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This Dental Specific Podcast is dedicated to the Dental "Entrepreneur" Michael Dinsio, Founder of Next Level Consultants, delivers #TRUTH when starting up a dental practice. From the very first step to getting the keys of a dental practice, Michael shares his raw & unscripted playbook with you. Not only does this podcast provide you with "What To Do" but more importantly "What Not To Do". With over over 15 years of experience & over 150 past clients, Michael delivers an educational and informative program in a real and genuine way. Start w/ Episode 01 - as we go through a STEP by STEP process.
00:03
The is so low to John, I don't even know where to start with that. Well, guess the problem is, and by the way, I love that question. Interesting, interesting. This is an interesting topic. What's the solution here? Show up, understand your part, and just crush it. Paper, click, social media, we can talk about all this stuff. But what really matters is patient experience, that wow factor.
00:34
Startup unscripted, questions you have with the truths you need to hear. Now your hosts, Michael Dinsio and John Bertagni.
00:52
All right, all right, everybody. Start up unscripted. Finishing strong here, John. This is the season finale, my friend. I just, I'm super excited about what we just accomplished this whole season. But I guess before we get- I'm actually shocked we're still friends. know. Well, we really aren't. On camera we are, but no, we're really good friends.
01:22
I think we gained a lot of friends through this program as well. But wait, before we get into this, let's just tee this up. Okay, so this is Startup unscripted episode, I guess we're on 16, the finale, finishing with the best for last, you and I. We started it with you and I, let's finish it with you and I. I'm Michael Dinsio, founder of Next Level Consultants. And I'm lucky enough to have a friend and partner
01:52
to have co-hosted this entire program. John, you've been a lot of fun this season. Thanks for joining. It's been a blast. Yeah, we had a blast. So I just wanted to say thank you to all of our listeners this season. And we had a vision for this whole program. Our goal with the obvious title of Startup Unscripted was
02:20
to work through the entire process of a startup from top to bottom. And we just finished episode 15 with financial planning. So we hope that they go from this idea of going into business all the way to making so much money that they need a financial planner to sock money away. I think we nailed it. What do you think? I do too. I mean, it was a lot of fun and you
02:49
When we went into this, it was to give people kind of a behind the curtain look or under the hood look. So they don't make mistakes. So they don't, you know, go down certain paths and have to, you know, turn themselves around and find the exit out of the maze, if you will, because this thing can be a maze. And so that's what we've done. And we've had great partners, you're right, that have helped
03:17
Also let them know in their specific areas of expertise, know, hey, think about it this way. Look at it this way. Don't listen to my buddy dentist or my buddy who's an accountant or my buddy, you know, listen to the experts. There you go with the hat. I love it. But that's, you know, that's, that's what we tried to do. And we gave our listeners access to real, real icons in the industry that
03:47
gave them, you know, our listeners pearls and we had some great feedback from listeners and the industry as a whole, even our peers were like about time someone is looking at the industry the way that we brought it. wow, I'm thankful that, you know, we accomplished our goals. I would like to jump into it because what our goal today is, is to kind of recap certain nuances that I think were pretty cool.
04:15
that we want to just close this season in anticipation of our next season, is, your client, your Joanna, started us all out with vision, which is what you have to do to start any sort of business. What is a quick takeaway on that? And listeners, we're not going to go point by point by point. We're just going to of blaze through this. But Mike, what do you think, man?
04:43
Yeah, man, I mean, we talked about it through the whole season of how important vision is. And I talked about it with my clients every single day. If they aren't starting this process with a clear idea of what they're trying to accomplish, then what's going to happen is the industry is going to dictate their vision for them.
05:13
Yeah. And I see it every single day. My clients don't get, don't get wrapped up into what everybody else wants to do with them. And that could, that could be anywhere from over engineering a space or buying crazy equipment or architecture or a type of computer that the IT company thinks about and not what you could actually do. Right. I mean, all the way through.
05:40
I mean, even from hiring the right people and having the customer engagement that you want, I mean, all the way through. So vision is such a key thing. Joanna, she talked about how she stumbled along the way and finally found this energy with her partner and they're crushing. And I actually just heard from her the other day. So that was a great episode to- Well, and I think the main takeaway with that is,
06:09
when you put your vision statement and your goals of your practice, stick to it. Joanna talked about it. Melladen talked about it. It's about staying true to that vision. And that's the key. Which segues right into the second episode with demographics. If you're not super clear about demographics, you're going to pick the wrong market. You're going to serve the wrong people. You won't have the right opportunities coming at you.
