Dentist to CEO: Scaling to 70+ Locations & $150M | EP. 7 | Emmet Scott

Chelsea Morrisey
Welcome back to the Full Arch Growth Show. My name is Chelsea Morrisey, CEO of the Implant Engine. My guest has never held a drill in his life. He came from accounting and financial planning, hosting a radio show about entrepreneurship until his best friend, a dentist, asked for help opening one practice.

Emmet Scott turned that one favor into Community Dental Partners, a $150 million DSO with 70-plus locations and 1,300 employees. Today, he’s CEO and Head Coach of DEO, coaching thousands of dental entrepreneurs.

If you’re a full arch dentist who wants to stop running a practice and start building a business, this episode is the blueprint from the man who built a dental empire without a dental degree.

Please welcome Emmet Scott.

Emmet, I’m so happy to have you on the show. As far as I could tell, you’ve never held a drill in your life. You came from accounting and financial planning. You were hosting a radio show about entrepreneurship, and then your best friend called and asked for help opening a dental office.

I think it’d be a good story to tell. Why don’t you tell us kind of how that came about?

Emmet Scott
Yeah, so it’s funny because I was really bothered by the fact that entrepreneurs were coming in having me invest their money, which you would think that was my core job, but I’m like, why aren’t they scaling their business?

And what I realized, which every entrepreneur probably appreciates this, there’s tons of books about starting a business, starting a practice. There’s not a lot out there of like, well, what happens if I’m actually successful? How do I go from entrepreneur to executive?

In fact, we rarely even talk about that. So, I got really fascinated with that, a consulting firm around that.

And yeah, I had a radio show out in Vegas called The Entrepreneur Life. And then my best friend from the age of two, a dentist, and he’s like, “Hey, I want to open a practice. I want to do it the right way. Can you help me out?”

Long story short, we did about half a million the first month. I said, “Let’s do a second one.” He’s like, “I don’t know if I know how to do that, but if you want to do it with me, that’d be cool.”

So all of a sudden I was the CEO of opening dental practices. We had three that year, each doing about five or six million, and we just kind of kept going.

We ended up with 70-plus locations, $150 million in revenue. I did not know what a DSO was, by the way. So about partway through I was like, are we doing something evil? I heard about these DSOs, you know.

I started doing some research and I found, you know, it’s about culture and structure like a lot of things.

Having had my radio show experience, I went ahead and launched a podcast called DSO Secrets. And I’m like, this is a great way for me to learn the industry. And then I ended up writing a book around that.

And then I was asked to serve as ADSO president right as COVID hit, actually. So that was interesting because now all of a sudden I was working with these billion-dollar groups with lobbying efforts, but then ADA was actually coming in, and so I was working with them.

So it got me deep into the industry very quickly, understanding the different parts and pieces.

And then Jake had started this group called DEO, Dentist Entrepreneur Organization, because you had ADA, which back then was kind of almost anti-entrepreneurship, and then you had DSOs, ADSO, that was huge.

So there was actually no place for just like a dentist who’s like, “I want to open a second, third, fifth, 10th location. Can I just have some masterminding?”

So Jake had started that. When I exited my DSO, I bought half the company and we started growing it together.

And yeah, that’s how DEO, we now have 600 owners, over 2,500 practices between them, $3.7 billion in revenue between all of them.

So we treat it like a virtual DSO. They keep all their equity, but we have a 40-person executive team of coaches that work with these members every week and help them out.

It’s everything I wish I would have had. I wish I could have just called and been like, “How do I solve this problem? How do I do this?”

You were in the trenches. When you think back to those early days, what are the things that pop out to you that you got wrong, maybe even embarrassingly wrong?

Emmet Scott
Well, first off, I had never been in the dental industry. I saw all this opportunity.

What I didn’t appreciate was it was still a mom-and-pop industry. So, there was no enterprise resources for people who wanted to grow.

I’ll give you an example. I remember we were on Dentrix, and again this is 2010-ish, and I go to run an AR report. It took 13 hours to run. Not because the computer was bad. That’s how long it would take back then to run.

And it only ran one way. It listed all the patients out and you had to click through these PDFs to get to the end result. And it wouldn’t organize by insurance type or anything like that.

So your RCM team, your collections team couldn’t go track that down. And so it hit me in the face like, okay, we’re trying to scale something that doesn’t have underlying resources.

And I realized there was a big difference between us as individual practice owners and what DSOs were investing to get the technology and software in place.

And I’ll just call them out. Back then I went to Dentrix and I’m like, “Hey, can you make this better? We need this.” And they’re like, “We own 60% of the marketplace,” you know, so it’s like…

Now the world’s changed. I mean, multiple PMS systems, cloud-based solutions, etc. But it really hit me in the face that to scale was going to take a lot.

I also didn’t fully appreciate, and I have a lot of empathy now, you go to In-N-Out Burger or something, they swipe a card, money’s in their account in 24 hours.

You do a ton of marketing, patient comes and scheduling, etc. You do the treatment, you’re 60, 90 days out before the insurance pays. Maybe if you’re really good, two weeks to 45 days.

Chelsea Morrisey
Yeah. So how are you managing that whole revenue cycle management department, insurance verification?

