Brews and Tiny Teeth, The Unfiltered Pediatric Dentistry Podcast Casey Goetz

Thad Harker is a project advisor at Primus Dental, a design and build full-service construction company that has built close to a 1000 dental offices across the Midwest.

Thad and I have a great conversation about dental office design and construction. He emphasizes that the construction process is all about managing people. We talk about how things have changed with higher interest rates and construction costs, but that it still makes financial sense to not lose opportunity cost and get yourself a "golden hammer."

Some topics we discuss in this episode:

- Why are construction costs high, and will they come back down?

- Why does location matter?

- Does it make sense to price shop a build-out?

- How have pediatric office designs changed post-COVID?

- Is it still worth it to do a start-up and be a practice owner?

Where would we be if we didn’t have the support of our non-dentist spouse/significant other/partner? This episode is specifically for them!

Today my wife, Jenna Goetz, reflects on her impact on my journey to become a pediatric dentist. We talk about when does it make sense for the spouse to work in the office, pursue his or her own career, or to stay home with kids. Jenna gives some advice to young power couples and how to get the most out of this journey. We also joke about how annoying dentists can be when you get them all around each other at conventions and meetings.

This is a great episode to listen to with your significant other who is not a dentist!

Chip Fichtner is the co-founder of Large Practice Sales and a return guest on the podcast. His firm helps practice owners complete transactions and partner with DSOs and "invisible" DSOs who allow the doctor to maintain autonomy and a minority position. We last spoke on the podcast about two years ago. Because of our episode, his firm closed a $50+ million dollar deal on a large pediatric office.

Chip has a tight pulse on what's going on in the DSO world. I wanted to get an update on what DSOs are doing with pediatric practices in light of the higher interest rates. I try to ask Chip some tougher questions in this interview.

In this episode, we discuss:

- Is access to capital an issue for DSOs right now?

- Have we seen any DSOs struggle or go under because of lower free cash flow?

- What happens to the dentist's retained equity in the parent company if the parent company fails?

- Who calculates EBITDA in these transactions, and where does all the variability come from?

- How does LPS keep tabs and verify the quality and financials of the DSOs they work with?

- What does the ideal pediatric dental practice look like in terms of commanding a high multiple?

Chip can be reached at www.largepracticesales.com

Everybody in pediatric dentistry is talking about the Soan right now, so I had to learn more. On today's episode, I hosted Dr. Ann Bynum and Chris Malzone from NuSmile. Chris had sent me a demo model to try out, so I took this opportunity to talk with him and Ann about the technology.

The Soan is an cordless electronic anesthetic pen. It allows you to give intraosseous injections to kids without collateral numbness. I specifically talk with Ann about the benefits of the device, technique questions, cost of using the device, and limitations.

Anybody that would like to learn more is welcome to check out Nusmile.com, as they host free webinars to learn more about the device.

Dr. Benjamin Morgan joins us on the podcast today. He's a pediatric dentist and the owner of Rockwall Pediatric Dentistry in the greater Dallas, Texas area.



Ben comes on to talk about a variety of topics, including his journey to practice ownership, why he dropped Texas Medicaid, creative ways that he increases his revenue, how he structures a 2-doctor practice, and what life is like being a pediatric dentist in a crowded Dallas market. We also discuss his decision NOT to build a 15,000 sq ft facility after buying the land and designing the space.

Dr. Bobby is a pediatric dentist, speaker, and authority on oral sedations. After 8 years as a pediatric dentist in the air force, he transitioned to an academic roll at Ohio State and now Cincinnati Children's Hospital. He frequently lectures for the AAPD at their sedation courses.

Dr. Bobby cracks a beer with me and we talk about some great topics, including life in academics, changing parent expectations that make our job difficult, and how he uses oral conscious sedation to manage those kids that fall in between the spectrum of full mouth rehab and minimally invasive dentistry.