Episode 50 - Elevating Your Practice With Glenn Krieger From Orthopreneurs

August 10, 2023

In this installment of The Golden Age of Orthodontics, we are excited to visit with Dr. Glenn Krieger, founder of Orthopreneurs. His Facebook group boasts over 6,000 members to date. We discuss with Dr. Krieger how Orthoprenuers came about and what he brings to orthodontics. We also discuss what advice he would give to start up ortho practices or anyone looking to develop more effective practice. What are the pros and cons of a DSO and an OSO? How are they structured, and who should consider joining? Dr. Glenn Krieger has invaluable insight into partnering with another doctor in your practice. Don’t miss this informative episode. Why? Because there’s never been a better time to be an orthodontist!

IN THIS EPISODE:

  • (01:12) Introduction of People and Practice hosts and Dr. Krieger. 
  • (05:01) Dr. Krieger explains the conception of the Orthopreneurs Facebook group. 
  • (09:02) Dr. Krieger delves into what an OSO is, how it operates and who should consider joining.  
  • (14:39) What are the pros and cons of a DSO and an OSO, and how may they benefit a new graduate? 
  • (22:20) Dr. Leon mentions there is another side to consider. Amy and Dr. Krieger discuss the value of community. 
  • (28:19) Dr. Krieger answers questions from a listener about partnering with another doctor. 
  • (38:55) Dr. Krieger reveals what he would be if he weren’t an orthodontist. 

KEY TAKEAWAYS: 

  • There are some naysayers regarding joining an OSO; however, often, they have not done their research.
  • One benefit of an OSO is that you are only grouped with successful practices.

Achieving practice growth isn’t as simple as it used to be. But with groundbreaking technology and new communication channels to reach more patients, People + Practice is an orthodontic marketing agency that firmly believes that there’s never been a better time to be in practice. 


Achieving practice growth isn’t as simple as it used to be. But with groundbreaking technology and new communication channels to reach more patients, People + Practice is an orthodontic marketing agency that firmly believes that there’s never been a better time to be in practice. 


EPISODE TRANSCRIPT

What follows is an AI-generated transcript. The transcript may contain errors and is not a substitute for watching the video.

(00:00:00) Dr. Leon Klempner: If you're an orthodontist and you're on Facebook, you probably already heard of Dr. Glenn Krieger. Uh, but did you know why he started the Entrepreneurs Facebook group, which by the way, has over 6,000 orthos from 91 countries, or what advice he would give to startups. Or are you just curious what he would be doing if he wasn't an orthodontist?

While inquiring Minds wanna know, stay tuned.

(00:00:30) 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.

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 (00:01:00) growth. And now welcome to the Golden Age of Orthodontics with the co-founders of People and practice, Dr. Leon Klempner and Amy 

(00:01:08) Glenn Krieger: Epstein.

Welcome to the Golden 

(00:01:12) Dr. Leon Klempner: Age Orthodontics. I'm Dr. Leon Klempner, trying to figure out what I want to be when I grow up. I'm currently a dad. I'm about to celebrate my 49th wedding anniversary. Uh, board certified orthodontist, director of Orthodontics at Mount Sinai Hospital here in New York, part-time faculty at Harvard.

I'm the c e o of people in practice. I'm also wannabe blues musician, and I'm joined by my partner, my daughter, my co-host, Amy Epstein. 

(00:01:42) Glenn Krieger: Okay, Amy. Who are 

(00:01:43) Amy Epstein: you? That's a good question. I'm still, I think I'm still figuring out what I wanna be when I grow up every day. Give it some thought, make some adjustments.

Um, you know, do you remember when you gave me that book? What color is your parachute? 

(00:01:59) Dr. Leon Klempner: (00:02:00) Absolutely. Remember that Didn't do you any good, 

(00:02:02) Glenn Krieger: did it? 

(00:02:04) Amy Epstein: Not at all. Anyway, okay, so I'm Amy Epstein. I am. Who am I? I'm a business owner. I'm a mother of two. I am a slightly above average cello player if I do say so myself.

Uh, I recently joined the board of my daughter's daycare because I wanna get back to, uh, the community that I live in up here in Westchester. I have an M B A marketing in 20 years of public relations and marketing experience. Now, going back to the intro, while I had heard about Dr. Glenn Krieger, I only really met him recently when I had the good fortune to sit next to him during dinner at the Dental Monitoring Summit, which was just this.

Spring and he is a force. Um, Glenn is our guest on the show today, and just to give you a little background about his, um, experience, he's a fellow of the Academy of General Dentistry and is a practicing orthodontist in Lewisville, Texas beside orthodontists. (00:03:00) His passion is building community. And I really like that about his approach.

I also feel like I'm a community builder in my own way. Uh, he feels that in today's competitive world, that the orthodontic and dental communities should be collaborative and should be sharing information so that we can help one another succeed. And that philosophy was really the genesis of the Entrepreneur's Facebook group, which he founded to help practice owners come together.

To crowdsource solutions. Now, there is now a meeting and there's all oth sorts of other resources that he can, um, let us know about, but the Facebook group, I think was really the genesis. He spends significant time in continuing education as well, working with consultants and business trainings, and giving presentations, publishing articles.

