Orthodontic practice management expert Chris Bentson, Founder, Bentson Copple Patterson & Associates, joins hosts Dr. Leon Klempner and Amy Epstein on the Golden Age of Orthodontics podcast to analyze the competitive landscape facing private practice orthodontics in 2026. With nearly four decades of experience in practice valuation and business strategy, Bentson shares critical data showing 3.5% growth in patient starts after three years of decline. The conversation explores how DSO consolidation is reshaping the specialty, why digital orthodontics technology is essential for differentiation, and what data-driven decision-making reveals about successful practices versus struggling ones. Bentson discusses the impact of federal student loan caps on new residents, the lifecycle of consolidation, and why practices that embrace consumer experience innovations, such as remote monitoring, consistently outperform competitors across every operational metric.
What you will Learn in this Episode:
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ABOUT THE GUEST:
Chris Bentson has been working with orthodontists regarding the business aspects of their practices for over thirty-five years. He is the founder of Bentson Copple Patterson & Associates. He spends much of his time working within the orthodontic industry. He joined the AAOF Board in 2016 and served as AAOF President in 2023-2024. He was awarded the 2022 “Outstanding Contribution to the Specialty Award” by a non-orthodontist from the AAO. Chris is also a guest lecturer in the Wharton Business School’s AAO Partnership course: “Mastering the Business of Orthodontics” covering “Practice Level Financial Management" and "Financial Acumen and Practice Transition Planning". Chris is a frequent presenter at AAO sponsored meetings and is a contributor to national orthodontic periodicals and journals.
EPISODE TRANSCRIPT
What follows is an AI-generated transcript. The transcript may contain errors and is not a substitute for watching the video.
GAOO - Episode 79 Chris Bentson Transcript
(00:00:00) Dr. Leon Klempner: Today we're joined by one of the most respected data experts in the industry. Chris Benson, if you want a clear, unfiltered read on where the specialty is heading in 2026. This is the conversation for you. Stay with me. Our Golden Age of Orthodontics podcast sponsors make it possible for us to bring you new episodes.
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(00:01:37) Narrator: The future of orthodontics is evolving and changing every day, but although the way to achieve practice growth has changed, there's never been a better time to be an orthodontist. Let's get into the minds of industry leaders, forward-thinking, orthodontists and technology insiders to learn how they see the future of the orthodontic specialty.
(00:01:57) How will digital orthodontics, artificial (00:02:00) intelligence, clear aligner therapy, remote monitoring, in-house printing, and other innovations change the way you practice? Join your host, Dr. Leon Klempner and Amy Epstein each month as they bring you insights, tips, and guest interviews focused on helping you capitalize on the opportunities for practice growth.
(00:02:17) And now welcome to the Golden Age of Orthodontics with the co-founders of People and practice, Dr. Leon Klempner and Amy Epstein.
(00:02:29) Dr. Leon Klempner: Welcome to the Golden Age of Orthodontics. I'm Leon Klempner, retired board certified orthodontist. Director of Orthodontics at Mount Sinai Hospital, part-time faculty at Harvard and Montefiore, the new current president of the New York State Society of Orthodontics, orthodontists, and the CEO, most importantly of people in practice.
(00:02:52) I practiced for about 40 years on Long Island before co-founding people in practice with my daughter and my (00:03:00) partner, and my podcast co-host. Welcome, Amy Epstein.
(00:03:05) Amy Epstein: Thank you. I heard you were retired like 15 years ago. Is that a thing? I am
(00:03:09) Dr. Leon Klempner: retired. I, I'm doing the things I love to do. That's the difference.
(00:03:13) But you know what? I loved it when I was practicing orthodontics, so I, I never, I don't have, I don't even consider myself ever working. That is the honest truth. How nice. I don't, I don't, I don't think. Yep. Not true. When before, before I, I went to dental school. I worked for the post office. That was a whole interesting thing.
(00:03:36) And then I, I sold, uh, shoes across the street. You drove a cab
(00:03:40) Amy Epstein: too, right? I
(00:03:41) Dr. Leon Klempner: drove a cab. I sold shoes. Um, I sold handbags. Um, so yeah, that was work. That's, but once I got to be an orthodontist. I mean, no greater profession in the world anyway. Welcome.
(00:03:57) Amy Epstein: Thank you very much. I'm (00:04:00) Amy Epstein. The only other work he does that's actually work is when I leave for a week and leave my small children with him.
(00:04:06) And then that's, that may be work. That's real work. That's real work. That's real hard stuff. Uh, I am glad to be here. I have an MBA in marketing, a background in, uh, corporate branding, marketing, public relations, and my dad and I co-founded people in practice in order to bring that. Kind of expertise to the industry of orthodontics?
(00:04:29) You know, it's funny, when I started in, when, when I was back in public relations, um, I was asked. It was some sort of like, introducing me or something like that. It was, well, what's your, what's your favorite quote? Um, and I, I thought about it, did some research and whatever. And, uh, this still holds true today.
(00:04:51) My favorite quote is, uh, in God we trust all others must bring data. It's, uh, w Edwards Deming. Uh, you (00:05:00) know, we all have instincts and look, I come from public relations and marketing and branding and orthodontics, and you come from an orthodontic background. Everything is measurable. Have you moved to that tooth?
