reSource Minute Videos

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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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:
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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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The reSource Minute - October/November 2024

Video Transcript:
Hi, this is Chris Benson, and it's time for another reSource Minute. Today's topic - Customer Service Basics.

It's always great to review customer service, and who does that better than anybody else? Ritz-Carlton - at least they're known for it. I recently heard a speaker talk about their customer service and the three pillars of how they provide that.

It starts with a warm greeting using the guest's name. Make sure you're providing that for your patients when they enter the office.

It then moves on to anticipating and fulfilling each patient's need. That starts with seating them on time. And how do you anticipate and make them have a wow factor? Take great notes in your chart and hearken back to those notes when the patient sits down. "Hey, you had a cross-country meet coming up.” “We talked about homecoming was coming up.” “We talked about how your family was going to go on a vacation. How was that?" That really connects you with the patient.

When the appointment is done, make sure that you look them in the eye, have a fond farewell, and use their name again.

These are just some fundamentals that you can review with your team on how to provide great customer service at each appointment and interaction with your patients.

Another piece that I wanted to pass on surprised me — it was data from SmileDirectClub, which doesn't exist anymore, and we're all happy about that. But it was when patients called to schedule a new patient exam or an initial interaction with SmileDirectClub during lunch.

Right before filming this video, I tried to call and pay a bill. It was 12:30, and they said, “We'll be back at 1:00.” That's not great customer service. Make sure you're managing your phones at lunch and look to the far left early in the morning, too. Just make sure that if you're not answering your phones with an alternative service, or a third-party service at 5:00, 6:00, or 7:00 AM, that when you get in, you're returning those calls promptly- that's when people want to be seen.

Just some good basics around customer service. That's the reSource Minute. We thought you'd like to know.

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 - 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 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 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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00:00 Introduction
00:07 The Power of Innovation
00:33 Big dreams from our Childhood
00:45 A Historic Space Innovation
01:11 The Evolution of Transportation
01:45 Business Innovations in Orthodontics
02:17 Clinical Innovations in Orthodontics
02:34 Celebrating Innovation in Orthodontics and the Future
2:59 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 - 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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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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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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