Dr. Paul Etchison: Dental Heroes, taking your practice to the next level
Episode Description
In this episode of Simplify Dentistry, hosts Dr. Mustafa Shah-Khan and Dr. Richard Offutt welcome Dr. Paul Etchison—practicing dentist, author of Dental Practice Hero, and host of the Dental Practice Heroes podcast. Paul shares his journey of building a thriving multi-doctor practice, the systems that created freedom instead of chaos, and the leadership lessons that help dentists design practices that serve both their patients and their lives.
Episode Navigation
00:00 – Welcome and introduction
01:42 – Paul’s early journey and practice growth
05:10 – Why systems equal freedom in dentistry
09:15 – Building high-performing teams and accountability
14:20 – Leadership lessons from Dental Practice Hero
20:40 – Common mistakes dentists make when scaling
27:15 – Balancing growth with work-life freedom
33:50 – How simplicity drives long-term success
38:12 – Closing thoughts and where to connect
Key Takeaways
Leadership & Systems
Systems are the key to scaling without losing control
Leadership means creating clarity, not micromanaging
Accountability structures empower teams and reduce stress for owners
Practice Growth Insights
Growth should support your life—not consume it
Culture comes from clear expectations and consistent follow-through
Scaling requires simplicity: fewer moving parts, stronger systems
Featured Discussion Topics
Scaling dental practices with systems
Leadership strategies for owners
Team culture and accountability
Work-life balance in dentistry
Lessons from Dental Practice Hero
Meet Our Guest
Dr. Paul Etchison is a practicing dentist, podcast host, and author of Dental Practice Hero: From Ordinary Practice to Extraordinary Experience. He grew his practice into a multi-doctor group while maintaining work-life balance and now helps other dentists simplify their practices through leadership, systems, and mindset.
Connect With Simplify Dentistry
Website: simplifydds.com Podcast: Available on all major platforms
Topics: dental leadership, dental practice systems, practice growth, work-life balance, dental entrepreneurship, team culture, accountability, practice management
Transcript
00;00;01;25 – 00;00;16;00
Speaker 1
Welcome to the Simplify Dentistry Podcast. Join us as we discuss clinical, operational and financial aspects of your practice. Hope you enjoy life and dare to simplify dentistry.
00;00;16;02 – 00;00;40;00
Dr. Mustafa Shah-Khan
Welcome back to the Simplify Dentistry Podcast. I’m your host, Dr. Mustafa Shah-Khan, along with my co-host, Doctor Richard Offutt. We want to welcome today’s guest, Doctor Paul Etchison. Doctor Etchison is the author of two books on dental practice management. As a dental coach, owner of a large group practice in south suburbs of Chicago, and is the owner and operator of Dental Practice Heroes podcast.
00;00;40;02 – 00;01;05;25
Dr. Mustafa Shah-Khan
We’d like to thank our sponsor, Oral Arts. Dental laboratories. Oral Arts is a full service dental lab based in Huntsville, Alabama, serving dentists nationwide with high quality US made prosthetics and orthodontic appliances. Oral Arts combines advanced technology with personalized service to deliver reliable, affordable solutions that support patient care. Oral Arts is one of the few labs that meets the standards to be part of my team.
00;01;05;28 – 00;01;25;29
Dr. Mustafa Shah-Khan
Take a look at oral arts. Dental com. Welcome back to the Simplify Dentistry Podcast. Paul Etchison, thanks for joining us today. I just kind of wanted to mention a couple things. I’m, you know, the quote unquote wet fingered dentist. And, when you’re in the trenches all day, every day, you gotta kind of, mention the products that you use.
00;01;26;01 – 00;01;49;03
Dr. Mustafa Shah-Khan
We’ve got a few great sponsors that I use every day. All day long. Today I was using hand pieces. I think the NSK electric line is as good as anything there is using comet burrs. And, you know, I did a great case using, our, our friends at oral Arts lab. Where you going to get into some of these cases where you may not have all of the knowledge and some of them, some of their technicians.
00;01;49;03 – 00;02;04;23
Dr. Mustafa Shah-Khan
And Martin over there helped walk me through this case that I was able to have great success with today. So I wanted to kind of start with mentioning some of our sponsor sponsors and then kind of get into, kind of Paul’s journey, you know, tell us a little bit about you, where you came from and, and what’s going on.
00;02;04;27 – 00;02;05;09
Dr. Mustafa Shah-Khan
Yeah.
00;02;05;11 – 00;02;21;07
Dr. Paul Etchison
Well, thanks for having me on, guys. Happy to be here. You know, I, I grew up in the Chicago area. I ended up opening a practice very close to where I grew up. So I did not go very far. You know, I went to school, actually, about 45 minutes from where I grew up, you know, so every everything’s have been around Chicago.
00;02;21;07 – 00;02;41;12
Dr. Paul Etchison
But, you know, I, I had an associate for about two years, and I really loved the clinical dentistry, I loved learning, I love taking care. And then when I started taking these practice management seminars and I started seeing, oh, man, there’s better ways to do like the business, there’s better ways to present present cases, there’s better ways to, like, make patients feel appreciated.
00;02;41;14 – 00;03;05;22
Dr. Paul Etchison
And I really started pushing those at my associate ship. And it was just hard, like I couldn’t get any traction. That management really just didn’t care about it. And that was that kind of point where I was like, you know what? It’s time for me to open my own practice. So I started looking at acquisitions, didn’t really find much, and then one day just stumbled across a building that wasn’t too far from where I wanted to be, look like a great area.
00;03;05;22 – 00;03;25;20
Dr. Paul Etchison
I looked on Google Maps, I looked where the other dentists were in the town and just opened up. And you know, the rest is history. I mean, we grew. There’s a long story and that comes with that. But that was 2012. So that was about, two and a half years after I graduated, we opened our startup practice, and our main focus when we opened was like, let’s just take great care of people.
00;03;25;22 – 00;03;42;24
Dr. Paul Etchison
Let’s do a little bit extra because the bar is so low in dentistry. And I was an advertising major. And one of the things that always stuck in my head was like this Fifth Third Bank study where they they ran very customer service focused stuff in, in one area, and then they didn’t run it in the other area.
00;03;42;24 – 00;04;02;11
Dr. Paul Etchison
And then they, they surveyed customers in the one area. And those customers said that customer service was actually better. Now, they didn’t say, like, it’s because I saw the ad, but they could find there was a correlation, there was a difference. So there was part of me that said, man, you could really tell patients how you want to feel about your brand and you can really communicate your brand in a different way.