We are thrilled to welcome to the podcast today, Dr. Glenn Krieger. Thank you so much for joining us. 

(00:03:53) Glenn Krieger: Hey, thank you for having me. I'm flattered I you're you, you guys have perfect voices for radio. I'm just saying I feel like I'm on an N P (00:04:00) R show of some 

(00:04:01) Amy Epstein: sort. Hey, you're not so bad. Yourself over there with, uh, your perfect clarity and, and podcast voice, so we know you have a podcast.

(00:04:10) Glenn Krieger: I, you 

(00:04:11) Dr. Leon Klempner: know, I, I've been told I have a face for radio, so I'm glad to hear my voice 

(00:04:15) Glenn Krieger: goes with it. Well, welcome Glen. 

(00:04:19) Dr. Leon Klempner: Um, Glen is, uh, a fellow New Yorker at heart, I believe, living in Texas now. Yes, sir. I feel like. Uh, Glenn was gracious enough to have me as a guest on his podcast, the Authorpreneur Authorpreneurs podcast with Dr.

Glenn Krieger. So if you haven't listened to that, uh, we'll put something in the show notes. You definitely wanna subscribe to that and check it out. Thank you. Uh, so this time we thought, uh, it would be interesting to have him on the other side of the mic, so to 

(00:04:51) Glenn Krieger: speak. So let's 

(00:04:52) Dr. Leon Klempner: start off basic question entrepreneurs.

Last time I looked. Over 6,000 members. How (00:05:00) did it 

(00:05:00) Glenn Krieger: come about? Yeah, we're probably about 6,500 members now from about 99 countries. I'm waiting for that hundredth. I don't know which one it's gonna be, but there's a lot of countries in there. Um, you know, my story's pretty simple. I was the youngest dental student in the country when I went to dental school.

And then when I went back to ortho, I was the oldest ortho resident in the country when I went back at age 44. And so I had 20 years of. Significant ce. A lot of focus on business. I did a year at the University of Washington Business School at a special program they had for dentists at the time. And you know the old saying in the land of the blind, the one-eyed man is king.

So when I went to residency here I was with 28, 29 year old. It's folks who didn't have a lot of business experience. So I was sort of the defacto, Hey Glenn, I got a contract. What do I do with it guy? You know, how do I find an attorney? How do I find an accountant? And (00:06:00) again, I'm not the most knowledgeable person on the planet, but certainly in that, in that sphere, if you will.

I, I, I knew more than most. And so I started guiding people and giving them advice and helping them along and. Reminding them that ortho residency is the easiest time of their life because when they get out, it's gonna get a lot more, uh, challenging. And um, when I came outta school in 2014, I. Um, there were some resources online.

There were some paid groups you could be a member of, and there was one group, uh, ortho 1 0 1, you may remember it, uh, that doctors team members could be members of. It was a little toxic. It was a lot of yelling, a lot of screaming, a lot of stuff didn't really resonate with me. And then one day he threw a whole series of.

Of what are now kind of famous events that occurred in one day. The whole site was shut down. And I fortuitously, I'd been walking out with my wife, we were walking, uh, our dogs that afternoon. And I said to her, you know, I don't like the toxicity of the group. I, I'm thinking about starting my own, you know, what do you (00:07:00) think?

And she said, well, you know, if you feel you have to go get it. And then I came back and my phone exploded with all the messages and I just, Said, Hey everybody. I'm starting a new group called Authorpreneurs, and the focus is gonna be on how to live a more profitable, low stress life. It's gonna be focused on business, it's gonna be focused on management, it's gonna be focused on leadership.

Um, the focus is not clinical. If you wanna post clinical, go for it. But you know, my firm belief is that. Every orthodontist who might be listening to this is more than a good enough trained orthodontist to do good results, but the overwhelming majority are not trained well enough to get great leadership or management or business results.

And the unfortunate truth in our industry is that people flock like moths to a flame. If I start talking about anything clinical, we start talking about how to develop a policy and system. Or how to manage HR more effectively or how to be a better leader through, you know, personal work. And all of a sudden everybody puts their hands up and goes, Ooh, I'm not really drawn to that, which is precisely (00:08:00) the reason why we need to keep doing what we're doing.

(00:08:05) Amy Epstein: Yeah, it's a. Wildly successful group. I think that everyone who we hear that everyone who is takes part in it really gets a lot out of it. And we know that there's the opportunity to put out questions and um, You know, get perspectives on all different topics. And one of them I know that comes up not only on entrepreneurs but in some of the other groups as well, is the not controversial topic, but, um, you know, a pretty relevant topic right now in the ortho world where people have strong opinions on both sides is the.

Decision to partner with an O S O and I know from talking to my dad that you partnered with Smile Doctors and are happy with your decision. Can you tell us a little bit about what orthodontists who are considering that type of decision should. Do research prepare for when considering (00:09:00) joining an O S O?