06:38
those two really fall into play really, really heavily in my mind. They do, they do 1000%. I mean, your demographics have to match your vision. Then of course, going right into banking from demographics. So now that you have your vision piece all mapped out, your business plan, everything that you're trying to accomplish, you find the right location based on that vision.
07:06
and working with a professional like Real Score and David James, then you walk into a bank's office or Starbucks these days and you meet that banker, you're not talking to that banker about, what should I do? You're telling the banker, this is what I'm doing, finance it. And if that bank isn't the right bank for you, move on to the next bank.
07:35
Again, I talked about this on the episode and I think Wells Fargo is a great bank. enjoy those conversations. But I think deep down inside of every single banker, they wish someone would just present a business plan and say, I need this amount of money. Do it or not do it. Too many times doctors are walking into that Starbucks and saying,
08:04
think I want to do a startup. I've been working for so and so, can I afford this? Well, and what that does, and you and I both seen it, right? In our vast career, people go down a path with a bank, and lo and behold, at the last minute, we're not funding you and especially in this day and age, that happens. So that clear message, that clear business plan, that, you know, knowing
08:34
what buckets you're going to fill with what money, that's going to help that bank early on tell you, I don't think that's going to work or this is going to work. You're bringing a point up with the buckets and sorry, it's a sensitive thing with me because next level, very honored and grateful, we're working on our 25th startup right now. And of those startups, we're struggling with some of the banks on the buckets.
09:03
And it's because some of the banks, just don't, they have a preconception of how the buckets should be set up based on 1980 rolls. it's so true. And we talk about this in episode, I forget which episode number it is, but the marketing episode of how much money you need to set aside for marketing, for consulting, for construction, and construction costs are out of control right now. So
09:32
to set up a budget based on 1990 standards with construction going as crazy high as it is, the buckets need to be changed a little bit for the project to run smoothly. so anyways, business plan, vision, all the way through to banking, you need to dictate and kind of demand what you're trying to get out that bank. I would agree. And those same demands,
10:01
go into the real estate play, right? 100%. And we had great, mean, some of those, that shark week with the hilarity of some of those individuals was just classic. My affinity with Chicago, obviously my sausage and all style voice came out. that whole world, I felt like that was really a pedestal of this group because
10:30
we were able to transform the US and the coverage of the US to help people understand all the needs no matter where they're looking, urban, rural, suburban. I thought it was brilliant. West coast, East coast. I just love that whole piece. But one of the takeaways there was hiring that representative early on.
10:59
Don't try and do it on yourself because you're going to get screwed jobbed and that's the last thing that you want. Hire these guys. It's nothing on you and it's going to save you headaches. But more importantly, once again, that vision, they're going to be able to tell you where you want to be or give you those options. Am I right? 100%. We interviewed six real estate companies. Six.
11:27
from West Coast to East Coast or East Coast to I forget. I mean, that is such a service to our listeners. I don't think they appreciate that. You get to listen to six dental specific real estate groups that have averaged, probably averaged 50 deals a year-ish, maybe 30 deals a year. The experience and the wealth of knowledge,
11:56
hiring an expert to kind of handle that is key. I do want to call out that we called it Shark Week for a reason. I want everybody to remember they are the best at negotiating, better than me, better than you listeners, better than John. I mean, they know how to negotiate real estate. That's what they do.
12:21
and they are doing it for you, not the seller, but for you. So you've got to get that representation. But there's a huge, there's a big asterisk that I want to call out that the reason we call it sharks, because they are sharks and they get paid. And we ask them the hard questions. They get paid at the end of the deal. And I've found that even working through a lot of those negotiations, they get to a point where they're like, let's go, let's go, let's go.
12:51
They smell the blood in the water as a shark does. And they start pushing for the end. And so I'm not taking away from them that you have to have someone like that on your team, but don't be afraid to ask for just a little bit more or take another extra week or two before you sign that lease. Because remember their commission is when they sign that, when you sign that. Good point. Yeah. So it's not like all these people are, you know, best friends. You're right.
