Episode #420: Is Private Practice Dead?, with Corinne Jameson-Kuehl

 DSOs have become more prevalent. But it doesn't mean private practice is dead! In fact, it’s thriving, and Kirk Behrendt brings in Corinne Jameson-Kuehl, owner of Custom Dental Solutions, to share her knowledge and experience to help you succeed in getting started. Whether you're buying a new practice, starting from scratch, going group or solo, she offers her best practices so you can achieve your practice goals and thrive. To learn more, listen to Episode 420 of The Best Practices Show!

Main Takeaways:

• Private practice dentistry is still alive and thriving.
• Understand the key foundational pieces for success.
• Be aware of innocent misunderstandings to avoid.
• Prepare appropriately so you're more likely to succeed.  

Quotes:

• “We’ve seen through the years with dentistry, private practice can thrive and really do well with the right parameters in place. I don't believe, as a whole, a lot of our new owners need anything other than a really good foundation to start their practices, get a few pieces in place that maybe they didn't learn in dental school, and then, at the right time, bring in their consulting group to ramp up their production and evaluate efficiencies and all these types of things. And they really can manage quite effectively on their own without giving some outside company a percentage of what they're working so hard for on a day-to-day basis.” (5:23—6:04)
• “There are a few pieces that [practice owners] need in place to be successful. Number one, we want to make sure they get credentialed appropriately. If they're going to be in an environment where it is insurance-based versus fee-for-service, which most new owners, we encourage they need to take some insurances and they need to build that rapport before they would even consider going fee-for-service. So, fraudulently, a lot of these people do not get credentialed appropriately and they think they can work under the previous owner’s name or their license or something, which is big fraud.” (7:07—7:39)
• “I just told a new owner the other day, because she said, ‘Well, I don't know about this. I don't know about that.’ And I said, ‘We just need to start. We just need to protect it from the beginning. You can bring all the fancy stuff later, after the smoke clears. But we do need to have policies of what's expected of you as an employer, and then what's expected of them as employees. And then, written job descriptions. We need that in place as well before we start hiring people. Or if we’re transitioning with the team that the previous owner had, is there a transition agreement in place? What does that look like? How are we moving forward with that relationship?’ So, those are foundational.” (8:10—8:49)
• “There truly are some innocent misunderstandings about [the credentialing] process, and I think people mean well when they just don't understand, and they think it’s okay. The reality is, each licensed professional, meaning a dentist, needs to apply for their own credential with that insurance company. So, if they're purchasing a practice where they're Delta Premier — which is wonderful; this is great — they themselves need to apply for that as well. It is fraud to work under the previous owner’s Premiere status or anything like that. And unfortunately, we see that all the time. And most of the time, it truly is innocent. People really don't know any better. But I would really hate to have somebody who’s just starting off start off on the wrong foot simply because they just didn't do their research to know that this is what needs to be in place.”  (9:26—10:18)
• “You can have different providers in the same location taking different insurances. But it is a nightmare for the administrators and for the schedulers as well, because we really have to be careful that if somebody would be credentialed with a different insurance company, [like a dentist taking over their father’s practice,] for instance, then those patients are all being scheduled appropriately with him versus the father, or something like that.” (12:11—12:36)
• “I don't believe private practice, anywhere, is dead. I think it is very much a big thing that many students consider and will continue to consider, unless something radical happens in dentistry and dentists can't be owners like it did in medical, which I don't foresee happening under my lifetime.” (20:02—20:24)
• “Everybody wants to be fee-for-service. That's their big goal. It’s on every podcast, “Let's be fee-for-service,’ which is a wonderful pipe dream — because for some people, it’s a wonderful reality. But for others, it’s not the reality, depending on where you are located, where you're practicing, what kind of personality you are and who you're serving. So, I think if you're going to be from scratch, again, depending on what community you're in, what influence you have on that community, you might have to take some insurances. It might be in your best interest to purchase a practice. But I would really do my double and triple diligence that you're purchasing what you think you're purchasing.” (21:57—22:38)
• “Maybe this is because I'm a mom, it’s hard for me to sit by an owner who’s crying because they feel they overpaid, and the patients keep walking out the door. And we usually tell them, ‘Expect about a 20% attrition rate.’ That's usually what we say. And unfortunately, sometimes, it’s more. And so, at that point, it’s like, man, this person maybe would've done better just to go from scratch versus spending all this money on these charts that are useless. Depending, again, on that relationship with that previous owner and the new owner, how does that relationship look, that really makes or breaks those deals, a lot of times, too.” (22:41—23:20)
• “Most of the time, I'm going to say [to go] solo. However, I do know some groups that are very successful as well — groups meaning two to four owners, generally. And what really works well is specific job duties for our owners. We’ve got one owner who is kind of the HR person. We’ve got one owner who’s doing the soft accounting. We’ve got one owner who’s the magic-maker, the person who’s bringing the cheer to the office every day, and making sure everybody’s happy with their vacation, and this and that. That's when it works really, really well. And again, if you're a huge practice and you have thousands of patients, a group might be the best way to go. People that have more of a collaborative personality really enjoy those group practices as well. But there's also a lot of frustration if owner detail is not outlined.” (23:53—24:45)
• “One thing I would interject as we’re chatting about this topic is, if you bring in other partnerships, we were talking a lot about the culture aspect, but what about the clinical alignment? So, that's where you have to see, what is the reality you're going to be clinically aligned with the same person, as far as going in for a hygiene check? Are you both going to address the periodontal problems the same exact way? Are you going to see, ‘Don't touch my stuff’? What products are you going to use that are going to be different? So, those are very real problems too, as far as clinical alignment and things like that.” (27:43—28:20)
• “We don't allow ourselves or our children or others to fail. We try to scoop up situations to prevent that. But failing grows us more. It helps us really home in on our focus and what we need to do.” (34:19—34:34)
• “If somebody has a fear of failing, I want to know how prepared they are. I mentioned that young owner assembling his team before he even bought. There still might be some failures, but you're prepared. And we know if you're prepared, you have so much of a higher success rate.” (35:14—35:33)
• “The lessons [from failure], you have to go through them. You have to go through the lessons. I think that's something that, again, we want to protect ourselves from, or our children from, or maybe our young owners from. But they need to learn that.” (36:36—36:51)
• “Definitely get the foundational pieces in place. It’s never too late. Sometimes, people feel that, ‘Oh, I jumped in, and I've had two years of hell since I bought this practice.’ It’s never too late to start putting in the right process and systems and getting your ducks in a row.” (39:00—39:15)