00;04;02;13 – 00;04;25;24
Dr. Paul Etchison
So every part of our process followed that line that how can we make every part as great a patient experience as possible and then following that as efficient as possible? So we really just kept tweaking things and tweaking things and we grew and it got really I mean, it was great. It was great problem to have. We grew fast, but it got pretty hectic and it got pretty I got burnt out.
00;04;25;24 – 00;04;43;27
Dr. Paul Etchison
I got pretty miserable for a point. And eventually that’s what caused me to get where I’m at today, where I’ve cut down my clinical days to nearly three days per month. And that was a process that took me five years. But that’s where I’m at now. That’s where I like being. And the other time I spend, I do my podcast.
00;04;43;27 – 00;04;51;04
Dr. Paul Etchison
I, coach clients and I manage my team too. So I’m still at the practice, but I’m not seeing patients.
00;04;51;07 – 00;04;58;05
Dr. Mustafa Shah-Khan
For three days per month. That’s fantastic. My wife already calls dentistry the greatest part time job. You really taking it another step? You know?
00;04;58;05 – 00;05;18;13
Dr. Richard Offutt
You know, you know, doctor and said something that that listening to you and reading your background and what you’ve all the same things you’ve done, you know, it, it it does take a, a very specific mindset. You have to have a mindset, that one your mindset was you were going to make it better. Right. And what what what steps is it going to take?
00;05;18;13 – 00;05;36;22
Dr. Richard Offutt
I mean, you know, you’re you’re a practitioner, you’re an author, you’re a coach. And and so talk a little bit to me about the mindset. What were you thinking when when when you or not not not not when you were burned out. I don’t want to know that. Yeah. Let’s skip that part. But what were you thinking when you said, I think I can make this better?
00;05;36;25 – 00;05;52;08
Dr. Paul Etchison
Well, I think when I was burnt out, I was thinking, what am I thinking? What was I thinking the whole time that got me here? But, you know, it’s it was one of those things that I think I’ve always had this attitude where I felt like I could do anything if I just had the right amount of experience and the right amount of training.
00;05;52;10 – 00;06;08;03
Dr. Paul Etchison
So it was one of those things. I was always very big on communication with my team. I was always like some people would say, like I was too friendly with my team. I mean, we we were very tight. We hung out on the weekends. We went out to eat and out for like happy hour after work quite often.
00;06;08;03 – 00;06;32;14
Dr. Paul Etchison
And we were just a really tight team. But what was really important to me, team wise is having that mindset that we are all equals here. And then also that I want this to be a safe place because if it’s not a safe place, I’m not going to hear about the things that go wrong. So I was always very critical of myself and that when things went wrong, or maybe I was asking feedback from a team member and they were being very honest with me.
00;06;32;16 – 00;06;54;05
Dr. Paul Etchison
I was always very just intentional that I didn’t want to get defensive. I didn’t want to make that person feel bad. I wanted them to feel validated and safe for bringing those things up, because I truly believe that if we would focus on every little thing that goes wrong at the practice, and these are just like day to day things, you know, you forget a lab case, you say something to a patient, they continue, they get confused.
00;06;54;05 – 00;07;15;14
Dr. Paul Etchison
You know, it’s not like horrible things happening like. But, we take those situations and we look at our team and we say, hey, guys, what happened? You know, and what can we do? So this never happens again. And we just continually refine our systems. And you know, that’s kind of where it took us to the next level where we kept growing and growing and growing.
00;07;15;17 – 00;07;35;14
Dr. Paul Etchison
But I think there was also another mind shift that happened later on in my career, when I started pulling myself out clinically and started spending less time at the practice, is I needed to get out of my own way. I needed to realize that I was bottlenecking. I had needed to realize that there are accomplished people on my team that can do the things that I was doing.
00;07;35;14 – 00;07;53;01
Dr. Paul Etchison
Now I’m saying like I was the cheerleader. I was appreciating everybody. I was leading the team. I was moderating discussions and encouraging communication with the team. But I didn’t really think anyone else could do that. I didn’t feel like anyone could manage my people as well as I could, and I had to change that mindset because that was when I was burnt out.
00;07;53;01 – 00;08;11;20
Dr. Paul Etchison
I just couldn’t do it anymore. I had 40 employees and it was just like, if each of them texted twice, you know, a week that’s 80 fires you got to put out, you know? So I had to sit there and say, you know what, I can’t do like this anymore. I really have to invest into my leaders who are my leaders here.
00;08;11;20 – 00;08;31;16
Dr. Paul Etchison
And what can I give them and what can I support them in? And also, when they screw up, support them and help them become better. So that I’m not the only one doing this leadership stuff. And it was that mindset that eventually got me the freedom that we have today, which is, you know, I’m using it doing other coaching and stuff like, but I do this with a lot of other dentists.
00;08;31;16 – 00;08;47;28
Dr. Paul Etchison
I teach them how to do this, and some of them open up other practices. Some of them just go golfing a whole bunch. Some of them spend time with their family. I’m one of those people I’ve always got to be do something. You know? So if I’m not opening more practices, at this point in my life, what I’m doing now is a lot having to do with my podcasting coaching.
00;08;48;00 – 00;09;14;05
Dr. Richard Offutt
You know, that’s a perfect segue into and what I like to talk about, and you brought it up perfectly is leadership. Now, what you’re describing is your leadership style. But you it’s changed. It’s morphed. It’s matured, if you will, to to where you first. Your leadership style, I guess, would have been all hands on. And then later it was like, there are a lot of good leaders that can do this in my on my team.
00;09;14;07 – 00;09;17;12
Dr. Richard Offutt
Talk a little bit about that. What was was that was that kind of a leap of faith?
00;09;17;15 – 00;09;33;15
Dr. Mustafa Shah-Khan
So, you know, with your thought be as far as developing your team and developing your practice and making it something that can grow and be more than you is empowering your team and empowering the people that you put in leadership positions. Is that the direction you take?
00;09;33;17 – 00;09;51;25
Dr. Paul Etchison
Yeah, I mean, absolutely. And my first step was I brought out an associate. I mean, we got to a point where we are doing roughly almost $2 million, and that was just with me four days a week. And this is 2014 ish. So I don’t know what I mean. It seems like it was long enough go where I should know, like adjusted for inflation nowadays.