13:20
we did challenge some questions and some of them, don't think some of the banks or the fiduciaries were able to answer our real questions from a compliance standpoint, which is we get, but I think that's what we wanted to do was press it a little bit. Hence the uncensored part. So the cool thing about the entire team is that everybody fills a hole, right?
13:48
and a consultant fills a hole, your real estate team fills a hole. One of the holes that gets filled by your team is an attorney that re-uses the LOI and really takes what the sharks do, the real estate guys and gals do, and they get it to a final final. And Tyler Jones was excellent. I loved his little pearl. He said, if you're going to take out an insurance policy,
14:17
on a $600,000 loan, do you think four to $6,000 is worth it? I I love that because- What I loved was that he doesn't even like attorneys. That's what I actually loved. No, but I I even referred people over to him, like from afar. I think he was just so spot on. I liked his approach. I like his price point for what he does.
14:45
But remember, it's not only release review, he could also do entities. He can do all that sort of stuff that's really, really important. And that's why, once again, he was front loaded on this series because he needs to be at the forefront of this. I thought he was fantastic. And we had a lot of great responses to him and feedback to his approach and his approachability.
15:15
love that. think, did we go into architecture soon after that? Right into architecture with Dr. Unthank, a legend in his own right. mean, he basically the grandfather of dental design. mean, I had some clients after listening to the episode saying, I'm hiring that dude. And I said, definitely, definitely do that. But when you become the godfather, your fees are such. so
15:44
We got to tap into that, but how that dude could navigate issues for you is incredible. The things that he's thinking about, the lighting, the sound, the aesthetics, the- The air conditioning, he is the best of the best. And actually his fees are not what people-
16:12
perceive them to be when it comes down to it. It's really interesting. 100%. He could charge probably twice as much to be honest with you with the knowledge. Some of his insight, that's what the startup uncensored world is about, which is avoiding stupidity that's going to cause you re-engineering or construction down the road. Build it right the first time or it's less
16:41
expensive to build it right the first time than to do it again. And I'll add that, you know, with an environment where construction is totally out of control. Yeah. You even, I mean, myself and you who's done this personally with your dental offices that used to own the startups that I'm a part of, even with all of our knowledge, you still won't get to his level to holding the contractors accountable.
17:11
And really navigating that design bid, design bid process. We talk about design build on the next episode with Apex and Bruce Johnson. And he kind of threw in a special flavor to the industry that I think the industry is moving in, which is design build. And it was really interesting.
17:39
I see a lot of design build throughout the country these days, but I just got a quote the other day, I won't say what builder and what market, 277 a square foot. And that was a startup. it kills the butt. That by itself, I think we talked about in the banking episode how construction will make up like,
18:07
60 or 70 % of your total budget in this case, it was 100%. 95 % of the budget. You bought a bunch of lawn chairs, a lawn chairs and an advocate. There's nothing left. And so you got to be careful and you got to balance the build versus the bid. And you just got to take note. I think that, know, selfish plug, that's where Next Level comes in and tries to help people navigate this process. But what did you think about Bruce and
18:37
I loved, you know, love, I love his, his approach. love his, you know, design scape and, you know, the simplicity of what he was able to do and the explanation of why having everything in house to potentially move forward projects when you have the design build and, really, once again, that vision piece and working in, in congruence with your bank.
19:05
to understand, this is all I'm able to afford, where you actually push the envelope and say, screw you, I'm not paying 277. My number is 174. Get to it. Let me know where we're going. so that's where knowledge base and understanding is going to help our listeners not get themselves into trouble. And you can go to them. I think we talked about it.
19:34
you can say this is my hard budget number, figure it out. Figure it out. I think that's where the design build really can go into your favors, trusting that contractor and really dictating what your budget is. But as one contractor told me here in Seattle, a long time ago, there absolutely is a game going on with the contractors called hide the pickle. I don't know what he meant by that, hide the pickle.
