Most practice owners don't think about their exit strategies until they near the end of their careers.
Dr. Rob Herron decided to think through his legacy early in his career and made a key decision to utilize Invisalign in his practice in order to create the impact in dentistry that he wanted.
Dr. Herron is joining Dr. John Meis and Wendy Briggs on the podcast today to talk about exit strategies, purpose, and how he used Invisalign to propel his practice forward. His approach to Invisalign allowed him to increase production and set his practice up for long-term success. Listen to learn exactly how he did it.
S1 00:00:01.932 [music] Welcome to the Double Your Production podcast with the Team Training Institute. The one place designed for dentists and their staff, who want to grow their practices by following in the footsteps of those that have done it, who are in the trenches, who know exactly what you’re going through. And now your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs.
S2 00:00:27.178 Hey, welcome everybody to the Double Your Production podcast. I’m Dr. John Meis and I’m here with Wendy Briggs. Wendy, would you like to introduce our guest?
S3 00:00:37.468 Absolutely. It would be my pleasure. So we have invited Dr. Rob Herron, one of our all-time favorite doctors, been working with him for, gosh, close to ten years now, and we are so excited to have him on our podcast today to share some really important insights with you about a strategy he’s embraced in his practice. But just a little bit about Dr. Rob. He practices in a relatively small town. He’s got two practices, one in Columbus, Kansas, and one in Pittsburg, Kansas. So he practices in rural America, but there’s still something really remarkable there. And we love Dr. Rob, we love having him at our events, everybody loves him, and I know you will too. So, Dr. Rob, welcome and thanks so much for being on today to share some of your insights with us.
S4 00:01:22.942 Well, thank you. That’s quite an introduction, Wendy. I’ll take it for sure [laughter].
S3 00:01:28.414 Well, you deserve it. It’s well deserved. Well, good. Well, some of the things that we are going to talk with you about today is really a principle that Dr. John and I have talked about – Dr. John teaches it really, really well – about knowing what your endgame is before you actually get to the end of your career. So, Dr. John, if you want to give just a quick overview of that principle and some of the things that we see that are very common mistakes the doctors make, and then we’ll let Dr. Rob talk about how some of these principles influence his current strategy.
S2 00:02:06.787 Sure. The typical trajectory of a dental practice is there’s growth during the first five or six years, and then it levels off. It remains flat for the next 20, 25 years, maybe a little longer. And then it starts to trail off and get worse and worse and worse, and that’s the point at which dentists usually then retire and try to sell their practice. So they’re selling their practice at the lowest value in 30 years, right? What happens is, because they didn’t plan for their retirement or their endgame, they lose much of the value of the practice, and the practice hasn’t evolved in a way that makes it easier to sell. So we talk about the endgame is choosing how that’s going to go so that you’re doing it by choice, not by default. And there’s several different endgame strategies that we teach, and Dr. Rob picked a very, very good one and he’s going to be extremely happy that he did it. So, Dr. Rob, you want to just kind of walk through your thought process when choosing your endgame?
S4 00:03:12.706 Absolutely. Of course, you know that that was one of my presentations over the years that has stuck with me the most. We’ve talked about that. Because it’s important, especially here in a rural situation. You maybe have some things going on differently than, say, in a large city, where there are associates and some are looking to live in that large city. When you’re looking at a smaller area, the way the paradigms have shifted, you have to be a little bit more careful about how you go about it. So listening years ago to what you’re saying, I knew I didn’t want to probably do the first three of what you talked about. I either wanted to– really what I wanted to get to was the legacy which is, of course, there are the practices continually to be built, there is potential of having more than one practice to have available and stay involved in the practice until you’re actually ready to leave, and then you can just go. But that’s why we did build this second practice about five years ago into a town that’s a college town that’s a little bit bigger. And people listening to this will hear 20,000 people and kind of smile when they say that’s a little bit bigger, but the first town was 3,400 that I started in about 30 years ago. And the writing on the wall was very obvious that I would never find someone that would come in and buy that practice. That just wasn’t going to happen. As proud of it as I was, that was not how things were going. And so I knew that I needed to get into a larger area to where there’s more going on, there’s more patients availability. They talk about ratios. Some are into it and others not, but we’re at about 1 in 5,000 in the city up here. So we’re just going along that path of trying to build something and continually build. And, Wendy, it was September of 2006 when I first heard you. So we can nail it down exactly because that’s the day that really pretty changed how I was looking at doing things. And since being a part of Team Training, our practice collections have grown times three. And I remember, John, you used to do one there are 3X, presentation that you used to give.