(00:05:10) Is the alignment straight? Is the arch wider? All that stuff is measurable. When you come from marketing and, and, uh, branding background, there's still a lot of data to be. Combed through, because in there you can have, like I said earlier, opinions, instincts, gut feelings, but it's in the data that the truth lies.
(00:05:31) So that's why I like that quote. And I still, it's my favorite.
(00:05:35) Dr. Leon Klempner: Well, I mean, you're preaching to the choir when you're speaking to orthodontists, right? We, we live in the data world. You know, the first thing we do when we see a new patient besides, you know, a physical exam, we take records. Right. We take a pan, we take a cef, we do a digital scan, look at the smile arc, look at the facial appearance, I mean all data, data, data, data before we come up with what we call a treatment plan.
(00:05:59) (00:06:00) So, um, you're preaching to the choir here when you, we talk about data.
(00:06:04) Amy Epstein: Well, the, the thing that's interesting that I think we. Do well and that we've done well, um, in partnering up with people in practice is bringing, you know, the marketing and the branding and, and the transition communications and all that stuff to orthodontics, which is obviously what you know best, but it's also about bringing as much data as possible to analyze.
(00:06:29) So it means collecting data, setting up. Infrastructure to be able to collect data on marketing and then analyzing that data and then processing that data and then revisiting that data to make sure that we're constantly improving. So I think that's one of the things that, aside from the, the merging of ortho and marketing, the, the merging of the data side of things into the marketing, I think we've done a really good job of, if we, if I.
(00:06:54) Do say so myself, but, so that's my segue. We (00:07:00) are thrilled to have one of the, uh, most influential data oriented experts in orthodontics with us today, and that's Chris Benson. Chris is a trusted voice in the orthodontic industry with nearly four decades of experience advising practices on valuation transitions, recruiting.
(00:07:21) Business strategy overall. He's a founding partner of Benson Koppel Patterson and Associates, and worked with orthodontists across the country to help shape and still does how the specialty thinks about its business fundamentals. He's also held leadership roles within the A a O foundation. Teaches at the Warden a a o partnership program and consulted with many of the major companies that are driving innovation in orthodontics today.
(00:07:48) Chris, thank you for being here. Welcome back to the Golden Age of Orthodontics.
(00:07:52) Chris Bentson: Thanks Amy. Thanks Leon. It's always a pleasure to be on this show and, uh, great to see both of you. Likewise.
(00:07:59) Dr. Leon Klempner: (00:08:00) Yeah. Well, welcome Chris. I think it's gotta be your, at least your third time, maybe fourth time over the years on the PAT podcast.
(00:08:08) And it's always like very well received. We always get like, hi. Uh, yeah,
(00:08:14) Amy Epstein: this, this, this episode does really well with view views and downloads.
(00:08:19) Dr. Leon Klempner: Yeah. Yeah. And I mean, we're, we're painting you as a data guy. I hope that's not. Too limiting or too insulting to you, because I know that insulting. I dunno. Well, I don't know.
(00:08:29) Well, you know, he does much, so many, so many things. Yeah. He says more than that. So, um, you know, well, I don't wanna box you into a corner, but today we wanna talk about data. Yeah.
(00:08:40) Chris Bentson: You know? Absolutely. And we,
(00:08:41) Dr. Leon Klempner: yeah. So, um, you know, uh, let me tell you what's on my mind. Our, our clients. Typically our marketing clients typically are solo or they're private practice practitioners, right?
(00:08:56) We, we don't have a lot of OSO (00:09:00) clients. It's not that we're opposed to it, but, you know, people that gravitate to us typically are in the private practice, uh, arena, and they, and they look to us to help them in terms of their marketing. So for our, and, and there's so many moving parts going on right now in our.
(00:09:19) Little cottage industry. So for our listeners, just can you broadly just lay out the competitive reality for non-corporate private practice orthodontists that, um, are, are looking to see what the future holds and are there any data points that matter most that maybe they aren't looking at?
(00:09:43) Chris Bentson: Yeah, absolutely.
(00:09:43) I think, I think the first one is there, there's fewer independent practice owners today than there was 10 years ago by like 19 points. So, oh, you know what drove that, um, is the Osos DSOs, maybe we'll touch on that later, but, um, that, that, uh, ate up, if you (00:10:00) will, a lot of the independent, you know, or larger group practices.
(00:10:03) Um, so I think, uh, what's true is at least. In our careers, Leon, it's, it's harder to make a buck in ortho today than it was 20 years ago, uh, 15 years ago, maybe even 10 years ago. Um, and there's several reasons for that. There's upward pressure on overhead, um, through a lot of technology that we said was gonna replace people, but it really didn't.
(00:10:27) From practice management systems to some of the digital stuff out there. Um. And we're also working longer. Um, so we're retiring at an older age today than we did 20 years ago. We average retirement age of an orthodontist. Today is 70 versus 55, 25 years ago. Why can we do that? Because of technology? Um, you know, you don't have to be as good with your hands and your eyes, and.
(00:10:50) And things like that as, as you age in the profession. So, and, and, and it's competitive, I would say everywhere. There's pockets where it's not, but it's, it's pretty competitive (00:11:00) everywhere. Um, and a lot of gps doing a lot more ortho today, so, uh, yeah, it is harder to make a buck the, the, the tough time since, you know, if you look back the last five years we had, we had COVID that upset the Apple Corp.