20:04
But there's definitely a hide the pickle thing, meaning where's the margin at? Where can you hide it through all of these quotes with the plumbers and contractors and framers and painters and flooring and then the, you know, and so there's that, there's that whole thing. So those two episodes, I'm pushing my clients to specifically saying, okay, before I spend an hour on the phone with you, go watch those two episodes because design build,
20:33
and design bid are two different concepts. anyway, and remember, remember the architects and Mike even talked about it and we discussed with other architects outside of Dr. Michael and thing that they like the bid process more so, you know, because they feel that there's that accountability piece and also the project gets done because there's another set of eyes. know, in Mike's standpoint, you have
21:02
architectural drawings like this, as opposed to architectural drawings like this, with some architects. The comment of that episode was, if you don't have an architect on staff holding the contractors accountable, and you do the design build process, they said, I brought up an architect once said to me, that's a fox in the hen house. Remember that? right. It's the fox in the hen house. That's right.
21:31
All right, so let's segue to equipment, because this was a two parter. And we're starting to get towards now the back end of a startup, right? So you've got contractors, you've got the vision, you've got the banking, you've got demographics, you've got construction and design. It's really starting to become something. We had so much fun on this equipment, this equipment episode. In fact, the industry was calling us, texting us.
21:57
John and I had so many equipment reps calling us saying, we weren't really sure where you were going to take this episode, but and it was a lot of fun. And I think Matt Zofo did a great job representing his industry or his ex industry. John, this is the space that you live in folks. I don't know if any of you know this and John doesn't throw this out too much, but he works for one of the largest
22:24
dental equipment manufacturers on this earth, this planet earth. And if you're not tapping into his knowledge and what he even could do for you as a startup, know Belmont is getting ready to roll out a really awesome startup package. John, you don't talk about this enough and our listeners could really benefit from this, but what did you think about the, you used to be an equipment rep. I used to be an equipment rep and you
22:51
And I bought the equipment for those dental offices that I own. it's that whole world, yeah, full circle. It's the way that I wanted it to be presented. It could have gone sideways. And I think that's where the industry was a little bit nervous about how we were going to approach it. But our approach was truly to make sure that we don't overload dentists with stuff that they don't need. They don't need to buy a mansion or a Lamborghini right out of cup.
23:20
out of school, you can buy a Toyota, you can buy a Lexus, you can buy different things along the way, and that will last you 20, 30 years. The main goal is to not sell you a Yugo, I'm aging myself, but things that were disposable cars that would last two, three years. So the goal was here, let's not overload you, let's not build it out seven ops from day one when you don't have.
23:49
know, patient one. And Matt did a great job. And you're right, you know, I worked for Belmont Equipment. We're rolling out a whole program for startups, which will be fantastic. It's going to be a special discounts and it's going to be curtailed to a startup dentist, but that will last them for 20, 30 years, which is the life of Belmont Equipment. It will last you a long, long time. So.
24:17
I thought Matt did a great job representing the industry. I thought it was interesting in those episodes, if you remember. It was all about differentiating yourself as the equipment rep who had experience over just slinging quotes and trying to lock you down into some deal or the buy two, get one. Or mail order, where you're hiring your own service tech.
24:46
to install the equipment shows up on your doorstep and you've got to install it or you need to find someone. mean, there's just that- Get out of here. There's definitely some extremes to that industry. And I think there's definitely that the more value you can create as a rep is obviously a really good thing. But then once you have that trust, it's that rep doesn't take you down the comb beam path or the milling machine path right out of the gate as a startup.
25:16
I mean, it's like drives you crazy. It's just like it's like it's like this extreme versus that extreme. And it's trying to find that sweet spot. And and I must say this, you know, as a consultant, it's just keep I don't care where people go. Burkhardt, Benco, Patterson, Schein, they're all really great companies. They really they really are. And there's amazing reps in every single company. As someone as a consultant, I look at it very objectively and I'm like, OK, how's this fit into our budget? What's most important?
25:46
for you as a clinician. And then from there, the decisions get really easy. And then who do you trust and who has the most experience? I don't care who it is and what their margins are. I just want to make sure it fits. that's, we have to stick to the vision that the client outlays in the beginning. And so we're spending a lot of time on that because we had a two-parter and it was fun. Yeah, I just thought it's, by the way, it's the second largest bucket that we're talking about.
26:15
outside of construction, then you get into equipment and technology. mean, that's, there's your numbers and that's what takes away from marketing and paying staff and paying yourself. So I think it was important that we did spend a little extra time on it, but you know, that gets into that, you know, I brought up technology that gets into that IT piece, which finding an expert in that world is really, really important.
