(When Dr. Fontenot first joined The Team Training Institute, he shared his story with us about his initial success. After a few more years and a big practice expansion, he's sharing his story again with some key updates. Click here to read his original interview.)

Dr. Ian Fontenot, a second-generation dentist from Carencro, Louisiana, quickly realized the limits of a one-person operation. By the end of his third month, he built his practice up to 116 patients a month on a part-time schedule and turned a profit by month four. By his fifth month, he could no longer handle all the business coming in.

Despite his early success, scaling was a challenge as he attempted to learn and manage everything to run his practice. “I didn’t even know how to file insurance,” Dr. Fontenot said.

At 33 years old, his workaholic approach led to physical exhaustion three years into his practice. “It was insane,” Dr.Fontenot said. “I didn’t know what to do. I was working over 40 hours a week.When everyone would leave on Fridays, I’d keep one assistant with me just to keep up.” But when he threw his back out at only 33 years old, he realized he had an unsustainable business model. The traditional consulting advice was to stop taking patient insurance and raise fees, but Dr. Fontenot found this strategy misaligned with his vision of patient-focused, accessible care. It also didn’t solve his problem. “By dropping insurance, the business became more dependent on me because patients were paying a higher fee to see me,” Dr. Fontenot said.

After meeting Wendy Briggs at a seminar and beginning coaching with The Team Training Institute (TTI), he found that the consulting philosophy resonated with his own. “What struck me was when Wendy said, ‘You can make your practice whatever you want, and you DO NOT have to stop taking insurance,’” Dr. Fontenot recalled. “This was different than every other consultant out there. Previously, every consultant told me the only way they could fix my problem was to charge more for my services and get off insurance.”  

Implementing TTI’s strategies, including a focus on preventive care and patient experience, transformed his practice. During the first year with TTI, working out of three to four chairs, Dr. Fontenot cut the number of patients he saw in half and still produced more than he ever had, exceeding seven figures. Doubling his revenue twice in three years and halving his working hours, Dr. Fontenot achieved a patient-centric, highly profitable practice and significantly increased the quality of patient care, garnering over 800 reviews online. “We just continue to grow with what TTI teaches us,” Dr. Fontenot said. “Being involved with TTI, you see what’s possible. Going into this, you’re an island with preconceived notions of what you can and can’t do. Then you start meeting all these other dentists… people practicing one day a week, another practicing six days a week but only working three hours, so you can see all the possibilities.”

In 2019, Dr. Fontenot signed a letter of intent, looking to expand into a larger office space, but when the building came back structurally unfavorable, he backed out. And then COVID-19 hit. At the time, Dr. Fontenot had nine employees, plus himself. “I didn’t stop and continued trying to expand,” here calls. “COVID screwed up our growth a little, but we only shrunk by six percent. Then we rebounded and increased twenty-five percent.”

Booked solid, with no room to grow, a bottleneck threatened to restrict the practice’s ability to expand any larger. “We became completely capacity-blocked,” he explained. “We just had no more room to grow.The biggest challenge was how we could continue to grow and keep the same culture and core values while still providing quality care.”

Dr. Fontenot considered opening a second practice, however, operating in a small, rural area where reputation is paramount, he was concerned about maintaining consistency from one location to the next. Another fear was taking on business debt. To ensure culture and quality remained the same and confirm he managed his financial risks well, Dr. Fontenot stepped up into The TeamTraining Institute’s CEO group. This high-level coaching program helps dentists who have a big vision and want to grow a large single-location practice or into multiple locations.

In the fall of 2023, Dr. Fontenot opened two new locations while closing his initial practice. “A year ago, we started building two spaces at the same time,” Dr. Fontenot explained. “One in one city as a scratch second satellite location and one as a relocation of my primary flagship practice. The satellite office is 3,300 square feet, with ten treatment rooms in a high-traffic retail location about 15 minutes from our flagship. My primary location turned from 1,800 square feet and six operatories into 4,000 plus square feet and 12 operatories. They opened within three weeks of each other.”

Dr. Fontenot doubled his staff to twenty and has four doctors, including himself. Within the first month of opening the two locations, he saw a significant patient intake, jumping from 80 to 221 new patients in a single month. Throughout all this growth patient care has improved. For example, the number of teeth they protect with sealants has tripled since starting with TTI. Equally impressive, Dr. Fontenot has done no marketing in the last five to six years and only recently did a little marketing due to opening a second location.