Emmet Scott
Yeah, it’s complicated. My business before this business was in dentistry, but I worked with Fortune 100, 500 companies. They’re on net 30 that turns into net 90, which turns into net 120 at times.

And so I learned cash flow management the hard way.

When we came into the Implant Engine, we did put a big emphasis on cash flow management because it can be an issue for agencies as well.

And I do think that as docs are scaling full arch, they’re coming up against other cash flow management challenges given the investment of full arch marketing and how that works with the structure of their GP.

But one of the things that I know about full arch is when it’s done well, it eliminates a lot of cash flow issues because these are cash-paying patients, right?

So it’s something that’s incredible to bring into the office and it can actually balance out some of those issues they have with insurance and GP and some of the slow billing.

Chelsea Morrisey
Yeah.

Emmet Scott
You have almost an opposite problem, which is you have all these prepaids, which are future liabilities.

And we see this in ortho. I had an orthodontist owner the other day. He probably didn’t love this, but I said, “You understand you’re running a Ponzi scheme right now?”

Basically, people are prepaying for stuff they won’t get for 24 months.

Are you managing that cost correctly? Because if you’re spending all the money today, then next month you have to hurry and sell a bunch of people to make payroll again.

So are you doing the accounting right to say this prepaid money I have is actually a liability for future services? I got to be careful on how fast I spend it.

So, it’s complex.

I mean, having consulted and coached in a lot of different industries, I think one thing your listeners could take away is that if you’re running a dental practice, you’re running a very complex entrepreneurial engine.

And if it feels hard, and it feels harder than some other buddy who has a business, it probably is harder. You’ve got clinical care, you’ve got this RCM piece. There’s just a lot of parts to it.

I think this is a really good segue into talking about all of those parts because, you know, what we see with full arch docs is they’re running a GP schedule. They’re pivoting to do complex surgical cases. They’re eating lunch at their desk.

They’re maxed out in every direction. I mean, literally every direction. Getting a call with their account manager can be challenging.

And I think that oftentimes they think the answer is more cases, and that does help. But what have you found has to actually change for the doctor to kind of stop being the bottleneck to their own growth?

Emmet Scott
So, one of the things we focus on is you’ve got, if you look at the three stages, you’ve got clinicians who’ve become entrepreneurs and they kind of feel like that was the end and then they’re just going to be a better and better entrepreneur.

A lot of times they’re missing the skill set to go from entrepreneur to executive.

And again, the old saying, what got you here won’t get you there.

Being a great clinician, taking care of patients, hiring good staff, that got you here.

And so the question is, what’s holding you back from that next level? Because they run out of time.

Entrepreneurship is a very hub-and-spoke type system. You’re the smartest one in the room. You’re running off of your intuition. You have high risk tolerance capabilities, etc.

But you’re also driven by your dopamine and cortisol, right?

So this is really exciting and shiny. We’re going to go buy this equipment. We’re going to go do this. We’re going to start this marketing idea. This really ticked me off. That’s what we’re going to focus on now.

Their strategic planning skills are pretty limited entrepreneurs.

So where you start to see the symptoms is, “I’m working my tail off. I have no time and I’m making less and less money.”

Right? And so there are inefficiencies that are starting to creep in. Revenue covers a lot of sins until it doesn’t.

And so staff costs start creeping up. People start asking for more money, etc.

If you don’t have a more comprehensive view of like, “I’m running a business,” I mean, you know this, Chelsea, but I say this to our members all the time.

You’re running a multi-million-dollar business here.

Maybe they’re running a million-dollar business, but I have them imagine they’re sitting in their car next to their buddy and their buddy’s like, “Yeah, I’m running a multi-million-dollar business.”

And they’re like, “Cool. So, how’s it doing financially?”

And they’re like, “I don’t know.”

Like, “Well, don’t you get your financials regularly and review them and like what benchmarks?”

“Yeah, no, I don’t. I just try to take care of patients really well.”

Whatever. So, there’s clearly some skill sets and capabilities that feel nerdy and not fun and like, why would I want to focus on that?

And it doesn’t have a lot of dopamine. It just makes you a lot of money and gives you a bunch of time back.

So, those are things that we see as an issue.

And one thing I know from being an entrepreneur is that a lot of us are prone to ADHD. I don’t know that all of us have it, but if you’re talking about dopamine, we’re talking about what gets us there is brute force, right, to a degree.

And I think that that brute force is only effective to a certain point.

And then once we stop being effective with brute force, I think we have a hard time making that transition.

And that transition is, in my experience, a transfer of what you know to the right people so that they can go out and execute.

But how do you do that when you’re in that moment where you don’t have enough time? And also how do you do that as an individual that is always looking for dopamine hits?

And also how do you do that when maybe you haven’t really got the hiring piece correct?

So, let’s talk about that moment where you’ve gotten to a place with pure brute force and now you aren’t scaling and you’re stuck and you’re out of time.

Let’s talk about that moment. How does Emmet Scott as a coach come in and help? And what are the things that you kind of try to help put in place?

Emmet Scott
So, a couple skill sets.