(00:11:13) But we bounced back really well from that 21. Is that. Upside once in a hundred year flood. Awesome year for everybody. But since then it's been negative, uh, negative growth in production collections. And patient starts in 22, 23, and 24 until this year. And I can report as of Monday the, the end of November data that I get to, uh, a chance to take a look at from some of the aggregators gauge.
(00:11:36) In OrthoFi particularly, you know, we're up three and a half percent so far, year to date in production. We're up. Uh, similarly in, in collections and up almost 2% in patient starts. We haven't seen that in three years. So, you know, I've been telling people, it's coming, it's coming, you know, we're gonna, it's gonna get better.
(00:11:53) And I think 26 is going to be, uh, on top of that by a couple of points. So it's good to see this year coming in so strong. (00:12:00) It's good to have some organic growth that's, uh, you don't have to create by fee increases right now. And so, you know, I think, uh. I love when Amy says I'm an MBA. What? What you see when you look at the Osos and DSOs is they outperform the independent uh, owners.
(00:12:17) Why? Because they're smarter. They look at the numbers better, and they can manage the metrics better. And so orthodontists have to be, have a sharper pencil. You have to be a better businessman or woman than you used to have to be. And if you do those things, um, and you'll be successful. And I think that there's a lot of data that.
(00:12:35) We see today that we never saw before. You know, how do I manage how many inbound calls I have and how many of those actually turn into an appointment that's captain. We're getting more granular about the way we look at our offices, and people who do it really well are, are, are succeeding in the marketplace.
(00:12:51) Dr. Leon Klempner: Yeah. So, you know, he, here's the, the, um, the trap about the three and a half percent growth Yeah. Is that not (00:13:00) everybody's growing by three point a half percent. And so, so it's like an asymmetric amount of growth and what, what, what we're seeing on the marketing side is that what I would. Consider the plain vanilla orthodontist, the ortho orthodontist that comes to market as we do braces and we do aligners.
(00:13:20) Things that I used to do. In my career that brought patients in, are no longer the ones that are prospering. So the, the ones that we are seeing that are doing the growth are the ones that have a real clear message that differentiates them from the pack. So, you know, when we hear this three and a half percent, I always kind of like, you know, have a little bit of a reservation about it because we get a lot of clients coming to us that are not growing that way.
(00:13:53) Amy Epstein: That's
(00:13:53) Chris Bentson: an average. There, there's a lot of orthodontists who do great clinical work but don't listen to the (00:14:00) market and, and the market evolves just like technology evolves in the way that we treat. But the consumer has evolved a great deal, um, over the last 15 years in orthodontics and. And they want a different experience.
(00:14:12) They want a different cadence of visits. They want digital. They don't want to come in to see you as much. And orthodontists have stiff on that for a long time. Um, you know, your message, your company, your, your podcast speaks to this regularly. But I find when I look around and, and you know, one of the advantages that, that maybe someone like myself gets from the data point is we.
(00:14:35) When we value a practice, we see what what you collect and how you spend it, um, and. You've got to be engaged, uh, in digital. To differentiate today, you've got to be, uh, and that's clinically how you treat, uh, the consumer wants that. You've got to be engaged in digital marketing efforts, um, and not just giving pencils and book bags and raffles.
(00:14:58) I mean, that stuff (00:15:00) kind of still works, but, but not as much so. I would guess Leon, in, in the middle of the road practice, there's an independent practice owner zone, a, a a 50-year-old, uh, solo practitioner that practices four days a week with a satellite one day a week and doing about 1.6 to 1.7 million at 60% overhead.
(00:15:20) That practice, a lot of times, isn't growing by three, four, 5%, where others are, it's not because they don't have scale, it's because I don't think they're listening to the consumer. Um, and providing a different experience than they did 10 or 15 years ago. And if you don't do that, you'll be left behind. I spent the better part of 10 years with a line light force dental monitoring now KLO, and trying to really understand the financial journey, not the clinical one.
(00:15:44) 'cause I, I, I know this stuff works, but it has certain advantages and not everybody uses it today. So from a differentiation point of view, I think, uh, those practices are winning more than those that don't engage that way.
(00:15:56) Amy Epstein: Yep. And I think the workflow too, that from a (00:16:00) technology standpoint, meaning like how you engage with people before they actually make an ex an appointment and come in that whole journey up until that point.
(00:16:08) 'cause that's the world we live in. Yeah. Before they come into the office, that experience is really important to. Not only, you know, from a marketing standpoint of, of course, build trust and, and educate people about what you do and why you're different and all that, but also when they start reaching out because for whatever reason they saw you, they have reviews.
(00:16:27) Gp, you know, they're. The workflow to getting them to the exam is also part of that technology, um, demand that consumers have shifted toward where you have to be able to provide more than just calling the practice and waiting on hold In order to make an appointment, you have to be able to ask questions in different ways.
(00:16:47) You have to be able to engage in requesting appointments in different ways, and you need confirmations. Text messaging and all that. So, um, the technology piece extends, I think, to that very specific part of the (00:17:00) consumer experience that has shifted significantly, both from consumer product, good company, ex, you know, uh, experiences and also in other parts of healthcare that are showing examples of how this can be done really well to fit in with your life, remind you about things and follow up with you and, and all of that.
(00:17:15) So,
(00:17:16) Chris Bentson: yeah, thank God I have kids because they, they really though are the ones in, in later in life that. It taught me what's going on in the world. Um, and I'm, I, I'm coming to New York and, uh, going to see my, my son who lives in Milford, Connecticut. Uh, Connecticut, with his wife and, and you know, they send us something.
