What is the Tooth and Coin Podcast?

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EPISODE NOTES

Jonathan:

Welcome to the Tooth & Coin Podcast, where we talk about your adventure of being a dental practice owner. In these episodes, we're going to be talking about problems that you will likely face as a practice owner, as well as give an idea about actionable solutions that you can take so that you can get past this problem in your practice. Some of these concepts are really big ones, some of them are very specific, but we hope that these episodes help you along with your journey.

Jonathan:

Now, a very important piece for you to understand is that this is not paid financial advice. This is not paid tax or legal advice. We are not your financial advisors, we are not your CPAs. This is two CPAs talking about informational and educational content to help you along with your journey. It's a very important piece for you to understand.

Jonathan:

Another thing that you need to know is if you enjoy today's content, join us on the Facebook group. So, we've got a Facebook group that is active with Dennis that is going to have content talking about what we're talking about today, to continue the discussion. Agree with us, don't agree with us, have a story to tell, have something to share? Join us in the Facebook group. If you go to Facebook and you search for Tooth & Coin Podcast, click on it to join it, and be able to join us there.

Jonathan:

Finally, if you need some more help, we're developing a list of resources that are going to be centering in and around our topics of discussion, to be able to help you a little bit more than what the content is doing. So, if you'd like access to that whenever it becomes ready, all you have to do is text the word "toothandcoin," T-O-O-T-H-A-N-D-C-O-I-N, to 33444. And that's "toothandcoin," all one word, no spaces, to 33444. Reply with your email address, and we'll email you instructions on how to get into the Facebook group, as well as add you to lists to be able to send you those resources when they're available. And if they're available, we'll go ahead and send them to you, as well. So onto today's episode, hope you enjoy it.

Jonathan:

Hello, ambitious dentists. So it is the Tooth & Coin podcast, episode number one, and we are here to discuss this new podcast learning experience that we're going to be creating and developing, and to be honest with you, learning a little bit more about the business of dentistry with everyone that is listening in. I have with myself, Mr. Joseph Rugger, who is a team member with Tooth & Coin, a long time friend of mine as well. Joseph, why don't you tell everybody about yourself, about your experience in the accounting and the dental world, the medical world?

Joseph:

Yeah, sure, absolutely. So, I always get a chance to tell my story and I get a chance to tell some funny parts of it and some fun sections of it, so hopefully that's of interest to your group. So, I grew up playing competitive baseball and ended up getting a chance to play college baseball at a small school in Batesville, Arkansas called Lyon College.

Joseph:

Ended up finishing three majors at Lyon: accounting, economics and finance. So, members and money are born and bred into me and formally educated. My first job out of college, I got a chance to go work for my collegiate fraternity, so my job for a year was to travel the country and hang out with college kids. It was a rough job, but somebody had to do it. I ended up doing that for about a year. I always tell people that my salary at the time was $17,000 a year, and I figured out that I was too smart to not make any money.

Joseph:

So, I went to grad school at IU Indianapolis and did a Master's of Professional Accounting there. Spent about two years working in public accounting in the Indianapolis, Indiana area. Worked for a top 50 CPA firm out of Carmel Indiana, and it was May... I think it was May. And I was still getting up, going to work, and I'd parked my car outside and I was scraping ice off my windshield, well into May living in Indiana, and a buddy of mine called me, and my friends of course, back home in Arkansas were all going to the lake in May and doing things outdoors and hiking, and here I was, scraping ice off my windshield well into May.

Joseph:

Anyways, so, buddy of mine, his parents owned a prosthetics company and he called me in the middle of the end of busy season in the accounting world. And he said, "Hey, our controller just left. Do you have any interest in coming to work for us in the prosthetics business?" And I said, "Absolutely, would love to come visit with you." And I got a chance to work in the prosthetics business for a company in northeast Arkansas for about 12 years, spent a couple of years as the controller and spent the bulk of my time there as the director of finance and administration, which is a fancy way of saying the CFO and the COO.

