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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.
Unknown: Start Up, Unscripted,
the questions you have with the
truths you need to hear.
Michael Dinsio: help doctors get
into practice the way they want
to get into practice.
Hashtag truth.
That's why we put it out there.
What we want to do is we want to
bring truth to the startup game.
Justin Schafer: And now your
host, Michael Dinsio. Alright,
alright guys,
Michael Dinsio: Alright alright,
here he is, Steve Anderson, my
guest for today. I'm a big fan
of Steve. I've learned a lot
from this guy. I've read his
book, solid book. And I'm really
excited to have him on today
because this guy brings a ton of
knowledge to the game of dental
construction. And I can't say
that about every contractor out
there. But I can definitely say
that of Steve. And we're going
to tap into some of his
knowledge today. So Steve,
welcome to the show. My friend.
Thank thank you for being part
of it.
Steve Anderson: Oh, I'm excited
to be here. And I really
appreciate the opportunity,
Michael?
Michael Dinsio: Oh, heck yeah,
man. Heck yeah. I mean, this is
our pleasure. So Steve, give me
a little bit about Denco. How
you started? You know, how'd you
get into the game? You know why
you still love what you do? Just
just kind of get give me Steve
Anderson - 101 here in maybe a
3o sec. little elevator pitch, I
suppose?
Steve Anderson: Well, I like
keeping things simple. The one
thing that is interesting, I was
driving to work, my 26 years
ago, and I'm gone. I am tired of
what I'm doing. And maybe some
of you can relate to this. Feel
beat up. It's all about numbers.
And just things aren't working.
And I'm going okay, so what can
I do different? And then my next
thought was, so if I'm going to
do that, who needs help? Going?
Wow, Dennis? Just pop no
offense, guys. But Dennis just
popped out there and say, Dennis
need help? Yeah, yeah. Because
all the experiences I've had up
to that point. And then the next
question is, is so how do I
become a rep, you know, a point
of value to them? And how can I
do things differently. And by
the time I got to work, I had my
business plan, understand we
have a big drive of 18 minutes.
Michael Dinsio: Did a business
plan in 18 minutes. In record
time.
Unknown: You know, bottom line
was it was just about focusing
on dentist, I let all the
residential go I let all my
other commercial go and I said,
Okay, what can I do to make this
happen. And I went to the THE
the Pride Institute, and I did
some other things. And quickly,
I realized something that
everybody has their own package.
And they try to sell their
wares. And they take this to the
dentist and they take the
dentists and cram them into
their program. But a lot of
times they forget about who the
dentist is. And all of a sudden,
the dentists lose their
identity, they lose how they
want to do things, and they lose
their dream, their dream gets
morphed and shaped differently
Michael Dinsio: Into a box in a
box. Into the program!
Steve Anderson: Into their box.
Yeah. And I thought this ain't
right.
Michael Dinsio: Yeah, I see. I
see that all the time
Steve Anderson: So that's where
the dream of my first book was,
Blueprints for Success. And it
was about basically a book that
every time I lectured at the
dental colleges and that was my
other dream is. I wanted to
lecture at both Midwestern AT
Stills locally, to help them
make better choices. And that
was the whole idea. You know,
it's simple premise. But it was
interesting of just where do you
start? And how do you take off
from there?
Michael Dinsio: And, guys, I
want to remind you, we're
talking to a general contractor.
I mean, I, I'm saying that I'm
saying that as as not being a
jerk, but what I'm saying here
is that Steve actually cares
about your dream, your vision,
your business, you're not gonna
hear contractors talk like this,
which is why he's the perfect
candidate for a podcast
interview, but like, the guy is
talking about vision right now.
And and he's a general
contractor, which is super cool,
because you're right, Steve. I
used to be in the wheel as I
call it back in the day, and now
I'm outside of that wheel. And
I'm seeing the wheel being a
problem for Docs because you're
right, everybody fits them into
their program, quote, unquote,
I'm doing air quotes folks for
for those of you that are not in
on the YouTube channel, but "the
program". So, Steve, So general
construction, how many projects
you think you do a year ish, or
over your career, whatever
Steve Anderson: We've done over
1000 design, build dental
offices.