00;09;51;25 – 00;10;11;07
Dr. Paul Etchison
But, you know, it’s I was at the point where I just, I needed a step back. So I stepped down to three days. I brought out an associate. And what was interesting is that fourth day, instead of like me seeing patients of the week, I started managing my team. And, you know, like you mentioned, my leadership style did change in my first leadership style was it’s my practice.
00;10;11;07 – 00;10;29;06
Dr. Paul Etchison
And I said, so, you know, I’m the boss here. I call the shots and you know, you don’t get very far with that. You realize there’s a lot of health politics with with management and, you know, the office and coming up with, you know, trying to get behavior the way that you want. I mean, you can’t just scream.
00;10;29;06 – 00;11;00;11
Dr. Paul Etchison
You can’t lead by intimidation. So I think at the beginning of my career, I was very just maybe an intimidator, you know, and I learned the hard way that that doesn’t work and eventually became more a better communicator, better in understanding empathetic listening in really trying to see my team’s perspectives. You know, one thing that really helped me is my wife is a hygienist, and she was a hygienist when I was in dental school, and she worked for this dentist that worked three days a week and usually took the fourth week every month off.
00;11;00;13 – 00;11;17;29
Dr. Paul Etchison
Now, I was in dental school. She was the only income. It was really hard for us when the her boss would go on vacation for a week, and my wife couldn’t go to work, so I got to see that perspective. But then now that I. So I’ve seen a lot of things from like the employee’s perspective. But now that I’m an owner, I see that owner’s perspective to.
00;11;18;02 – 00;11;35;01
Dr. Paul Etchison
So I think I’ve taken that experience and said, man, no matter what happens here, there’s always going to be two perspectives. And no matter what I do, I’ve got to have that safety. You know, the psychological safety, I mean, just not, getting defensive with people, but also I need to validate the other people’s, their experience as well.
00;11;35;01 – 00;11;51;07
Dr. Paul Etchison
And I think that’s where we really screw up a lot with leadership is we get into these things of, I’m right and you’re wrong. You know, that’s not what happened. I didn’t do that. No, you’re interpreting it wrong. And I think it’s just so much more productive. If we said, you know what I hear where you’re coming from, I hear why you might.
00;11;51;13 – 00;12;13;25
Dr. Paul Etchison
Why you feel that way. These were my true intentions. This was my true motivation for doing that. And I’m sorry that it got interpreted the way it did. But you know, this is what I want. This is what I meant. And how can we move forward instead of just, no, you’re wrong, I’m right. And the fact of the matter is that if you could tell somebody you’re right over and over again, they’re eventually say, okay, whatever, you’re right, but they’re going home and they’re not thinking you were right.
00;12;13;27 – 00;12;30;20
Dr. Paul Etchison
They’re just thinking they hate your guts. So, realize that it being right or I’m throwing up the air quotes here. Being right is a lot more important to my team than it is to me, and I think it should be like that for most out of leaders. I think we could solve ourselves a lot of headaches if we took that principle on and internalize that.
00;12;30;21 – 00;12;58;13
Dr. Richard Offutt
The point you made on giving, giving the person you’re talking with a place to stand in the conversation is really important. I had a good friend who was a, dental consultant coach, and he he would he would talk about that all the time by giving, giving, whoever you’re discussing, whether it be at a patient in a case presentation or an employee, whatever, but give them a place, a place to stand, where they then feel that they’re being heard.
00;12;58;16 – 00;13;00;05
Dr. Richard Offutt
I guess very important.
00;13;00;07 – 00;13;25;15
Dr. Mustafa Shah-Khan
I oh, one thing I wanted to talk to you a little bit about is, where are you getting that? You know, dental practice heroes. Is your your website, your coaching, your consulting, your podcast. When I was looking at that and reading about, you know, what is podcast and all about, one thing I kept saying was, take a practice from 2 to 6 million, with associates, work less and make more.
00;13;25;17 – 00;13;31;06
Dr. Mustafa Shah-Khan
I think that resonates with every dentist that’s in the game. Talk a little bit about that. Yeah.
00;13;31;06 – 00;13;47;11
Dr. Paul Etchison
I think I’ve always just. And this could have just been my experience that I was just running so fast. You know, I, I was I think I’m on the faster end of a clinician. I don’t think I’m sloppy. I don’t think I’m cavalier by any means. But, you know, I always ran fast and I always said, how can I make this more efficient?
00;13;47;13 – 00;14;07;20
Dr. Paul Etchison
And it got to the point where I was like, man, can I make this more efficient? Can I do in three days what I was doing in four? And what can I do next to do in two days in, you know, what I was doing in three before? And there was a certain point this it just happened is like you get we had the first associate, we had the second associate.
00;14;07;22 – 00;14;32;01
Dr. Paul Etchison
And I think I like produce maybe like $800,000 a year, something like that. And I looked at, okay, for $800,000 and 30% production. If I paid myself as an associate, what percentage of my income was for doing dentistry, and what percentage of my income was for managing and owning this practice and running? Running this team and my production as being an associate was like 17% of what I was making every year.
00;14;32;03 – 00;14;51;12
Dr. Paul Etchison
Yeah, I was spending about 95% of my time at the practice, still seeing patients. So what happens is how you can get to 2 to 6 million is you’ve got to start scaling. You know, you’ve got to pull yourself back. Now, you can still practice four days a week. I can go back to practicing four days a week at my practice right now.
00;14;51;18 – 00;15;13;21
Dr. Paul Etchison
And that’s because of the way it runs. But I can tell you, I couldn’t stay practicing four days a week and ever got it to this point because it requires a leader to kind of put these systems together and somebody just get this team, you know, just to show them where we’re going. So as far as like scaling for practice owners, I really think it’s hard to do four days clinical.
00;15;13;21 – 00;15;31;23
Dr. Paul Etchison
I mean, it’s it hurts our bodies. It hurts our minds. And I think one of the things that hurts about dentistry is that it’s somewhat unpredictable. You know, you can do everything perfect and the patient can still have a negative outcome. And that can be frustrating for a lot of dentist. And I think it’s important that we we have a good home life.
00;15;31;23 – 00;15;48;27
Dr. Paul Etchison
I mean, we’re very blessed in this profession. There is no reason why we should be miserable. And I spent a lot of my years in my career being miserable, but I it had to do a lot of internal work to figure out how to get out of that. But if if we practice too much, you know, we’re just burning the candle at both ends, that’s not a good way to live.