(00:09:02) Glenn Krieger: Sure. Yeah. And you know, it's kind of funny 'cause it's really controversial for those who really don't understand it, right? For those who really understand it, it's not controversial, it's easy, right? It's a yes or a no. But like many things, uh, in orthodontics and dentistry in life, You know, there's often a, a, a vocal minority that doesn't really understand it, but knows that it has to be bad.

And so first thing I would say is that most orthodontists. Aren't in a position to have people in their life who are gonna be able to guide them on these things really well from a neutral perspective. Um, I happen to have a cousin who's runs a private equity firm and started one himself, and so I've got great resources to where I can talk to somebody.

But we did a deep dive for probably six months of real research on the pros, the cons, the model. Because the model is the key to everything. When you understand what the model of an o Ss O is, or you know, then you really start to understand, um, how these things really function. (00:10:00) And so we interviewed a bunch, uh, spoke to a, a number of DSOs and Osos, uh, ultimately felt it was the right decision for us to go that route.

If people are looking for resources, you know, if they go to authorpreneurs.com, uh, and look at my blog. Uh, there's an article in there that was written in May of 21, I just reposted on it in Entrepreneurs yesterday, as a matter of fact. Um, that that talks a great deal about, it's probably about five to six pages long.

That gives people a very broad overview of what is an O S O, how does an oso work? What does it mean to an orthodontist? Where does the money come from? Everything that you really need to understand as a basic primer. And then of course there, I, I updated that yesterday in entrepreneurs with a lot more information about where things are today.

But to go back to your original question, The key understanding of an oath of an O s O is that number one, they want to acquire good practices. They don't wanna acquire you when you're six months out of (00:11:00) residency. And if your practice is going down in, in, in value, this is not an exit strategy for. For a doctor who's looking to retire, um, I want you to, I want everybody to think about it as if they were looking to buy an ortho practice.

Would you buy an ortho practice that's going down? Would you buy an ortho practice that's doing 200,000 a year or 500,000 a year? You're, you're investing in the doctor that's running it and their ability to keep it running and to keep it profitable and keep it growing. And the whole premise is that if we can pool, take smile doctors, for instance, if they can pool a number of like-minded, Um, core value based, uh, practitioners who build successful practices together and then institute some, uh, economies of scale like buying power, HR, and, and manage things from an effective higher level and institute systems that are congruent and draw everybody together that you (00:12:00) can be more profitable just from that.

So the whole goal of an O S O, it's private equity backed. And the whole goal of an O S O is to to buy something, invest in it, invest time, resources, money, and then eventually sell that to another private equity company that gives it more money. I. And the equity they have in it, as the name would imply private equity is how they make their money.

And for orthodontists it means getting a very large paycheck upfront. Hopefully it means practice autonomy if you join the right one. And smile. Doctors for sure allowed me practice autonomy. Um, and it allows you the opportunity, hopefully, to get some equity in the company, meaning that when they succeed by running a more profitable, better run organization than the one you joined, uh, that the enterprise makes money.

And because you have equity in the enterprise, you make money as well. And it's one of the more misunderstood parts of the whole process. And it's not a (00:13:00) get rich quick scheme, although. You know, you're being paid for the work you've put in over 5, 10, 15, 20 years. So it's not get rich quick, but it can make people wealthy.

Uh, it can allow you to partner with 20, 50, a hundred, 300 other doctors. So you've got a common goal. Um, and it's a topic I could sit here and talk about for hours on end, but I hope that gives you a little bit of basic understanding of, of what an O S O is and some of the reasons why we chose to join one.

Yeah, I, and I 

(00:13:30) Dr. Leon Klempner: get it. I mean, I could see it, it, it's not for everyone, but you know, no, I teach a lot of residents and as you know, going to ortho school now, The residents are coming out, particularly at Harvard, coming out with 500,000, 600,000, 700,000, and they need to pay off their debt. And the entry into the marketplace for a new graduate is, is much more limiting than it was years ago.

The. Associateships leading to partnerships, (00:14:00) those don't really exist anymore. So it's a great opportunity to 

(00:14:04) Glenn Krieger: make money. 

(00:14:05) Dr. Leon Klempner: And you know, recently I posted on the, uh, entrepreneur's Facebook page that I wanted to do, uh, a podcast with a. Um, you know, somebody that's working in A D S O or O S O model and to give us the pros and give us the cons.

'cause there's always pluses and minuses and I got crickets for sure. Now I don't know if I got crickets because there are legal implications they have to sign something that they can't discuss negatively. I don't know what it is, but crickets. So, uh, tell me, you know, 

(00:14:39) Glenn Krieger: what are the pluses and minuses? You know, I, at first, I'll tell you the whole crickets thing, my 2 cents is obviously, I think a young orthodontist is kind of scared to get out there and speak about it.

A multi-billion dollar organization. It doesn't have to be SMILE doctors, it could be anybody. There's only been one company that's ever had an equity turn in orthodontics in the (00:15:00) US and that SMILE Doctors, so I wanna say multi-billion. I'm applying to one, but they're big companies. And it could be intimidating, I think for somebody to say, I'm going out there, I don't think it's legal.