S2 00:05:58.329 That’s right, yeah. The 3X, yeah, we did it.
S4 00:06:01.184 And when I first heard that, I just, “No, that’s not going to happen.” And I’ve been able to live that, and it’s really, truly amazing. I’m 55, so I knew that I needed to start looking for that endgame. And I don’t do extractions, I don’t do endo, so I was limiting myself, and knowingly limiting myself. So I started to work towards a different endgame that I thought I could do even well in my 60s, and that was orthodontics. And I’ve done bands and brackets since 1996, and I started doing in this line in about 2006. And in the last few years, that’s really become more and more of the Invisalign that we’re doing because of some changes and how their protocols– so we can do a lot more difficult cases faster. So it just became– to me, that looks like a good way that I could bring in associates that would do all the restoring and so forth, and I can still have a hand in it and still be a part of it without just sitting at home and watching TV.
S3 00:07:22.786 So this is what I love about this answer, Dr. Rob, is that you recognized, “Okay, these are the things that I enjoy doing,” and you looked to the future, right? And you thought, “At some point, I’m going to want to give up the throttle a little bit, and I still have some things that I feel good about doing.” And you knew your vision was to build a legacy practice, so that that would continue on after you were gone. And that’s what you’ve been working hard to build over the last 10, 12 years. But what’s awesome, what I think is so remarkable about where you are now, is that then you really, distinctly defined your strategy and you thought, “Okay, we’re really going to grow the Invisalign side of this practice,” because of the technology changes, and you saw that that was kind of the way, the trend of what people were wanting. So what I think is remarkable is I think– don’t be so modest. Tell our listeners what just happened last year for you.
S4 00:08:16.534 I was blessed, let’s start with that, okay? [laughter] I took some courses from Dr. David Galler, and there’s a community that he had started within Invisalign that we do a lot of sharing. Everyone’s so diverse that if I told somebody how I did something, it wouldn’t be used against me competitively. So we share a lot of ideas, for those who are familiar with Invisalign, we share [client?] checks. We talk about, “How would you go about doing it? Do you think I can do it?” And we have all levels of people in this group, from someone that’s been doing it for 12 years, like me, to someone that just has started and just is out of school. What I think you’re talking about is that I was named one of the practices of the year. And so I still have to say it, it’s within the Galler group. And there were several of those names, but it was practices, it was doctors that influenced this group to become what it became. And my part of what I did was I think I was very active in the [inaudible] community, and very much worked within it to encourage people. And just honestly, you guys know me, I was just being myself. I didn’t really think about it. I was just being me. And that ended up being a very nice award back in September. And so I’m very proud of it and humbled by it, and it was very touching to be in that big dinner. It was very surprising. I wasn’t expecting that but very surprising to be a part and to be recognized for being a part of a greater group.
S2 00:10:20.469 Yeah. That’s awesome.
S3 00:10:21.641 Yeah. It’s so great.
S2 00:10:22.465 Congratulations, and that really is great. So if we go back to– you were talking about the legacy model. And for those who aren’t familiar with it, it really is the model that you build the practice, you get associate dentists at the appropriate time, you ask them to invest in the practice, and you use those dollars to build the practice. So it’s somewhat of a matter of timing. So they’re building the value of the practice so when the times comes, you have built-in buyers for your share of the practice, and you have retained and maintained, if not improved, the value of the practice. And then Dr. Rob can just go to Invisalign, do some exams, maybe some hygiene exams, and just support the other doctors in that way as the practice continues to grow, and grow, and grow. It’s an outstanding strategy.
S3 00:11:22.917 Absolutely.
S4 00:11:24.236 And it is, and then I thought that it was really almost my only strategy where I’m at. I mean, the other strategy was you closed the door and you say, “Hey, it’s been nice.” But that’s not a really good benefit strategy, and–
S2 00:11:41.866 Yes. Certainly not for your patients. Yeah. Certainly for your patients.
S4 00:11:44.977 No. No.
S2 00:11:45.472 And not for you either.
