Perfil de los oradores:
El Dr. Paul Goodman es odontólogo, propietario de múltiples consultorios dentales, asesor de transición y fundador de Dental Nachos y Dentist Job Connect. Dental Nachos es una comunidad de más de 75,000 profesionales de odontología que se reúnen para establecer redes de contacto, compartir recursos y participar en CE (formación continua), tanto en directo como bajo demanda. Dentist Job Connect es una plataforma y servicio para odontólogos que buscan puestos de asociado, así como para propietarios de consultorios y consultorios grupales que desean contratar personal. Tras graduarse en la Facultad de Medicina Dental de la Universidad de Pensilvania en 2002, el Dr. Goodman realizó una formación complementaria en el Centro Médico Albert Einstein de Filadelfia. El Dr. Goodman reside en Center City, Filadelfia, junto a su esposa, sus dos hijas y su perro goldendoodle.
Kevin Wills, CPA, FACMPE, is a Healthcare Territory Practice Manager with PNC Bank who specializes in helping healthcare practices improve profitability, strengthen cash flow, and make informed financial decisions. With extensive knowledge of the healthcare industry, Kevin works closely with practice owners on areas such as banking relationships, growth planning, financing strategies, and overall practice performance, helping them build stronger businesses and achieve their long-term financial goals.
Transcripción del video:
Dr Goodman: At Dental Nachos, our goal is to help you do three things, increase success, decrease stress, and most of all, reduce the number of times you feel like crying inside a day. I am a dentist, a dental practice owner, and I know what that feeling is like, and our sponsors here today are here to help us increase smiling and decrease crying for dentists. Joining me today is Kevin Wills, a healthcare territory practice manager with PNC Bank.
Kevin is a seasoned financial specialist and helps healthcare practices increase profitability and improve cash flow. He holds a strong knowledge of the healthcare industry and understands how to capitalize on the changing market conditions that directly benefit independently owned healthcare practices. But before we get started, we need to disclose that PNC Healthcare Banking is a Dental Nachos sponsor.
We also want to inform you that all loans, lines of credit, and PNC Bank credit cards are subject to credit approval. Bank deposit products and services are provided by PNC Bank, National Association Member FDIC. This discussion is for educational purposes only and does not constitute investment, tax, or legal advice.
Kevin, thanks for joining us. It's that time of year again. Dentists have a ton of items on their to-do list like finishing strong in production, preparing for taxes, bonuses, equipment purchases, and planning for 2027.
When you look at successful practice owners, what separates those who've had a great year from those who feel like they're scrambling?
Kevin Wills: Well, first off, Paul, thanks for having me on today. I'm excited to spend some time with you. That was a whole mouthful there at the start of this, but I appreciate you making me sound like I was maybe greater than I am, but we're going to have a great discussion.
Excited. Sí. I think when we look at our client base broadly and we look at what are our best practices doing on a day in and day out basis, especially if we think about year-end here, I think that most of our really successful practices are not waiting until December to figure out, hey, how are we going to wrap up this year? What are we going to do? Start doing from a planning perspective, so to speak.
Most of them are starting right here as we come into Q4 to allow for enough time, not just to plan, but to actually get those plans put into motion, Paul. I think that's, at times, a little bit of the difference of you can have the greatest plan, but if you don't allow enough time to execute, it'll just be the greatest plan that nobody ever saw to fruition. Don't like seeing practices waiting to the last minute, causing themselves undue stress.
Certainly, the clock always will run out on 31 de diciembre and limit their opportunity in terms of what some of the options would have been here before year-end that they could have done from a planning perspective.
Dr. Goodman: I always say desperation can cause disasters. I love this.
We're looking at x-rays and making diagnoses. Tell us about that with the practices. What should Dennis be saying? Hey, what's my x-ray? What should I be looking at? What report? What P&L? What balance sheet? Tell us more about that.
Kevin Wills: I love that question. Love the analogy too with the fact that, hey, we're looking at x-rays. Do we really x-ray our own practice from a financial perspective? Again, as I think about that topic itself, I think when practice owners start digging into the numbers, they're trying to get to this place of, how did we do this year? I think part of getting into the numbers also is understanding the why.