Michael Dinsio: Design build.
Okay, so 1000 design builds. So
folks, if you don't know what
Steve means by design, build,
rewind, and go check out those
other episodes, we kind of
define that. We don't need to
get into that today. But it
might come up because the two
things that I wanted to discuss
today, in no particular order,
is why construction costs have
gotten so out of whack. And I
know that's timestamping
something today. But I'm
noticing that it's it's an
overwhelming, or it's a theme
throughout my career just in the
last 15 years that construction
was X and now it's Y and over
the years, it's just gotten even
crazier, more recently. And and
so I want to discuss, like, Hey,
how's this impact the doctor?
And why things are happening the
way they are? And then number
two, what are some things we can
do, especially with all your
knowledge, as a design build
firm? What are some things we
can do to make a construction
project more budget friendly?
Doesn't mean that we we make it
look like a boxed ugly, like you
know, sorry? Comfort Dental, but
a Comfort Dental. But there's
absolutely things we can do.
Right? Steve, so I want to tap
into that years of experience.
So let's hit the first one
inflation. Construction costs
are wacky, I don't think... I'll
say it for you, you're not
pocketing the difference as the
general contractor. Your
expenses have gone up, Right? Is
that what's going on?
Steve Anderson: Yes. In fact, my
CPA, we're just having a Zoom
meeting.
Michael Dinsio: Just a minute
ago. Yeah.
Steve Anderson: So last week, we
were talking about Steve, your
I've heard that I actually just
heard that the other day in in
your profits down? and I said,
Yeah, cutting my profits, I am
cutting, but the costs keep
going up. And the challenge is,
is yes, my volume went up, and
my profits went down. And
percentage wise, what's
interesting is in this
marketplace right now, is we're
getting hit from not only the
suppliers, where they have cost
increases, and you've all seen
that whether you go to Home
Depot or the grocery store,
wherever you go, your suppliers
and vendors. But, everybody has
cost increases. And then on top
of that the challenge is is the
labor pool. You know, for years,
everybody says you're to their
kids, you need to go to college.
Well, unfortunately, that's left
the labor pool out. You know,
the trades people. And not only
that, but you know, in Arizona,
they had this big thing where a
lot of Hispanics went back to
Mexico because they got tired
and scared of other things. And
here, we're at an all time
influx of people like in this
valley. I'm told it's between
seven and 9000 people a month.
the Phoenix Valley market.
And what's really frustrating is
that has a impact on the
availability of professional
trades. And you know, finding a
good plumber finding a good ...
and if you don't already have
relationships with new plumbers
and electricians and stuff, you
can't grow. Because, nobody has
time for you. You have no
relationships. On top of that,
the issue is, They're seeing an
opportunity too charge premiums
for their work. A good plumber
and a good electrician are
starting to charge premiums for
it, because they can get it.
Also they're struggling because
they can't keep their manpower,
and then they can't add new
manpower to it. And so they can
only handle so much.
Michael Dinsio: It's a trickle
down. You know, it's interesting
as you were talking, you know,
my audience is for the most
part, non owners right now.
Okay. And, folks, you don't know
this, but as Steve was talking
about it, the same exact issues
he's having is what you're gonna
have, you know, the insurance
companies are bringing the
profits down, right. The the
volume is going up sometimes a
lot of cases with dentistry and
then and then your costs like
supplies and stuff and labor are
going up. So businesses
business, right, small
businesses are definitely
getting punched right in the
face. But Steve, you're still
doing well. I'm doing well.
Small businesses are still
working. Dentists are still
doing great.
Steve Anderson: You know I work
a little harder for it, but you
know? But the big issue is is
like dentist, you love it. Once
you have that passion, once you
have that thing built within
you, it doesn't matter really
what I make, I just get the
opportunity to go work. Yes,
you'd like to make money and
like I like to be profitable.
You need to be profitable to be
there for your clients and your
patients in the future. But
really, the idea is, is we're
gonna get through this. And it's
a situation where it's a cycle.
And if if the government just
let it go, its cycle will be
okay.
