The Dental Truth Project

The Dental Truth Project

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The Dental Truth Project No fluff. No spin. Just bold, unfiltered conversations about what’s really happening in the dental industry. Hosted by Ken Kaufman, AccruDent Co-Founder, this podcast dives into the mistakes, wins, and truths that DSO leaders, clinicians, and consultants usually avoid. Expect real talk, raw insights, and answers to the questions no one else is asking.

4D AGO

Serial Embezzlers Are Job-Hopping Through Dental Practices—Is Yours Next? (E.17)

David Harris, CEO of World's Largest Dental Forensic Accounting Firm, Drops a Bombshell: 70% of Dental Practice Owners Will Be Embezzled—And the Bigger You Grow, the Worse It Gets. David Harris reveals the shocking truth dentistry doesn't want to admit: If you own 20 practices, there's an 80% chance someone is stealing from you RIGHT NOW. The digitization of payments didn't make dental practices safer—it created a goldmine for thieves. That "gold jar" in your operatory? It holds $15,000 while you obsess over the $800 cash drawer. And here's the kicker: 100,000 serial embezzlers are circulating through dental practices across America, hopping from office to office because DSOs are too hungry for "experienced" staff to screen properly. Key Revelations: The Guardian Who Steals Most embezzlement in dental practices is committed by the office manager—when the guard steals and has no oversight, they get away with it every time Reports are abstractions—thieves exploit "selective reporting" to hide their tracks DSOs are so hungry for "experienced" staff, they skip proper pre-employment screening Most theft today isn't cash—it's diverted credit card payments, manipulated adjustments, and phantom bonuses 💡 The "Ask Ken" Question: "My collections are growing, but I don't feel richer. Where is all the money going?" Ken's answer: You're likely suffering from working capital pinch—growing accounts receivable while paying vendors too quickly. David adds the brutal alternative: Someone might be stealing from you. If your organization isn't growing but has this problem, embezzlement is your #1 suspect. Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

25 min
12/24/2025

Will AI allow me to fire my RCM team? (E.16)

Louis Chan (Kaylie.ai CEO) and Jonas Sison (Kaylie.ai CFO) shut down the industry's biggest AI fear: At a DEO conference, someone asked if AI could "fire their RCM team" - the answer reveals why that DSO is already failing. The real threat isn't automation replacing humans; it's leaders who don't understand that AI exists to eliminate "unsuitable for human use" tasks (like calling insurance companies 40 times a day) so your team can finally focus on patient experience and edge cases that actually move the needle. Key Revelations: AI Won't Fire Your Team (But This Mindset Will Kill Your DSO) The Tribal Knowledge Crisis: 20 years of denial insights and appeal strategies trapped in office managers' heads—when they leave, decades of intelligence vanishes because it never escapes departmental silos. The $100K+ Fee Mystery: Practices tell patients "80% covered" without knowing if that's your fees or insurance's UCR, then surprise them with $300 bills after fighting denials—forcing a choice between one-star reviews or six-figure write-offs. Technology's Real Job: Front desk juggles 3-4 jobs while battling insurance on hold—even 90% satisfaction means 30 weekly patients had terrible experiences, which is why AI should handle repetitive tasks so humans close the final 10% gap. 💡 The "Ask Ken" Question: "My practice management software data can't be trusted - what should I do?" Ken's answer: Garbage in, garbage out. If you don't trust what's coming out of your PMS, all fingers point back at you and your team. You need to fix how you're using the system - the software isn't the problem, your processes are. Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

19 min
12/17/2025

We Pulled Insurance Duty From Our Front Desk - Revenue Jumped 30% (E.15)