00;15;49;00 – 00;16;12;27
Dr. Paul Etchison
And there are ways to back yourself out, find a nice level of clinical, work that is comfortable for you and still, you know, enough time to run your practice. And I would just say I just one last thing is that in my I keep talking about when I was miserable, a lot of it was just overwhelm, you know, and what I’ve noticed about in my career is when I have been the most stressed out in the most overwhelmed.
00;16;13;04 – 00;16;29;20
Dr. Paul Etchison
It was when I had things with my team I really wanted to work on. I wanted to talk to this person. I want to solve this conflict between these two people, or I wanted to train my team on, how to answer the phone a certain way. And I couldn’t get to it because I kept seeing patients. And then I would book a five hour gap.
00;16;29;20 – 00;16;46;04
Dr. Paul Etchison
Okay, okay. Cause my admin day now, I won’t see patients and somebody knock on my office door. Hey, this person’s on the phone. Can they want to come in and see you or. Hey, this patient’s here. They don’t want the other doctor to do their hygiene check. They really love you. They’ve been coming here since you opened up, and you’re a nice person.
00;16;46;04 – 00;16;58;16
Dr. Paul Etchison
So you see how. See that person? You now see that person. And I kept getting sucked back into the clinical. And that was what was overwhelming to me, is there are so many other things piling up that I knew I should be doing that I needed to do for the business that just couldn’t get to it.
00;16;58;18 – 00;17;16;28
Dr. Richard Offutt
You know, when you were doing the scale, when you were scaling the practice and adding associates, did you did you did you have anybody helping you, mentoring you or kind of coaching you? You know, I always say everybody needs a coach. You know, you’re playing golf. We probably all need a coach. If you’re playing whatever, everybody needs a coach.
00;17;16;28 – 00;17;18;01
Dr. Mustafa Shah-Khan
Tiger woods has a swing okay.
00;17;18;01 – 00;17;22;15
Dr. Richard Offutt
Yeah. You did you did you have a swing coach to help you help you scale your business?
00;17;22;21 – 00;17;40;20
Dr. Paul Etchison
Yeah I you know, I had I had worked with three different consultants over my career and and I never worked very long with them. I think what I really appreciated working with consultants is getting an outside opinion and like a game plan, but I was I always was pretty comfortable with implementation. I could take it through. I just needed to get some solutions.
00;17;40;20 – 00;17;55;18
Dr. Paul Etchison
You know, someone to talk with, some solutions with me. And I think it’s one of the things they say. It’s hard to read the label of the bottle when you’re inside the prescription. I mean, you can’t when you’re in it. So sometimes I would tell people, well, what did you do with that? They’d ask, what did that cancer or what did that, consultant do for you?
00;17;55;21 – 00;18;11;29
Dr. Paul Etchison
And I tell them, they said, you need to pay somebody that much money to tell you that that’s what you needed to do. So I tell you, I did. I absolutely did. I had some mentors as well. I had a few people that were a little bit ahead of me that I could lean on. I could call, get some help when I needed it.
00;18;11;29 – 00;18;33;22
Dr. Paul Etchison
But, you know, when my practice got a certain size, it became hard, you know, to find, like, hey, how do you handle all these phone calls coming in when everyone I talk to has got, you know, 2 to 4 people working at the front desk, and I’ve got ten, you know, like, it’s just an insane amount of phone calls coming in and you try to, like, compartmentalize your front desk team.
00;18;33;22 – 00;18;49;07
Dr. Paul Etchison
And sometimes you just there was times where I felt like I had nobody to turn to, and we just figured a lot of things out on my own. But I don’t want to say that I created it. I didn’t I did not reinvent the wheel. I did have people to help and lean on, but there was always part of me that felt guilty taking too much time.
00;18;49;07 – 00;18;56;22
Dr. Paul Etchison
And then there’s part of me that was just like, this is under control. I got this. And and just being young and naive and not knowing what I didn’t know.
00;18;56;24 – 00;19;17;16
Dr. Mustafa Shah-Khan
You know, it was one thing that we talked about and doctor off and I’ve talked about it, we’ve talked about it with Paul Goodman. Everybody talks about when you do make that decision to go from 4 to 3 and you bring the associate on, you know, essentially you are cannibalizing yourself to a certain extent and and they all say that everybody takes a pay cut when they take the associate in.
00;19;17;16 – 00;19;22;13
Dr. Mustafa Shah-Khan
At first, you know, you talked about going from 2 to 6. Talk about how those two merge.
00;19;22;16 – 00;19;43;10
Dr. Paul Etchison
Yeah. So when I first brought in associate, I went from four days a week to three days, and this associate came on three days. The associate eventually came on the other two days that she was full time. Five days a week when I was three, maybe like 5 or 6 months later. But I was completely I was happy, you know, taking home 50% as much money as I did the previous year.
00;19;43;12 – 00;19;53;06
Dr. Paul Etchison
I mean, that’s how much at that time I just wanted time and just peace and room to breathe. I was just seeing so many patients. And so, but you know what I need to kind of.
00;19;53;06 – 00;19;55;22
Dr. Mustafa Shah-Khan
Talk about as the ripple effect?
00;19;55;25 – 00;20;15;22
Dr. Paul Etchison
Yeah. I mean, it’s one of those things, it’s. Well, it everything ripples. I mean, it ripples through to your home life. It ripple through to your families, through your spouse. I mean, everything is all connected. And, you know, we we hear these people that we gotta have work life balance. I’d rather I’ve tried to balance a little bit of this, a little bit of that, but it didn’t really feel good until I was.
00;20;15;24 – 00;20;36;17
Dr. Paul Etchison
I had them kind of working together, you know, everything working as one. But, you know, back to your question. It was one of those things that I ended up making more money that year. And what I think is when I’ll practice will get about one and a half to 2 million, and then you add another associate, as long as you can get that associates somewhat productive.
00;20;36;17 – 00;20;55;27
Dr. Paul Etchison
And and what I teach is $600 per hour in collectible dollars. That’s what I want every one of my associates to do. Bare minimum. I don’t want them to do any less than that. And and I found that’s a predictable number with the systems. But you get to a point where your fixed expenses get so less that. I mean, there was times I was like, man, what what do I make here?