Michael Dinsio: Hey, here we go,
Politics. I like it, I like it!
But this is a this is a no
politics zone. But I like what
you're saying. But if we don't
want to piss everybody off, we
better keep away from from that
conversation.
Steve Anderson: I will. I'll
step away. lol
Michael Dinsio: I do want to hit
a little bit on the labor and
the resources, the lack of
resource because I'm finding
this is not nationally, not
Steve, and Arizona, this is
nationally, I'm finding that the
bigger players like yourself in
Arizona, are more resistant to
getting more people involved on
the bidding process. I know you
guys don't love bidding, I think
I think a lot of the doctors
want to bid, because they don't
want to feel like they're being
taken advantage. And the bidding
process does make them feel like
they're getting the right price
that that Steve isn't just kind
of, and okay, so whatever bid or
no bed, let's just throw that
out the window. But like, the
idea of not finding enough
plumbers to get into the quote.
So only, like, for example,
Steve only asking one guy for
pricing.
Steve Anderson: Yeah. So first,
let me backtrack just a little
second about personnel. You
know, personally, as a company,
I've been very blessed with some
very good people, and I pay them
well, but on top of that, when
we first started having
increases, I gave them across
the board a $2 - $3 raise, and I
just did that again! You know,
and we just keep bumping their
wages, and not because we think
they're exceptionally well, we
do but on top of that, we want
to make sure that they're not
looking around.
Michael Dinsio: But you're
talking about people that you
you employ at Denco. Yes, so you
do... So folks, I just want you
to hear this, because when
you're interviewing contractors,
you know, some contractors have
no services in house and they
and they bid all divisions or
all the all the things. And some
contractors have things in house
too, right?
Steve Anderson: And a mix of...
Michael Dinsio: And a mix of.
And so what you just described
as the services that you have in
house, and you're giving your
folks a bump in rates, which is
great, right? Because they need
money, and you want to stay on
top of
Steve Anderson: Well they gotta
survive, and just the cost of
living has gone up tremendously.
Michael Dinsio: So just that
part, but but just.. And that's
awesome. And by the way, by
Steve, having folks in house, he
can probably be a little bit
more competitive, because
there's no markup in that
particular division. So if it's
framing, for example, Steve can
get a little bit more
competitive, the more people he
has on staff. But but I want to
talk more about the subs.
Because, again, back to my
original issues, the contractors
just kind of have their favorite
sub and they just asked that one
plumber to bid the project, just
the one and they're not getting
multiple. And that seems to be a
thing. Why is that? Give me why
is that?
Steve Anderson: Yeah, we also we
pick trades for the project. You
know, when we have a very
critical time sensitive project,
there's certain subs that I
wouldn't even include and it
just might be one plumber, one
electrician, one mechanical. I
know because of my experience
and the challenges I have that
we repeatedly run into issues
where there's nonperformance and
they have excuses not to show
up. Or, oh I forgot to order, or
I didn't get the spec in and all
sudden they show up of material
that we didn't approve and just
lots of issues. And so you want
performance. And so that's where
we go to people that we know
that can perform and do well.
Michael Dinsio: Yeah, yeah. And
then back to there aren't enough
plumbers. So if there were
enough plumbers who knew dental
and could do a good job, then
you'd be okay with bringing in
multiple people, right? So it
sounds like in some situations,
you've got one group that does a
fantastic job that always
performs and then you've got
maybe to others that are just
not just not getting the job
done.
Steve Anderson: Well we have the
ABCs, we have the extremely good
ones that we can always depend
on. And sometimes they get a
little attitude, but we, you
know,
Michael Dinsio: You deal with
it, lol!
Steve Anderson: They still do
the excellent job. And the issue
is, is, then we have the other
group that they're good. And but
they're not excellent, they're
good. And they'll get things
done. And we still get things
done in a timely fashion. And
then there's the C group where
they might be a good price
point. But, man, they're hell on
wheels from the standpoint of
they just mess up with a
schedule and constantly
rescheduling and doing things.
Michael Dinsio: And who hears
about that? You do! When the
doctor is mad because you're not
on track, you're the one thats
on the line.