One that has to happen is we have to come to the realization of like we’re just going to keep wandering in the wilderness for 40 years unless we change something, right?

I love your term there that brute force has gotten us to our ceiling of complexity, but it’s not going to push through.

So that has to be real.

And sometimes that takes a while before someone’s like, “So I’ve been five more years and same revenue and same game and same story with the staff and everything else.”

Some people have lower pain tolerances and after a few months they’re like, “Yeah, I can see this isn’t going to work. I need new skill sets.”

So that aha has to happen.

The two main tools that distinguish entrepreneurs from executives is executives really think about return on investment for every action they take.

Entrepreneurs enjoy the experience. That’s what makes us awesome. We’re like business is the CrossFit of personal development and isn’t this fun?

And who cares if I make any money in the beginning? Like, I’m just learning a ton and I’m the captain of my own ship, and that’s kind of our own return on investment until it’s like I’m making less than my associates are making now, you know, or whatever.

Like there’s some aha, or like I’m actually opened up two more practices and I was doing better when I only had one.

So something like that has to happen where we’re like, I have six kids. So at some point you had to say, do I want to have kids that know who I am and that I was at their stuff, or am I okay with sacrificing the opportunity cost?

Chelsea Morrisey
Yeah. So if I’m going to focus on the highest return on investments, I’ve got to have a more mature process than that looks shiny or that made me mad or I’m frustrated by that.

Emmet Scott
We use a simple framework that I created called IDOPE because we all have dopamine, right?

So IDOPE, and it’s an acronym, and what it is is we have a whole spreadsheet that we work through with our owners that every idea, that’s the I, has to be documented.

So we’re going to write down everything, Chelsea, you have in your brain that you want to run your business and you think would be really cool.

Then we’re going to organize that in those organizational columns in our software.

We’re going to find out what’s the return on investment if we actually solve this.

Sure. If I fix this, if I get the new website, if I hire this person, what is the return on investment? Who’s responsible for that?

Right? If all my items say Suzie, Suzie, Susie, Susie, Susie, and she’s also the office manager, we might already have an aha of like, oh yeah, we’re not going to be able to do all this stuff, so let’s not go hire 20 vendors to go work on it, right?

Once we organize, document, organize, then we’re going to prioritize.

We’ll have enough data there to say, I have resources and I get the highest return by focusing on this thing.

Whether that’s the most sexy or not doesn’t matter anymore. It’s the best one because it’ll start feeding money back into the business and it’ll start feeding time in.

It’ll also change my mindset of like what’s the cheapest solution to what’s the highest return on investment.

Most dentists are good at negotiating price. They actually aren’t thinking about what’s the highest return.

Maybe the more expensive is the cheapest when I calculate return.

Once I’ve taken every idea, documented it, organized it, prioritized it, then I execute.

Most entrepreneurs, idea, execute, idea, execute.

Emmet Scott
It’s kind of like they’re running a manufacturing plant and they’re like building a blue truck and they’re like, “Stop team. We’re going to do red cars. Red cars.”

And they start doing red cars. They’re like, “Stop. We’re going to do yellow motorcycles.”

And over time you get all this inefficiency of labor cost, but we don’t have the warehouse to go look and say, “Look how inefficient I’ve been.”

Because we’re a service business. It just evaporates, right?

And then we just see labor.

Even worse, we see teams that don’t really want to execute because they know if they just wait till Friday, Emmet will change his mind. He’ll be mad about something else or excited about something else and then we’ll wait till Tuesday, then we’ll wait till the next Friday.

And I think that it shows up the way you know that you’re operating that way. It’ll show up eventually.

It’ll erode your team culture and you’ll see it in their attitudes. Your team will be burned out with you, the way that kind of impulsivity.

Chelsea Morrisey
At the Implant Engine we operate on EOS, which is an Entrepreneurial Operating System, probably has some similar components to what you’re talking about.

But one thing we do that maybe people will find helpful is we establish our rocks, which are basically our items that we want to move forward for that quarter.

You can’t change it after that initial quarterly meeting.

And if you don’t get your rocks done, every person in the company has a rock. If you don’t get it done, you know, it’s a problem, right?

You don’t want to be the person that didn’t get your rock done.

So, it does eliminate some of the “let’s work on this instead” because you can’t change your rock and we have a culture where everyone wants to get theirs done.

We’ve done a good job of presenting and congratulating and rewarding people to get them done.

So it does kind of realign your focus.

And then you start to think, well, I’ll put that on my list for next quarter’s rocks.

And that allows you to have it on a list. So you feel as though it’s somewhere. You put it there, and it’s not going to disappear if you don’t work on it today, but it also, as you’ve already discussed, is not a priority for the quarter.

And it would have to be something really big to make it into that priorities list.

So it does allow for more focus and organization and less chaotic, less of a chaotic mess.

But I do find that with doctors that what the team works on is what they’re in the mood for that day, not so much what they’ve established and set as kind of a goal for that quarter.

Emmet Scott
It’s kind of a dopamine downer to have to write stuff down or have somebody write it down.

But once you get out of the entrepreneurial addiction and start moving towards this executive function, it’s where all the free time and money is at.

Chelsea Morrisey
Yep.

And that thought process of going through is this a right-now thing?