Joseph:

We got a chance to do all kinds of crazy fun stuff. We had four locations when I started there. After I'd been there for a little while, we divested two of our locations, so we went from four locations in two states to two locations, and then over the course of the next 10 years, we opened up a number of new branches, expanded into another state, and by the time I left, we had eight locations across two states, had about 75 employees. Did a whole bunch of work for folks. We ended up seeing about 10,000 patients a year as far as delivered services.

Joseph:

So, we got a chance to really head up the finance arm, got a chance to really understand the medical billing side. We used HCPCS codes in the prosthetics business, and got a chance to see and learn ICD-9, and then that became ICD-10, and everything in between, and got a chance to understand the difference between a usual and customary fee, or a UCR fee and allowed fee. I was having a conversation the other day with somebody about how to measure your revenue, but got a chance to spend 12 years in the prosthetics business.

Joseph:

And then, actually, just got reminded on LinkedIn the other day that it's my three-year anniversary at Tooth & Coin. I had all these people say, "Hey, congrats on your work anniversary." And I'm like, "What in the world are they talking about?" Sure enough, February was my three-year anniversary at Tooth & Coin.

Jonathan:

My wife can tell you that dates are the things that I forget the most. So, I was not one of the people that congratulated you. So that's on mem though. So it's a little dirty laundry for the listeners there. So, cool. So you were in the medical industry. For the listeners, what would be the equivalent of a small to mid-size DSO pro office, somewhere that had eight to 10 locations doing somewhere in the eight figure range of revenue? Is that about accurate?

Joseph:

I'd say that's pretty close. Yeah. Yeah.

Jonathan:

Yeah. So, that's what you did in terms of a CFO type role. By the way, one of the episodes that we're definitely going to record is, what is a CFO and what do they do? Because I get a lot of calls about that and I try to explain it, and I'd love to hear what a CFO actually does compared to what I think that they do, since I've never actually been the CFO of somewhere.

Joseph:

Sure.

Jonathan:

So, cool. So you're a CFO and you've been at Tooth & Coin for three years now. What else is relevant in terms of your accounting, CPA, financial background?

Joseph:

Well, I think it's always interesting for me to tell people how I ended up working for you at Tooth & Coin. I think that's always an interesting story. So, I moved to the Dallas, Fort Worth area a couple of years ago, and I was interviewing for a couple of different jobs and working with recruiters. And I ended up getting a call from a recruiter to talk to them about being the CFO for a big dental services organization, or DSO, here in the metroplex.

Joseph:

I think they had about 80 or 90 offices across Dallas and throughout north Texas. And anyways, Jonathan, you and I have been friends for a number of years, randomly sat next to each other at a continuing education in Little Rock, and struck up a conversation and became friends. That was what? 15 years ago, I think.

Jonathan:

Yeah.

Joseph:

But anyways, we'd stayed in touch and stayed friends over the years. So, I had this interview coming up with this DSO and I thought to myself, "Who do I know that I can pick their brain about the different stuff that I need to study and prepare for this interview?" So I called you and reached out to you and said, "Hey, I've got this interview coming up. Would you be willing to share some stuff?" Anyways, and we started talking and you told me... a couple of days later you were like, "Man, if he's interested in making a move, maybe he should come to work for us."

Joseph:

So that started that conversation. So, been with you at Tooth & Coin for the last three years. Got a chance to do all kinds of really, really cool stuff inside the CPA profession on both the professional level and also on the volunteer level. Education is something that is near and dear to my heart, so I've done continuing professional education and taught continuing education across the country for both the AICPA, and I think I'm up to 16 different states across the U.S. that I've taught in.

Joseph:

I've taught in two foreign countries. I got a call from the AICPA and they said, "Hey, do you have time on your calendar to come teach in the Caymans?" And I said, "You know what? Something just opened up. I do have time to do that."