Before expanding, his practice achieved over 20% profit after accounting for his and his wife’s salaries, a figure he is now using to fuel the growth of his dental practices.

This strategic move aims to grow the practice three to four times its current size. Inline with his five-year plan set in 2018-2019, Dr. Fontenot will reduce his clinical days to three per week in January 2024, allocating a day or two for administrative tasks. His immediate one-year goal is to stabilize the second office. At the same time, his longer-term vision for the next three to five years includes adding another practice, likely through acquisition rather than starting from scratch.

Dr. Fontenot’s story underscores the power of innovative, patient-oriented approaches in dental practice growth. The following are key elements Dr.Fontenot believes are crucial to his success:

Identify your principles and express them daily.

Knowing what you want for your practice is crucial. Dr. Fontenot and his team completed a vision day with The Team Training Institute, where they determined the practice’s essential principles and core values. This is reinforced by his leadership team and communicated clearly and repeatedly every day.  

“We’re all in the same bus going to the same endpoint,” Dr. Fontenot said. “I think a huge part of that is your reputation in the community. If your people don’t fit some sort of vision, the patients perceive that, and they don’t know if they want to be a part of that. But when you’ve got a unified team vision, and all have the same heart, I think people want to be a part of that, including the patients. I keep that close to my heart, so that’s what we try to do. The people that I have around me see that vision. We reiterate the vision every single day, even to all the new people. What makes the biggest difference is that the people in charge have non-negotiables and stick with these non-negotiables. It’s easy to say, ‘Oh, I’m going to cancel my schedule and have a day off, or I’m going to be aggravated this morning, and I’m going to let everybody see it.’The people in charge come level-headed daily and push for the same objectives every day. We show up to work and try to give world-class service; if we’re not, we need to figure it out. I feel like we have done that really well, even though we had so much stress and trying to open two offices at the same time, and I’m still practicing.”

Find Great People

A key aspect of his rapid growth was finding people who aligned with Dr. Fontenot’s values and were dedicated to his vision for the practice. He attributes his success in attracting high-quality staff, including dentists, hygienists, and dental assistants, to his investment in creating state-of-the-art clinics and providing high-quality training and education. The modern and advanced facilities appeal to professionals, who can visibly see and buy into the practice’s growth. This makes it significantly easier for them to hire capable employees.

“Having new, state-of-the-art clinics is a huge draw and provided a huge win,” he said. “Patients buy into the growth because they can see it. I’ve had an easier time hiring because of that. If I had bought an older office, or if I would have stayed in my current situation and renovated it a little bit, I wouldn’t have had the pool to get as many good staff members as fast as I needed to. The people that I have in my leadership positions have been with me for a long time. They eat and sleep that compassion and comprehensive care—and that’s huge. These great people are making this office theirs. This train is already on the tracks, and even if I wanted to stop it, the people around me have already completely adopted these values. They live it on a daily basis, and it’s pushing the office forward. I do not nearly have to do what I did in the early days, as far as pushing this agenda and these core values.”

Additionally, the staff is motivated by the opportunities for growth, including potential leadership and management roles, which are attractive to current and prospective employees. This dynamic environment, focused on education and growth, is a significant factor in staff satisfaction and retention.

“Being associated with an organization such as The Team Training Institute definitely gives us some validity from a staff point of view,” he said. “It gives credibility to the decisions we make because they know we’re not just making random decisions, but instead we’re thinking them through. That’s a huge value. Education is big, too. I’ve had a lot of friends whose staff members have left because there were no educational opportunities. For us, our staff members are consistently receiving updated new protocols. Doing new things is part of our culture. Staff like the idea that there are growth opportunities, too. It appeals to them to know they could jump into a leadership role or management role.”

Align Your Team with The Way You Want to Conduct Business

Dr. Fontenot continually focuses on training and education to foster a uniform culture, understanding and use of the distinct business methodologies for the practice. Investing time and resources, he regularly schedules training with The Team Training Institute and shuts the practice down for the day so everyone can attend.