(00:17:33) You gotta download the app to get your tickets to the train, to, you know, and, uh. You know, if you're, if you're relying on yearbook ads and, and very traditional marketing and paper, uh, and things like that, you're, you're not experiencing the growth that you can experience, and you won't, you'll be, you'll be left behind.
(00:17:52) And so you've got to listen to, uh, what the consumer wants, how they find out about you. They, you guys know the data I that, that I don't, I mean, they, (00:18:00) they know so much more about you before. There is a conversation, um, largely they've made up their minds based on what, what they found out about you before they talked to you.
(00:18:10) Mm-hmm. So that's not only does that conversation have to be stellar, but uh, the ways that keep you communicate with the market have to be stellar as well before, and. You know, that's an art, it's a skill. And, and that's, that's one thing that these large groups, osos and DSOs understand better at many times than the independent doctors.
(00:18:28) So you've got to engage with consultants and groups like yours to learn that. Um, and then. Not just listen to it, but implement what you ask them to do. That's sometimes a jump, right? You hear what Chris
(00:18:40) Dr. Leon Klempner: said there? Chris said that you should engage a company like people in practice and mark that down.
(00:18:46) Chris Bentson: Yeah, it works. You know, I, I, I will tell you just overall on consultants and I've, I've been amazed about this and this, this is data that's been true for 30 years. The JCO does a biannual practice. You know, survey that comes out in four parts every two years, and it, it (00:19:00) always asks the question, do you engage with a consultant?
(00:19:02) And it used to be just practice management consultants, and now there's so many more yourselves in, you know, marketing some other things only 20% consistently over the last. 40 years that that study has been coming out. Every engage. And when I value those practices from our shop, the, those practices always without exception, outperform in every operational and, and financial metric.
(00:19:23) And so I, I asked myself why wouldn't I? Um, and um, there's lots of reasons for it, but one of 'em is because you're so smart, you don't think you need to. And, and so, uh, you know,
(00:19:34) Amy Epstein: have you been hanging out with orthodontists a lot?
(00:19:38) So, okay, let, let me go back for a second. Uh, you mentioned just a minute ago, you brought back into the conversation the osos, the DSOs. I wanna talk about that a little bit because consolidation has obviously been one of the most significant forces, um, that's shaping the competitive landscape. Uh, you know, over the last maybe 5, 5, 10 years, it's been (00:20:00) really picking up speed.
(00:20:01) Um, but. You know, for right now, it, where we are right now is are we seeing a shift? Are we, is that rate slowing down? Is there an inflection point that we're at? Like, where do you see us in that curve of, uh, consolidation?
(00:20:18) Chris Bentson: Yeah. Well, consolidation is a lifecycle, uh, just like a practice lifecycle does. And if you listen to, um, the private equity people, the venture people and the broker people, um.
(00:20:30) I probably don't all agree on this, but on average they would say we're in the sixth inning of, of the cycle. Right. So we really saw some aggressive growth in 17, 18, 19, 20, 21. Uh, you know, interest rates change, cost of capital change, things like that. Things slowed down. But, um, you know, as we counsel doctors, we say, you know, this is, this only really works well for you if you believe that the stock will become valuable because you don't get paid (00:21:00) all cash.
(00:21:00) You get paid these bigger numbers, but then you have to work back. And so you look at the companies. That have aggregated orthodontists, that have done the, the term is recapitalize and that's when your stock becomes liquid and you can take some money off the table. There's only really been two big aggregators in Ortho that have done that Smile.
(00:21:18) Doctors has done it three times and they have 450 orthodontists, a great company. They have a multi-billion dollar valuation, and uh, we think that's a very safe bet if you're interested in that. The other one is. One that I kind of discarded for a while 'cause it wasn't ortho centric, but I have great interest in now and respect for, and that's MB two.
(00:21:38) They have 125 orthodontists, um, in their group and they've recapped three times. They also also have a multi-billion dollar valuation and both those shops have very happy doctors, uh, on balance. Now we all know of six or seven orthodontic centric names, um, that aggregated up, none of which have had a recapitalization event Now.(00:22:00)
(00:22:00) So you ask yourself in those groups that are now 5, 6, 7 years old, the the natives are getting rest restless. And the doctors say, yeah, I got a lot of money, but then I worked back for you for this period of time for less than I would've made. When do I get that home run, uh, that second bite of the apple, they call it, you know, on my stock And it hasn't occurred yet.
(00:22:18) Um, you know, there's one out in the market now that is gonna try to turn, that would be good for the others if it did. But to answer your question, it's slowing down. It's not speeding up. Um, and it's going to continue to slow down and the big guys will end up eating the little guys, um, in my opinion, and it'll kind of cap out.
(00:22:36) And so does it go away forever? No. And I don't see these groups as morally good or morally bad. They're just an option that exists today that didn't exist 10 years ago. Mm-hmm. And, you know, they're serving. A certain subset of orthodontics very well, and that is the, the very young orthodontists are going to work for them right outta school because they have debt and they'll pay you more.
(00:22:55) And some of the bigger practices have used them as an exit ramp, uh, because a young (00:23:00) orthodontist couldn't afford to buy them. And so it's, it's served a purpose, but, um. It's not gonna take over the specialty. If your kid wants to be an orthodontist, that's a good idea. Uh, they can be an independent orthodontist forever, as far as I can see, but it's gonna probably cap out at 30%.