Jonathan:

"I think I can make that work."

Joseph:

Yeah. Yeah. I got another call to say, "Would you like to come speak at The Bahamas Institute of Chartered Accountants?" And I said, "Absolutely. I think that would be good." So, I've gotten the chance to teach and coach at the CPA level and certainly with lots of other entrepreneurs across the dental industry and across a number of other industries, and I really, really enjoy the educational part of what we do, because... Warren Buffett, I think, said it best, that accounting is the language of business and it's up to us to figure out what the story is.

Joseph:

The numbers do tell a story, and we've got to figure out, number one, make sure the numbers are right, but number two is to figure out what story that's telling. And one of the things that I'm passionate about is I really, really want to help small businesses grow and succeed. That's something that I figured out early on in my education, is that as an accountant, we're going to have that ability, and I'm trying to simplify that even more, Jonathan. And what I really want to tell them is, "I want to help you win with money," which I think is near and dear to our hearts as CPAs.

Joseph:

So, I've gotten a chance to travel quite a bit. I've been to, I think, 30 countries or something like that, been to all 50 states, hope to come visit your state, whoever you guys are that are out listening, and come hang out, teach some stuff, and that kind of thing. So I think that's all certainly relevant to our discussion here. At this juncture, I'm getting ready to become the chair-elect of the Arkansas Society of CPAs.

Joseph:

It's a volunteer organization that I've been a part of since I became a licensed CPA, and we're doing lots of great stuff inside the Arkansas Society, and to get a chance to share that's an honor. I was telling you this the other day, I'll be the youngest chair in the history of the Arkansas CPA Society, which is a really, really great honor for me to have.

Jonathan:

Another honor that you had recently bestowed upon you was the AICPA Young CPA Leader of the Year Award? Did I get the title right of that?

Joseph:

Yeah, so that was really cool. It's funny. My wife was kidding with me the other day. She was like, "Are we still young?" I was like, "Yes, we are still considered young." But it's the AICPA Young CPA of the Year in honor of a guy named [Maximum McColloughby 00:11:20], and it was named in his honor. And it's an award that sets out to recognize volunteerism in the profession, who's helping capital markets and who's helping the profession move forward from every angle, both from a professionalism standpoint to a volunteer to, what kind of impact are we making inside of our communities?

Joseph:

So, I was awarded that in the middle of a global pandemic and we were supposed to go to Las Vegas for this big convention. And of course, all that got canceled, and we ended up having... the AICPA did a great job, and we ended up having a really cool virtual ceremony that went out on Facebook live that you could go check out where I got a chance to come talk about volunteerism and what it means to me and hear some of my friends talk about the profession and the awards and all that stuff. But yeah, that was a big honor that I got from the AICPA.

Jonathan:

Really was. And just for people that are listening, that's the equivalent of the ADA giving out a Young Dentist Leader Award, and they only give it out to one person a year. It's not like the thing that you get in high school where you get to sign up for the who's who-

Joseph:

Who's who.

Jonathan:

and pay some money to be a part of it. It's a big deal, and we're really proud of you for it for be able to do that. So, cool. So, for anyone who has not listened to Start Your Dental Practice or is not aware of Tooth & Coin, my name is Jonathan van Horn. I am the CPA and the owner of Tooth & Coin, which is a CPA firm. We are located in Arkansas, but we help dentists everywhere in the country in the United States. We have clients in just about every state. We have around 250 offices we help out.

Jonathan:

And our mission is to help bridge the gap between you being a successful dentist and you being a successful entrepreneur. We do that in ways that we can help. We try to not venture outside of the realms of the things that we don't know how to do. We find that a lot of people make the mistake of trying to get their hands in too many cookie jars. We've learned through experience that the best way to help our clients is to give them the advice that we know the most about, and that is the accounting, tax, and business financial world, so to speak.