S4 00:11:47.569 Or the 16 ladies that work for me, just, “Hey, thanks. It’s been nice.” So trying to make this work in a rural environment is the struggle, and I’m not complaining by any means. It’s just things are different and you have to be able to change, and that’s what we’re trying to do. I’m at two offices. I have another place where I can put one if there were two of me [laughter]. But as other rural practitioners that are about my age or so forth know that it’s very difficult to recruit to a smaller area. It can be done, but it’s a different challenge than if you were to be in Dallas. They have their own challenges. I think each one has their own set of, “Okay, I’ve got to make it work like this.” And for us, it’s literally finding someone that’s willing to come to a smaller area, at least initially. But with that being said, what I have changed my areas of looking is going to maybe someone that’s not right out of school but going to someone that’s maybe been out three years, five years, that have maybe been working in other situations that just aren’t working for them. And to give them a place to come and work in a private practice and with the things that that entails. And so that’s where, just even as we speak, we’re kind of looking at what it would take to recruit doctors from maybe a not so great situation.
S3 00:13:42.423 Right. And what’s interesting about your structure is the opportunity to be huge. Right? Because you said right now you’re referring extractions and you’re referring endo. And so if you have– if you’re going to attract or recruit a doctor that enjoys those specialties within your practice, then it’s really incredible. I know you’ve recruited some associates in the past that have done extremely well from the very beginning.
S4 00:14:05.683 Yeah, they did very well. Because also the biggest thing for us docs that’s [inaudible] docs to know on something like that is that you have to give them a chance to succeed. The young man that was here for about six months, before he knew, he had to go home. Mom was sick. But he did five implants in that time. He did several units of crown and molar bridges, and a lot of single units. I knew I couldn’t cherry pick the cases because he would be disgruntled and not be making money, and soon leave just because he’d have a better opportunity elsewhere. So I think a lot of times we have to realize– I knew that I was going to take a production hit the first couple of months. And actually, it ended up only being the first month that he was here, and then I saw my projection jump above what it was before he came. So I think there’s some things there that we think it would help one way but it actually works out another way. So that’s what I’ll be looking for. Again, now I’ll be looking for someone at least initially to be coming as an associate and take some time. Right now I’m working five days a week. I love dentistry, but I would like to maybe be able to take a day there somewhere that I don’t feel guilty about [laughter]. Because if I’m not there– well, because my staff, they all want to work full-time, and it’s hard to keep 16 people busy if I’m not there. So just someone to come into the practice work as an associate. And I have to be flexible. If it’s someone that wants to work four days a week, five days a week, I’ll find a way to make that happen. If it’s somebody that wants to work two days a week, I’ll find a way to make that happen. Now, I know that I’m the one that has to be flexible in how I’m looking at the next 10 years. It may not be like what I’m exactly looking at. It might present itself in another way. And so I know that I have to be prepared to go, “Well, I didn’t see that coming, but let’s run with it.” And–
S3 00:16:30.020 One other thing too, Dr. Rob, that I think it’s so interesting and so fascinating about your [inaudible] focused so much on the Invisalign, is that even though you are working five days a week, think about how that has probably, dramatically boosted your revenue without putting too much strain and stress on you as the dentist. Right? So do you mind sharing with our listeners how many Invisalign cases you’ve done recently or did last year, just so they can kind of get a sense for how well that strategy is working for you?
S4 00:17:01.988 Sure. For years, I would maybe do five cases, seven cases of Invisalign and then the rest was bands and brackets. About two years ago, I hired in a staff member that has been a treatment coordinator for someone else that did a lot of Invisalign. And she basically said, “I want to keep a job here. I don’t know how to assist.” [laughter] She says, “I want to help you build the Invisalign.” And we did. She wanted to make sure she had a job. And so I went to the Galler course, which is called Reingage, and we immediately started doing– we started before that, but we’ve been averaging between 60 and 70 cases a year in Invisalign. And that’s teens and adults, so we average about five cases a month, little over one a week. And that can grow your revenue. I mean, it really can. It can make a change into cash flow as well. But as we speak [inaudible] again, we see the challenges of SmileDirectClub, there’s a thing called Candid, then there’s Uniform Teeth, all these little secondary ones that are coming up to challenge Invisalign. And so, what I’d become a part of is the Academy of Clear Aligners– American Academy of Clear Aligners, because that’s not just Invisalign. That’s clear aligners, that’s– it’s changing very quickly. I would say, within the next three years we’re going to be printing our own aligners 3D in the offices. For an old guy, it changes fast but you have to go, “Okay, we’ve got to make this change.” But I think clear aligners are the way it’s going to be done in 80% of especially mild to moderate moving teeth. Severe still may take bands and brackets, but we’ve moved some pretty severe cases with plastic. And it’s just the shift that we’ve seen from amalgam to composite 20 years ago, different things like that, that when you’re an old guy you go, “Wow, I thought I was going to be doing it like this forever.” And you have to be able to make that change.