Snippets:

• 0:00 Introduction.
• 1:48 Corinne’s background.
• 2:59 Is private practice dead?
• 6:40 Foundational pieces to success.
• 8:50 Innocent misunderstandings to avoid.
• 11:42 Having different providers in the same location.
• 13:02 Misconceptions about younger dentists.
• 17:03 Is there a DSO takeover?
• 20:38 Scratch start, or buy a practice?
• 23:22 Group or solo?
• 26:20 Partnerships and coverage.
• 32:05 Advice for designing the practice you want.
• 33:02 Getting past the fear of failure.
• 38:49 Last thoughts.
• 39:46 Corinne’s contact information.

Reach Out to Corinne:

Corinne’s website: https://customdentalsolutions.com/  

Corinne’s Facebook: https://www.facebook.com/customdentalsolutions/

Corinne’s social media: @customdentalsolutions

Corinne Jameson-Kuehl Bio:

Corinne Jameson-Kuehl, RDH, BS, has been involved in the business of dentistry for over 20 years. She is an experienced dental business owner with background experiences as a private practice clinician, practice development administrator, and previous dental staffing company founder and owner.

Corinne’s professional interests include writing articles and presenting continuing education to dental audiences across the nation. She is the regional coordinator for the Oral Cancer Foundation and was the 2016 recipient of the Sunstar Butler Award of Distinction. Her professional memberships include ADA, ADHA, Seattle Study Club, AADOM, and AADH. Along with Dental and Business education, Corinne holds numerous Human Resources certifications including DISC, Driving Forces, and Emotional Intelligence to better ensure employment success!

Corinne and her team at Custom Dental Solutions provide “hands-on” practical business development and proven solutions to owners of small businesses focusing mainly on private practice dental offices. It brings her great reward to see her clients navigate changes successfully in their personal and professional lives.