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The dental practice ownership podcast for dentists ready to start, buy, or grow their dental business.
Mike Dinsio, MBA and Paula Quinn, BSDH have joined forces. Now combining past shows from "Startup Unscripted" and "Dental Acquisition Unscripted" into one. They bring 30+ years of dental industry experience together with a modern approach to "the business of dentistry."
Each episode features unscripted conversations with expert guest content. They share real life experiences, proven strategies, and actionable insights on dental practice ownership. Whether you're new to ownership, planning a dental startup, or navigating a practice acquisition—we've got you covered.
CHANNEL TOPICS INCLUDE:
✓ How to start a dental practice from scratch
✓ Buying a dental practice: What you need to know
✓ Practice management hacks, tips, and tricks
✓ Dental marketing and SEO strategies that work
✓ Financial planning and profitability for practice owners
✓ Building and leading high-performing dental teams
✓ Industry trends: DSOs, technology, and the future of dentistry
Next Level Consultants is Michael and Paula's consulting firm. Their approach to working with dentists? Customized strategies that are tailored to your unique market, team, and goals—no cookie-cutter packages. Visit: www.nxlevelconsultants.com/resources/podcast
Join our growing community of dental practice owners and entrepreneurs. Watch LIVE on YouTube & ask questions directly. Subscribe on Apple or Spotify. New episodes weekly. No scripts. Just real talk about running a successful dental practice.
Rate the show 5 stars and help other dentists discover us! ⭐⭐⭐⭐⭐
Welcome to Dental Unscripted.
Where Mike Dinsio and Paula Quinn break
down the practice ownership journey,
one episode at a time.
Starting up,
buying and running a successful dental
practice.
Hey, hey, guys.
Welcome back to another episode of Dental
Unscripted.
It is podcast day.
So if you are on Instagram,
you're just seeing us talk all day on
podcasting, which is super cool.
We got some cool topics today.
We just finished one that was really
practice ownership driven.
And today and this one is going to
be more about debunking this idea that
startups are scary.
Of course, naturally, startups are scary,
but ownership should just be scary.
They're hard in different ways.
And we're going to talk about all kinds
of things as it relates to startups and
how to be successful in them financially,
right out of the gate so that you
can make it happen for yourself if startup
is the way to go.
Acquisitions are equally as scary,
I promise you.
We could talk a little bit about that,
but before we get too,
too far into the topics and the
conversation,
I wanted to say good morning to Paula
Quinn.
Paula, what's up, man?
Good morning.
How are you doing?
Just hanging with you now, I guess.
Here we are talking to people on their
way to work.
And if you are,
I hope we motivate you.
But as always, too,
I'd just like to remind you guys to
like, subscribe, follow.
do all the things.
You could even make comments and we'll
discuss those questions online.
So if you're listening to this on Facebook
or LinkedIn and you make a comment,
you literally can ask us a question live,
which is super cool.
So pay attention to the schedule.
I think we promote that.
And so, yeah,
if you're interested in the topic,
join us.
With that being said,
let's just get right into it.
Today's topic again is debunking a scary
startup.
And I'm proud to say that Next Level
has been a part of a handful of
million dollar starts.
um it doesn't happen very often and i
don't want to say that that is the
uh guarantee or if that that is definitely
the that what happens every time um but
it is possible and so and and how
is that possible we should talk about
today um because
um startups can be like i said we
take a lot of calls from docs and
they're like you know i'd rather buy i'd
rather buy it rather buy it rather buy
it's all here all day long i'd rather
buy and the one reason why they would
rather buy is for one reason what do
you think it is paula why would why
would people say that to me all the
time i'd rather buy all right gosh i
don't know but my guess would why did
you want to buy why did you want
to buy not start
Well, it's already there.
The shell is there.
Hopefully the people are there.
It's already a running business.
You get to look at what it's been
profiting and you kind of hope that you're
profiting the same thing immediately.
There's immediate cash flow.
That's it right there.
I mean, there's a lot of things.
No trick question.
And that's the main one right there is
the money.
And that's the funny thing is a lot
of clients of ours buy practices that
aren't making any money or not making much
money.
Let's just say that.
And those are basically startups.