(00:23:13) It's in the low twenties right now, and it's gonna slow down. And then I think there'll be a consolidation of the consolidators. We said that for a long time, but that's typically, if you look at medicine, if you look at, uh, pharma, if you look at vet, if you look at some of the other spaces, it's there. So.
(00:23:28) The big bad wolf isn't so big and bad anymore.
(00:23:31) Dr. Leon Klempner: You know, I, there are a couple of things come to mind for me and, and one of them is, um, what's going on right now with, uh, residents that are coming outta school and the. The new federal student loan guidelines that are exist now that limit the amount that, that the fed, that the federal government is willing to give you, which now leaves them to, you know, get private loans at much (00:24:00) higher rates.
(00:24:01) So, I, I'm curious for your, from your perspective, you know, how do you think. That these changes are going to shape the pipeline for future orthodontics. And specifically, what ripple effects might you see, uh, in private practice owners that they should be thinking about now?
(00:24:23) Chris Bentson: Well, this is mostly opinion, um, that I'm going to give to you, but, um, I think short term will have some effects, um, because it'll happen so abruptly.
(00:24:32) I think go these, go into effect these caps to a mid part of next year. Um, and the way I understand the caps, right now on the federal side, there are 50,000 a year, 200,000 cap. Um, and when you look at the orthodontic resident base, average orthodontic resident debt now is 400 plus or minus. No. Shannon from my team could tell you more.
(00:24:50) Exactly. So where's that other 200,000 bucks gonna come from? Um, it's going to come. I'm not afraid about, uh, of this, by the way. It's gonna (00:25:00) come from. Private at lower rates. It's gonna come from, uh, some creativity in the finance world that doesn't exist today that's going to come to meet this need. Why?
(00:25:10) Because, um, the margins are so good in orthodontics that, um, banks understand that banks who loan money to orthodontists that have a half a million dollars in debt and have never had a W2 before and just got a, a. Partnered up in marriage and maybe have a child on the way will gladly loan that, that person 800 to a million dollars.
(00:25:33) That's not gonna change. Um, the metrics actually are gonna get better, um, with digital orthodontics in the future. And so I think the market's gonna figure it out. I, I personally, am not too upset about the government capping this. I'm not sure that that's where they should be spending that kind of money anyways.
(00:25:50) The gap will be filled. I think some of the state programs, and we see this in different states already, will offer some loan forgiveness if you go to a less (00:26:00) desired area for a period of time to try to help residents in their state. I think some of these really high tuition programs, we'll have to have it come to make a meeting and decide, you know, can we still.
(00:26:11) Attract people, uh, at these fees or not, but I think some change will occur. I think it's good change. And I, I suspect over the next 10 years, what you're gonna see is lower orthodontic education debt. Um, still money available for anybody that wants to be an orthodontist. Um, that vacuums gonna be filled with the private sector at competitive rates.
(00:26:31) So, short term, is there gonna be some problems? I think so, probably, but they're gonna figure it out. I think we'll have way more, uh, you know, applications for residents, uh, than we have resident seats, just as we have for the last 40 years of my career. And I don't see that going away.
(00:26:47) Dr. Leon Klempner: So, you know, to me, higher loans, which means higher payments, means more debt, means coming outta school.
(00:26:55) You need to generate some income and certainly the (00:27:00) DSOs and Osos. If we look at the, at the positive side of it, they've created opportunities for orthodontists to repay some of their debt, to gain some experience to, um, learn a little bit about the business and at people in practice, we, we see a lot of startups now, maybe five or six years outta practice that are a little bit further outta debt.
(00:27:21) Know that. If they want a captain in their own ship and now's the right time. So we, we actually designed programs for startups where we can package all of the, you know, digital assets that they would need to get off the ground at an affordable rate. But for the private orthodontist, just to swing back to them again, um, don't you think that they're, they, they'll have a, a much more difficult time, uh, recruiting and bringing somebody in outta school.
(00:27:51) Chris Bentson: I don't think so because the, the data that we see shows that. I mean, early part of my career, 90% of the, of the residents, and I'll call (00:28:00) this the eighties and nineties, um, got outta their program and went to buy a practice or buy a, uh, or start their own de novo practice. Um, 10% went to work for somebody today that, that's a hundred percent flipped around.
(00:28:14) Um, so today 90% go to work for somebody, 10% go out to buy a practice, you know? So who's buying the practices that we're valuing? It's people that are bouncing out of these associate slash corporate jobs that have been in 'em for five or six years, and I've called 'em for years, kind of delayed runway children.
(00:28:32) Um, but what happens when you, when you get in, uh. Right outta residency to a program is, um, your hand speed goes, your ability, uh, to, to treat, uh, imp improves and you make a lot more money than you would if, uh, you went to work for another orthodontist. But your money is, is, is capped and there's no real pathway to equity.
(00:28:55) There's some kind of pathways that they'll try to tell you, you know, here's some stock, here's some (00:29:00) stock options. We can spin out this and do a de novo. The DSOs and Osos haven't cracked the code on how to do that well, and so. They start looking around and they go, well, this is good money. I I, is this what I'm gonna do for the next 25, 35 years?