Why did we end up performing the way that we did this year? If I'm sitting in the seat of a dental practice owner, I think the place where I start, and I think this is near and dear to most dentists' heart, I'm going to look right at the top of my income statement, where production and essentially collections sit. If I look this year, was it what we were expecting or what we had planned for as a team? Does that number give me the warm and fuzzy like it did at the end of 2025 as we come here to the end of 2026? Production's one measurement, certainly. We talk about collections.
How efficient are we in terms of transitioning all of that production into actual dollars collected that the practice can utilize for obviously paying expenses, growth, all of the great things that need to take place on a daily basis? One of the ones that I like to focus on when I have discussions with clients, Paul, is looking at the net collection rate by payer. If you're contracted with a bunch of PPOs, which many practices are, if I look at what percentage of what I build in terms of production versus what I collected, is that percentage consistent with last year? If it wasn't consistent, is it a change that I was anticipating? Did my fee schedule change with that particular insurer? Hopefully, if the fee schedule change, it was in our favor and it went up and we actually saw a higher percentage realized in terms of our production. If it went down, that would be one of those where that would be a head scratcher for me of let's dig in.
Are we really digging in and scrubbing those claims as they're coming through with the EOBs? New patrons? Go ahead, Paul. Key factors. All those are important.
Dr. Goodman: One of the things to show some compassion for us dental practice owners is in dental school, they don't talk about this at all. It is this information and these words and these phrases, that's why you guys are doing such good work here, can just be totally new. It's amazing how confident the world is in dentists running a practice, which is great and owning it.
Then when you're one running it, like myself, you're like, I wish I learned some of this stuff earlier here. Let's talk about mistakes. What mistakes do you see that dentists make with practice metrics?
Kevin Wills: I think for most, again, I'll go back to one of my first points that I made, I think a lot get caught up in the top line number.
The warm and fuzzy is in what everybody asks initially, and I think bankers were guilty of it also when we meet a new practice owner. One of the first questions we ask is, hey, how much did you collect last year? It's a starting point in terms of looking at how successful you are running your playbook there in the practice of whatever your model is of who you want to be in terms of the dental space, but it certainly isn't the only metric.
Dr. Goodman: I think what's key there is I'll interject is people used to ask back in the 80s for exercise, how much can you bench press? That was the only number they asked about.
Bench press and we're done. Then we realized years later, you had to have good core strength, you had a good flexibility, and your body was not just about bench pressing. While there's one metric, you don't throw out total collections or productions.
There's ways to be more sophisticated, as I hear you saying, in truly identifying your success.
Kevin Wills: Sí, totalmente. I think the other one is just overall patient count, Paul.
Again, I think one of the other really fun ones to look at is how many new patients am I bringing in on a monthly basis? I've gotten into these discussions with many of our clients as well in terms of if you look at total patient count year over year, it's relatively stagnant, but what the numbers show in terms of new patient count from, oh, I'm bringing on 25 new patients a month, all of our marketing is really working, but clearly, we must be losing 25 out the back door as well, almost on an equal cadence from a monthly basis because you had 1800 active patients in 2025 at the end of the year. If you have 1800 active patients at the end of 2026, man, there's something that is going on in terms of the experience of the patient. That's one of those warning signs that we can look at.
Why aren't they coming back?
Dr. Goodman: Also, just as a dentist has done this for years, new patients all come in different types, right? There's someone who's coming just for an emergency and never going to come back. There's a family that stays and really being purposeful about evaluating this key. Now, let's the next topic, all dentists love and hate taxes.
I want to share with you, I saw something, Kevin, that 100% of patients think that their dentist is expensive. I think 100% of dentists think they're paying too much in taxes. Tell us a little bit about taxes and how dentists can prepare for this, be aware to rhyme, take it away.
Kevin Wills: I'm going to have to figure out where you saw that amazing new stat that 100% of dentists feel that way. I think I am, by training, I'm not licensed. I am a CPA, got my CPA right out of school.
I never did tax prep myself. I think a lot of people misunderstand what is tax preparation versus tax planning. Tax preparation starts after 31 de diciembre has already ended.
We've moved into the next calendar year. Now, it's a matter of I got to get all my financials over to my account and let them start building up my tax return, figure out how much I'm going to owe. Hopefully, I don't owe anything, but we know that's usually not the case.