I think we've also seen an influx of these, uh, anonymous posts in groups. You know, uh, there's a new Chick-fil-A down the block, uh, who's tried it, and someone will post that kind of anonymously. So I think people are just kind of scared. It's, it's, there's a really funny post by Kyle Fala on the digital orthodontist that I, I encourage everybody to go listen or read about, you know, um, what's appropriate to post anonymously and what is not.

But in answering your question, initially, I do think, I do think. People are nervous to get up on stage, if you will. Um, but I'll do everything I can to try to help that along. But going back to your question, what are the pros? Well, I'm a strong advocate, and anybody out there who's listening should certainly reach out to me on Facebook if they want to, or reach out to the podcast, whoever you want.

Um, If they wanna learn more. But I think, uh, today's, (00:16:00) and you have to be careful, there's a big distinction between A D S O and an O S O, right? A D S O is predominantly dental or multi-specialty. An ortho, an O S O is orthos almost entirely orthodontic. You could have some pediatric here and there, but it's predominantly ortho run.

If you're going to a well run o s o, and I'm not talking about one that's got five or 10. Practices and that could be well run. Talking about something that's got a significant number of doctors in it and has been around for a while. Um, you know that if you go into work in it, chances are you're gonna work alongside or under the direction of.

Somebody who was acquired by that O S O, which means, as I said earlier, probably successful at building a practice. Probably so knows something about leadership, something about management. And you're gonna get paid really well. The pay is pretty solid. You might have the opportunity to develop equity in the broader organization or to earn equity over (00:17:00) time.

And it's, you know, any good osso should lean on an associate. To, to continue trying to build the practice. You know, if you go to A D S O and, you know, raise your hand if you've ever worked at A D S O, which I've done, you know, it's often plug and play. You show up one day a month or one day a week at a specific dental office.

The assistants or general dental assistants, you know, they don't have, they don't have an upper life five bracket, so you gotta, you know, it, it. I once had an assistant bond brackets with with band lock, which for those of you who are not orthodontics, orthodontists just makes you just wanna grab your head and be like, what are you doing?

'cause it's blue. Um, and so those situations are not very fun for orthos. Traditionally, those are the ones we came outta school and went into. They work you like a dog. They don't pay you amazingly well. You, I worried really about my professional future and was I putting my license on the line by working on these patients with these assistance and these conditions.

In most osos, you're not (00:18:00) gonna have to worry about that because compliance and, and making sure things are done above board is really important to them. They're not fly by night organizations. So I think there's a major positive of. Possibly getting some great experience alongside a, a proven doc, uh, learning management, learning systems, being in a good office.

'cause I'm yet to see an osso acquired o Office that was a dump. Um mm-hmm. And you have the opportunity to, while trying to build a practice a little bit, right? They're expecting you to try to be productive and it's in your best interest to do that. Um, you're not gonna get massive pressure on you, but.

Some, some osos like Smile Doctors Again, you're gonna hear me keep saying Smile Doctors, because again, while I am affiliated and a partner there, I don't know the practices within other ones 'cause I don't practice in them. So I can only speak to SMILE doctors, but they've got a program called Rising Stars where they'll take a young associate.

And mentor them and teach them management (00:19:00) and leadership and try to make them the best they can be. And the hope is that these people will stay for long periods of time because it's a safe, uh, hopefully enjoyable, hopefully lucrative and rewarding place to be. And if you can get around the idea that you don't have, you don't have ownership, right?

That's one of the negatives. If you're looking to be an owner, you don't have ownership per se, but what if you could earn. A hundred thousand, 150,000, a half a million in equity in the broader private equity, um, of the company, right? If you can earn a quarter of a million dollars in equity, and I know associates who have earned a quarter of a million dollars in equity by working for a number of years, when that private equity transaction occurs, which is hopefully, let's call it a two to three x.

Multiple being fair and, and and historically accurate. You know, that associate could potentially work at an O S O for 5, 7, 10 years. Walk away (00:20:00) with a lot of money in their pocket that they've earned a lot of experience and maybe have half a million to a million dollars of equity that they've just earned, pay their long-term capital gains at 20% or so, and now have cash to go buy a practice if that's where they want to go, or to build a practice.

So to me, it's a far better direction for anybody, even if they don't have huge loans. Right, to make a great living, potentially get equity, get mentorship. And again, I'm speaking with SMILE doctors, but I'm sure there's other ones out there that'll do this. And a downside again is, you know, you're not the boss, right?

But that's gonna be the case no matter where you work. Um, you know, the, the biggie is the restrictive covenant, right? Because you, you work in one practice and you got a restricted t there's a lot of green space open for you. You work in an O S O that's got 75 offices in your state or. A D S O that's got 75 offices in your state and you leave them, you know, you're, you might have a harder time finding a place to practice, but again, (00:21:00) I would say if you go in with the right mindset, if you wanna work, you wanna make a living, you wanna become a better ortho, you wanna become a better leader and manager and you wanna be around.

And this is really key, being around some really smart and talented people. Uh, at meetings and on phone calls, and osso is a great place to be because again, I don't wanna embarrass anybody, but when I'm on a phone call, For Smile Doctors and I'm around people like Ben Fishbein and Amanda Gallagher and Ed Wenz and Zach Casagrande and you know Josh Adcox and Scott Law.