And so the value of buying a company,
in my opinion,
is to all the things that Paula said,
is having a company that's already set up,
already employees, already making money.
And you get the opportunity and the luxury
of just kind of plugging in
and making a strong impact to the patients
and the team.
And hopefully it's on somewhat of an easy
thing.
But as you and I know, Paula,
that's not the case.
It's not easy.
acquisitions are not easy.
And I think everybody thinks there's just
the one benefit of cash flow.
And so I want to talk about startups
today.
And I want to kind of break this
down as to how to do a startup
and not be so scary and there's like
there's like three or four things there
might be more as they pop into my
head but there's like three or four things
that make startups not very scary and the
first one right out of the gate is
choosing a location where there's a need
for you as a startup and
And I think a lot of our clients,
they call me and they say,
I want to do a startup,
but they want to be in the same
place that everybody's already at.
It's one of the most competitive markets
already.
Here in Seattle, it's like Bellevue,
Issaquah, Kirkland.
Guess what, folks?
That was hot twenty years ago.
Not really,
but it was up and coming fifteen years
ago.
That's when you wanted to go there.
You want to catch that growth on the
upswing, not a plateau, you know.
And but but I think it's like and
Paula, you know,
this is why you wanted to buy your
practice.
In some ways,
it was kind of a startup.
In some ways,
your practice was kind of startup.
And the number number one reason why you
wanted it, I think.
was you do you know why where i'm
going with this it was a mile within
my house yeah that's it so you're reading
my mind and um that's the thing is
is like people are you know dentists you
guys are making good money
You're making good money.
You live where you live.
Your kids are going to the school in
that community.
You have a lifestyle.
And so now you want a business within
that lifestyle.
Well,
people don't typically live in like
gentrified areas.
Not so, you know, like,
like if you're a dentist,
you're making good money.
You're probably not in, in a,
in an area that's up and coming.
You're probably living in a nice area.
And guess what?
Those nice areas are,
already have dental offices.
And so if you plant your business as
a startup right there,
get your boxing gloves on.
And I think that's where the stigma
of a scary startup comes from because if
you start a business in a very saturated
area um you're gonna you know paul you
you've helped me with these startups this
is where the stigma is at it's like
how difficult is it to find new patients
very hard
right yeah um you know if you want
to share a story just just please paul
interrupt me but like because i could go
on a rant or rant here for an
hour probably but like that's probably not
the best startup unless you're totally in
a situation where your partner um can
support you and you've got a lot of
money and all the things and you're good
with slow growth
then that could be an opportunity for you.
But just have the expectation that it's
gonna be super slow growth.
If you need to support your family day
one, you don't have a spouse, partner,
whatever that has a really great job and
you need fast growth, guess what?
We got to go to a fast growth
area.
And so I'm debunking a starter because if
you're willing,
the million dollar starts that we did,
two or three of them went into areas
that was desperate.
I'm talking desperate for another dentist.
There was one dentist serving like eight
thousand people.
You literally they could have literally
put a building up and just said dentist
and did no marketing.
And they were and just crushed,
like literally crushed that people drive
by and oh, new dentist.
I think I'll go there.
I think they were some in some instances
they were waiting.
They had people.
They knew they were coming and they're
trying to schedule six months out,
you know?
Yeah.
When are you opening?
When are you opening?
Yeah.
And you were helping them do that.
Like,
how do we schedule these people when
you're getting a flood of people?
That's just not a typical.
And then there's everything in between.
So there's like the really competitive
areas and then there's just like the real
competition.
high demand so that's number one debunking
a scary startup it's not so scary when
there's eight thousand people and there's
one dentist in that little town that's not
scary guys let's just do a startup there's
eight thousand dentists in a one mile
radius that's what it's scary totally
different totally i feel like here in
arizona sometimes i'm like
mm-hmm and and to that point Paula like
in some markets it is it is very
more competitive than others you know and
then and then the other thing is the
high growth so I'll just touch on that
so high growth you know if an area
right now doesn't need another dentist but
the area in general has really high growth
You could need another dentist in the
future.
And I think a lot of real estate
people chase this.
This is where we get into trouble with
startups,
where a real estate agent knows the area
really well.
And they're like, oh my God,
this is gonna be the best place.
Oh my gosh, let's get you right here.