(00:29:14) Um, and they, they really, uh, I believe did not decide to be an orthodontist, to be an employee doctor. They decided to be an orthodontist, to be a cottage owned, you know, independent owner. They're just doing it lighter. And so those are the people that are coming out and they're coming out. 80% of those are coming out and, and doing something.
(00:29:35) There's, there's some career people that these DSOs, um, will keep for, for a career, and that's fine. They just didn't want the risk of ownership. But I'm very bullish that, um, yeah. Is it harder? Absolutely. But there's, there's opportunities. I, again, I think there, the a o PAC and the A DA PAC is gonna start beating up, um, uh.
(00:29:55) Some of this loan forgiveness stuff is actually gonna come to fruition if you, if (00:30:00) you act a certain way. So I think we'll figure out the, the tuition is kind of maxed out and it'll incrementally maybe stay the same or go down. The opportunities with the osos and DSOs is gonna expand a great deal. And so you're gonna go into private practice and what you can do with digital today on.
(00:30:17) Three days a week, um, and work someplace else, one or two days a week is a good combination. We see a lot of that happening. So I'm, I am not a wet blanket on the future. Even with all the headwinds that you suggest that we have, it's gonna be okay.
(00:30:31) Dr. Leon Klempner: So let's talk about digital just for a second, since, since you brought it up and, you know, you and I, for, I don't know, as long as I could remember, have been preaching the same message to Orthos for a lot of years, and the message was that.
(00:30:47) The digital orthodontics is not just a trend, it, it's a paradigm shift. And just coincidentally, I got a message today from, um, a recent grad. Working (00:31:00) in a, uh, OSO that wants to come out on his own. And as I said, we're seeing a lot, a lot in this particular category. And the question he asked me is a very good question, uh, because as you, as you mentioned before, when you look at the, the p and ls or the balance sheets, uh, of, of, of, uh, orthodontist, you know, technology is eating up a, a larger and larger share of the, of it.
(00:31:25) So this, this, um. Orthodontist asked me, uh, specifically, uh, what part of digital treatment creates the most advantage for patients and parents? He wants to choose. He knows that digital orthodontics is the future, but he wants to make a smart decision as to what to invest in. So how would you, uh, how would you answer somebody like that?
(00:31:51) Chris Bentson: It's a very wise question, and it'll probably sound like I have a smart Alec answer, but the, the only way to make digital work (00:32:00) clinically is to be in the deep, deep digital penetration of braces and aligners. Um, that's the only way it works or, or be in deep penetration of one, uh, uh, at 60 to 70% of your starts.
(00:32:14) And so I would not suggest to that doctor that they just choose aligners or just choose digital braces or just choose a monitoring company. I would say listen that. The biggest investment orthodontists ever make and, and have for the last 40 years is in people. And the only way that you can justify and affordably, um, have the right number of people, um, if you choose to go digital, is to fully express what digital can do for your practice.
(00:32:44) And what digital does for a practice is four or five things. We know that the data's very clear that whether you're aligners or digital braces, you'll have fewer appointments. That's a fact. We know that if you want to, and not all people do want to, specifically the corporations, but you (00:33:00) can treat people in fewer months, um, than you can with analog.
(00:33:05) Uh. Braces. And so you can choose whether, whether that's a, an advantage for you or not. We know that you need less people because you're doing less work and seeing people at bigger intervals in, in, in mid treatment, um, with a digital practice. And we know that the consumer would, given the opportunity side by side, do you want this many appointments and this long of treatment versus this many appointments and this long of treatment?
(00:33:30) They will choose digital 98% of the time. And so the consumer wants it as well. So I would say to this doctor, listen, um, you know, 27 years ago, an a new digital idea came out called Invisalign. And over the last 27 years, it's evolved to be, uh, the largest dental company in the world. Um, and it now has about 80 competitors around the globe.
(00:33:53) Yet still for all that success, only one in 4K starts are in aligners. All (00:34:00) right, and so now with digital braces and what got me excited about a light force and KLO and and, and dibs and those things is now we can start every patient with a scan and we can have a conversation with the patient that we have custom.
(00:34:14) Another thing the customer wants, we have custom braces where we have aligners. They already know a lot about aligners. They already know braces, but the aligner. The, the custom braces come with the same advantages, really as the aligners. Um, I'm sure the aligner companies would argue that, but now I can go a hundred percent of my cases or 80 a, a deep, deep amount of them.
(00:34:35) And when I do that, I actually do need less people. So I would tell your. Questioner doctor, I would say, listen, you gotta go digital braces. Choose the one you want. Um, you know, I've chosen KLON and I spent a lot of time with Lifeforce, and I love that technology and those people, but the price points between those two and you can have a full, uh, uh, you know, array of brackets.
(00:34:55) Right now were, were better for me in at this point in my career (00:35:00) to try to influence why I think this is a good idea. And with aligners, you've got Invisalign, you've got, you know, four or five other. Awesome competitors at different price points. And so I would say pick the ones that work for your price point in your marketplace and you can affordably be 60 to 70% of your starts are digital.
(00:35:18) You can have fewer people you can keep your overhead at or even below where it's been historically with analog. And this is a huge differentiator for you today, where it won't be tomorrow when. Everybody's digital. So that's what I would tell 'em. Yeah. And I see startups do that and I think Jill Allen and some others, um, would, would probably that work with a lot of startups, would, would concur with that.