And you go through and say, “Hey, of the top priorities, what are going to move the needle for me financially?”

I think what you’ll find is that initial dopamine of that idea, when you really compare them to all the other ideas, you’re like, “Actually, no. I think this can wait.”

If you just give it a little bit of time, it’s almost like why you don’t respond to something when you’re angry.

You know? It’s like you just wait and you’re like, “Well, I actually don’t feel that way at all.”

Emmet Scott
Turns out, yeah.

I train the office manager, if they’re bigger, an ops director.

Let’s say Emmet comes in and he’s super excited about something.

The thing that I want the ops director to do is I want them to immediately start writing it down because I want to feel validated that I’m being heard and, like you said, this is still exciting to me.

And so they’re going to be like, “Awesome, Emmet, I put it on the IDOPE sheet.”

And then they ask the most powerful question.

“Where does this fit against everything else that we’re working on?”

Because I only speak in present urgent tense.

So my team has to be able to look past that and bring some maturity to me and to the system to not think that everything I say and comes out of my mouth means we drop everything else.

So, you know, in a dental practice, if I don’t know, I’m getting sued over some patient, that might prioritize against other things I was excited about. And so that would need to be addressed.

But there’s a lot of things that you find the entrepreneur owner will then say, “Oh, no, no. I’m just thinking someday in the future. It’d be really cool if…”

The team can say, “Okay, cool. Got it there, Doc. That’s awesome.”

And then they can stay focused on their top three.

And I think if dentists really thought about it, let’s say they’re in the middle of a surgery and every five seconds someone’s coming in and bringing in a new idea while they’re trying to do their surgery.

This is what they do to their team and then they’re frustrated that their team isn’t more productive.

It’s like, doc, if you can just hold that impulsive thought and not disrupt their flow for today and put that on a list and have a structured meeting every month or every quarter where you go through that list at a time when they’ve designated for that, you’re going to have a significantly more productive team.

Like, you know, I’ve had to maintain my impulses with the company. You know, we have 80 working here now.

And it’s a lot easier now because we have a leadership team. But I still have to restrain myself with sharing every idea that I have in that moment because I know they’re going to want to because I’m the boss.

They’re going to stop what they’re doing and they’re going to want to give me the time, and I don’t want them necessarily to be contact switching every five minutes because I don’t respect what they’re doing or their time.

That’s unfair.

And then I hold them to a deadline at the end of the quarter, but I’ve distracted them every single day.

Emmet Scott
So, I don’t think people are really thinking about it.

It’s like for us to get good work done, we have to have really solid focus time. We can’t be constantly disrupted.

Chelsea Morrisey
Yeah. I like a cadence, you know, even weekly for a lot of these practices where they can just sit down, kind of batch all their ideas.

“Hey, I was listening to this podcast. We should do this. I watched this. I was thinking about it. I went to this conference,” whatever it might be.

And they go ahead and just work through that sheet, and it makes a big difference.

We then tie that over to the financials.

This I saw before I got into dental, but most people who are getting their financials done by their tax accountant.

The problem there is that the tax accountant really makes a lot of money doing taxes, by the way, and is really prone to organizing your financials to make their tax return as easy as possible.

They are not managerial accountants.

So it’s kind of like if you walked into a dentist and said, “Hey, I have this two-year-old and also I have my parents who need all the, you know, a cleaning.”

Like a dentist would be like, “Okay, you got too many things here.”

Like this isn’t, now maybe one dentist would be like, sure, we do it all here, but they’re not going to do it all great, right?

It’s the same with accountants.

They’re doing primarily, most of them are doing your books to keep your tax return with them, but they’re not doing it well.

And so we have a very specific way we have all of our owners organize their chart of accounts.

And it’s amazing how much it unlocks clarity when I look at the books that most of these dentists are working off of.

I couldn’t run their business effectively, and I ran a $150 million group at every stage, right?

So, because there’s so much movement that would, okay, wait, that’s an Italy trip. That’s your strategic planning.

You’re running so much through for tax purposes.

Also, when you have doctor pay and hygiene pay and supplies and labs kind of just grouped in the core practice area, those are moving up based on revenue movements.

So, we group those all in a cost of goods section.

So, we have very specific ways that immediately unlocks for even the non-account types.

Like, okay, I get what’s going on. I get why this is too high and this is too low.

Otherwise, every month, if they’re even getting it every month, I mean, this is the other thing that drives me insane.

“Hey, Chelsea, sorry I didn’t get you your financials. It’s tax season. We’re really busy right now.”

Do you not think I’m running a multi-million-dollar business over here?

So, entrepreneurs also tolerate like that’s what got them there. They tolerate a lot because they have to because of the risk.

Executives don’t tolerate. They get what they need in order to run their business effectively.

And anyway, those two things by themselves and then we have a ton of playbooks and things that we help our members with getting their financials cleaned up.

Man, it’s amazing to watch their face.

Like, “I finally know what’s going on.”

Because most of our stress as owners is we just don’t know. And we’re trying to run this off of our gut.

Yeah. You can scale when and you can get more free time when you’re not running off of your gut.

And then you start organizing these projects around the ROI and you just watch your time free up and the money come in.