And two blocks this way,
they're putting this development in.
And three blocks this way,
they're putting that.
Well, no one lives there today.
And probably won't live there for another
three years because developments,
if you don't know, take forever.
And by the way,
some developments don't even work.
Where Paula lives,
I think she was telling me this mega
master plan Marriott,
who Buku Dollars was coming in.
And didn't they pull the plug?
They're not doing it now.
I mean, it's somewhat Bill,
and allegedly they pulled the plug.
And it wasn't the Marriott.
It was something even – it was like
the Ritz, I think, wasn't it?
I thought it was something even bigger
than – I mean,
not that Marriott's not just as big,
but I think it was something even more
upscale.
Yeah,
that's the point is like development is
very difficult.
to really plan on.
And so here you are assuming that you
put your shop up together and you're like,
oh, this is going to be great.
We've got all these high growth areas and
then things fall apart, recessions, COVID,
a virus comes out and knocks it.
You just don't know.
So your plan has to make sense today
and in the future.
So that's all things.
So I talked to- What don't you say
though, Michael,
like-
you know, and,
and cause you do the marketing for them
and stuff like that though.
And obviously we never know what marketing
is going to work,
but I just know like with my practice,
we kind of talked about it being a
startup, a quasi startup.
Obviously it had existing patients,
but it was a very low volume.
And there was a dentist right next door
to me.
There was one,
one business in between ours.
and i think a lot of mine was
putting in the work going around to
businesses customer service patient
experience whatever you want to call it
like i think you can set yourself apart
No, no.
I mean,
I love that you're saying that because
that does debunk a startup is doing all
of that.
I think what you're describing, Paula,
customer service, tight systems,
networking, doing all the things.
That's the X factor.
That's the X factor that can get you
from average to impeccable.
When I talk,
when I speak to our clients and,
and random people, I,
I don't assume they're not,
I assume that they're average because if I
coach people on impeccable, impeccable,
I'll get somebody in trouble.
Now I can tell,
I can immediately tell the clients that
call me that will have that immediately
can tell.
but I still coach them conservatively.
I'll put them in an area.
But to Paula's point,
all of you considering startup have the
ability to have the X factor.
I could give you just as many examples
of startups that went into very
competitive areas that crushed it.
just as many as I could tell you
had people that didn't crush it,
that were in areas that needed a dentist,
why it's the X factor.
So, so yeah, no, I, when I,
when I, yeah, that's a great question.
And I, and I want to define that.
Like when I talk to you on these
podcasts, it's, it's,
I'm talking about a very blanket statement
of everybody kind of in the middle.
Um, but if you are the X factor,
you will do even better.
Um, and,
so so so that so location we talked
about a lot of demographics location
matters that's debunk one debunk two is
keeping your job keeping your job so um
Here's the deal.
When I look at people's projections for
startups and I look at the success our
startups have in the first year to two
years,
they typically make somewhere between
eighty to a hundred thousand in profit
their first and sometimes second year.
So nobody's getting rich off of a hundred
thousand as a dentist.
The average dentist,
statistically speaking,
is like one twenty to one forty.
That's the average across the nation.
Right.
And and so a hundred eight making eighty
to a hundred is not enough.
But that's your startup, your first year,
very first year.
You can do eighty thousand dollars.
So to debunk the scary financial part,
if you work somewhere else and make fifty
thousand part time and you add that to
the number I just gave you,
now we're talking about the average income
all of a sudden.
But can I afford all the loans I
just took on?
I already have student debt.
Now I've got- That's the question.
That's a great question.
If you can support your lifestyle at
one-fifty, one-eighty,
one-twenty to one-fifty,
If you can support your lifestyle off of
that,
then the startup is not scary financially,
because you can work and make fifty,
and then you can work at your startup
and make eighty to a hundred.
It's kind of the range.
So you're right, Paula.
A lot of our clients that make three
hundred
as an associate job working for the man
in a turn and burn location,
just beat down, wore down,
they're really busy doing big procedures,
whatever your case is,
it's gonna be difficult to go down from
two to three hundred down to one fifty.
That's a good point.
But I think a lot of people are
surprised that they can make eighty to a
hundred their first year.
I think that's surprising to people.