00;20;56;00 – 00;21;16;10
Dr. Paul Etchison
I think I’m taking home 37% of every dollar, or maybe I’m taking home 120% of every dollar I produce personally. Like it just on how you looked at it. But we found a sweet spot with the overhead and that was about me with one associate. Now, when I had the second associate, you know, the overhead got higher, but I made more because it was a bigger piece.
00;21;16;10 – 00;21;33;06
Dr. Paul Etchison
You know, I made less of a bigger piece, which was more in the third associates. Same thing happened, brought on some specialists. Every time I brought somebody on, the overhead has increased. And I think when you have a larger practice, like I have, I have three full time doctors. That’s not including myself. And I have two specialists and we’ve had three specialists.
00;21;33;06 – 00;21;51;16
Dr. Paul Etchison
We had two. We have two right now. You have to become very admin heavy because you need to be able to handle all those phone calls, and there’s a lot to do. So, I think a payroll gets a little bit larger, but it’s one of those things if we can put the systems in place, we have the leadership systems in place and we can trust our team, man.
00;21;51;16 – 00;21;56;15
Dr. Paul Etchison
I mean, it’s it’s not unmanageable. It’s unmanageable if you’re doing it by yourself, though, you need to have a team.
00;21;56;17 – 00;22;20;24
Dr. Richard Offutt
You know, Paul, I one of the things that that I talk a lot about is, is, especially in the, DSO era is the dentists need to focus on building a sustainable business. A, a practice that is profitable on its own, not where you’re trying to sell it to the next DSO or what have you, but a sustainable, long, long haul business.
00;22;20;27 – 00;22;45;17
Dr. Richard Offutt
Well, and which is exactly what you have done. And it’s not now. It supports your life however you want it to. But what’s critically important to that are systems, putting in place, you know, you can’t do a 6 or $8 million practice and be a you and granny working off a spreadsheet. It just doesn’t work. So talk a little bit about system implementation.
00;22;45;17 – 00;22;52;14
Dr. Richard Offutt
And you specifically have mentioned a couple scheduling leadership and and money systems. If you could talk about that a little bit, that’d be great.
00;22;52;16 – 00;23;09;08
Dr. Paul Etchison
Well, you know, it’s like what is the best way to do every element of the practice? I mean, when we think about what does a patient do when they move through our practice, they come in, we answer the phone, we give them appointment, we check on their insurance, they come in with, they experience our services, such as, you know, the exam and the patient experience.
00;23;09;11 – 00;23;29;11
Dr. Paul Etchison
And then we present treatment. We take a payment, we do the treatment we collect on it, and then we send it back through the recall system. So, every part of that whole journey can we improve upon and say, what is the way that we do this part? You know, for instance, I would say collections, see this in a lot of my clients practices.
00;23;29;11 – 00;23;48;29
Dr. Paul Etchison
Oh, my gosh, my front desk wants more people. They need more people. They’re overwhelmed. They’re this and that. And what they’re doing is they’re collecting on their patients the after they do the procedure and sometimes they do and sometimes they don’t, and sometimes they have to get the EOB in order the chart and they send a statement and then they have to call on it.
00;23;48;29 – 00;24;07;15
Dr. Paul Etchison
And then the patient, like, comes and says, well, what do I owe money for? Now we got to look it up. And then you look at this whole transit action, and we spend maybe 60 to 90 minutes with one transaction with one patient, when we could have simply said, this is what you owe. Do you want to schedule that treatment today?
00;24;07;15 – 00;24;27;27
Dr. Paul Etchison
And they said, yes, this is what you owe to schedule the treatment. Now the payments. And for now, when they come back, they’re they’re not asking more questions about what is my insurance coverage. Everything is done, the payment is taken, and you’ve taken that 90 minute just extravaganza and turned it into a two minute conversation of, this is what you owe, and this is what we require for you to schedule with us.
00;24;28;03 – 00;24;51;18
Dr. Paul Etchison
Now you’ve got pre collected. Now they’re going to show up. So your your your cancellation rate lowers. So it’s little things like that. You know we it’s one of the most unfortunate things collection systems is when I see this in so many practices. We’ve done everything we’ve done we’ve got we acquired the patient. We treated them. We did everything except get paid and it’s so common.
00;24;51;20 – 00;25;12;19
Dr. Paul Etchison
So like one thing that I say and I say a whole bunch of things that my team probably makes fun of me behind my back because I say it so much, but I say the payments not in the BRS, not spend. You know, the payments on in the browser not going to spend. We do not spend that. Bur unless the patient portion is in, and it has been a number of times that the patient does not have it and the best magic trick in the world, you say, okay, we got to reschedule that.
00;25;12;19 – 00;25;33;23
Dr. Paul Etchison
That just credit card just appears every time. So, it’s all in the way that you train your front end team to present these things with confidence. And it’s not harsh. It’s not? No, we’re not doing it unless you pay us. It’s it’s polite, it’s kind. It’s it’s this is the reason we do this is because we we want to get the money stuff out of the way before the day of the procedure.
00;25;33;23 – 00;25;49;23
Dr. Paul Etchison
Because if we don’t get that stuff out of the way, we might have to do insurance stuff and go over a treatment plan. Now, we might get you seated late. Now you might throw our whole day off. So in order to stay on time for all of our patients, we require the payment before we schedule it. That’s it.
00;25;49;28 – 00;25;50;25
Dr. Paul Etchison
You know, it’s it’s it’s what.
00;25;51;01 – 00;26;12;10
Dr. Mustafa Shah-Khan
You said that, you know, Doctor Offit used to always say, you know, he’s periodontist. Everybody paid whatever they’re going to pay before anybody went back. And if there was a change in the procedure, well, that’s, that’s what happens. But you know, they’re going to pay whatever before they get back. I had to get rid of a front desk person the other day, and, my college daughter has been in my office.
00;26;12;12 – 00;26;29;04
Dr. Mustafa Shah-Khan
The for the past couple of weeks. And it’s interesting because it’s really, you know, she’s 20 and it’s black and white to her. She’s like, patient owes 1200 bucks. Patient walks up and is like, your balance is 1200 bucks. And she comes to me. She is dad. She goes, some of these people are telling me that they’re not going to pay right now.
00;26;29;04 – 00;26;49;07
Dr. Mustafa Shah-Khan
They want to invoice some things like that. And she goes, how how do you succeed if they don’t pay you? And and it made me really look at it. And I was like, you know, I have a pretty successful practice, but think of what your R could be if you just adhered to the philosophy of a 20 year old, you know, and it just makes perfect sense to put.