Moving that starting discussion back here in Q4 of actually getting into a discussion around tax planning, I think is the most significant thing that most dentists potentially miss out on. I've had a lot of discussions where dentists say, well, no, I actually haven't spoken to my CPA about any year-end tax plans that we could put in place. That's where you really can start making some moves to potentially minimize what the tax burden is going to be here towards the end of the year.
Maybe start giving yourself a little bit of a lift as you think about some things you can put in place for 2026. I think for most people, it comes down to they just want to know, hey, Paul, just tell me how bad it's going to be. What do I have to pay? Just give me a quick glimpse in what you think it is.
I think, is there an opportunity to accelerate some expenses into this year to maybe reduce that tax burden overall? Is there the ability to defer any income into it?
Dr. Goodman: My next question, I want to give credit to Lexis, because they, I believe, are the December to remember where they say, buy a Lexis in December. The dental version of that is, should we all go out and buy CBCTs because we want to save on taxes? Tell us about that, because there's a lot of talk throughout the dental community, buy this to save on taxes. Tell us about when it makes sense to buy this, when it doesn't make sense, some information that can help our audience.
Kevin Wills: Sí, claro. I'm going to lead off this segment for sure, saying I'm going to share this for educational purposes only, and I highly recommend that all of your listeners consult a qualified CPA for their tax advice. But when you think about equipment purchases, Paul, and you're docking into this is one of the big levers that a practice might be able to pull here in Q4 in terms of minimizing a tax bill.
I love the December to remember commercials, by the way, so I appreciate that. I think where we need to start the discussion, though, is it can't start from the place of, well, I'm just trying to save some tax dollars. The tax dollars are going to help decrease the overall cost of that piece of equipment that you're purchasing, but you're still going to be paying a decent chunk.
It could be, let's say, depending on what tax bracket, maybe you're saving 40% or somewhere thereabouts in that piece of equipment, but you're still on the hook for paying the other amount of that. I think where it needs to start is, is there an opportunity inside of the practice that you already see to improve technology? Is there something we can bring in that's going to improve patient care? Will it improve our efficiency? Does it potentially increase our production or throughput on a daily basis? Will it help me with profitability on keeping something in-house, whether that's 3D printing?
Dr. Goodman: What I hear you saying is, and I want to share, I am not a tax professional myself. I am a doctor of nachos, that's made up, but I am that.
As a practice owner, I'm just sharing with you, if it makes sense to buy it, buy it, but don't buy it just to save on taxes, because adding technology to your practice comes with a cost that's not just money, it's also time and workflow. You may want to buy this fancy, shiny toy at a convention at the end of the year thinking, hey, I saved on taxes. What you bring back to your team is a giant headache.
That is my contribution as a dental practice owner.
Kevin Wills: I think it's great counsel. I'm going to date myself here.
I've been around dental practices since 2008 from a financial services perspective, kind of when intraoral cameras first came on the market. Every practice was buying one for every operatory in the practice. Then I would go back in there six months later, and all of those intraoral cameras were still in the box sitting in the corner of the operatory. Just a good example.
Dr. Goodman: I'm going to ask that, what's still in the box in your practice, do I have that? The next thing I want to share is, growing up, even though my dad was a dentist, I had this perception from one of my favorite shows growing up, DuckTales, that dentists had a big pile of gold coins like Scrooge McDuck. I thought that their practices, dentists were so successful, Kevin, that they just had a whole room filled with gold coins.
Then I became a practice owner. Tell us about this. You can be profitable but still feel restricted or tight on cash.
It doesn't sound like it makes sense, but tell us why practices that are profitable can still feel that way.
Kevin Wills: I appreciate that question too, Paul. Again, I'm appreciative of a lot of the analogies you're bringing up.
I think I went into banking because I also thought I could be like Scrooge McDuck, involved and swim around every day in the front end of the workday, but that doesn't happen either. I think for most, and there's a couple of big things that you're going to see that will be that difference between profitability and actual cash flow. Two different metrics, profitability is going to play itself out on your income statement or your P&L, for every practice, your profit and loss.
Some things that don't show up on your P&L, you're not fully accounting for all of your debt payments there, because principal is not a deductible item on your P&L, the interest is. We're only picking up on that.
Dr. Goodman: I learned this. I don't want to be too technical, but I learned this. Stuff counts as money that you make that doesn't feel like money that you make. I don't know if I can distill it down for a six-year-old dentist here.