Steve Anderson: In my mind
schedule is the most important
thing to me, because especially
when dentists want to do a
remodel, what are they
interested in? As few down days
as they possibly can, and they
want to make sure that it gets
delivered accordingly. And
that's one thing we're known
for, is be able to deliver what
we promise.
Michael Dinsio: Yeah, folks, I
hope you're appreciating this
conversation because they are
business is too. They are, the
contractors and they are they're
getting hit from all angles.
You're coming at them for
timeline, you're also going to
hit them up for quality a punch
list at the end of the project.
If it's not good, it's all on
the contractor shoulders. And so
by you wanting it all, and I'm
finding that a lot of my clients
want at all, they want the
cheapest, they want it to be the
fastest, they want it to be the
best quality well, okay, I don't
know if that even exists.
Steve Anderson: I just met a
client yesterday that he's
having me finish some things
because he said I can't put up
with this guy anymore. And he's
been on the project 17 months.
It was supposed to be a six
month design build. And after
all that, he's saying, I'm told
I'm gonna have a permit. I've
heard this for the last three
months, I need a result a
seeable, I want to be able to,
you know, go to work. So we're
gonna go in and do some
remodeling on a project that is
done. Just because he doesn't
Michael Dinsio: Yeah, yeah,
yeah. Well, do you see? Do you
have the conversation with the
client? And say, hey, look, I
can get this price down. But let
me let me tell you what's going
to happen. What's going to
happen is you're going to be two
months late, and that can't come
back on me.
Steve Anderson: You know, and,
and even before that is, you
know, people, I would say
probably 90% of our clients are,
we're the only person that they
come to, and get a quote from.
And I say, why is that? Well,
what's interesting, it's no
different than I found in what I
teach at the schools is, you
know, if you can trust someone.
You know, the bottom line is,
you know, in our book, we talk
about how you can tell, they're
trustworthy, and you want to do
your due diligence. You know,
there's such a thing as earned
trust, versus just blind trust.
But with earn trust, and you
have that ability to perform.
You want to go on seek, wherever
you are in the country, do your
interviews and spend your time
finding out is it someone I can
relate to? You know, little
things, you know, they say, I'm
going get the quote to you in a
couple of days. And three weeks
later, you get it... Is that so
many consider? You know there's
telltale signs that you can
tell, you know, you just got
done pouring your heart out, and
the next thing they're doing,
when you're done talking,
they're talking about something
totally different. Are they
listening to you?
Michael Dinsio: Yeah. That's a
good one.
Steve Anderson: You know, or you
just, you just got, I just had
an architect. I met with a
client not too long ago, and he
had a full set of drawings and
plans in hand and said, Steve,
let's go to work.
Michael Dinsio: Okay.
Steve Anderson: And I said,
let's set it aside and talk a
minute. And that's the thing
that gets missed. Is someone
asking you questions, and I'm
looking at his plans, and I'm
looking at him and said, you
just got done telling me that
the guy that you're hiring is
100 pounds bigger than you and
you're already I bet you're too
tight in the operatories. You
said, I had a specialist 10
years ago designed it for me and
I hate the damn thing. The
operatories suck, and I said do
you know that all your new six
operatories are exactly the
same?
Michael Dinsio: hahah yeah
Steve Anderson: And I said, you
have a six foot hallway out in
the hallway that we could move
back a foot and a half and you'd
have all the room you want the
opportunities. inI seen his
mouth drop and he says you could
do that? But everyone listening,
just keep in mind that what's
missing right now.. Is just find
that trusted professional that
you can count on to ask those
extra questions and look come
alongside you. And it's not
about trying to sell you
something, it's about giving you
good advice.
But Steve, but Steve, I work
nationwide with hundreds of,
quote unquote, great folks like
you right? Across the country.
And I'm going to tell you right
now, people aren't asking enough
questions like you, like you
are. So my advice on top of that
advice is not only just get good
people that are asking good
questions and listening. My
advice is, take ownership of the
project. And, you ask more
questions. You dig in, you
understand the process. Because
if you back to the blind trust,
if you're blindly trusting your
team, who is the man, the woman
who gets the job done in that
particular market. They're still
back to what we were saying in
the beginning the program,
quote, unquote. That everybody
is fitting you in and that's how
you get a small operatory versus
just extending it a foot. Which
is no problem as long as it's
ADA compliant, and get a
wheelchair down. Right? So I
mean, of course, you can do it!