Yeah, the anxiety they must feel of not knowing their financials but also not knowing how to know their financials.

Emmet Scott
I have every number for our business right at the tip of my fingers, and that helps me sleep at night.

And it also allows us to make hiring decisions.

And you can’t scale effectively if you don’t know your numbers and you don’t have projections.

So you can’t have projections if you don’t know your current numbers.

How are you supposed to know how to hire and when to hire?

You’re either going to be hiring too early or too late, which if we go back to cash flow is a major issue or patient experience or anything, right?

That hiring piece is what allows us to scale. It’s getting that right.

When you organize the financials, we can show them little tricks that strategically just opens things up.

And I’ll give you one for everybody right now.

Two doctors makes more money than two locations.

So, we have a lot of docs who orient themselves around, “I want to have 10 locations someday,” right?

It’s not that that’s evil or anything, but it’s actually the wrong way to think about profitability.

And you know, you’ve probably seen this, Chelsea, they have like five locations and one’s making, or two are making money, and the other are sucking money, right?

So, they just got too far out on their skis because again, dopamine does that.

And so when you think about your financials, doc number one, after supplies and labs, you’re going to get about 50% profitability off of doc number one.

And that’s going to cover your overhead. And typically doc number one is yourself.

Doc number two, you’re going to get about 50% profitability and there’s zero overhead because you already covered it.

Right? There’s not like, you don’t pay more rent because you have a second doctor. You don’t pay another office manager.

So, think about that.

I add a second doctor and let’s say I’m amazing and I do $100,000 a month and this doctor sucks because he only does $40,000 a month, right?

Which isn’t terrible but not as good as me.

At $40,000 a month, 50% profitability, I’ll make an extra quarter-million-dollar in profitability at passive income to me as an owner off of that $40,000 doc.

If I don’t know that and I can’t see that clearly, then I start going, “I got to open another location. I can’t afford this doctor. How is people paying bonuses to these doctors? There’s no way that math works.”

Because they have the wrong math in front of them.

And so they’re making a logical decision off the wrong data.

Yeah. So, it starts with getting the right data. That’s something that you guys can help with.

And so, I think there’s a mindset piece here where I noticed that with myself in my first business.

I was afraid to pay people what they were worth. I would always be looking for the cheapest labor because I was afraid to pay payrolls, afraid I wouldn’t be able to pay it.

And what we did at the Implant Engine is quite different.

We pay people more than they ask for. We find the best people and we pay them what they ask for or more, right? And we bonus really well.

And that’s meant that we have an incredible team.

But that was a mindset shift for me to start hiring and taking risks with my payroll.

And I think there’s a point at which it’s obvious a doctor needs to bring in an associate, but they’re stuck and they think they can do it all.

And what that ends up happening is burnout.

But what is that mental piece that you help them work through of like it’s time to let go of some of the stuff that isn’t high value enough for your time?

Emmet Scott
I think in fairness a lot of people talk about getting out of the chair or bringing on an associate and no one addresses maybe two main issues.

One is the financial piece and them having an understanding because they think the risk is higher than it is.

And they do need to understand what their patient flow is. Is that associate going to eat?

The other piece is I think they know this in their gut, and especially ones where it’s like, “I’ve hired an associate, there’s nobody good out there.”

They’re not very good leaders.

Being a great clinician is different than being a great chief dental officer. Totally.

And so that skill set, we have a chief dental officer whose sole job is she’s training our owner docs on how that skill works.

So I think having respect for the fact that, and in fact, the better you are at anything, this isn’t just true for dentists, the worse you are at training other people.

Because a lot of the way you got good at it was your type A personality, your ambition, your grit, etc.

So, you’ve hardcoded this into your intuition on how to do stuff.

And to get that out takes a lot of patience.

And so it’s a little bit like me coming to you, Chelsea, and like, “Hey, you breathe so well. How do you breathe?”

And you’re like, “I don’t know. I suck in, blow out.”

You know, like it’s not.

And so it’s like you do this procedure, you have this conversation. How does that happen?

Now, how do I have that right conversation? And how do I create that standard of care with a dentist that’s not going to spark their ego?

That’s its own skill set.

You can wear a Plaud pen, right? Record everything in your operatory for the day, or use someone like Avoira or any of these others.

You can record that information and it can tell you, because you think that everything you do is custom and it’s not.

There are real patterns we all use, which is what makes us so effective.

So you can do that, and a lot of times they’ll work with our coaches to be able to capture what is their formula and then we’ll build that out.

And that helps them be better leaders, and you can’t scale without being a good leader, right?

Chelsea Morrisey
So yeah, when you’re talking about being a better leader, you work with a ton of offices, you’ve owned a ton of offices.

What are the characteristics they have to lead kind of an A+ team so they can free up their time?

Emmet Scott
So, one, they have a self-awareness that they’re strong here and they’re about to go from A student to F student.

Because I think that humility puts them already in a place where they’re going to scale as a leader.

If I show up and I say, “Hey guys, I haven’t done this before, but this is my vision. Can you guys help me along the way and create that collaborative environment?”

You’re already going to buy yourself a bunch of time.