That's what I felt as a business. Oh, I made all this money, but it's not all the money you got. There's probably a good Curb Your Enthusiasm or Seinfeld joke about this.
I think that's what you're alluding to, because when I see your list here of these debt payments and tax obligations, these are things that decrease your cash flow that can be income that don't feel like income.
Kevin Wills: You're spot on. At times, some of those aren't necessarily planned for, even though that we know, hey, I'm going to be making quarterly estimated tax payments and those sorts of things.
They're not really fun to put on the radar screen. I'm just going to wait until 15 de septiembre, rip the Band-Aid off approach to it. One of the other ones too, Paul, that's been a little bit sneaky, I will say, in terms of just the overall profitability and cash flow practices. I would love to get your point of view on this. Payroll has certainly had a lot of pressures upward in terms of just competition for talent, making sure that every one of those critical seats in your office is filled. We've seen certainly from every role throughout the office, but specifically hygiene in terms of just where those hours go on.
Dr. Goodman: When you're in network, you have restrictions on what PPOs allow you to charge. Even if you're out of network, it doesn't mean you can just write a number on the board and say, everyone pay this. I think as someone who's been in network for years and is now out of network with my practices, and there's pros and cons to both, I think I felt the same way as an in-network dentist.
I'm like, oh, when I'm out of network, I'll just write a number on the board and everyone will run and pay it. I think what dentists need to embrace is that what your team expects to make, which can be the going rate, the industry standard, may not be what you can increase your top line revenue. Then I feel it's like there's a good analogy.
It's like your metabolism gets slower as you age. I'm dealing with that. You're still working out, you're still eating the same things, but I think that's how dental practices feel.
I think that's key. Evaluating these expenses and at least being aware of them are so important to planning success.
Kevin Wills: It makes a ton of sense the way that you laid it out there.Out of curiosity, I would assume like in fairness, in every practice though, payroll is typically the largest.
Dr. Goodman: If you look at percentage, 25% to 30%, it could be 25% to 30%. One of the things that makes me laugh-ish is there's 50 states in the US.
When you go get a coffee in New York City, it costs different than the Midwest and different than LA and different than Philadelphia. When dentists share like, hey, the going rate for this position area is this, and they said that's way too much. If you offer low, guess what you have? No team members that want to work for you.
I want to share with you, you cannot run a practice without team members. This, I think, is valuable. I have two more topics I want to go over with you before we wrap up.
This is not my joke. Comedian said the worst time to be looking for a plunger is when you need a plunger. When should dentists talk to a bank? Only when they buy and sell their practice? Is that the only times you should talk to a bank? Or are there some other times that you should connect with your bank?
Kevin Wills: Selfishly, we would love to be talking to our clients every day.
That's not going to happen. You guys all have businesses to run, and those businesses require you to be providing patient care. From our perspective, I think you hit the nail on the head right with your first statement in terms of, I think many dentists think it's time to talk to my banker when I have some financing need.
Hey, I want to expand to another location. I'm getting ready to sell, whatever that's going to look like. Hey, the first person I should give a call to is my banker.
From our perspective, again, our best-in-class practices are staying very closely connected with their banker, quarterly, maybe semiannual at most, but we're touching base with those clients. An interesting point that I always like to bring up is when you think about the business of anything, but the business of dentistry in particular, you're interacting with your bank on a daily basis. You may not be going there, so to speak, right, Paul? I've got one client that I've money flowing into the account.
Maybe it's electronic deposits that are coming in. I'm depositing checks, maybe remotely from the office, but I'm working with my bank every day. If we look broad scope at PNC, just as a for instance, if we look at all the healthcare clients that we have, Paul, at PNC, only about one third of our total healthcare clients actually borrow money from us today.
Two thirds are on the other side of the spectrum of, I'm running my business, don't have a capital need that I need to borrow. What ideas do you have for me in terms of, what are some of my colleagues doing? What could I be doing better in the practice? I think that's maybe some of the paradigm shift we have to make, which is the business of dentistry is really hard.
Dr. Goodman: I'm with you on that.That brings us to our wrap-up segment, which is important. This, I go into the title of dentists are people too, right? We don't live in our dormitory. We thought our teachers live in the classroom.
We are people too. We have real lives with, could be real families or real pets or real vacations. We need to manage our personal financial wellness, right? If you could speak to us about, you're using a bank like PNC for your business, you're using it for your personal account.