But you just got to ask the
questions.
But the biggest thing, Michael,
that I see repeatedly as the
doctors don't know what
questions to ask.
Michael Dinsio: Yeah, that's,
that's true. Well, that's what I
Steve Anderson: But, there is a
risk!
come in for. But hey, this isn't
about me. This isn't about me.
Michael Dinsio: I'm gonna go
there. I'm gonna go there.
This is about you. But that's
that's exactly right. They don't
Don't. Even this podcast! Even
this podcast! I mean, Steve and
know what questions to ask.
However, I will say that the
market is changing in that free
information is very accessible.
There are a lot of good things
to learn. But there's...
I are trusted advisors, we care
about our clients. But Steve's
advice for client A, might not
be for client B, and client B
might not be for C. There is no
program with Steve, I bet, or
with me for that matter. So even
the information that you're
hearing on my podcast, or this
episode might not be perfect for
you.
Steve Anderson: That's right.
The little thing that gets
missed is when I talk to
students, and the big thing I
say is look around the room. Are
you all different? You bet you
are.
Michael Dinsio: Yeah, heck yeah.
Steve Anderson: And the biggest,
biggest single thing that gets
missed in the programs that
people put out there is they
forget the identity of the
dentist. Yes. And the one thing
is, you want people that are
jump on board with you and help
you to the process where they're
looking out for your best
interest. So they're coming up
to you and giving you great
ideas and options and ideas.
Suggestions. And that's what
Michael Dinsio: That's right.
That's right. All right. Let's
you're looking for.
get back on construction,
because that's what you know,
most best i love i i love having
conversations with Steve because
it never turns into
construction. It turns into just
good business conversations. But
Steve knows a lot about
construction. So we talked about
inflation. We talked about the
crunch word that that
contractors have, where there's
timelines and profitability and
inflationary expenses, like
labor and, and lumber and all
the things. Steve, let's talk
about things that we can do to
minimize the costs the all what
can we do to offset what we just
talked about in the beginning of
the program, labor, all the
things are up. What are some
things that we can do to lower
the cost and construction?
Because construction is
literally like 60% or 70% of the
total project budget. So if we
could focus on construction and
Value Engineering and things
things that you know that I
don't know that the doctors
don't know, if we could just
save 10% or something in your
department, that's big dollars.
So what are some of those
things?
Steve Anderson: First start with
your team. You know, once you
find that trusted person, ask
him for options because your
situation is going to be unique
in that fact alone. So start
with your architect, you know,
sometimes they they create a
situation where it's over
designed, and so by going to
your contractor..., simple thing
that I do is I always do a
budget when I first get a plan
and a preliminary floor plan and
then I do a budget when I get
the final plans back. And then
when I get my numbers in, I'm
going wow, electricals really
high here and it's a quick catch
really realize that and hey, you
know, there's some optional
lighting availble. Sometimes
electricians come up with some
ridiculous lighting packages
that you can save thousand, tens
of thousands of dollars just on
a package. The other issue is,
is going into your contractor
and just ask him for other
suggestions as you design the
project. Another thing to keep
in mind is, if there's a
designer involved one thing that
we know about designers, Now, I
gonna be crass on this is...
Michael Dinsio: Go do it, that's
the kind of program this is go!
Steve Anderson: Okay. It's like
herding kittens, herding cats.
The one thing that we know about
these cats that are running
around with these great ideas is
usually they have no limit.
Yeah, and so I I've had so many
designers over the year, do a
little smoke screens, and oh,
everything will be fine. And
everything will be in the
budget, and the last minute that
goes its way over budget and
can't get it in. And so that's
where you need your team. That's
where we talk about is find that
trusted person to really helped
you oversee the whole project,
and then also help you with
those little things. Then you
get from your contractor and
your trusted advisor to help you
look at things that also can be
added later, you might have some
great design features, and I'm
not knocking designers, because
there's a great place for them.