00;26;49;08 – 00;27;01;18
Dr. Richard Offutt
Her on a percentage. And she’ll collect every dollar. You put her on, put a, put a nut on that thing and say, okay, you know, you get you get up one and a half, one and a half on everything you collect.
00;27;01;18 – 00;27;04;04
Dr. Mustafa Shah-Khan
That’s right. She’s cheap as hell, too.
00;27;04;07 – 00;27;19;09
Dr. Paul Etchison
You know, what’s funny is I remember when we we used to collect at the day of the procedure before the patient went back. And then we went to collecting to schedule the appointment. And when we made that switch, like, my front desk gave me a whole bunch of just, like, just they had just a lot of push back on it.
00;27;19;12 – 00;27;31;02
Dr. Paul Etchison
And I remember one of them said, well, what are we supposed to say when they say, no, I’ll pay. Can I pay on the day of the procedure? And I’m like, well, say it to me. And she goes, I’m sure. Like what? Like role play? And she goes, well, what I want, can I pay in the day of procedure?
00;27;31;05 – 00;27;46;28
Dr. Paul Etchison
I just looked and I said, no, we don’t do it like that. That’s all you got to say, you know? But you know, and then some people say, hey, if you if you can’t do it now, just call us when you’re ready. We’re happy to accommodate you. This is our policy. It’s when we it’s when we start explaining ourselves.
00;27;46;28 – 00;28;04;00
Dr. Paul Etchison
It’s it’s one of those things with tone, man. We went out of network with Delta. And these are the things you can’t read this you this is you can’t just you can’t just magically make this work. This is another system. We went out of network with Delta and we could not, for the life of us, get an out of network Delta patient to come to our office.
00;28;04;00 – 00;28;18;29
Dr. Paul Etchison
As a new patient. We saved a whole bunch of them, but we couldn’t get a new patient. So I listened to the new patient call. And this is what we say when somebody calls maybe Cigna. They say, hey, do you take my insurance? Yeah. What is it? Cigna yeah we are. We’re a network provider. Are you looking to be a new patient?
00;28;19;00 – 00;28;41;21
Dr. Paul Etchison
Are you looking for a new dentist? We’re all excited. Woo it’s it’s we’re happy. And then when somebody calls and says hey do you take Delta. We go we do. However we are an out of network provider. And then it’s just silence. And then there’s silence on the phone. The patient goes, okay, okay, thanks. Bye. And all we had to do was say, we do accept that.
00;28;41;21 – 00;28;59;20
Dr. Paul Etchison
However, we’re not a network provider. But if you do have a PPO, you do still get benefits here. Would you like me to check on those to see what they are? That’s all we did. And it changed everything with our new patient Delta patients. And it required me to really listen to phone calls, sit down with the front desk team.
00;28;59;22 – 00;29;28;18
Dr. Paul Etchison
And it sounds so simple, but it was one of the most challenging things I probably have ever done in my career is convince, my the culture at my front desk that we weren’t being deceptive by doing that. And, but yeah, it’s just one of those things. It’s there’s all these little things we can do. So what I’m coming back to is saying that your front desk, these policies, these things that your patients might find unpopular, they are not unpopular if the front desk knows how to present it confidently and kindly.
00;29;28;23 – 00;29;29;25
Dr. Paul Etchison
That’s what I’m saying.
00;29;29;27 – 00;29;48;08
Dr. Mustafa Shah-Khan
So, support. One thing. We talk a lot about it. Simplified dentistry is, the five year tenure, 20 year doc, you know, and what what advice do you have for the five year tenure 20 or doc? Why don’t you let us know what what is your advice to the doc who’s been out five years was advice for the doc is about ten years.
00;29;48;08 – 00;29;51;03
Dr. Mustafa Shah-Khan
And most advice for the doc has been out 20 years.
00;29;51;05 – 00;30;06;19
Dr. Paul Etchison
Well, I’d say five years. You should have a pretty good idea where you want to be, you know? Do I want to own a practice or am I just cool, be an associate? Because ownership is not for everybody. You know, there’s there’s a lot of parts. There are times where I wish I wasn’t associated, you know, that. But, you know, I love the ownership.
00;30;06;19 – 00;30;21;14
Dr. Paul Etchison
I love the management more than I think. I love the clinical dentistry. At this point in my career, it wasn’t like that when I first got out of school. But I think your first five years is about, you know, getting your feet set somewhere. And I’m going to talk specifically about practice ownership because, yes, that’s just the way I’m going.
00;30;21;14 – 00;30;41;10
Dr. Paul Etchison
Just entrepreneurial. So five years, you know, you get your practice going, you’re getting to your first capacity point, which is about 1.5 to $2 million. You need to get your systems in order. You got to get everything so that it’s fast, it’s efficient, and you can get to that 1.5 to 2 million. And then the next stage is, you know, this is maybe when you get to like closer to ten years.
00;30;41;12 – 00;31;02;03
Dr. Paul Etchison
Well, I mean, this is between 5 and 10 is bring you on that associate. I wanted to retire and get financially free before I was 40. So I ran my ass off. I grinded and there was one point where I think I was saving 70% of my income so I could get to this, this number of savings and assets and stuff.
00;31;02;05 – 00;31;24;28
Dr. Paul Etchison
And I got there at 39, like right before my 40th birthday, and it felt empty as hell. And what I realized was, okay, well, now I don’t really have to practice or work anymore, but I want to. So how much different could my life have been if I said, well, instead of getting financial freedom at 40, I get it at 60 or 70, how much less could I even made?
00;31;24;28 – 00;31;42;13
Dr. Paul Etchison
Or how much more could have? I have spent on experiences of my family and how much like, you know, calmer could buy my life than if I wasn’t grinding so hard to rat race to that number that literally didn’t absolutely nothing for me. Emotionally. It was empty as hell feeling. It was like the last box. It’s box to check.
00;31;42;18 – 00;31;59;19
Dr. Paul Etchison
And you said, crap. I still feel like something’s missing. What? What are we going to do now? So I would say that’s the wrong way to do it. So if you I would say my advice for everybody is you will continue to work until you don’t want to anymore, until you can’t anymore. You will be doing something and I was of the mind.