I, I could, I could go on and on and on. They're all my partners. So if I'm a young Orthodon and I see that Josh Adcox, who's like a genius with demo monitoring is on there. I can just text him and go, Josh, do you mind if I have a couple questions for you about dental monitoring? He'll say, sure. I'll see the Zach Casagrande is on there, one of the top two or three Invisalign providers in the United States in terms of volume.

Hey, you know, Zach, do you mind if I ask you some questions about some preferences? I. You know, Amanda, (00:22:00) anybody, you can ask these questions. So to me, that's a huge plus. And as long as you get good legal representation to make sure that you have your i's dotted and your T's crossed, and all the pros and cons explained to you, I see it as a vital part of your decision making process when you take your first job.

Hmm. So, Glenn, 

(00:22:20) Dr. Leon Klempner: it's clear that you could speak, uh, about this topic. For a while, and I know you've got another podcast, so I wanna move on. But I do wanna just insert the, the other argument, which is that there are a lot of, uh, financial advisors that would tell you that owning your own practice in the long run put you in a better financial position than if you were to join, uh, and stay with an o ss o.

So just that's, that's a topic for another podcast and I'd love to have you back and, and, and Sure. You know, Discuss that, that aspect 

(00:22:55) Glenn Krieger: of it as well. Yep. Love to. Yep, would love to. And I run the numbers, by the way. (00:23:00) Go ahead. What's that? I run the numbers. I've run the numbers on spreadsheets using every variable I can, and the only problem you face is in that argument.

We have to take into account the equity rollover, the transaction value from the enterprise level, and nobody knows what that number is. Because if you have a hundred thousand in equity and the company does six x versus two x over two or three turns, it plays a huge role. But like you said, whenever you want, we can dive into that one.

And they, and there may be no equity 

(00:23:30) Dr. Leon Klempner: depending. Go. 

(00:23:34) Amy Epstein: I wanted to just mention that I, you know, the point about community is important, and I think it probably speaks to the success of the entrepreneurs, uh, entrepreneurs overall. You know, the, the group and the meeting and everything is that, um, Doctors, all team members, everyone looks for community.

You can work in your own practice, but when you have (00:24:00) community, you're exposed to all the different scenarios that they've ever dealt with and the solutions that they've, uh, uncovered as. Um, the most effective, the technologies that they're using and to what effect? You mentioned dental monitoring earlier, and so I think there's, there is a lot of value in there and, you know, we, to, to plug our own second podcast, we, we have something that we're launching too, that's supposed to, that's designed to a way like entrepreneurs is, uh, to connect the broader orthodontic team.

To others that are having experiences that they'd like to learn from, having problems that they'd like to find solutions to. So I think the point about community Glen is really well taken. I. 

(00:24:43) Glenn Krieger: Uh, you know, I think the statistics would bear out the fact that the overwhelming majority of us practicing or practicing alone, not, not 90%, you know, but it's more than the majority, I, I would be willing to bet, are practicing by themselves.

And I think one of the reasons why (00:25:00) entrepreneurs and other groups have been successful aren't necessarily a function of the individual running them. It's because I think as human beings we crave that togetherness. Not everybody, but. The joke we all make, and, and I'm sure you two could appreciate this, is that nobody gets us, like us.

I can sit around a barbecue with, you know, 30 of my friends who are all college graduates, professionals, and I, they don't understand what we do on a regular basis. They have no idea because we are the CEOs of a company and work alongside the line worker. Right it, you wouldn't see Lee Koka back in the day working a line all day long with a guy who graduated high school and was making 15 bucks an hour and expect that to be his social group at work all day long.

And so they're great people. I love my, my team members. I. But again, where the CEO is working the line, we're entrepreneurs, we're managers, we're marketers. We're always worried about making payroll. If you care (00:26:00) about your business, you gotta, you're going to eat what you kill. You gotta take home a living.

And the overwhelming majority of our friends who are physicians, attorneys, private equity businessmen, Um, many of them don't really understand what it is that we do, and I think that that goes to what exactly you mentioned about community is. 'cause if you put five orthodontists in a room, we could all just throw our hands up and have a drink over the fact that, you know, who here has a mom who called and says, I'm I.

Pissed off that I can't get in after school. You know, go tell that to your attorney friends and they'll sort of like, you know, laugh you outta the room. But we all share the same problems and unfortunately there are lots of people who aren't blessed with a positive outlook or you know, are cursed with a little bit of a depression or anxiety, unfortunately.

And it's a real affliction. And I think these communities are saving lives, to be honest. I think they're, I've gotten, I dunno about you guys. I'd love to hear from you if you've gotten messages or emails from people that said, you know what, I was on the brink. And then I heard that podcast, or I, I saw that post (00:27:00) where someone reached out to me.

And, but for the groups that are out there and the people like yourselves doing what you're doing, I think there's people out there that would've slipped through the cracks. Mm-hmm. Yeah, I mean, 

(00:27:11) Dr. Leon Klempner: I totally 

(00:27:12) Amy Epstein: agree. Real purpose to the work that everybody does. So 

(00:27:17) Dr. Leon Klempner: I'm gonna switch at peop one, one quick plug, if I may.