Michael Dinsio: Absolutely.
Yeah,
Steve Anderson: But understand
what's really important is
understanding that there's a
budget and understanding that we
need to get within it. And by
doing that, as sometimes it's
simply taking this beautiful
item/object out. Yeah. And you
can still build the room and add
whether it's a water feature,
whether it's a
No not for start ups. No water
features for start ups.
I agree with you, but whatever
it might be, but you know,
whether it's a special wood
wall, or whether it's, it's a
special ceiling, or something
that can be added.
Michael Dinsio: Alrght so,
Steve, to that point. I, love
that, folks, I just want you to
digest this for a second. So
Steve suggesting that you
partner with your contractor? It
doesn't have to be so adversary.
I mean, I get that in the
beginning, you have to earn
trust, like Steve said. But at
some point, you have to trust
the partner. Okay, if I could
say this in a different way.
Steve Anderson: Well let say
this... let me give you an
example. I had a doctor that I
did a class at the school and he
took my book, and he, and he was
getting ready to do his office.
And we gave him a budget and and
then we came back with a final
price. And there was some things
that he added. And so he got a
designer involved. And he said,
Steve, you know, I went through
and, you know, overall, I'm 15%
high on my budget. He said,
Steve, we need to come down. And
what can we do? And I am going
High Five! You know, he got it.
He understood, that there's a
budget. It's not there to just
look at and say I can't do
anything with a budget is
something in which you work
towards keeping that?
Michael Dinsio: That's right.
Once you do commit to your
partners, the best person the
best partner, to your project is
going to be with your contractor
to try to find opportunities to
cut costs. But and they won't,
they won't usually give you some
of them will... But they usually
won't let you tap into their
knowledge until they're on your
team. It's like giving free
advice. And then you don't pick
them and you go with another
contractor after this contractor
busted their ass and can get you
all these $30,000 Savings of
ideas and then you just walk
over to the other contract.
That's not cool. So I always
talk about like, You got to find
your partner. They do need to
earn your trust. But you're
right, the architects and space
planners, they... When I was a
banker Steve, we got three
minutes, so just hang tight.
When I was a banker. Do you know
how many calls I got from the
space planner and architects
Thoughts about that?
about budget? Is like zero, like
maybe one or two in however many
years I was a banker. Do you
know how many calls I got from
the contractor? About budget,
now? I know what you're thinking
audience you're like, Oh, those
guys are trying to figure out my
budget so they can max it out?
No, they're trying to make sure
that it works because they care
now. Sure. Again, you know, the
audience Steve is probably
thinking like, well, they're
asking for the budget so that
they can max it out and and pad
their pockets and sure there
could be some folks out there
Steve Anderson: And also asking
whether there is a budget, you
that are doing that. But the
whole point is, if you're not
asking about budget, then are
you really a partner to the
project? I mean, you got to
think about the other way too.
Sure, there could be some bad
guys out there. But if someone
isn't asking about budget, then
then are they really spending
your money wisely? I don't know.
I don't know.
know, and some people just say,
Oh, it'll just work and, and
there's always, I have a client
that I did five offices for
we're about to do is six, and he
goes, I've got it all covered,
and we're fine. And I said, toy
with me. And we went through a
budget form that I have, and I
said, let's just go through
this. And we did it and came up
with a number and I said, so
what were you expecting? He says
about $150,000 less. It wasn't
just construction, though. It
was talking about equipment.
We're talking about all these
things. He's going oh, crap! So
it's important to look at.
Michael Dinsio: Well Steve,
sorry, to to speed that last
segment up. We're out of time.
I, so appreciate your knowledge.
Folks, if you haven't gotten
Steve's book, check it out.
Steve's a fantastic resource for
you. Denco is a fantastic
company to partner with. I know
that most of my audience is
national. Steve primarily works
in Arizona. So if you're an
Arizona Doc, you need to reach
out to Steve. But thank you,
sir, any last bit before we get
cut off here? Any last? Last
thing?
Steve Anderson: Just follow your
passion. And be true to
yourself.