00;31;59;26 – 00;32;14;06
Dr. Paul Etchison
Everybody says that you will watch me sit on my ass all day. I’ll sit on my ass. I’ll watch TV all day. I couldn’t do it. I don’t know anyone that has. I know a number of dentists that have reached financial freedom, in their 40s. And they’re all doing the same thing. They’re all still working in dentistry.
00;32;14;12 – 00;32;29;09
Dr. Paul Etchison
They’re all still practicing. Because the fact of the matter is, is you’ve got to do something and dentistry should not be so horrible that you want to run away from it. You can make it really nice, but you got to put the time in and you got to take your foot off the gas sometimes. And I think that’s where we get screwed up.
00;32;29;09 – 00;32;33;23
Dr. Paul Etchison
We’re just running. Running, running more and more. More. I would say so, yeah.
00;32;33;29 – 00;32;58;01
Dr. Mustafa Shah-Khan
The son is an author, is a coach, podcast host, part time clinician. You know, talk to me a little bit about him. You’re saying that at the ten year level, you have to have your systems in place and you have to have your practice running. As a coach, I’m sure you get into practices where they don’t have that going and you have to help guide them.
00;32;58;07 – 00;33;21;22
Dr. Mustafa Shah-Khan
But, you know, and then I look at where I am, I’m 24 years into the game or whatever it is. Sometimes I feel like I’ve gotten complacent. And my systems aren’t updated. And they were the way they, they were, do you walk in offices? Where is a 20 year doc? And, yeah, you’re like, you know, you got to get your systems in order, and this is how you have to do it because you’ve gotten stuck.
00;33;21;25 – 00;33;39;05
Dr. Paul Etchison
Well, I think it matters to what is what is the doctor? What if the doctors complacent? That’s that’s fine, I am I am not one that says, I know. You know, I said a few times that you got to get it efficient. But the fact of the matter is, if you’re happy and you’re comfortable and you like your level of practice, rock and roll, more power to you, you know?
00;33;39;05 – 00;33;57;24
Dr. Paul Etchison
But if you if you’re reaching out and you’re going to say, hey, I want to practice two days a week and I and I want to make $1 million a year, you can’t book two hours for a simple extraction. It just doesn’t work. You know, you you got to do things a certain way. So that’s when you need those systems.
00;33;57;24 – 00;34;00;25
Dr. Paul Etchison
So I think it just comes down to like, what do you want? If so, what.
00;34;00;25 – 00;34;05;28
Dr. Mustafa Shah-Khan
Does a typical person come to dental practice? Here’s one. When does somebody seek out, Paul Atcheson.
00;34;05;28 – 00;34;25;18
Dr. Paul Etchison
You know, it’s typically I say most of the people I’m working with either are at that point where they’re between 1 million and 1.5 million, and they’re ready to cut down a day and and associate in a number of my clients are ones that already have an associate or two, and they’re just looking to refine their systems and, and kind of create that leadership team to take off the management from them.
00;34;25;20 – 00;34;47;19
Dr. Paul Etchison
So, but you know, what’s interesting is most of the people that reach out to me, it’s doesn’t really have so much to do with the practice cycle as it does with the family. It’s always like, I’ve got I just had my first child. I just had my second child, my wife’s pregnant. Or it’s or it’s a female who’s like, you know, I have 2 or 3 kids and I want to be home with them more than I am right now.
00;34;47;22 – 00;35;08;17
Dr. Paul Etchison
And thinking to want someone I worked with at Kentucky recently. Her name is Alex, and she’s working 4 or 5 days a week, and she’s got two kids at home. We got her down to three days and did not take a single dip in income, and we did it in like six and a half months. I mean, it didn’t take long to make that transition, but, it’s anybody who wants to spend more time doing other things and who wouldn’t want that?
00;35;08;20 – 00;35;26;13
Dr. Paul Etchison
Unless you truly love being at your practice and, you know, shooting it with your patience, I, I found that was fairly exhausting for me. You know, I’m somewhat of an introvert, and for me to put on that happy face for every single patient and for me to run to where I was seeing 40, 40 patients every day.
00;35;26;15 – 00;35;29;02
Dr. Richard Offutt
Freaking exhausting. Really? Yeah. I mean, you.
00;35;29;02 – 00;35;30;18
Dr. Paul Etchison
See my smile and you walk out and.
00;35;30;18 – 00;35;34;19
Dr. Richard Offutt
The wife looks at you and says, man, you look beaten. And you go, I am. Yeah.
00;35;34;22 – 00;35;48;20
Dr. Paul Etchison
I was the martyr. I was like, I work so hard, I would I’d see her. You know, she is a stay at home mom and she’s such a good mom. And she, she works so hard for the kids, and. But it was one of those things, man. When when I would go to work early in the morning and she was still in bed, I would just.
00;35;48;25 – 00;35;57;25
Dr. Paul Etchison
I would martyr. Man, my life is so hard. Oh, gosh, I got to go here and do that with the, with the, with all these patients. But that was more of a me issue than her issue. Yeah.
00;35;58;01 – 00;36;14;11
Dr. Mustafa Shah-Khan
So yeah, one thing that we’re, we’re talking a lot about is, you know, the dental entrepreneur, you know, and if you want to be the entrepreneur, you want to get out from, you know, behind get out from the operatory. What’s your advice for docs who are trying to, you know, get out from the operatory?
00;36;14;11 – 00;36;34;20
Dr. Mustafa Shah-Khan
Is it something where they’re expanding their practice and having more associates? Or what about just getting out of clinical practice altogether and doing other things like, you know, you are an author, you, you do have a podcast, you have other things. What’s your advice on on putting systems in place to become a dental entrepreneur?
00;36;34;23 – 00;36;48;22
Dr. Paul Etchison
You know, I think the thing is, is like I still say like, you just got to get it to a point where you’ve got that freedom that systems when you put the systems in there and you get it. So it’s a comfortable level, you’ll decide, do you want to keep this practice or do you want to do something else.
00;36;48;25 – 00;36;59;14
Dr. Richard Offutt
So so you’ve done a lot of things. You know you you’ve built a great practice. You you you’ve you’ve coached you, you know, you’ve written books. What’s next in your life? What’s next for for Doctor Edgerton?
00;36;59;19 – 00;37;17;13
Dr. Paul Etchison
Guys, you know, my big thing right now is just my coaching program, you know, starting to mastermind. I love creating videos. I love creating training materials. I love working with doctors. I love taking docs from 4 or 5 days a week down to 2 or 3 days, because I see what it does for their lives and their quality of living.