Francesca Pregano's 30% Growth Formula: Remove Insurance Drama From Your Front Desk + AI-Powered "Wheel of Retention" Francesca Pregano, COO with 19 years in dental, discovered the real reason multi-location practices bleed patients: It's not bad dentistry - it's front desk staff drowning in insurance conversations they can't win. Her radical solution? Strip all financial chaos out of the office entirely and give the team one job: make patients feel welcome and collect the right data. Key Revelations: The Wheel of Retention That Doubled Profitability Created remote RCM team to handle ALL financial conversations outside the practice, tracks Day Sales Outstanding and audits the entire revenue cycle Training front desk staff to explain complex insurance processing was impossible with high turnover. Front office now focuses solely on: collecting patient data, creating happiness, and guiding patients through the visit Insurance companies' post-rollup data disasters were destroying collections, patients don't care whose fault billing errors are - they just leave 💡 The "Ask Ken" Question: "When is it the right time to hire a fractional CFO?" Ken's answer: It depends on your trajectory, not just your size. Planning to grow from 1 to 3-6 practices? Get a fractional CFO NOW - rapid growth needs serious financial guidance to avoid expensive mistakes. Growing slower? You can wait, but by 5-10 locations, you NEED a financial heavy hitter making sure everything runs smoothly. Francesca's brutal truth: She spent years in operations before realizing she didn't truly understand it until she mastered finance. Working alongside a CFO taught her to read P&L statements and understand profitability drivers. Without the finance piece, you're just looking at numbers without knowing WHY they matter - especially dangerous before you start to scale. Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

27 min
12/10/2025

Revisiting the Four Dental Legends' Game-Changing Perspectives You Can't Ignore (E.14)

Ken Kaufman & Nathan Chitty dive deep into the first 4 episodes of Dental Truth Project - uncovering the game-changing insights from industry legends Brian Calao, AJ Peek, Eric Roman, and Gareth that every DSO leader needs to understand. The brutal truth about advisors flooding into dental for easy money, why the "highest bidder" might bankrupt your equity rollover, and the associate dentist management crisis that's quietly destroying DSO profitability from the inside out. Key Revelations: Legends Perspectives Brian Colao's warning: "If you can't get along with your affiliated dentists, you don't have a business." The good ones who stay are amazing. The replacements? Disaster. A.J. Peek's equity killer: The highest bidder is also the closest to defaulting. Push your multiple too high, and one missed covenant wipes out your rollover equity. Eric Roman's uncomfortable truth: Dentists refuse to coach other dentists—and it's hurting patients, associates, and profitability. Gareth Petsch's market reality: Valuations dropped from 10x EBITDA to 5-7x in 24 months. But renewed investor interest is emerging as the dust settles. 💡 The "Ask Ken" Question: "Can a DSO avoid surprises with their tax bills?" Ken's answer: Find a tax CPA who meets with you quarterly BEFORE estimated payments are due. Bring your financials (cash or accrual - whichever you use for tax). Get forecasts, not surprises. No one wants to overpay and give the government an interest-free loan. Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

21 min
12/03/2025

The KPI Standoff: When DSOs and Vendors Speak Different Languages (E.13)

Nathaniel Baker, Overjet Key Account Executive, drops truth bombs about why DSOs and dental tech companies keep missing the mark: Most DSOs are "organized chaos" that don't have their act together (even the biggest ones), industry partners are pitching products without understanding what success actually means to each stakeholder, and the #1 reason pilots fail isn't the technology - it's that nobody agrees on what winning looks like. Key Revelations: The Alignment Problem in DSO Operations Ask a CFO, COO, and Chief Clinical Officer what success looks like - you'll get 3 completely different answers Pilots fail because DSOs don't take true ownership - "it's just a pilot, we'll shake hands if it doesn't work" KPIs don't stick - DSOs jump from one metric to the next without staying in the fight Procurement managers hit with decision fatigue start hiding their "dirty laundry" from vendors 💡 The "Ask Ken" Question: "What's the single most important financial KPI for a DSO?" Ken's answer: Free cash flow. Collections matter, but buyers, banks, and partners all anchor to your EBITDA and ability to generate cash. Look at cash from operations minus capex - if it's positive, you're generating cash. If it's negative, your business is consuming cash and you need to figure out why. 🎁 Free Resource: Free Cash Flow Analysis Discover how to evaluate DSO financial health and operational efficiency by identifying cash available for practice reinvestment, partner distributions, or debt reduction. This guide gives you the framework to assess whether your DSO generates enough cash to sustain growth, fund acquisitions, market challenges. DOWNLOAD YOUR FREE GUIDE NOW! https://resources.accrudent.com/accrudent-free-cash-flow-analysis-template Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

29 min
11/26/2025

Niche Down or Burn Out: Why Top Dentists Do Less and Earn More (E.12)