26:44
really, really, it's really important. But I've noticed that prices lately dating myself here and heading into the end of 2021. This episode, whenever you watch it, but prices are sitting to get out of control in that department, too. are they really? Okay. Yeah, I mean, I used to be somewhere in the low 20s, even you could maybe even break into the 19s. And today, they're close to 30. And I can't get them off that. And so
27:11
It's really figuring out as a startup what you have to have. And that's really the same conversation through the whole process. What you have to have as a startup versus what you maybe could wait a couple of years for. Security cameras and incredible sound and, you know, a hundred computers. Well, you really don't need that many. And server versus cloud. And so we got into some great conversations with Ian, but check that out.
27:40
we kind of roll right into now the business part of the whole thing. I feel like folks need to remember that the end of a project, you got a beautiful office now, but where the hell are the patients? Where are they coming from? Right? And so, and you need a team that believes in what you're trying to do and buy into your vision.
28:10
to execute it for you. And so we rolled into HR for Health and Care Credit and how to hire a front office person and all those episodes. I think- those were key episodes because that's the infrastructure, right? It is. I mean, Care Credit, how do you get paid for some of these larger cases? And quite frankly, we're blowing through insurance money. And I thought that episode was great in talking about
28:39
ratios of money and how many people actually use the product versus, you know, our thought process of how great it is. know, basically HR for Health, you know, just all the handbooks and staffing correctly, that infrastructure is so important. And all of it gets kind of put off until like 30 days before. And then also, by the way, marketing gets put off.
29:06
until 30 days before where we talked about our main takeaway was that needs to start three months in advance. Yes. then that's it was going was infrastructure is going to start getting built out. But let's spend a little time on what we learned in marketing. was SEO, pay-per-click, social media, branding. We talked about all that stuff in a two-parter. Mike Shoun, owner of Affordable Image,
29:34
He really did a great job of breaking down what SEO really is because it's this fictitious buzzword that everybody talks about. But Mike made it really easy by simply saying it's the psychology of what people are searching for. Right. And so if someone's looking for a dentist, what are they going to key in so that you go to the top? I think that's- to capture those key words or, you know, to
30:04
to optimize your site. that's, you know, he did a great job of that. And actually we have to pay deference to him. He helped us in our promotion of startup, you know, and did a great job. And we saw that through all the media outlets. Fantastic firm and a thousand percent right. If you're not marketing your practice 90 days before start, you're hurting yourself.
30:31
Quit getting lost into the carpet and the paint colors and start thinking about how you're going to drive patients through your practice. And it's also, and you know, we also talked about not only external marketing, we also talked about internal marketing and, you know, boots on the ground marketing within your community, how important that was and the efficacy of that. So it wasn't only, you know, paper or digital marketing. This was also internal.
31:00
which doesn't cost you that much money. And also external boots on the ground, girls, handout flyers, go to this or guys, whoever it is. like that's as effective if not more that community outreach. So once we get those patients in, right? You we got to deal with- You to manage your business. You got to manage- Well, it's, yeah. But we're also going to talk about billing. How do we bill these people?
31:30
Are we doing fee for service? we gonna, you know, are we doing managed care? Are we do, what are we doing? And how do we credential? And how do we get those fees correct? I thought that was a great episode. And there's a concept there that I wanna throw out that I think people aren't really buying into and in modern day world where, you know, you.
31:55
You think business would be really easy to bring cash in and pay your expenses and the rest is profit. But the key with a dental office is cash in, insurance, credit cards, care credit. You're getting money from all of these different sources and insurance is probably 60 % of most practices. And credentialing to your point is exactly right. And the thing that I want to throw out is that like,
32:23
When you're spending money on marketing, sending postcards out and pay per click and trying to track the ROI, they say that $200 to $300 is what you'll spend per new patient acquisition. $200 to $300 is what you're spending to get a new patient to come through your door on average. You with me? Yeah. Vernon, for a patient that comes through Delta Dental's website, what did you pay for that?