00;37;17;19 – 00;37;28;11
Dr. Paul Etchison
So right now that’s the focus. And knowing me, I’ll probably be bored with it in a few years. And the new focus will just it’ll appear and we’ll figure it.
00;37;28;11 – 00;37;29;13
Dr. Richard Offutt
Out when we go, you know.
00;37;29;13 – 00;37;47;04
Dr. Paul Etchison
We’ll figure it out when we get there. That’s why I said I don’t I can’t begin with the end in mind. I’m just doing now. And I could say I’ve probably been doing this for at least two more years, but who the heck knows? I mean, there’s there’s you know what I just did, this is a great story is I just I applied for a job at a haunted house for the season.
00;37;47;06 – 00;37;58;03
Dr. Paul Etchison
So I was just like, I kind of want to just, like, hide behind a door and just scare people. I don’t know, it just sounds like fun. So I’m going to give that a shot. But that’s that’s going to be a seasonal job, maybe six weeks or something like that.
00;37;58;05 – 00;38;05;05
Dr. Mustafa Shah-Khan
This October hopefully for listeners, you know, kind of what’s your advice on how to simplify dentistry for them?
00;38;05;08 – 00;38;21;25
Dr. Paul Etchison
Yeah, I think it’s one of those things is it nobody thinks it’s sexy. I have a podcast. Every time I release a podcast on leadership, nobody listens. It doesn’t get as much listens is How to Be a millionaire, how to to your profit. That’s always going to get more listeners, but I think it’s the most powerful thing you can do.
00;38;21;26 – 00;38;43;20
Dr. Paul Etchison
It’s stems from everything. It’s a way to simplify. It is to learn how to lead. Learn how to communicate with your team. Forgive, offer grace to your team. And I think if you could just find a way to communicate with your team that’s respectful. That’s nice. That honors both people in that relationships. Once and needs. I think you can do a whole lot with your practice.
00;38;43;20 – 00;39;02;00
Dr. Paul Etchison
Everything else just kind of falls in line. As long as you take every little issue with the practice and everything goes wrong and say, let’s fix it so it doesn’t go wrong again. So I would say start there. It’s life’s too short to be pissed off and firing people like crazy. Sometimes we do. But, I mean, it makes life a lot easier if you can communicate.
00;39;02;01 – 00;39;27;17
Dr. Paul Etchison
Got good relationships with your team. I’ve had good and bad, and I really love the good. And sometimes when things get bad, it’s. You got to do that. Those difficult conversations and those never feel good. But, my supply would be lead, lead. And in addition, write things down, sit in, get introspective and write about things that you’re doing.
00;39;27;19 – 00;39;45;28
Dr. Paul Etchison
The one thing I did, I was working with a life coach, and she’d asked me if you wrote out your journal your whole week, what percentage of the things that you’re doing bring you joy, and what percentage of do you just absolutely hate? And I did this exercise, and I hated nearly 85% of the things I was doing, which is a really crappy way to live.
00;39;46;01 – 00;40;00;18
Dr. Paul Etchison
And and some of it was like, I don’t like checking hygiene. I don’t want to see new patients anymore. And it was a lot of things that I could delegate off to my team. And we went through this list and we just focused on how can I, how can the next time I have to do this, how can I do it?
00;40;00;18 – 00;40;17;11
Dr. Paul Etchison
So it’s the last time I ever do it. And there are so many things that I said, man, I have to do that. I’m the owner. Nobody else can do it. I was wrong, I mean, you could get rid of so many things, but it starts with writing it down and then just picking those tiny little chunks and just attacking one of the two of those things every week.
00;40;17;14 – 00;40;31;15
Dr. Paul Etchison
And before you know it, you’re get a point where 85% of the things you’re doing bring you joy and 15% suck. So, but I don’t get that kind of personal growth unless I write it down and I journal it. So that would be my second piece of how to simplify things.
00;40;31;17 – 00;40;44;22
Dr. Mustafa Shah-Khan
Yeah. You know, I listen to a lot of what you’re saying, and, you know, I’m at that spot, you know, a million and a half, 2 million out of practice and, four days a week. And I’d like to, you know, get to three days, two days. And I keep listening to you, and I’m like, maybe I’m gonna call Paul Atchison.
00;40;44;25 – 00;40;52;19
Dr. Mustafa Shah-Khan
For our listeners, how would how would they get in touch with Paul and how did they get involved with your mastermind, your coaching, your podcast, all that stuff?
00;40;52;23 – 00;41;09;13
Dr. Paul Etchison
Yeah. So, dental practice heroes.com. That is my website. That’s where all my information is. They can go there, they can set up a free strategy call with me. And I just want to listen to people what their practices are like. And then if I can help them, I will tell them how. If I can’t, they’ll at least walk away with some free advice.
00;41;09;13 – 00;41;29;04
Dr. Paul Etchison
But I would say anyone who’s thinking about it, just do it. I mean, you’ve got nothing to lose. And I do this with clients is I mean, it’s it’s not cheap, you know, it’s an investment. But I’ve never had a client that didn’t get that back and then some. And the earlier you do it in your career, the better, that you’re going to set yourself up for the rest of your life.
00;41;29;04 – 00;41;44;26
Dr. Paul Etchison
So I’d say, if someone’s thinking, oh, that’s not for me. I don’t have this. I don’t have the communication skills, I don’t have the team. I don’t have the technical ability to speed this, that. That’s baloney. I I’ve done I’ve been doing that. I’ve been coaching for six years and I’ve never had anybody. We couldn’t do it before.
00;41;44;26 – 00;41;56;27
Dr. Paul Etchison
So there is a way and it’s possible. And if someone’s listening, thinking they can’t do it, I assure you that you can’t. So dental practice heroes.com. Check that out. Set up a call with me and and we’ll talk and see where it goes.
00;41;56;29 – 00;42;01;15
Dr. Richard Offutt
Paul. Thank you. I appreciate you coming on talking with Doctor Shah-Khan. And I.
00;42;01;18 – 00;42;12;13
Dr. Mustafa Shah-Khan
Or. Yeah, I really enjoyed it. You know, I enjoyed being on on your podcast. Look forward to saying that as well. And been on dental practice heroes. Yeah. Thank you very much. And, we appreciate it.
00;42;12;16 – 00;42;14;03
Dr. Paul Etchison
Thanks for having me, guys. Great conversation.