What opportunities are there? How can you help us enjoy all the hard work that we've done? Tell us a little bit about personal banking and personal financial wellness.
Kevin Wills: Sí. Thanks, Paul.
We always like to start, first off, are you prepared for the unexpected, right? Do we have emergency reserves personally, just in case something were to pop up? That's no different than any other human in the United States, so to speak. Looking at the insurance side of it though, I think as an area of opportunity for a lot of practice owners, many get their very first life insurance policy through the ADA while they're still in dental school, the big group policy, awesome opportunity, right? But you're getting at a point where you're on the front end of starting your life. And as you start adding to your point, family, homes, cars, a business, reassessing what that overall insurance coverage looks like, I think is critically important.
Again, estate planning goes into it, college savings, managing your personal debt. I think overall for every practice owner, as we get into Q4, as we think about, so where are we going to land the plane on the practice this year? We then have to segue into that conversation of, and how is this going to now parlay itself into what I'm trying to accomplish personally for myself and my family? And I think that's all part of this year-end Q4 planning session, I certainly would envision.
Dr. Goodman: I think that's what is key.
We're sharing with Dentists, at the end of the year, you look back 90 days, what did you do to be successful? Who did you connect with? How did you track? What planning are you doing? And my sense is, I'll share something that is a theme, and a theme is not a study, right? Most people who are healthy also keep their teeth healthy. It is rare that I have someone walk in who is so healthy with their body, and their teeth are in a mess. It does happen at times, but in general, the behavior of going to the dentist twice a year, three times a year, translates.
My assumption is, you see some of the similar things, where practice owners are paying attention to their practice metrics, also personally doing well. Is that a fair theme to think about?
Kevin Wills: It is. A really great theme that I would say is very consistent.
Those same people are the ones who like to lean on their advisors, want to get into a planning discussion, so to speak, and make sure that they've got a clear idea of where am I at today, where am I trying to go, and do I have the right plan in place to get there. It's hard to draw that line in between, here's where the practice stop, and here's where my personal stuff begins, and so really taking that holistic approach to the planning makes a boatload of sense, and again, Q4 is a great time to do it.
Dr. Goodman: Me encanta eso. Well, in our parting message, if someone just came on right now, and was listening to us, and they missed all the fun Scrooge McDuck references, and things like that, but they listened to this, what's one thing you want them to take away? Go and do this before the end of the year. Go and make sure you're paying attention to this. What would be your one thing?
Kevin Wills: I guess my one-liner would be, don't wait until year-end planning becomes year-end panic, and I've seen that plenty of times from a boatload of people that we work with. Again, your advisory team wants to help. We're sitting here. We're ready to go.Get your appointment scheduled. Talk to your CPA. Talk to your banker.
Talk to your personal financial advisor, your attorney, and more importantly, none of this happens without the leadership team inside of that practice also being on the same page. I think, again, getting everybody together, let's build a blueprint, and really, for those practices that can finish 2025 strong, they're going to have a lot of momentum going into 2026, and that's really the goal of this whole thing. Let's have a really awesome 2027.
Dr. Goodman: 2027, yeah. We're accelerating the years like that. What I can share is, what I like to help my sponsors with is how you can talk dentists to explain to dentists what something feels like.
My one thing is, if you said to one of your dentists, hey, do you ever have that patient where you recommended a crown in February, and they call you up a week before the end of the year and say, I have to get in because my insurance covers it, and you go, oh, look who it is, Bob. We talked about this in February. If you just said this and let it sit and say, how do you feel when that happens? This is how we feel.
We feel frustrated. We feel annoyed. We feel reactive.
We feel like we have to change our life to solve their problem, but dentists usually are really good people, and we try to solve that problem, but it's not fun. Why don't we make things more fun by being proactive instead of reactive? We are all going to feel this in Q4. The person who said, I got to get in for four fillings on 30 de diciembre because my PPO plan is expiring, and you look back in your notes like these were recommended in March.
You can use that technique and be like, that's what we want you to do. More fun, more proactive, less reactive. Thank you so much for sharing with me, Kevin.
People can reach out to us at Dental Nachos to connect with PNC. We truly appreciate your sponsorship.
Kevin Wills:. Thanks for having me today, Paul.
