in your minds. One is if you have multiple locations, indeed, you're probably going to collect more money. Our data shows that year-to-year. Because you collect more money, you're going to collect more income. And the big myth is that if I have more locations, it might be bigger, but my overhead will go up. And this data, again, last year, is consistent with what we've seen over the last 20 years, that your overhead will not go up materially.

In fact, three or more locations in this study show that the overhead is lower by 7%, as you add locations. How does that translate to value? More income means more profit, but you're actually being more efficient because you have the same number of days to do the same amount of work.

And so you'll see that on average, these bigger practices are getting 90% of the trailing 12 months of collection as a metric versus the 83 that we saw on average - it's very important information for you to know.

Lastly, just to sum things up on the numbers from last year on valuations, a bit of perspective. It's always good to take a step back and look at where were things 10 years ago and where are they today. And what we see is a trend, that I believe will continue, and I think it's driven by digital, and I've talked a lot about that. But what you see is if you look at the value before debt column here, practices are almost the size over the last 11 years. They're more profitable and they're valued higher. I really do think that's because you can see more patients in the same amount of time with fewer visits, and you can see them at an equivalent overhead. That's the story of the future. It's a bright one for orthodontics.

To finish up this reSource Minute, we wanted to invite you to see us in New Orleans. We're going to be at the AAO Annual Session, and there are a number of places where you can see us. You can see them listed there. I'm giving a presentation on Sunday afternoon. If you'd like to join me. And of course, we have a booth, Booth 1622, come by. We hope to see you there.

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

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Orthodontic Valuation Data Trends (April 2024) - The reSource Minute

Bentson Copple Patterson & Associates April 24, 2024 3:35 pm

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The reSource Minute - March 2024

Video Transcript:

Hi, this is Chris Benson, and it's time for another reSource Minute. Today's topic is, "Bye Bye, Referral Pads."

About 50 years ago, my mom took me to see my general dentist for a regular checkup, and he told her it was time for Chris to get braces. I don't know if he did a referral pad or a business card - but she told him to call Dr. Don Thompson in Overland Park, Kansas.


That's how it's worked for a long, long time. This idea, Bright Referral, brings that idea into the 21st century. You've seen some of these electronic business tap cards. That's essentially what this is. Instead of referral pads, you're going to supply your referring dentist with what's called a Bright card, with your information loaded on it.


The patient will use their Android or iPhone to scan the QR code. It's going to be loaded with your information. They enter a few things and information is automatically sent to you that you can act upon. Who wins? In this case - we think of three people.


First, the patients. It's so convenient. It sets you apart from just a business card or referral pad slip. The GP knows exactly who they've referred to you and you get immediate information that you can act on in different ways. The results are pretty astounding, early on in this endeavor.


This is written by an orthodontist, the company is. It's owned by an orthodontist. And 107 of your colleagues use this right now. What they're finding is they're getting more referrals.


The patient's feedback seems to be that they think it's hip, cool, different, and it's driving more referrals from the GPS than they've received in the past. So I think it's an idea that I would give a try. It's very inexpensive to try.


It's a time when we've gone in my lifetime from 80% of your referrals coming from directly from a GP to about 30%. It differentiates your practice as a higher-tech practice. And I think the patients and the consumer is going to accept this.


If you want to try the Bright card, you can look up their website or take a picture of this screen - the QR code is right there - to find out more information. I thought it was a great idea that we wanted to pass on.


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

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Bye, Bye Referral Pads (March 2024) - The reSource Minute

Bentson Copple Patterson & Associates March 28, 2024 9:01 pm

reSource Minute Videos

The reSource Minute - February 2024

Video Transcript:

This is Chris Bentson, and it's time for another reSource Minute. Today's topic, is orthodontic lab fees and profit.

I am asked all the time, "As we do more and more digital, that comes with lab fees, whether it's with aligners or digital braces, can I make more money?" I have some data that I think is going to be instructive on that topic.

What's happening all over the country now - digital aligners have been out for 25 years plus, digital braces have been out for really almost six or seven years plus, and we're beginning to gather a lot of data from a lot of practices from all over the country. As we aggregate that data, we can begin to build some models that show you, based on your practice type and I'll go through a few in a minute, what happens to your profitability as you go deeper into digital.

We put this all in a spreadsheet with a number of different models, and you'll see there are lots of numbers that we've analyzed. So we're taking a really deep dive.