Yeah. At, at People in Practice, one of the things we have is something called the Inner Circle. Which is, um, clients of ours where we meet periodically and discuss different topics openly, and I think. Speaking to the community that this has been one of the most, what, what, what I've gotten back is that one of the most, uh, valuable add-ons to working with a marketing company is, is creating such a community.

So yeah, we're, we're totally on board 

(00:27:49) Glenn Krieger: with that. Yep. It's beautiful. 

(00:27:52) Amy Epstein: So, Glen, traditionally on our podcast, we invite our listeners to, uh, submit (00:28:00) questions that our guests can then answer. Would you mind if we played one for you now? 

(00:28:05) Glenn Krieger: No, it's like, it's like that old TV show, right where the voice comes out of nowhere and says, oh my god, Jimmy was such a great student as a child.

Yeah, I'd love it. I'm looking forward. Okay.

Hey there. Doug Shaw here practicing orthodontist in Rockwell, Texas, but I am currently coming to you from the Red Rocks of Southern Utah in St. George. My question to you is, Glenn, what advice would you give a new startup, orthodontic practice, or anybody trying to develop a more effective practice for that matter?

Yeah, that's Doug. He's my partner. Um, he's in Utah with his family right now and, uh, his wife and kids. And, um, I love that guy. He's one of my best friends in the whole world and, uh, it brings such a smile to my face to see him. Love you, Doug. I really do, man. Um, and if, if I can just, I'll answer the question, but I just wanna throw something out there for anybody.

Um, anybody who's (00:29:00) met Doug and I, uh, the, the first question they always ask us is, can you explain your partnership? We don't get it because, you know, I was 44 when I started residency. He was about 29. Um, we went to residency together and just found a, a common moral base and. You know it, we just, we said to each other like, one day we're gonna practice together.

And he had a job waiting for himself in Oklahoma. I had a job waiting in Florida, both great options. And then one day I just wanted outta Florida, I wanted to move to Texas and I said, Doug, I'm moving to Texas. You wanna come with me? And he is like, for reals. For reals and that's all it took. And he said, sure.

We had no plan. We just knew we were gonna practice together. His wife was on board, my wife was on board, and I tell everybody this. Two things, one, please go listen to the Entrepreneurs Podcast. Episode number one, I think it was like 300 episodes. Number one, I felt the most important was Doug and I talking about our partnership.

Because it's unique, it's different. And for anybody out there who wants to (00:30:00) learn, what makes a partnership work? It could, who knows, two years from now, it might go up in flames. I hope not. 'cause I, I, he's my friend and I'd be broken, broken up about that. But the key thing here to remember is don't ever, and I'd love again afterwards if you want to take this one.

I, I, I'd love to hear your feedback from both of you, but I would tell everybody, don't ever partner with somebody for any reason other than love. If you love that person. If you love them. I mean, I'm not saying well, we get along, we've hung out at a couple of football games. If you love that person, if you couldn't imagine your life without that person, partner with them.

But if, if, if you're not going to be best friends, if you're not going to invite each other over the house all the time, if you're not gonna put them down as the executor on your will. Right. You should not be their partner. I don't care how good the, the, the business opportunity is. I don't care about how many practices they have.

The road to ruin is literally with the corpses of partnerships that were built on (00:31:00) money or opportunity. And I beg everybody, if you're thinking about a partnership and you don't know the person, get to know them. Spend time with them, learn if they're gonna be your best friend because this, and I would argue, Is, is almost as important, if not as important as your spouse or significant other.

The moment I met Doug, we just knew. We just knew he was the one. I just knew it, he knew it about me. And when I met my wife, I knew she was the one. And, um, again, if our partnership broke up tomorrow, I wouldn't lose a moment's sleep over the money. I would, I would, I would lose a lot of tears over the friendship.

And, um, and again, I, I don't know what your feedback is, but you asked me about startups. I mean, I'm just saying rule number one, gonna partner with anybody on a startup. Mm-hmm. Best friends. And 

(00:31:52) Amy Epstein: so, I mean, you're preaching to the choir over here if you ask for our, our opinion on it. I mean, it's a, a father daughter team over here.

(00:32:00) So, uh, I mean, agree with you a hundred percent. 

(00:32:03) Dr. Leon Klempner: The minute I saw Amy, I said, all right, that's gonna be my partner. You know? 

(00:32:08) Glenn Krieger: But you know, there are a, to be fair, but in fairness, but in fairness, there are a lot of father-daughter relationships that I'm privy to in the ortho world where they're not best friends.

Where. Being partners is probably not a good idea where the younger of the two feels under the thumb or it doesn't feel like they can get out and do what they want to do. Mm-hmm. Mm-hmm. Or there's a communication issue, and that's why I said, if ever your partnership is going south, work on the friendship.

Don't work on building up the numbers. I mean, that's important. You know, your team needs to be addressed, but work on the love. I know it sounds silly. It sounds weird. We don't use the word love a lot in business, but you better love your partner. I mean, you, you better love being around them. And so, you know, rule number one for startup would be that.