Alex Sharp, CEO of Shared Practices Group, exposes the hidden cause of dental burnout: You're stressed because you're trying to be everything to everyone. The dentists thriving right now? They've niched down, gone deep on one thing, and escaped the hamster wheel. The Amazon model of dentistry (crowns, fillings, root canals, sleep apnea, ortho aligners, implants - all in one day) is literally designed to burn you out. Here's why the narrow path is actually the profitable one. Key Revelations: Why Simplicity Actually Scales (And Complexity Kills You) "Simplicity scales. Complexity doesn't." - If you're juggling 15+ procedure types, you're a jack of all trades and master of none Case presentation friction: Team isn't fluent in procedures they rarely do. The result: Longer appointments, more stress, inconsistent patient experience Dentists panic about consolidation like it's game over. The real opportunity: Niche players will always emerge because specialized service beats commoditization 💡 The "Ask Ken" Question: "How do I keep my lenders happy while growing my DSO?" Ken's answer: Two words: No surprises. Treat your bank as a partner, not the enemy. Watch your covenants MONTHLY - they're more important than your financial statements. If you're close to tripping a covenant, collaborate early. Proactive communication builds banking relationships that actually support growth. 🎁 Free Resource: Why Loan Covenant Maintenance Matters Proactive covenant management = better loan terms, lower rates, and financial freedom to grow instead of firefighting with lenders. DOWNLOAD YOUR FREE GUIDE NOW! https://resources.accrudent.com/accrudent-loan-covenant-maintenance Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

28 min
11/19/2025

Unqualified Practice Brokers Are Costing Dentists Millions (E.11)

Maria Melone, former KPMG auditor turned M&A advisor with 100+ dental transactions under her belt, exposes the valuation myths costing dentists millions: "Percentage of collections" isn't a valuation method - it's just a reference point. Unqualified brokers are flooding the market with misleading valuations. And here's the kicker: the exact same practice sale can legitimately be framed as 28x, 15x, or 8x EBITDA depending on the calculation method - yet most dentists obsess over the multiple while completely ignoring the other side of the equation. Key Revelations: Sale Process Dentists Get Catastrophically Wrong The Direct Solicitation Trap: Buyers make unsolicited offers attractive specifically to prevent you from going to market and creating competition The Advisor Imposter Crisis: Former dental sales reps are now calling themselves M&A advisors without valuation training or deal experience The Buyer Pool Gap: 25-50 buyers vs. 2,500+ buyers = massive value left on the table before you even negotiate The Equity Rollover Minefield: Every DSO and PE firm has different equity terms - most advisors can't decode which deals are favorable vs. high-risk 💡 The "Ask Ken" Question: "What's the fastest way to know if my DSO is overstaffed?" Ken's answer: Watch the 30% revenue threshold. Staff costs (assistants, front office - NOT doctors or hygienists) should stay under 30% of revenue, ideally closer to 25%. Cross that 30% line and you're bleeding efficiency. In today's market, 25% staffing cost means you've built a highly efficient operation that buyers will pay premium multiples for. Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

20 min
11/12/2025

Paying Off Debt Early Is Bankrupting Dentists (E.10)

Howard Polansky, former practicing dentist turned financial strategist, exposes a controversial debt elimination system that has CPAs arguing and dentists gasping: One client freed up $190,000 in annual cash flow in a single hour without changing a thing about their practice. The secret? "Velocity banking" - strategically using lines of credit to reverse-engineer the tools banks use against you. Key Revelations: The Line of Credit Revolution Traditional debt traps you with fixed payments until you die Your line of credit becomes your checking AND savings account - money flows for YOUR benefit, not the bank's Strategic use of lines of credit can eliminate 12 years of debt in just 18 months Paying extra principal on loans creates a dangerous liquidity trap 💡 The "Ask Ken" Question: "What's the fastest way to know if my DSO is overstaffed?" Ken's answer: Look at two key metrics. First, staff costs as a percentage of collections - if you're spending more than 28-30% of your revenue or collections on staffing, you likely have an issue. Second, check your production per clinical FTE. If that number is too low, you're probably overstaffed with assistants and possibly a hygienist. The math tells the story. Got a burning question about dental finance? Submit your question, and it could be featured in a future episode. Ask Ken Form: https://resources.accrudent.com/ask-ken-form-the-dental-truth-project

20 min

The Dental Truth Project No fluff. No spin. Just bold, unfiltered conversations about what’s really happening in the dental industry. Hosted by Ken Kaufman, AccruDent Co-Founder, this podcast dives into the mistakes, wins, and truths that DSO leaders, clinicians, and consultants usually avoid. Expect real talk, raw insights, and answers to the questions no one else is asking.

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