(00:35:40) Dr. Leon Klempner: I, and, you know, um, recent grads are all in on this's. Yeah. They wanna do it. There's no convincing there. They wanna do it, and then they're getting it now in their programs. So they're, they're coming out and they, and they understand this. It's the more established practices that have a hard time with this, they're the most people
(00:35:58) Chris Bentson: to change.
(00:35:59) Yeah, (00:36:00)
(00:36:00) Dr. Leon Klempner: yeah. But, you know, but you know, you know, I'd be interested in your perspective on this, but here's my takeaway on that is that. What's misunderstood is that, and I'll use industry speak and say, you know, you do need to go all in. Meaning that you know, you can't. Dip your foot into it and try it and just use it for, you know, let's say remote monitoring, for example.
(00:36:23) Just use it for, you know, my kids that are away at college and expect to see anything. But there is a learning curve here, and there is, and you don't get the result immediately. In fact, you know, there's, there's an argument that you would, you would take a hit at the beginning, but if you stick through it, you'll see the, you'll reap the benefits.
(00:36:45) But a lot of. Practitioners in my experience, they'll start, they'll see the learning curve. They're not seeing the return on investment, and then they opt out. And that, that doesn't, that doesn't work.
(00:36:59) Chris Bentson: So, so (00:37:00) typical. I, I spent the last 10 years, I mean, I spent six years with the line, four years with Light Force now, uh, you know, KLO and really understanding the financial journey and, and it's not.
(00:37:10) Maybe you'll make a little bit less money. It's, you will make less money, um, in the first 18 months. Somewhere in there, depending on what mix of products you have, if you don't grow. Okay? If you're growing at 10%, growth takes care of a lot of sins, right? Um, and, and you can, you can kind of do it, but if you're an established orthodontist and.
(00:37:30) You agree on the math and you say to your team, look what I bought you. I, you know, here, this is great. And the team has to do all new things and learn new skills, and they come back to me as the orthodontist and say, I don't like learning these new things. It doesn't work as good as what we used to do.
(00:37:47) Then the whole thing falls. So it takes strong leadership from the orthodontist, uh, to be totally committed to the idea. It takes going in very deep. Um, which. Scary because I still act like an analog practice. I need this many staff people, (00:38:00) I don't get any reduction, um, because I still gotta de bond those cases.
(00:38:03) And that's 18 to 24 months out. Right. And so for a period of time during that change is where the stress is. And so, you know, what we're trying to do, uh, with the digital companies I've been working for is prepare the doctor that this is how this is gonna go. So it's not a surprise, but what happens is exactly what you said.
(00:38:21) I get six months into it, I've, I've not gone all in, but I've done. Pretty far in, I'm getting all these lab bills all of a sudden and my income's not going up if I'm not growing last three years. And I, I look at myself and my, and I talk to my team and they go, we liked it the other way. Um, and I called my rep up and said, I just can't do this anymore.
(00:38:43) Yeah. Um, so it works better for younger doctors and when I see who's embracing digital the hardest, it's 35 to 45-year-old orthodontist. And so it may be. Longer, uh, uh, road than I take to really a trip out. Uh, us old guys. Uh, but we're hard. It's hard for us to change and it takes mostly great (00:39:00) doctor leadership of the doctor saying, I know it's gonna happen.
(00:39:03) It's gonna be okay for 18 months. We're gonna do this and then it'll be great. And that's what happens.
(00:39:08) Dr. Leon Klempner: Wait, are we the old guys now?
(00:39:10) Chris Bentson: Yeah, I think so.
(00:39:14) Amy Epstein: Surprise. Um. Chris. So, uh, while, while we still have you, uh, I want to kind of tie a couple of things together. You know, we, this is the Golden Age of Orthodontics podcast. So there are some things that you said today that I just want to bring up and close on, which is that it sounds to me. Like even with the, um, student loan cap and everything, there's still going to be an investment in orthodontics.
(00:39:40) Right? That's making you feel good. Um, about the future. The, you mentioned at the top of the show about, you know, veterinary medicine, accounting law orthodontics is still outperforming those other professional pathways. Why? Why, why is that? (00:40:00)
(00:40:00) Chris Bentson: You know, there, there, there's the obvious thing. You know, nobody dies in orthodontics.
(00:40:04) You know, you're not on call. Um, insurance is largely out of your life. Is is less so than medicine. Um, you know, there's multiple ways to practice now with digital, not digital, you don't have to be digital to degrade orthodontics, but there's just so many options Now. You can be corporate, you can be not corporate.
(00:40:21) The biggest reason I think is aspirational. I don't go be a hedge fund manager to change another person's life except my own life, right? Mm-hmm. I don't go to be an attorney. Maybe I do, depending on my fund, you know how I look at that, uh, and maybe I can have an impact on somebody. But as we do surveys with every resident every year for a long, long time, and we say, why did you wanna make this crazy choice?
(00:40:44) To have a half a million dollars in debt, not make any money till you're 30, start your family later and then go have to borrow another million bucks or go work for somebody else. Why would you do that? Because it doesn't make sense to a dad, right? Uh, I've got three kids. I'm like, wow, I, (00:41:00) that doesn't make a lot of sense.
(00:41:01) And they say, because I wanna have an impact on people's lives. And it sounds so trite. Um, but it's so true, and it was so true for me. This is why I love this, this specialty so much. I had orthodontics as an 11-year-old awkward redhead, not socially huge. Great. You know, physically I was, I remember you Chris, I remember you in the office.