So that's debunking number two is you can
make money and will make money.
You won't make it within the first six
months, by the way,
but you will make that in the last
six months if you follow all of the
rules and the game plan.
So don't quit your job as debunk number
two.
Paula,
when you're coaching people and you have
our clients on the back end,
how many of them come to you and
say,
I think I'm going to quit my job?
Oh, at ninety percent.
So even our clients are not following the
rules.
Now,
I will say if you have been forced,
you know,
when they they're honest with their
employer and and unfortunately they the
employer chooses a different route.
But I would say majority of them fight
it.
You know,
they usually say Michael said to,
but
But they also said, I said,
don't hire a hygienist,
but I have this perfect hygienist.
Well,
we're going to get to that team team.
I say no, but I will say, um,
majority want to quit.
Um,
And that makes sense, doesn't it?
That makes sense because- Yeah,
you just had a new baby and you're
babysitting somebody else's.
Yeah, exactly.
You're leaving your baby alone while you
go take care of somebody else's.
That's right.
So to put that into context a little
bit more,
and I love this conversation because you
go from an associate physician where
typically you're really busy seeing,
I don't know how many patients-
per day you know sometimes you're working
two columns and you're also seeing exams
so you're super busy as an associate and
you're probably making really good money
as seeing all these patients and then
that's what your expectation is of the
startup is seeing eight patients a day ten
patients a day as a start that's not
the expectation folks you'll be lucky to
get
three,
four patients a day the first four or
five months until the first hygiene cycle.
In the first six months,
you're gonna be lucky to see four to
six patients per day.
So you're not busy at all.
Yeah, they're lucky.
I know.
That's what I'm saying.
They're super lucky.
That's hitting a grand slam in marketing,
hitting a grand slam.
And so like I'm thinking, Paula,
like I remember when I talked to you
early, early, early, early, early,
early on when we first started our
business relationship and you were even
calculating your hours.
And I was like kind of hearing you
talk.
And I don't know if you remember this
conversation, but you're a hygienist.
You were a consultant.
You were also a speaker.
So you were making money in all different
kinds of ways.
That's like a dentist.
They're working at this associate job,
this associate job,
and they also have their startup.
And we actually have a client, Dr. K,
just like this.
He's working five days a week,
but he's not busy, right?
And so I'm like, dude,
consolidate your days and go make money
every single day,
not a little money every day.
You're making big money every day.
But yeah, you're right.
Does that make sense?
So like you, Paul, I was like, dude,
when you speak, you speak.
When you're doing this, do this.
But like every hour matters.
You are your knowledge, your hands.
Doctors, same thing.
Your knowledge,
your hands need to always be working,
whether it's in your office or someone
else's office.
you need to be earning dollars and not
sitting around twiddling your thumbs.
Any comment to that?
Because, Paula,
you see them in the first three months
when they're scheduling and they want to
quit.
And I get that because they're so excited
about their new business,
but it's just not there yet.
It's just not there yet,
especially in the first three months.
And can you convox that as far as
the schedule goes?
That's about what it looks like?
Or worse.
Yeah.
I mean, you know,
and I would say even some get really
excited because the first week people have
been waiting on them to open.
So they've got like this little, you know,
maybe ten patients they've got to get on
the schedule.
But it does it does taper off for
a while.
So don't, you know, they're ready.
They're like, Oh, I have, or even better.
Yeah.
I have patients that have inquired.
I got to get them all on the
schedule.
Do you have any on the schedule?
No.
Okay.
Well then you don't have patients,
you know, it's,
I walk shirt tank all the time and
they'll, and you know, the,
the funny thing they always say is, well,
we went to this convention and we had
all kinds of interests and they always
say,
do you have a purchase order in hand?
And they're like,
Well, no, but they're like, okay,
then you don't have a deal.
It's not real until they're on the
schedule.
Yeah, I know.
I talked to another one of our startups
yesterday, Carolyn,
and I won't say last names,
and she's super excited because she's
beating the projections that I set up for
her.
I know who you're speaking of,
and she's a firecracker.
I mean, she's...
She is.
And she's beating the projection.
She puts herself out there on a daily
basis.
Daily basis.
But the funny thing about the most recent
conversation with her is she's like,
I'm interviewing for hygienists.
