The Best Practices Show with Kirk Behrendt

Private practice is getting squeezed by complexity, competition, and promises that “bigger is better.” That pressure is pushing more dentists to consider selling, scaling, or giving up control. In this episode, Kirk Behrendt talks with Dr. Christian Coachman, dentist and educator, about why celebrating independent private practice matters, why quality in dentistry isn’t scalable, and what private practitioners can do to stay clinically excellent without burning out. To learn how community, support, and smart strategy can help you protect your freedom and your standards, listen to Episode 1011 of The Best Practices Show!Main TakeawaysPrivate practice protects the dentist’s freedom to make key decisions that support quality and patient-first care.Motivation, attention to detail, and passion can decline when a practice is sold and clinical decisions are influenced by outside ownership.Quality in dentistry is not scalable, and it typically drops as practices grow beyond a size that can be closely managed.The temptation to scale often hits when a dentist reaches a ceiling on fees but demand continues to grow.Independent dentists can gain many advantages of large organizations by joining a real community that offers support and shared resources.The increasing demands of technology, marketing, leadership, and management are pressuring private practitioners and fueling DSO interest.Many dentists who sell are financially relieved but still want their freedom back once non-compete periods end.Snippets00:00 Intro – Protecting Independent Private Practice01:12 Why Private Practice Matters02:45 Introducing Dr. Christian Coachman04:10 Celebrating the Freedom of Ownership06:30 The Current Challenges Facing Private Dentists08:55 The Mindset Shift Required to Stay Independent11:20 Why Community and Collaboration Matter13:40 Innovation in Modern Private Practice16:05 The Future of Independent Dentistry18:30 Why Events Like The Exchange Matter20:10 Final Thoughts – Choosing Freedom Intentionally21:32 OutroGuest Bio/Guest ResourcesDr. Christian Coachman is a dentist and dental technician known internationally for his work in dental communication, treatment planning, and interdisciplinary collaboration. He is the founder of Digital Smile Design and has spent decades working inside dental practices, observing patient interactions, and teaching clinicians how to communicate more effectively with patients and teams. He lectures globally and consults with dentists seeking to improve trust, case acceptance, and long-term patient relationships.Guest resources mentioned in the episode:Digital Smile Design: https://digitalsmiledesign.comDr. Christian Coachman on Instagram: https://www.instagram.com/chriscoachmanMore Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Are you relying on the sale of your practice to fund your retirement? Before you accept an attractive offer from a DSO, it’s critical to understand what those numbers really mean — and what alternatives exist.In this episode, Kirk Behrendt interviews Dr. Bob Margeas, founder of Iowa Dental Group in Des Moines, Iowa, about how he evaluated multiple DSO offers, broke down EBITDA and earn-outs, and ultimately chose a different transition strategy. They discuss adjusted EBITDA, recap risk, associate buy-ins, creative ownership structures, and why equity matters more than a headline purchase price. If you’re considering selling your practice — or simply want to understand your options — listen to Episode 1010 of The Best Practices Show!Main TakeawaysEBITDA is calculated differently than a dentist’s net income and often includes add-backs that significantly change a practice’s valuation.Most DSOs evaluate practices on an accrual basis rather than cash basis accounting, which affects perceived profitability.Earn-outs and recapitalization payouts are tied to performance and market conditions and are not guaranteed.Selling to a DSO typically requires the dentist to stay for several years, effectively replacing future EBITDA with the sale proceeds.Structuring an associate buy-in based on trailing three-year profits can allow debt to be serviced without increasing production.Ownership equity creates long-term wealth potential that an associate-only model does not provide.Dentists who are financially independent have more flexibility and leverage when evaluating transition options.Snippets00:00 Intro03:00 The difference between a DSO and a DPO.05:00 Understanding EBITDA and common add-backs.08:00 Why DSOs prefer accrual accounting over cash basis.10:00 How earn-outs and clawbacks work.13:30 Hiring an associate based on personality and communication skills.15:00 Structuring a 20% buy-in using trailing three-year profits.17:00 Reducing clinical days while maintaining profitability.21:00 Merging practices into a holding company model.24:00 Why saving early creates flexibility at transition.30:00 “I’m just a referee” — communicating treatment without pressure.34:00 Why equity ownership is essential for long-term wealth.Guest Bio/Guest ResourcesDr. Bob Margeas is the founder of Iowa Dental Group in Des Moines, Iowa. He is a nationally recognized clinician and educator known for his expertise in restorative dentistry, financial management, and practice efficiency. Dr. Margeas lectures to study clubs and professional groups across the country and mentors dentists on both clinical and business systems. Dr. Margeas welcomes dentists to observe him in practice by contacting his office directly.More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Many dental practices feel surprised by their numbers at the end of the month, even when they review reports regularly. In this episode, Kirk Behrendt sits down with Miranda Beeson, leadership coach at ACT Dental, to explain the difference between leading and lagging indicators and why relying too heavily on historical data creates stress, reactivity, and missed opportunities. They break down how leading indicators connect daily behaviors to long-term results, how to spot problems earlier, and how to use data to lead calmly instead of reactively. If you want to understand which numbers actually help you influence outcomes before it’s too late, listen to Episode 1009 of The