Rule number two is you don't know anything. You don't know anything. You if, if you think you know (00:33:00) what a startup is like, and you've never done a startup, You have no idea. And, um, there was a post in entrepreneurs recently about somebody who had an opportunity to go do a startup, and it was in an O S O or a D S O.

And I, my, my response to them was, you know, I wouldn't, and, and again, I don't mean this in any insulting way, and I think both of you will get it as well. Many of your listeners, I would not want to take a long-term position in of equity in any O S O that had proven doctors in it, but would rather take an associate and plug them into, start a new practice.

To me that was, you know, I would rather take somebody who's done it before who has a track record, who knows what they're doing to run that, because if they're choosing the other route, that worries me a little bit about leadership and the management, the way they wanna run things there, if that's a routine way of doing things.

But I think you have to understand, you don't know anything. And when you think you know something, you don't, and you're gonna learn how little you know, and that's when you're really starting to learn. And so hire as many (00:34:00) consultants as you can for specific purposes. You want marketing. You hire a marketing consultant, you want to get a control of your numbers.

Either hire a consultant who will teach you or go to a course where you'll learn how to read a p and l and a balance sheet and understand the difference between cash and accrual, right? And understand what does it mean when a line item says what it's saying And you, you're running a business, so don't forget you're running a business and you need to understand the numbers.

You need to develop projections, right? Um, things don't happen by accident, and that which is given attention. Happens. So develop a business plan, develop policies and systems, follow things by the book. Consider getting engaged in something like e o s, which is the Entrepreneurial operating system developed by Gino Wickman.

Read the book Traction. It'll give you a very good summary of it, and you can always invest in getting one of their implementers for about $7,500 a day. That will end up making you a hundred times that over the course of your (00:35:00) career. And so, um, I think the most important thing, if someone's listening and says, I'm thinking of doing a startup.

Number one top of the list is follow the basic e o s premise of developing your five year or 10 year plan. When you close your eyes without any compromise whatsoever, what does your life, not your practice alone? What does your life look like in five or 10 years? You pick the di, the the distance out you want, maybe seven go biblical.

But seven years from now, what does your life look like? Um, I know it sounds silly, but how many kids do you have? Are you married? Are you unmarried? Are you traveling a lot? Where do you live? What kind of house do you live in? Um, What does your commute look like? What kind of patients do you wanna work on?

You wanna work on the wealthy with higher income, higher cost, however, a lot more maintenance. Do you wanna work on a lower income or a middle income where you might have different kinds of individuals that are easier to work on? (00:36:00) Trust me. Raise your hand if you've worked on both. Um, You know, what kind of patients do you wanna see?

How many do you wanna see a day? What does your practice look like? How much team do you have? Write that down for five or seven years as crystal clear as you can be for me to be there in five years. What benchmarks? And by the way, there should be objective numbers in there, not just subjective for me to hit those numbers in five years, at three years.

What numbers do I need to have to say that if I'm going from New York to California? When I hit Chicago, how do I know that I'm on the right path? Right? How do I en know that I'm not ending up in Duluth or Fort Lauderdale? Mm-hmm. So three years. What are my numbers? And gimme five to 10 things of what the practice and life look like in three years now.

Go down to one year. Okay. I'm heading towards California. I know I wanna hit Chicago. What does Western Pennsylvania look like to me? So a, a year from now, one year from right now, what are the objective measured benchmarks in overhead (00:37:00) production, staff numbers, um, starts, new patient calls, leads, whatever you want that you can measure, make a scorecard of five things that you need to measure.

And now, last but not least, what are the things that are preventing you from right now to getting to that one year number? So we call those, or e o s calls, those your boulders, your rocks. Develop them. Assign them for 90 day time periods of who's in charge of that rock and tackle 'em. And in 90 days, you should be able to knock off 80% as your success rate.

Knock 'em off. Now pick another bunch of rocks that are gonna get you to your one year goal. And when you get to one year, are you on track or not? And if not, why not? And if you follow that pattern, It's, it's predictable now. Now you're not just opening up a shingle. And to quote General Omar Bradley, who said, we must navigate by the light of the stars, not by that of every passing ship.

And the light of the stars in this case is your objective quantifiable (00:38:00) map. Are you on your map, are you not? And if you use that to guide you, All the other stuff I mentioned is important, but if you've got a roadmap to take you where you want to go, every decision about technology, about hiring, about marketing all becomes crystal clear.

'cause either it matches or it doesn't. And core values are gonna play a huge role in all of that. So again, we could talk about this for hours, but I hope that helped in some way. 

(00:38:26) Amy Epstein: It sure does. And you know, I'm about to ask you our final question. And I feel like I may even wait be able to figure out an answer to that, to the question, which is, don't get it.

The, the beginning of the co of the show, we talked about, you know, uh, you know, what, what we wanted to be when we grew up, or how we were figuring out who we wanted to be. So, Glenn, if you weren't an orthodontist, what would you be? 

(00:38:55) Glenn Krieger: You know, it's such a hard question. Um, I know you probably hear that from everybody, that it's a hard (00:39:00) question.