S3 00:19:45.033 I couldn’t agree more. Charles Darwin, one of my favorite quotes from him is, “It’s not the strongest of the species that survives. It’s the one that’s most adaptable to change.” And that’s one thing that we see with our most successful members like you, Dr. Rob, is that they stay aware of the trends in dentistry. Dr. John is teaching megatrends in dentistry, and they adapt, and they adjust, and they learn, and they’re committed to continuous improvement. So it’s a common denominator in the successful dentists we work with, isn’t it, Dr. John?
S2 00:20:14.678 That’s for sure. They all have a vision, yet that vision evolves over time as the industry changes, as technology changes, as patient demands change. So Rob is just a great example of having been super successful at that. And, Rob, do you think that adding another dentist or two, and when there’s a good fit you’re going to invite them to invest in your practice, you think that’s going to increase the number of Invisalign cases you do?
S4 00:20:48.408 Well, a lot of my friends that are part of this group, they’re doing 100 and– close to 200 cases a year. They’re doing that, but they’re not doing that as a solo practice. They’re doing that as a group practice. And so, like with a good friend of mine in Amarillo, none of the other three partners want to touch ortho, and so he gets them all. So you can just imagine exponentially the growth if you even had one more of you in there to see double the patients, and then you have another one that then doubles that and continues to go. You become the feeder. I’ll feed them extractions, I’ll feed them endo, and they feed me the Invisalign. He becomes the old guy– he’s the old guy that does the Invisalign and has beautiful cases when they get that. That’s what I’m looking for, because then those associates and then potential partners, they gain from the increase of the value of the practice, and we all gain by us doing more of that.
S3 00:21:58.180 Right.
S2 00:21:58.640 Yeah, for sure. No, that is capturing the dentistry that your patients need to have. And that’s going to drive up patient referrals because patients don’t like to be referred out, so when they get what they like, then they refer their friends and their family, and that’s how you build that referral practice.
S4 00:22:23.477 Right. And you’ve always talked, Johnny, you’re saying that I have a practice within a practice, and that’s what we found out when the associate was here for about six months.
S2 00:22:33.746 Yeah, you were referring out a full dental practice. Yeah [laughter].
S4 00:22:38.449 In the six months he was here, he did right at $500,000 in production.
S2 00:22:47.418 That’s terrific.
S4 00:22:48.066 And I didn’t realize it was going to be that much. [laughter] I mean, I was like, “Oh, we’ve got to find somebody pretty quick,” because we know what we’re leaving on the table.
S2 00:22:57.919 Sure.
S3 00:22:58.730 Right.
S4 00:22:59.216 So we are actively in that process, trying to find somebody that understands the wonderful benefits of Southeast Kansas [laughter].
S2 00:23:11.711 That’s right.
S3 00:23:12.709 And there are many. I’ve been there myself. And so there are some benefits, but sometimes, like you said, it can be just more challenging recruiting. Like I said, it’s been wonderful to be a part of your journey, Dr. Rob, and watch your evolution of your practices and your development of your team. And I’m just delighted that you were willing to come on and share some of your insights about your endgame and vision in building a licensed practice for our listeners. Because I know there’s probably a lot of people on here that got a lot out of it, so I just want to thank you for that.
S4 00:23:46.715 I hope so. I mean, I do. And, Wendy, you’ve seen the ups and downs. You’ve seen me up and you’ve seen me down, and you and John have always been there to be a big part of it, and so I very much appreciate Team Training and what it does for us.
S2 00:24:04.596 Well, thanks, Rob. You’ve been such a fantastic member, and it’s just been fantastic to see you over these years decide on where you’re going and just head toward it. And then you’re building it, and you’re about 80% of the way there. So I’m so proud of the progress that you’ve made and really excited to see all the neat things that are coming in your future.
S4 00:24:27.856 Great. That’s great. Looking forward to seeing you guys real soon.
S2 00:24:31.448 All right.
S3 00:24:31.888 Thanks so much, Dr. Rob.
S2 00:24:32.816 Thanks, Rob. [crosstalk] Bye-bye.
S4 00:24:34.824 Bye-bye. [music]
Most dental practice owners believe they need more new patients in their practice to be more successful.
What we find (overwhelmingly) is that most practices actually have more patients than they can serve effectively. The problem isn't in the number of patients in the practice, it's most often about how effectively the office is serving them.