32:53
zero US dollars. Zero US dollars. So that is something to consider when you're getting your butt kicked on the insurance breaks. Just think without them, maybe you wouldn't have as many patients. It's free. It's free. It's not free because the fees are less. But it is a marketing generator. So well, we kind of
33:22
We kind of summed up then right into dental accounting pros who helped us with bookkeeping and talking about CPA works. That episode, my Zoom account crashed on you and Kevin and you two literally ran the whole show. So I didn't know if I needed you back. Why don't you summarize that episode? Because I wasn't there.
33:49
No, but I think what that was, that, you know, that amalgamation of those financial individuals that deal with your numbers and your bookkeeping and your accounting, especially in those first years, you know, when you have such capital outlay and you can take advantage of some, you know, small business owner advantages, you know, section 179, advanced appreciation, all these sort of things.
34:17
You definitely want to work with someone that understands small business, especially in dental. And they did a great job. And then obviously that ongoing bookkeeping and all the way down to, you know, payroll, all of that, having someone that can manage that and give you the peace of mind, you know, you're running your other business. Don't try and be, you know, a man of many hats or a gal of many hats. It doesn't make sense.
34:47
These people can make your life a heck of a lot easier. But don't feel bad about being frugal either in that department. must say. I mean, no, no, no. And I might say like, hire the big shops of, know, ADT or, or I mean, ADP or whoever it is. There's a lot of other firms that can do it, including your accountant that can do payroll and, and manage things really, really well. I always say make sure you know how to read.
35:15
and set up your P &L before you completely delegate it. That to me is probably one of the biggest things that I make sure my clients understand because in a world where most dentists don't own their own business, them setting up their shop and just delegating everything sets that person up for failure in my opinion, when it comes to financials. If you're relying on your bookkeeper and CPA
35:45
to tell you if you're making money every quarter, that's a problem. Right. Right. That's actually scary. And probably that happens 75 % of the time. 100%. So which leads us to once you have profit, which was kind of our last episode content wise, was Michelle, or Michelle Stephanie saying with Northstar resource group. And we talked about a couple of things. We talked about how to put your money away.
36:15
strategies around that. we also talked about benefits and how to differentiate yourself from the dentist right down the street. And they might be paying $60 for a hygienist, but maybe maybe you only need to pay 55 with some Benny's, know, and so I thought that was a phenomenal episode. And it was really a good one to finish the season on. I couldn't agree more. We
36:44
We just blasted through it, you know, a quick synopsis and some highlights, but, you know, I think overall our viewership and listenership, those individual episodes, they can go back to, because there was a lot more than just what we just highlighted. I think, and that's the crazy thing is we see, we're still seeing people pop back in.
37:14
You know, and so that's what I love seeing. you know, obviously we, the technology piece, we can see unique users and then, you know, first time users and then repeat. I mean, it's crazy. Our people come and look at ourselves, look at us for some reason on an ongoing basis. It's great. Well, they definitely don't log in to...
37:37
to stare at our looks, John, but it's definitely the content. I would say that there's probably a solid three to five pearls in every episode if you hang in there. And I would challenge everybody to revisit those episodes and listen to them. And I think with that being said, I just wanted to say thanks to you, John, and thanks to our.
38:04
listeners again, I mean, if you're not following us on Instagram, Facebook, watching this stuff and subscribing on YouTube, you're missing out. And also you're missing out on potentially having a relationship with you and me, John, where these folks could literally email us, ask us questions, and frankly, we could help them through the process.
38:29
So take advantage of that. We are starting season two, which is going to be all around acquisitions. John, you alluded to it. And it's something that I'm really excited about because startups are huge and lots of people are doing them, but even more people are doing acquisitions. And you've bought and sold many practices. I'm helping. I've bought and sold.
38:59
quite frankly, in my career and it's gonna be a good one. It's gonna be fun. And lastly, our partners, we can't forget them. For all those people that we mentioned, they were an integral part. No one wants to just listen to you and I. They brought a different perspective. So, Mike, I think- I was just gonna forget them, by the way. was gonna forget them. Thanks.
39:27
Thanks for looping them back into the conversation. No. But, Mike, I think we accomplished what we set out to do. I thank you for your compelling approach to this industry that we both love and that we're both just trying to make a little bit more interesting and a little bit more level playing field for everyone. So I feel proud of this accomplishment right here.
39:58
Well, with that being said, let's close this season one down and hopefully many, more to come. thanks again, my friend. out. Peace.