A leader is going to be organized in their thoughts and their vision.

So, I’m kind of a broken record, but like you come back and it’s like IDOPE systems, right? They’re going to have that in place.

They’re going to be open to taking on crucial conversations.

So, I hear leaders like, “Oh, yeah, I’m great. I’m not scared to fire anyone.”

Right?

It’s like, but are you scared to have the conversation to help them develop?

Leaders are the ones that come in and say, “Hey, listen, you not wearing deodorant is really causing a problem?”

Nobody wants to have those conversations.

But those are the ones that leaders end up taking on.

So being willing to kind of start to organize systems, be able to have crucial conversations, to set vision, and to run things ultimately by financial outcomes.

Like, I love good culture. It is hard to have a good culture when you’re losing money.

Totally. It’s hard to pay for lunches or ask everyone how they’re doing.

Like, the stress of that is so intense. You’re in survival mode.

And so that cortisol spike, it’s really hard to be empathetic and be a transformational leader.

Now, the way you hack the system, the way I grew so quick, you know, because we grew at about $10 million a year.

And so people ask, “How did you do that?”

Well, one, I already had experience saying, “How do I scale from entrepreneur to executive?”

So I knew a little bit of what I was doing.

But if I was going to give someone like a cheat code for this, just like a dentist can look in a mouth and in three seconds they know the whole treatment plan and they’re slowing their brain down to explain it.

There are people who are experts that have enough pattern recognition on all parts of your business.

You just have to be good enough and willing enough to bring them in for a period of time.

So, at DEO, we do everything month to month. We have fractional services for every position.

So if you’re like, “I’ve never hired office managers, or the ones I’ve hired haven’t been that great,” then you could bring in a fractional COO.

And they’ve hired hundreds of office managers. They know what it looks like, and they know how to scale them.

Collection side, whatever piece it might be.

The way I scaled quickly is I was just bringing in experts all the time.

I wouldn’t keep them forever.

Sometimes I just needed them to run through a wall for me like, “Hey, I need you to fix my collections process.” And then after that, drop them off.

Again, I love your word, grit.

The entrepreneur is like, “I’m going to figure this out on my own.”

That’s fine. Like, if you want to do it, but you better have unlimited time and money eventually.

Chelsea Morrisey
Totally. Yeah. I mean, I prefer a shortcut. I don’t know about you, but I prefer someone just…

I’m getting old. I’ll be 50 this year. Like, I’m done with this. I’ll figure this out on my own.

Emmet Scott
I’m like, who already knows this? And I just have to be humble enough to follow what they’re saying.

One thing I’ve noticed about dentists, and I hope nobody’s offended by this, but that I haven’t seen in other industries is there’s so much of “I’m going to hire someone and not listen to what they have to say.”

There’s a lot of that of “I am not the problem here. I am amazing and I don’t have anything to learn.”

That’s kind of the energy.

And there’s also a lot of dentists that I can spot right away. I’m like, you are going to the moon because they say, “I’ve worked a lot on this, but I know I still have room to grow, and we’re open to hear what you guys have to say.”

Emmet Scott
I think a lot of us when we think about leaders, we think of someone who already knows all the answers and can drive the vision and push through.

And I think it’s just weird for most people to figure out to get to transformational leadership does have an element of vulnerability to it.

And so I think we’re always trying to put on a face for our team and everything’s going to work out, and we kind of are prone as entrepreneurs to not like the negative.

We tend to shut that down. We don’t really know how to lean into that as raw material to help with our success.

We kind of see that as negative.

So, I think all those things tend to work against us initially, and so it’s new skill sets to learn.

Like, how do I be vulnerable but I can’t also walk in and be like, “Guys, we’re all going to die, but I don’t know what I’m doing here. I’d love some help.”

Or, you know, the way they show up to you, like you mentioned Chelsea, of like, “Hey, I think we’re crushing it here. We’re getting crushed there.”

That’s something that I establish with any new owners that come in is every one of our owners are crushing it and getting crushed.

So, let’s just talk about that.

That’s the story of entrepreneurship.

But the reality is, if they knew how to do it, they’d be doing it already.

So the fact that they aren’t scaling to this degree or in this area shows that there is some type of block there.

And you know, you should, as an entrepreneur, you should be open to all the answers even if that answer points right back to you.

Emmet Scott
Totally. And his capability is just off the chart.

There’s always in the hierarchy of the human race someone who’s way ahead of you.

Like, I need to find the person who’s just a little bit ahead so that my limited mindset can at least somewhat consume it.

But no, that’s what makes this fun.

When you realize like I’m good, but there’s someone who’s 10 times better, totally. And like, how do I get myself around them?

And that person might be my employee, right?

That might be someone that I hire that can teach me something.

I mean, truly I feel like entrepreneurs rarely consider that the person they might be learning from is the person they’ve hired.

And I think it’s crazy that that ever happens, but it’s true.

As an entrepreneur, you have this ego that you created this business and you know the most about everything.

You might not say that out loud, but I think there is an element of that.

And you shut yourself off to learning from the people that you’ve hired for that role.

And if you hire well, you should be hiring experts that should teach you about the position and about the role.