Jonathan:

And from a numbers perspective, that does mean a lot of things. And what we hope to do on this podcast is talk about a little bit about those things and help solve some of the problems that are out there in the industry that seems to stem from the fact that most dentists spend about 15,000 hours learning how to become a dentist and almost zero hours learning how to be a business owner.

Jonathan:

So, this podcast is hopefully going to be informative and help a bit with that problem. So, a little bit more about me. I was driven to the CPA world from a young age. I was from a small business family. My parents owned a small business, my grandparents owned a small business. My parents owned a furniture store, my grandparents owned a manufacturing company. And whenever I was in the eighth grade, my parents sat us down in the living room.

Jonathan:

My dad sat down on the fireplace, and he said to us, "Jonathan," and my sister and my mom. "The business had failed. We are going through bankruptcy. We're going to have to sell the house. We're going to have to move away from our family home that we lived in since I was born, and leave the place that I had known and grown up and loved."

Jonathan:

And so we had to move halfway across the state from one Arkansas town to a more rural Arkansas town, and if you think that you live in a rural place, I went from a town of about 25,000 people to about 8,000 people, and moved out of a four bedroom, two bath house that was in a pretty nice area to a two bedroom, one bath apartment that was in an area that wasn't the best. And it was a really rough time for my family.

Jonathan:

And my dad always said, "Jonathan, the reason that the business failed wasn't because the business wasn't working. It was because I didn't keep up with the numbers. I didn't know about the business side." My dad was the sales and marketing person. He was not the business guy. He was the person that made the sales happen, made the revenue come in, but he didn't ever keep up with the business side of things, the financial side of things.

Jonathan:

He'd actually relied a lot on my grandfather, the one who owned the manufacturing company, to do those things. But unfortunately, my grandfather died about... I guess it was at this point almost 35 years ago. So, he wasn't around very long to help out with that furniture store. And my dad always said if he had had somebody there that could have kept an eye on the numbers, could have kept an eye on how the business was doing from a business standpoint, that we would have been okay, the business would have survived.

Jonathan:

It went through a bit of a hard time, but we would have made it out of there if he just had a better eye on the numbers and a better eye on the business side of things. So, he always said that. He even says that today still. Actually, we had a discussion about this about a month ago, and he's still saying the same thing about coulda, woulda, shoulda stuff.

Jonathan:

So, I grew up thinking that that's what CPAs did, because that was what my dad said CPAs did. And I went into school and I got real close to becoming a math professor. So, a big fan of numbers. Always enjoyed math as a subject and had way too much nerdy fun with it, but did end up going the route of CPA, much like Joseph said. He wanted to make some money in the world. So I figured being a teacher was probably not the best way to make money in the world. So I thought, "Let's go with the CPA route," and also I could also be able to help a lot more people. When I got out into the CPO world, very quickly found out that's not actually what CPAs do, as I find a lot of people are surprised about.

Jonathan:

CPAs don't typically really help with businesses. The CPA industry was created around compliance. It was created around making sure that you filed and paid your taxes so that you don't pay penalties and interest or go to jail. We call that compliance in our industry, and I didn't want to do just compliance. I wanted to do more. So, after working for five or 10 years in the public space, helping out people with compliance, I said, "Enough is enough. I'm going to go and start this new business." And that is how Tooth & Coin was born, and our mission statement of helping dentist bridge that gap of being a successful clinician with being a successful entrepreneur was born.

Jonathan:

So, that's the story of Tooth & Coin, my personal story of how I became a CPA, why I became a CPA, and just a little bit more into the mind of who it is that's talking to you through these things. There is a podcast out there that you can go and listen to. It's called Start Your Dental Practice. Our CPA firm does specialize in new practice owners, so we have about 250 offices we help out with as of today, which is the beginning of 2021, and over 200 of those were new practice owners whenever they came on with us and our firm.