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“A big part is the training,” Dr. Fontenot emphasized.“My office manager has regular calls with a TTI admin coach. Hygiene has their normal calls with a TTI hygiene coach. And two times a year, we have a TTI hygiene coach come in and train. We’re about to start all the new hires at both locations. Everybody who has never had the TTI Hygiene Explosion training will attend.We’ll close down for that—basically, take a day off and have both location strain under The Team Training Institute to get everyone flying in the same direction, using the same tribal language that we use. That’s a big part. We will continue to invest and attend some group team meetings when we can. From a financial standpoint, it can be hard to do all the stuff, but we try to do as much as we can.”

Work on Developing Great People

Dr.Fontenot credits The Team Training Institute for huge leadership development, which has contributed to his growth and peace of mind. “Other consultants aren’t focusing on the leadership of the organization past the doctor the way TTI does,” he said. “The whole point of the doctor CEO is to take on fewer jobs and less stuff. You must understand that you can’t do that without having other people to take stuff off your plate. So, the leadership development is massive. It’s a big deal in reducing the stress for sure.”

Taking training a step further, Dr. Fontenot underscores the importance of aligning his office manager’s decision-making with his own. To achieve this, for nearly two years, he consistently attended meetings with his office manager and a TTI admin coach. This preparation was crucial in enabling the office manager to independently handle decisions, particularly as the practice expanded. In the current structure, employees primarily consult the manager or team leads, reserving only complex issues for Dr. Fontenot. In the larger office, the office manager plays a central role, while in the second location, the lead front desk assumes more decision-making responsibilities. With the office manager efficiently handling operations and having access to financial tools like debit cards and QuickBooks, Dr. Fontenot is confident that the practice can run smoothly in his absence. This system ensures effective management and scalability of his dental practices.

“Getting my office manager to think like I think and anticipate how I’m going to make decisions was huge,” Dr. Fontenot said. “I was coaching her whenever we were taking those admin calls with our TTI admin coach for years before we scaled so she could make decisions. I knew when the time hit, she needed to be able to make decisions similar to how I would make them without asking me. Now, with the structure of the business, people go to the manager first, or they go to the leads, and I’m a last resort. So, if it gets to me, it’s a really difficult problem that other people can’t figure out. We’re still scaling some management. But technically, I could take off, and my office manager, other than signing the checks, could run the business if I had to walk away for a couple of weeks.”

Spend One-On-One Time with Your Doctors

By training his leaders, Dr. Fontenot was able to back off other duties so he could also spend time training and meeting with each of his doctors. This individually scheduled time helps new doctors feel more comfortable, makes them productive faster, and doesn’t make them feel like they are infringing on your time.

“What was really helpful is me physically making time to train each one of the doctors,” he said. “As they are starting, for at least the first 90 days I meet with them at the end of the day for30 minutes—just me and the doc. Once they get past the 90 days, I’ll meet with them for an hour weekly to go over cases or anything they feel uncomfortable with. I’m doing that in both locations, and that’s been huge. During the first go-around with my associate, I didn’t do that. This go around, my associate was able to be more productive at a year than my other associate was at three years in. So, I think that made a huge difference, and I find fewer issues.”

Learn How to Let Go

The Team Training Institute helped Dr. Fontenot eliminate the mindset of micromanaging his team. “You must train, delegate, and audit—and then you’ve got to let go,” Dr. Fontenot said. “That’s a big one, and it’s tough for people. TTI does well at teaching us to empower our team by giving them responsibility and authority to make decisions. Prior to TTI, on a scale of one to ten, I’d say I was able to delegate at about a three or four. Now,I’m at a seven on the delegation scale. It’s not perfect, but I’ve doubled in developing leaders. It’s an essential concept.”

Do Thorough Groundwork to Manage Financial Risks

Dr. Fontenot overcame his apprehension towards business debt by reevaluating its role in achieving growth. Raised with a mindset of avoiding debt, he learned through The TeamTraining Institute to view it as a strategic tool for expansion. This shift in perspective, coupled with careful financial planning, including maintaining cash reserves and streamlined operations, enabled him to leverage debt effectively. This approach transformed a potential source of stress into an opportunity for life-changing growth.