I think a good associate could come in and teach doc something about business in theory if they were open to it, or anything, right?

So, I think hiring people that you genuinely respect their expertise and we’ll talk about this hiring piece kind of as a last piece here because I think it’s important, but also being open and willing to learn from your team and hiring coaches that you’re open and willing to learn from.

I mean, that’s the cheat code, right?

That’s how you fast track.

Chelsea Morrisey
I saw a meme. It had said, to push through, not listen to what anyone says, and to go for your vision is courage. It’s also stupidity, and that’s what makes life hard, you know.

So I think you’re right. It’s being able to listen to your team.

And then I also see on the other end there’s people who are tolerating team members that they shouldn’t, and that’s what makes it hard.

It’s somewhere down the middle.

Like an executive knows when to draw the line and get their team to do something that maybe they don’t want to do.

And everybody has that. They can hear it and feel it right now.

They’re just on the edge of my leadership capability, right?

Because what they represent is either number one, I don’t know how to work with them well, or number two, I’m unwilling to have the right conversations and maybe get them out of the organization too.

So I just sit there and tolerate it because it’s right on the edge.

And so I look for those things because they give me my next, you know, how I said it’s like CrossFit.

It’s like if you can do overhead press, but then can you do handstand push-ups? You know, it’s like it’s my next opportunity.

Chelsea Morrisey
Yeah.

Emmet Scott
And that’s what kind of makes this cool once you lean into it.

Any business that’s growing is always broken.

So, if you just kind of enjoy that journey, you know, it gets pretty fun.

Chelsea Morrisey
Yeah, you’re so right.

What I thought early on was that you get to a certain level and you stop having problems.

I don’t think I ever said that out loud to myself, but I think I thought, “Oh, if I can just get here, I’m not going to have any problems.”

Actually, you have new problems at every phase, and as a leader they’re often more and more challenging for sure.

Like, it’s just pure crap at that point. It’s like it’s been filtered to you.

Problems.

Yeah. It’s like when someone says, “I want to be the CEO.”

It’s like, so you want to work through legal issues a lot. You know, that’s what large-based organizations or fundraising or whatever it might be.

The other thing that’s hard as you scale is you get farther and farther away from the dopamine.

Chelsea Morrisey
Yep. Totally.

Emmet Scott
Right. Like a dentist who’s there in the chair, I mean, it’s like I produce this much. I saw the patients. They’re exciting.

A dentist who’s up here over a bunch of people or like an office manager who’s become an ops director, it’s like, “What did you do today?”

“Well, I got Frank and Sam to not argue anymore, and I think we got them on the same page and they’re not going to quit and their production will, you know, whatever it is.”

Like, it’s not as tangible, and so there’s a maturity to it that you have to develop.

Chelsea Morrisey
Yeah, totally. And you have to decide if you want it.

Some people say, “I want 10 locations,” but what that day-to-day looks like at 10 locations, I think people should work from that day and work backwards and say, “Do I want my life to look like that and feel like that?”

And if the answer is no, that’s okay.

But I think we should be working from the constraint of how that will look and feel and painting that vision.

Because having 10 locations is going to turn them into a different person.

They’re going to have different day-to-day responsibilities, and there’s going to be some sacrifices in between where they’re at.

If the answer is they want time, freedom, and to be more wealthy than the average person so that they can take their boat out, well, maybe 10 locations isn’t actually what they need to do that.

Like you’re saying, maybe what they need is one really profitable location and a few mindset shifts and some hiring shifts.

Emmet Scott
Right.

Chelsea Morrisey
So, I think with entrepreneurs, we have this idea.

They heard some guy at a conference had 10 locations, so I want 10 locations.

What they actually want is something truly different.

Emmet Scott
I think that’s really smart. I think that’s smart what you said.

I think the last question that I kind of want to ask you, in terms of offices that you see that have it all, are making good money, and the offices that you see that are struggling, what is the one takeaway you want these dentists to know that is just in their brain that they can reflect on every day that’s going to make them better and turn them into that more profitable office?

Emmet Scott
Man, we’ve hit on so many good things.

So, let me summarize a couple and then see if I can add maybe one or two more elements.

So, a couple things that might be painful to hear is it’s rare that someone’s coming to you because of your clinical care.

And part of the reason is, one, they just expect you to be good.

So it’s actually a commodity to be great.

You know, no one’s like, “I came to you because you actually know clinical,” versus I didn’t go to that.

Which kind of leads into number two.

Like a customer doesn’t know clinical outcomes.

Like they might know if their bite feels off or something like that, but they really don’t know the intricacies of that.

They are experts on one thing, and that is how they felt.

And how they felt was both the patient experience and also the convenience piece.

So, I think dentists who are really mindful of who their customer is tend to just scale quickly.

And then there’s new problems that come with that and new skill sets that we’ve already hit on in this.

I want to hit on the staff piece for a second here.

I think one of the traps that a lot of entrepreneurs fall into is they see staff different than they see their customers because customers are paying them money and staff I’m paying money to.

But if we thought of our staff as all of our team as revenue-producing agents within our business, and the way that here’s where this shows up.

Even the way we recruit is so different than how we market for patients, right?