Jonathan:

So if you're a new practice owner, someone who's within five years of ownership, we'd love to be able to talk to you about how we can help you out with your dental practice as well. But to this podcast, the Tooth & Coin podcast, what are we here for? Why are we doing this? Why are we talking today? The purpose is fairly simple. I discussed it briefly before I went with my intro is that there are a lot of problems that need to be faced inside of the dental industry and a lot of the lessons that need to be taught to people in terms of what business is and how to approach it.

Jonathan:

There's a lot of confusion around a lot of different subject matter, and who better to talk to you guys about those things than a couple of guys that have experience running a CPA firm that helps out 250 offices around the country, someone who acted as a CFO for 12 years for a very big medical organization, and has helped lots of our clients right now that are dentists, help get their way through the business of dentistry and be able to talk about the things that we know how to talk about?

Jonathan:

So, the purpose of the podcast is that. We're going to be highlighting problems, we're going to be talking about the solutions to those problems, and we're going to be trying to give you resources around ways to be able to solve those problems. I think one thing that Joseph and I do not want this podcast to turn into, just for full expectations for you so that you guys can hold us accountable is, we don't want this podcast to just be informational only.

Jonathan:

We want this podcast to be actionable. We want it to be something that you can execute based off of. We want it to actually solve problems, not just highlight them. Anytime you do any type of content, it's hard to sometimes bridge the gap between educational, entertainment, and action. And we're going to do our best to focus on highlighting the problems, and then giving you the solutions and giving you the resources to be able to take action on those solutions. So to me, that's the reason for the podcast. Joseph, what are some of the things you're wanting to solve with this podcast, as well?

Joseph:

I think at a high level, Jonathan, you and I, we've got just such varied and similar experience of the business of healthcare here, and as we sit back and think... I'm as guilty as anybody else. I think everybody knows the stuff that's in my head, and as we have new team members come on, as we have new dentists come on, I find that there's a whole lot of stuff that's inside my head that not everybody knows, that everybody's not read all the books that I've read.

Joseph:

They haven't listened to all the same stuff that I have. And I forget that. So, I look forward to getting a chance to just really share some insights and some things that we see, and some things that each individual listener can take home with them and can digest and see how does it apply to their individual practice, their individual situation? So we've got all this knowledge and expertise. We want to put it out into the world. We want to help you build a better business, a better practice, a better life, eventually. That's really what we're trying to do, here. We're trying to help you reach your entrepreneurial dreams and goals and help you with all those things.

Jonathan:

Yeah, exactly. And another important piece of all of it is, I find a lot of the times, when a client asks us a question, there is the book answer, and then there's the contextual answer. And I feel like we're in a unique position to be able to give a lot of context around some of these, about how to approach the book solution versus the real life solution of what we've seen happen. Other things that we're going to be looking to do with this podcast...

Jonathan:

So, we're going to be looking to have this be an engagement platform with other dentists that are out there in terms of ways that you guys have solved the problems we're talking about. So, this isn't only about us sharing what we know. It's also about you sharing what you know` with the rest of the people that are out there so that we can all have a prosperous and full lives, so that we can all do better.

Jonathan:

We all can live a life of abundance, and there's always information that can be shared. And so, we're going to be having ability to grow a community out of this podcast, and we're also going to be using real life questions from real life dentists that are having these real life problems, and talk about ways that could potentially have solutions, things that could be answered. We're going to be literally pulling questions from clients of ours, of course, with permission from the client, or have it be anonymous.

Jonathan:

We'll be pulling real questions that clients are having so that we can answer those things, because if our clients are asking those questions of us, I know that the people that are listening are probably having those same questions. They need to be answered by somebody. And hopefully, we can give that answer and be a resource to the industry. So, that's the problem that we're trying to solve. That's how we're going to try and solve it. Is there anything that else you wanted to add, Joseph, in terms of what we're trying to do here with the podcast?

Joseph:

I'm looking forward to going on this journey with you, Jonathan. You and I have been friends for a long time, and we both have two things that are inherent in us: we want to serve and help other people, and we want to educate. I'm looking forward to doing both of that to our audience, with our audience.