I'm like, what are you doing?
And she goes, well,
I'm just look at these numbers.
I'm like, yeah, that's great.
But you just hit X in collections and
you're just finally making some money now.
So now you want to go back into
the red by hiring a hygienist?
And she's like, whoa, right?
And I talked her off of not.
I'm like, well,
what's your schedule look like in the
future?
Well, it's about the same.
So she's seeing this projection,
but it's not there.
It's a false projection.
And the bottom line is I mentioned that
you can make eighty to one hundred.
But the last debunk is managing your
expenses as a startup.
And it's not in the way that you
think.
Like you might be thinking...
You or the audience?
The audience.
I know you know, Paula.
But like everybody is like, well,
I can't afford that software and I can't
afford that marketing and I can't
afford...
this this and that operate operationally
they say they can't and so they're very
and as you should be as you should
be very very concerned about the costs the
monthly costs um of the business but the
one expense
that oftentimes gets screwed up by
startups that aren't our clients or even
our clients try and they fight is what,
Paula?
What?
How do you get upside down and profit
in a startup?
You know the answer already.
What's the biggest expense?
Team.
So how do they...
So when you are coaching our clients...
And they're thinking, what do they think?
Actually,
I want you to kind of lead us
here because they're probably thinking X
amount of days and this many employees.
What do they all say?
Oh, they're usually at least one, four,
if not five days.
So they want to open five days.
And then if they're not going to be
open,
they at least want their front office to
sit there, you know,
the eight hours a day that they're not
open to maybe answer the phone.
And then they want to have two dental
assistants,
a front office and a hygienist.
So they're thinking three or four people
right out the gate.
Right.
And they don't know any better because of
where they just came from.
But again,
if you remember what I just said in
the episode earlier,
you're going to be lucky,
lucky if you saw three to four patients
per day.
So here we are.
If you did it your way, guys,
you would be open five days a week
seeing one patient a day because you're
open five days.
Yeah.
It's the same patient count.
So you're seeing one patient a day.
You have a hygienist sitting around,
two dental assistants sitting around and a
front office.
So we're talking fifty,
hundred plus patients.
Yeah, at least a hundred dollars an hour.
A hundred dollars an hour.
That's not employee taxes, employer.
That's just just the hourly wage.
That's the hourly wage.
And on an annual basis,
you're probably close to what you're.
Well, monthly,
you're probably close to thirty to forty
thousand a month.
Just in the overhead there and times that
by twelve.
And there's your annual.
There's all your profit, by the way.
It's gone.
Poof.
Profit's gone.
So debunk number three is manage your
expenses.
So what is your game plan, Paul,
day one from a scheduling and hiring
perspective to keep wages down?
two people my my wish is both people
cross-trained worst case scenario front
office plus a cross-trained dental
assistant yeah um so two people doctor
does hygiene for at least the first six
months what hygiene you can do it you
can do it um
And so, you know, if I,
if I had my way,
they'd be open two days a week,
but three days is about the minimum I
can get them.
So we usually compromise on three days a
week.
Um, you know, that's,
that's where I usually get them to
employees three days a week.
And quite frankly, try to manage that.
You know, if, if,
If you have all your employees in the
morning.
Schedule an eight a.m.
and a four p.m.
Try to build from lunch outward so that
if you have to shorten the day,
we can go home.
There's outsourcing,
people who can answer the phone and things
like that that will actually be more
attentive than an employee sitting around
for eight hours with nobody there to help.
manage and monitor that so yeah so so
to that point guys like what I would
like for you to see listening to this
podcast is that you know your loan
payments your rent payment your software
payment your lab payment your supply all
of these payments are relative
on a single digit percentage of expenses,
I said that kind of complicated,
are very small expenses compared to wages.
And if you don't control your wages,
you won't make eighty to one hundred.
You won't.
And so I think you said something that
was interesting, Paula,
that I wanted to point out is that
even the first month
is not indicative to how it's going to
be in month two three four and five
the first month is always bigger why
because i push our clients to do all
that stuff to get some kind of vip
list get some kind of backlog of patients
so that first month and even the first
week is really busy and they're thinking
oh i'm open this is sweet i usually
see collections pop
And then it goes back down and then
it pops back up again because it's
sustained.