(00:41:24) And, and, and my orthodontist actually changed my life such that I loved to go to see him. And when I went to undergrad, I said, that's who I wanna be. That's the impact he had. Okay. My life took a, a, a, a little bit different turn, and that's, that's not what I ended up doing. But then I had him again, orthodontic at 60.
(00:41:43) And it changed my life just as much. Um, and I think orthodontists forget when it's hard and it's hard right now that the impact they have on. 70% of their patients are adolescents, 30% are are adults. Same impact for both (00:42:00) groups, but that's the reason it will always live, is because there's really smart people that wanna do this to change somebody else's life.
(00:42:07) Leon, you do it on the, on the in, in the, in other countries, bringing smiles to people. But a smile is a pretty incredible gift, and I think, uh, that's why it will always work.
(00:42:18) Dr. Leon Klempner: I, I'll tell you, Chris, um, I just finished the, uh. Sinex Simon Sinek course. That the a a o Yeah. Gives, you know, to find your why.
(00:42:27) Chris Bentson: Yeah.
(00:42:27) Dr. Leon Klempner: And I, and, and, you know, it's, it was exhausting, you know, it was a o over a course of a year, and at the end you have to put together like, stories of your life that are memorable and pick five of them and find the commonality and the theme. It's like, and then you have to get somebody to work with you to listen to it and give you feedback.
(00:42:46) And I, Amy, I, I had Gail as the, uh. Perfect. Yeah, Amy knows Gail. She worked with me for years anyway, so you know, my why turns out to be after all of that. Turns out to be my why is to (00:43:00) help other people so that they can get what they want and that, and that's really that, you know, I don't know how I ended up in this field.
(00:43:07) I was blessed, you know, but when I look back, I guess maybe there was a reason for it, you know? And mm-hmm. And just what you said, I think is. Common for other orthodontists. That's why we're such great people. Orthodontists are just great people. Yeah, they're smart, they're nice, upbeat, environ. They're,
(00:43:23) Chris Bentson: and it, it really is cool.
(00:43:25) And I, and I, and I think sometimes you forget it when after you get into it for four or five years and it gets hard and, and it gets to be a grind. But, um, it comes back to you in the end. Happiness waits for you. So just keep grinding guys. It's gonna be great. You can do it. Um, there's always gonna be headwinds, but these are all manageable.
(00:43:41) And I am more bullish on the specialty than ever.
(00:43:45) Dr. Leon Klempner: You and us. That's great.
(00:43:47) Amy Epstein: Chris, thanks so much. Always pleasure talking to you. Appreciate your insights. If we have listeners who may have questions for you, may wanna talk to you about, uh, the types of services that you can recommend, consultants or, (00:44:00) you know, maybe your own insights, how might
(00:44:02) Chris Bentson: they reach out to you?
(00:44:04) I, uh, just look up Benson Coplan Associates. Um, I'm trying to become Leon. I I actually am semi-retired, but I find I'm working harder than I've ever worked, but I, I sold the Romanian interest to Doug and Shannon on my team at the end of last year and working back as an associate for them. Uh, and so that's, that's been a lot of fun.
(00:44:20) And, um, I joined the board of KLO and, um, I'd invite you to, to look up them. I, I believe they will be very successful in that digital orthodontic. Bracket space and, um, we'd invite you to take a look at at them and you can find them on, on the website as well.
(00:44:36) Amy Epstein: Yep. And, uh, you know, a mention of KLO and they're one of the two sponsors of this podcast that makes it possible for us to bring guests like you onto the show.
(00:44:46) So we appreciate their partnership very much.
(00:44:49) Chris Bentson: Yeah.
(00:44:49) Amy Epstein: Chris, until next time, happy holidays. Thank you again. Appreciate you very much.
(00:44:55) Chris Bentson: Thanks for all the work you do for the specialty. Uh, great to see you. Thanks, Chris.
(00:44:58) Dr. Leon Klempner: Yeah. (00:45:00)
(00:45:00) Amy Epstein: You can subscribe or download other episodes of the Golden Age of Orthodontics on Apple Podcasts, Spotify, SoundCloud, YouTube, or wherever you get your podcast.
(00:45:09) And if you enjoyed, enjoyed this episode, which I know you will. We'd appreciate it if you would tell a colleague. And for more information about people in practice, which is a Mark marketing consultancy, specifically designed to bring sophisticated marketing communications to the orthodontic industry, you can visit our [email protected].
(00:45:30) Dr. Leon Klempner: You're getting better with that, Amy.
(00:45:31) Amy Epstein: Thank you. I was, I thought that was a good one. Right? I'm proud of that one.
(00:45:36) Dr. Leon Klempner: Thank you for watching and listening. If you wanna contact me directly, my email [email protected]. As Amy said, we couldn't do this without the support of our sponsors. K Owen, shout out, grin.
(00:45:48) Shout out. Uh, you can get a special offer from both of those companies by visiting our partner, page ppl practice.com. And remember. Remember for Forward (00:46:00) Thinking Orthodontist. It has never, ever been a better time to be an orthodontist. We are in the Golden Age, so take advantage of it. So till next time, see ya.
(00:46:15) Narrator: Thank you for tuning in to the Golden Age of Orthodontics. Subscribe now on Apple Podcasts, Spotify. Or visit our website at the golden age of orthodontics.com for direct links to both the audio and video versions of this episode.
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