Jonathan:

Absolutely. So, to give some of our audience members some ideas of the different topics we're going to be approaching whenever we come down in these episodes, some of the topics that we've already highlighted that we want to talk about. Understanding the business model of dentistry. We want you to know how much cash do you really need to have in your business. How to pay less in taxes while your net worth is more important than you think and why it matters. What's a dental practice's true value?

Jonathan:

Fixed versus variable expenses and your breakeven point. Analyzing your overhead. Staffing percentages, personal finance. Recurring charges, and do you actually use them? The purpose of continuing education. How to understand your financial statements, and why it's also a total waste of time. How to manage expectations whenever it comes to leadership. How to lead people. How to handle turnover in your office. Training protocols. Crucial conversations. Understanding what your sales and production actually mean in your office. Understanding how to handle new patients and how to measure your growth and how to measure your marketing expenses and calculate your ROIs.

Jonathan:

And just tons of more things that we're going to try and talk about. Those are the ones that we've literally just brainstormed off the top of our heads over the course of a few conversations that we could give full and really good information on, as between Joseph and myself. For areas where we are not expert subject matters... or subject matter experts, rather, we plan on reaching out to the industry and finding the best people to be able to talk to you about those subjects.

Jonathan:

So for example, we will not be talking to you about how to increase your hygiene revenue. That's not something that we're going to be talking about because neither Joseph or I has ever had to talk to a hygienist and tell them how to do their job. Now, we could have a conversation about how to talk to an employee and how to manage an expectation, but we're not going to talk to you and say, "Hey, this person needs to be doing... 30% of their patients need to be receiving fluoride treatment, because that's an industry standard."

Jonathan:

Now, I can tell you that may be an industry standard, but how you go from where you are today to that standard is anyone's guess for Joseph and I. And so we're going to have somebody on that's going to be able to actually answer that question and give you some guidance and help you with those things. So, that is what we'll be doing in terms of the episode breakdown. Again, the current format that we're we're working with is, highlight the problem, talk about the solution, and then give resources.

Jonathan:

That's what our content's going to be about. We're going to try and keep our episodes somewhere in the 20-to-30 minute range. We don't want you to have to devote a full hour of your day just to listen to our podcast. That is giving us some accountability to keep the episodes on point and not to go down too many rabbit trails in terms of conversation, and so that we can really make the time that you're giving to us and putting us in your ears to be as high-value as possible.

Jonathan:

So, that is our plans with Tooth & Coin podcast. We hope to have you guys on the journey with us, and if you would, make sure to follow us on all the social media, and we will see you on the next episode.

Jonathan:

That's it for today, guys. I hope you enjoyed this episode of the Tooth & Coin podcast. If you are going to be a practice owner or a new practice owner, and you're interested in CPA services, head on over to toothandcoin.com, where you can check out more about our CPA services. We help out around 250 offices around the country. I would love to be able to have the discussion about how we could help your new practice.

Jonathan:

We do specialize in new practice owners, so people that are about to be an owner of a practice they're acquiring, about to be an owner of a practice they are starting up, or has become an owner in the past five years. That is our specialty. We'd love to be able to talk to you about how we could help you in your services with your tax and accounting services.

Jonathan:

And if you enjoyed today's episode, again, go to the Facebook group, talk to us about what we've talked about, join in on the discussion, and let's create an environment where we can talk about some of these things so that we can all help each other get through these things together so that this adventure of business ownership is more fun, more productive, and better in the longterm.

Jonathan:

Lastly, if you want access to those resources that we are currently building, just text the word "toothandcoin" to 33444, that's "toothandcoin," no spaces, T-O-O-T-H-A-N-D-C-O-I-N to 33444. Reply with your email address, and we'll send you the instructions on the Facebook group. We'll send you the resources when they're available, and we will see you next week.

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