“My biggest fear was debt,” Dr. Fontenot said. “I had to reestablish my relationship with business debt and learn to use it as a lever to turn to increase my growth. As long as the numbers are right and you’re looking at it the correct way, debt doesn’t have to be a bad thing. That was a really big thing for me that The Team Training Institute helped me get past. I think a lot of people are afraid to grow. They worry about what’s going to happen on the other side. Now, I think if you get your ducks in a row, the growth shouldn’t be scary.”

Tiger Proof Your Practice

Prior to working with The Team Training Institute, Dr. Fontenot’s practice relied solely on him. While not yet completely duplicated, the practice is tiger-proofed twice as much as it was three years ago and is close to being completely covered should he need to step away for whatever reason. “It’s kind of scary to think about if something happened to you—not just your employees and patients, but your family,” Dr. Fontenot said. “My dad’s a dentist, and four or five years ago, he fell off a ladder and couldn’t practice for two months. They weren’t able to see a single patient. Luckily, my dad’s in a good position. He was 63 and everything was paid off. But it’s totally different for a man that’s 35 years old. My wife works for me, so that would be life changing. Now, because of tiger-proofing, technically, I could take a month or two off, and we’d be fine from a financial standpoint because I have other doctors, and we have duplicated every single position on the staff. In the next couple of years, adding another doctor in the second location and scaling the other practice is going to help us.”

Reviewing his journey over the last ten years since starting his practice, Dr. Fontenot reflects on the evolving nature of his stress levels as his dental practice has grown. Despite having nearly 20 staff members now, compared to three to six in the early years of his practice, he experiences only half the stress he did back then. This reduction is attributed to his developing leadership skills and a more focused approach to his responsibilities, delegating tasks more effectively each year. Additionally, Dr. Fontenot credits a significant portion of his ability to manage this workload to his wife, Kimberly. She handles many domestic responsibilities, including financial tasks, allowing him to concentrate on his business. He emphasizes the importance of having a supportive partner in life, acknowledging that his wife’s role has been crucial in enabling him to push his professional limits without burning out. For Dr. Fontenot, choosing the right life partner has been critical to his success and well-being.

“In the first two years of my practice, my stress level was almost boiling over,” he said. “Now, with 20 team members, it nowhere compares to the stress I had. Now, I’m at half the stress level. It sounds weird to say that a small office was more stressful, but I had no leadership tools back then. I was the office manager, the dentist, the CPA, the everything. Now, every year, I focus tighter and tighter and tighter on the duties that I do. So, every year, I’m taking more and more things off my list of what I must do. If it weren’t for The Team Training Institute, my practice would have shrunk because I had dropped all insurances, and there would have been a small fee for service practice with a small staff. While highly profitable, the flip side of that is you have all the risk in the world—because if I get hurt or ill, I can’t practice, and everybody’s out of a job. TTI helps me sleep better at night. Tiger-proofing helps. Plus, it allows you to take vacations while still growing the business. TTI has allowed me to do more things. I can take breaks, and the beautiful part is we’re scaling. I’m able to pick and choose things that I enjoy doing in the organization and then hire out for the things I don’t enjoy doing. Of course, the only reason I can run like this is because of my wife, Kimberly. I’m definitely an involved father, but she takes care of everything from the home front standpoint. She knows how to support me to run as hard as I can run. I would have hit a wall long ago if it weren’t for her taking things off my personal plate. To me, one of the biggest decisions you’re going to make in your life from a business standpoint is the partner you choose.”

Involvement with The Team Training Institute has significantly enhanced Dr. Ian Fontenot’s work-life balance, allowing him to be a more hands-on father and spend quality time with his family.

“The organization has been extremely good for me,” he said. “I’m able to come back at five o’clock and be there for my kids. A lot of times, I knock off when the kids are in school, and my wife and I take the day to spend time on our relationship, going for walks, going on dates, things we wouldn’t have been able to do. On the weekends, we’re able to pay babysitters just because of the financial resources that we have now. We’re able to spend time together, and it’s brought us a lot closer together. We also physically have the time to do it because she doesn’t have to work another job. I don’t think I would have been able to do that without having The Team Training Institute help me figure out the business part of it. But you could also have someone who doesn’t want to grow a big organization. They just want to get organized with systems that make them more productive while decreasing their stress. And that’s good, too.It’s one of the things I like about The Team Training Institute. It’s not cookie-cutter—they will figure out how to make it work for whatever your goal is, just like they have for me.”