Um, it is a hard question, you know, 'cause I've, I've changed, right? At 47, I became somebody totally different. And so a, like, like your dad, like Leon, I don't think I'm ever gonna grow up. Um, if I could do it all over again, uh, and you know, Realistically, I mean, I, I wanna be a lead guitarist in a rock band.

I mean, I, I don't play guitar well at all. I'm horrible. So I think that's my alter ego wanting to do that. Um, 

(00:39:28) Amy Epstein: We have three mediocre musicians on this call, by the way, so we can start our own. No, no, you're mediocre band 

(00:39:33) Glenn Krieger: above average cello player. I'm a far below average. I, I have some talents and one of them is not music, I promise you.

Um, but, but, but if I could, if I could, you know, it's hard to say because it's gonna come out for the wrong reasons. It's gonna sound bad when I say this, and I, I. It's okay to mock me for it, but if I could do it all over again, a politician, but not for the reasons you, (00:40:00) you would think. Right. I'm about community.

My social capital is connecting people. Um, and, and I wanna make change in this world. I can't see a problem and not fix it. That's been the driving factor of everything in my life has been I see a problem and I wanna fix it, and I wanna bring people together. And money has never played the number one role in my life.

I've walked away from my dad's practice. He had four practices. I chose to move to Seattle. You know, we were in Seattle. I had a killer practice, but my wife couldn't live there. We left it and went to ortho residency. I had a job waiting for me. That was a cushy, amazing job in Florida, but we felt it'd be better for the family to be in Texas.

So I money has never played a role, and if I could go to politics in the purest sense of politics, where you could change policy and help people and bring people together and change the world in the right way, which unfortunately is not what politics. In my opinion, it's become about today. Mm-hmm. That would've been beautiful.

Short of that, uh, (00:41:00) professional headhunter would've been great. Taking people who have a skill and putting them with, and connecting two companies together, a company with a person watching them both succeed. To me, that would be a pretty amazing job to have. I can see 

(00:41:14) Amy Epstein: you in all those roles. Thank you successfully.

Glen, thank you so much for joining us today. It's been a pleasure talking with you. If our listeners have questions for you or want to learn more about entrepreneurs or your summit or anything, or the podcast, how is it easiest to reach you? 

(00:41:33) Glenn Krieger: Easy. They can either, um, reach me out on Facebook. If they're on Facebook, which a lot of people are not.

Uh, if they're on Facebook, they can hit me up just to, you know, Glen Krieger dmm me. I'm thrilled to, to talk to anybody. If somebody wants to send me, um, just a simple email, I'm always happy to get emails at Glen, which is g l e n n, at Krieger Mail. Dot com. That's just K R I E G E R M A I L (00:42:00) dot.com. And I'll, you know, email isn't the greatest way to get me, but um, if you're not on Facebook, get me that way.

I'm always happy to, to answer any questions that anybody has because again, I like what you're doing. We're all in this together and we're only gonna get better if we help each other. 

(00:42:15) Amy Epstein: Truth. Thanks Glen, we'll have you on again, appreciate your time very much. 

(00:42:20) Glenn Krieger: Likewise. Thank you. 

(00:42:23) Amy Epstein: This episode is powered by Dental Monitoring.

You can learn more about them on our website or on [email protected], and you can subscribe or download other episodes of our podcast, the Golden Age Orthodontics on Apple Podcast, Spotify, SoundCloud, and YouTube, or wherever you get your podcasts. If you enjoyed it, we'd appreciate you telling a colleague.

For more information about people in practice, we are marketing and growth consultants. Please check out our [email protected] and the next time you check out your Golden Age of Orthodontics podcast feed, (00:43:00) you'll see our inaugural episode of Practice Talk, which is a brand new podcast for people in practice media that amplifies the voices of ortho practice team members like we were talking about earlier.

With the overarching goal of unearthing the strategies that create thriving ortho practices by the people who do it. Every day the team members. So this podcast came about because we were thinking about how we could build a community to support orthodontic team members. And they ask for our advice every day because as consultants we talk with lots of practices, but each of those individual practices, they, there aren't a lot of.

Ways to know what's going on in other practices. So we, that's the reason why we started up this podcast and we know that people trust those who are in the same shoes as they are. And so we're gonna use our platform, um, and our, our powers to connect people, um, like Glen does with entrepreneurs. So we (00:44:00) look forward to introducing you to practice talk, um, in just a few weeks.

Thanks for listening to the Golden Age, and we hope you enjoy practice talk. 

(00:44:10) Dr. Leon Klempner: Uh, we appreciate, uh, everybody for watching and listening. Uh, Very grateful to Glen for sharing all of his knowledge and background with the group. Uh, if you'd like to contact me, you can email me [email protected]. Um, if you wanna chat with me, I have a live chat going on on our website that connects to my phone, so I'm actually answering those chats on in, in real time.

So if you got nothing to do, you wanna say hi. Uh, you can reach me there. And most importantly, most importantly, remember for forward-thinking orthodontists. There has never been a better time to be an orthodontist. Take advantage of it, so bye for now.

(00:44:56) Narrator: Thank you for tuning in to the Golden Age of Orthodontics. (00:45:00) 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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