What the data tells us is if you're a smaller practice, you do take a little bit of a hit in profitability for the first 18 months because you're finishing those analog cases as you're adding digital cases. But at month 18 or so, you break even to where you were prior, and you begin to make more and more money because you're more efficient, and you're basically trading staff dollars for lab dollars.

If you're a practice that says, “I just want to try digital, I just want to dabble in it a little bit” - and that's what most people do - you'll see that, yes, you do take a dip in your profitability, and the trough of that dip, it's usually where you go, is this worth it? But you can also see over time - Yes, it is worth it - you become more and more profitable. And that break-even point is about the 12th month. If you're a dabbler, as you get into it, I'll try digital deeper and deeper and deeper incrementally.

If you kind of go all in and you happen to have a practice that's growing at 5% plus, the graph looks pretty cool. This is that up-and-to-the-right kind of graph that everybody looks for, but you really don't take a hit in profit at all. It's kind of up and down for the first six months, but by the 8th month, you're profitable in making money.

So, I believe that digital is the way of the future. I believe the consumer wants it because. It's so convenient and efficient for them, and it's efficient for you, too.

What we'll see over time in the orthodontic space is that doctors, single doctors, will become larger. They'll be able to produce more, and won't have to take a ton of homework home. After they get the digital workflow down, they'll be more profitable and they'll be happier, I think, with the lifestyle that they've created.

So that's the story on digital. Here's some data behind it. That's the reSource Minute we thought you'd want to know.

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Orthodontic Lab Fees & Profit (February 2024) - The reSource Minute

Bentson Copple Patterson & Associates February 27, 2024 8:25 pm

reSource Minute Videos

The reSource Minute - January 2024

Video Transcript:
Hi, this is Chris Bentson, and it's time for another reSource Minute. We want to review the results of 2023 on three slides.

If you look at the Gaidge data that we use so frequently, you can see how we did in the fourth quarter, October, November, and December. You'll notice that December was exceptionally soft compared to December of 2022; however, if you look at the year-end data, January through December, we were essentially flat on production - that's good. We were slightly down on collections - not bad.

You collected about last year what you collected in 2022, and our starts were down by almost 2 1/2%. When I see this, I think the fee increases in 2023 that you implemented kind of saved the day. That's why you were flat.

If you didn't increase your fees, you were down further than this. If you want to look at it a different way, let's look at the OrthoFi data. They measure things a little bit differently. They call it Same Store Growth, think of that as a practice's growth compared to the prior year.

You can see the top column is month-to-month, the same soft December that we saw in the Gaidge data. But for the year their practices were -2%, and again, that's kind of what we saw. I want to draw your attention to the third line, which is case acceptance. And you'll see each month of the fourth quarter we were below 70% for the first time all year.

I think that tells us something about the softening of the consumer, and we're going to have to see how that drags into the early part of 2024. But I think the consumer is watching their wallet right now.

The last slide I want to show you compares our bumper year of 2021 to last year, and everything looks negative except for two things. A couple of comments - one is the average contract amount is up when you compare 2021 to 2023. Why is that? Because we suggested you increase your fees in '22. We hope you did. We suggested you increase them again in 2023. We hope you did. And I'm suggesting you increase them again in 2024.

Inflation is going to come in under 4% this year for last year. So anywhere between 3 1/2% and 4% is a good price increase. If you didn't increase your fees, then your average contract fee is flat to negative, probably, and that's important. The other thing that was up when you compare 2021 to 2022 is child starts.

Why would that be? If you go back eleven to twelve years and look at birth rates in 2011 and 2012, we birthed 4.3 million kids in the United States. And those were peak years compared to the prior decades. Last year and the year before, 3.6 million. So that's 700 fewer kids.

It's not going to happen all of a sudden, but incrementally, year-over-year going forward for the next decade, you're going to have fewer kids to enter into orthodontic treatment. That means your adult messaging has got to improve.

When you look at where we really got hurt last year - where was that? It was on the adult side; the far right column is aligner starts at -16% when you compare it to 2021. So, we know the adults have kind of disappeared. I think 2024 is going to kind of be a mirror image of 2023. Not great news, but not horrific.

Make sure and raise your fees. And then I think after the election, we'll get into above-average growth years of between four and five, organic growth for 2025, 2026, and 2027. Then we'll flatten out to around 3% again as we close out the decade. That's as far as I can see.

So some food for thought. That's the reSource minute, we thought you'd want to know.

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2023 Orthodontic Practice Financial Overview (January 2024) - The reSource Minute

Bentson Copple Patterson & Associates January 25, 2024 9:13 pm