We put this beautiful website up. We have, like, ideally, we have this social media marketing we’re doing. We’ve got pay-per-click we’re doing.

We make it convenient for them to schedule, etc.

We barely take time to write the ad effectively.

We have nowhere on our site that would actually attract people to it.

We’re not overly concerned about our reviews and how that would impact someone wanting to work at our office.

When they are onboarded, I mean, it’s nothing like the patient experience, that’s for sure.

You know, if we’re good at the patient experience, we might still be terrible at the onboarding of our team experience.

And then we say things like, “You just can’t hire anyone good these days.”

But we really don’t understand that customer.

And especially clinicians, we’re like, “I’m paying them a quarter million, $400,000 a year. Like, do I really have to cater to them as if they were a customer?”

And it’s like, well, let’s reverse that.

If you’re paying them 30% of their production, they’re making you 70%.

Right? Like, yeah, you should cater to them, right?

And then if this team is effective, they’re the ones, I mean, it’s really amazing when you think about your team in this context.

A group of people who wake up every day to execute on my vision.

That’s pretty amazing.

But we kind of just treat them differently.

And I’m not saying we have to have dog day and nap time and all of that stuff, but wherever the gap is between how you treat patients and how you treat your team, I think you’ve come back to that a few times, Chelsea, which is smart, is like good leaders kind of figure out that team piece.

And again, we’re not saying you should keep everybody.

You should have standards there and continue to develop that out just like you shouldn’t keep every patient, right?

So, yeah, knowing what that looks like.

But anyway, those are a couple.

Like, your question was what’s the difference between good or maybe bad and great?

And there’s different levels to this, right?

Like, I go into the gym. There’s levels to this.

I’m like, “Oh, I’m… I used to be 300 pounds for about 26 years. I’m more fit than that a couple years ago. I’m like, this is not working. My health is like, you know, so I’m feeling pretty good.”

And then you go to the gym and you’re like, “But she looks really… he’s amazing.”

You know, like there’s levels to this depending on how elite you want to be.

And there’s, I think, if you’re humble about there’s another level, what sacrifices do I want to make to get to that level?

The advantage I have is with 600 owners we’re coaching every week, you just see patterns, right?

So you can quickly see what’s working and what’s not.

Like, we don’t have to make it up. Like, this would be a good idea.

It’s like this crushes whether they’re doing All-on-X or their pediatric Medicaid or their general dentist.

Like these formulas work totally, you know, and then these don’t.

They keep trying this way. We see everybody in this mindset and it just doesn’t work.

And so it starts to get pretty algebraic on what works and what doesn’t.

The piece I want to come back to that we touched on is to kind of close us out is like, yes, we’re talking about hiring really good people, but you’re also talking about knowing when to fire.

Because keeping the wrong people around in the wrong seat on the bus is actually extremely costly to a company.

And a question we ask ourselves lately is, “Would I hire them again for that role?”

Simple.

Would I hire them again?

If the answer is no, I would not hire them again for that seat.

Would I, if I was interviewing them, would they be the first candidate for any other seat that I would pick?

And a few times the answer has been yes, and it’s been amazing.

And a couple of times it’s like, no, I wouldn’t, if I was interviewing 20 candidates, I wouldn’t hire them for that role.

And I definitely wouldn’t hire them again for this role.

At that point, it’s an easy decision.

Chelsea Morrisey
I love that.

I mean, still, I take it. I’ve just enjoyed learning from you so much.

I’ve had several mindset shifts here that I think are just, I cannot wait to bring back to my team.

Thank you for your time. I really appreciate it.

Where can people find you and DEO?

The way that we think about the world from an executive is we’re all solving three questions.

What should I work on?

How do I solve that problem?

And who on my team or vendor or whatever is going to actually do the activity?

So, you can jump on one of those calls and they’ll kind of help you sort some of the what that you’re working on and then you can decide if you want us to help with the how and who and so forth.

But yeah, deodentalgroup.com.

And you get access to a couple things.

You get access to an app that has a ton of trainings in it and we’ve got it broken out.

Your team gets access as well.

It’s a whole community of entrepreneurs, office managers, ops directors, HR people, etc.

So, everyone in the organization gets access there.

We have live events, live trainings on the app that they have, and you get a coach every week that you meet with.

But you get access to any of the executives to ask questions.

So anybody who’s interested and wants to check it out.

Chelsea Morrisey
I’ve had the pleasure of meeting a couple of your coaches and they’re incredibly smart people.

So, I know that there’s really good people that work there and, yeah, I definitely recommend going and checking it out.

We know we have offices that work with you guys and they absolutely love it.

So, amazing work there and thank you for your time. I appreciate it.

Emmet Scott
Fun to talk to a fellow entrepreneur. I always love that energy, you know.

So, we’re all kind of navigating the same journey together in any industry.

Chelsea Morrisey
We are, but we’re unique.

Emmet Scott
One thing I do say is like you’re in the top 1% now, you get to work with the other 99%, you know?

So, you’re going to have to figure this out, but it’s nice to sometimes just get in a room with other entrepreneurs and just, you know, hammer stuff out.

Chelsea Morrisey
That’s right. That’s right. Thank you, Emmet.