It stabilizes.
And your marketing is kicking in by month
four, five and six.
So so I would hope that month four,
five and six start looking pretty regular.
But month one, one is like exciting.
Two is super depressing.
Three is you want to jump off of
a bridge.
Four is a recovery from not jumping off
the bridge.
Five is probably like, OK,
I might actually make it.
And six is like, holy shit.
All of those people that came in the
first month, we reappointed.
So let's call it thirty people from the
first month.
And then we got thirty more new patients.
So now we're seeing double the patients
that we saw in the last in one
month.
And they're like, oh, my God,
we actually might make it.
And so that's how it goes.
And Paula always has to get the people
that want to jump off the bridge.
So debunking the startup on the financial
level is great.
Now those are the top three.
I do have two more.
So I have five, two more.
It's thirty minutes in.
I know.
I know.
And I'm not going to go into so
much detail because those first three are
probably the most important.
But the the last two that I that
I will throw out as far as debunking
a startup is
we negotiate your lease to give you lots
of flexibility in the beginning so your
lease only gets more expensive the longer
it goes out so you're so in the
beginning you're going to have a lot of
payment flexibility and a lot of ways
you're going to have free rent you have
free rent in your first few months if
the project's controlled so free rent
you'll you'll be able to cash flow and
make more money if you don't have rent
i promise
That's number one.
So number four is flexibility in the lease
that lets you be able to do this
at a much lower expense in the first
year.
The fifth one is lending.
Lending.
The lending debunk is probably equally as
important as all the others.
And that is getting enough money.
If you undercapitalize your project,
you're gonna be very stressed.
everybody's like,
I don't want to borrow that much.
I don't want to borrow that much.
You have to borrow as much.
Actually, Paula,
when you bought your practice,
what did I tell you?
You made me borrow.
How much more?
I think it was seventy five or one
hundred.
More than probably you wanted.
And you were like, well,
I thank God you listened to me,
but you didn't realize it until probably
month two,
three that you absolutely needed that.
Yeah.
It's not fun watching your checkbook,
you know,
payrolls around the corner and you don't
have that in there.
It is not, it is not a, uh,
You got to be,
you got to be a pretty even headed
person not to explode.
Let's just put it.
It's that payroll.
We just talked about it.
And so like,
if you don't borrow enough money, Well,
you can push, not that,
not that maybe not a bank loan,
but you can push, I mean,
you don't want to, but you know,
you can push a vendor.
You, you can't team,
you have to pay them.
Like you cannot be late.
Your payroll.
Yeah.
I mean, yeah.
I mean,
you even if you're late on a loan.
Yeah.
You're going to have repercussions and
that's going to really suck.
But you can't not pay team.
They're going to walk out like they're not
going to.
No.
Yeah.
The team you have.
You have to.
No, no.
It's exactly right.
So control their hours because their
expectation is to get paid on those hours.
Yeah, at first you're all happy paying,
like, oh,
they worked forty hours this week.
No big deal.
Well, after that,
you do that and you watch it.
You're like, OK, everyone out the door.
Get the hell out of here.
You finish your notes tomorrow morning.
I'll finish your notes for you.
Yeah, exactly.
Exactly.
So so so that that fifth that fifth
thing is get enough money, number one.
And number two,
there are banks out there that graduate
your payment.
So in the first year as a startup,
your payments are oftentimes lower than
interest only.
And so you have that flexibility built in.
The lease and the loan have smaller
payments in your first two years and three
years even.
And that gives you the chance to get
into profit.
And so borrow enough money and work with
the right banks that graduate your payment
continue to work, control your wages,
find a location that needs a dentist,
I think that's all of them.
And I'm telling you guys,
startups are scary at first,
but so are acquisitions.
I promise you we could have a two-part
episode on how scary acquisitions are.
So anything else to add or comment on,
Paula?
No, I don't think so.
I think you did a great job.
yeah well thank you and uh i pre
i appreciate it uh let's let's uh let's
shut it down but again as a reminder
like side this uh like uh subscribe all
the things and uh keep plugging into our
program as we deliver topics on how to
buy how to start and how to run
your dental practice um i guess until next
time we'll talk to you later paulo all
right have a good day thanks guys
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