Best Practices Show!Main TakeawaysLagging indicators show what has already happened in a practice and cannot be changed once reported.Leading indicators help predict future outcomes and guide daily and weekly behavior.Practices that focus only on lagging indicators often feel blindsided and become reactive under pressure.Tracking leading indicators weekly allows leaders to correct course before the end of the month.Hygiene reappointment, diagnostic percentage, and case acceptance are examples of leading indicators that influence production.Teams engage more effectively when they understand which daily actions influence practice results.Snippets00:52 Leading indicators versus lagging indicators and why both matter.02:28 Why lagging indicators create reactive leadership and team stress.03:50 Using hygiene metrics to predict future production.06:11 Planning ahead for known schedule disruptions like holidays.07:38 What it looks like when practices rely only on lagging indicators.09:42 How leadership changes when leading indicators are used correctly.11:39 Tracking diagnostic percentage and case acceptance week over week.14:47 A simple first step to start using leading indicators today.Guest Bio/Guest ResourcesMiranda Beeson has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.Miranda graduated from Old Dominion University and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach.More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Is online continuing education enough to elevate your dentistry? With unlimited access to webinars, social media cases, and on-demand videos, it’s easy to believe you can master complex procedures from a screen. But is that really how clinical excellence is built? In this episode, Kirk Behrendt interviews Dr. Adamo Notarantonio, educator, clinician, and faculty member at the Kois Center, about the critical differences between online and in-person learning. They discuss why hands-on training, mentorship, and layered learning are essential for developing technical skill, clinical judgment, and the ability to think under pressure. You’ll learn how to adopt CE with patience, how to avoid the social media comparison trap, and why real growth requires more than watching a video. If you want to elevate your thinking and your results, listen to Episode 1008 of The Best Practices Show!Main TakeawaysIn-person, hands-on education is essential for mastering clinical techniques that cannot be fully learned through online videos.True clinical growth requires repetition, deliberate practice, and mentorship over time.Social media often presents highlight reels that do not reflect the full clinical reality behind cases.The ability to think outside the box during unexpected clinical situations separates good clinicians from great clinicians.Layered learning—lecture, hands-on application, mentorship, and case review—deepens understanding and improves implementation.Dentists should focus on competing with themselves rather than comparing their work to others.Adopting CE effectively requires patience and a long-term mindset rather than seeking rapid results.Snippets00:00 Introduction and Welcome00:18 Meet Adamo: A Special Guest01:20 The Importance of Continuing Education02:48 Adamo's Journey and Career Changes04:15 Hands-On Learning vs. Online Education07:43 The Value of In-Person Training09:48 Thinking Outside the Box in Dentistry12:22 Mindset and Continuous Learning14:47 The Reality of Social Media in Dentistry16:29 The Reality of Before and After16:41 The Trust Factor with Instagram16:58 AI in Dentistry Presentations17:29 The Importance of Clinical Tips18:20 The Role of Educators in Dentistry20:27 Understanding Constricted Chewing Patterns21:53 The Value of Layered Learning23:48 The Future of Continuing Education (CE)24:50 Shadowing and Mentorship in Dentistry27:42 Final Thoughts on Adopting CE29:25 Where to Learn More About Adamo31:01 Conclusion and Podcast Wrap-UpGuest Bio/Guest ResourcesDr. Adamo Notarantonio is a practicing dentist, speaker, and educator who serves as faculty at the Kois Center. He is a past president of the American Academy of Cosmetic Dentistry and has earned accreditation status within the organization. Dr. Notarantonio lectures nationally and teaches hands-on composite and restorative courses. He previously owned a private practice in Long Island, New York, and now practices as an associate while focusing extensively on education and mentorship.Instagram: https://www.instagram.com/adamoelvis/Course website: https://www.imprescourses.com/Kois Center: https://www.koiscenter.com/More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Running a dental practice can feel like an endless cycle of putting out fires, reacting to problems, and repeating the same frustrations day after day. In this episode, Kirk Behrendt sits down with Christina Burn, Director of Operations at ACT Dental, to explain why most of these daily issues stem from a lack of clear systems, not people. Together, they break down how systems create predictability, reduce stress, improve team accountability, and support long-term growth. You’ll learn where to start with systems, how to build them with your team, and how to keep them relevant as your practice evolves. To learn how to stop firefighting and start creating predictability, listen to Episode 1007 of The Best Practices Show!Main Takeaways:Most recurring daily problems in a dental practice are caused by missing or unclear systems rather than individual team performance.Systems create predictability, which leads to less stress, better patient experiences, and more consistent outcomes for doctors and teams.Practices should aim to be systems-driven instead of people-dependent to avoid burnout and constant staff additions.Effective systems start with a clearly defined “why” that connects directly to patient experience and team success.The best systems are created collaboratively during dedicated team meeting time, not by the doctor alone or outside of work hours.Systems should be specific, step-by-step, and written clearly so anyone in the practice can follow them when needed.Systems must be treated as living tools that are reviewed, updated, and improved as the practice grows and changes.Snippets:00:00 Introduction and Welcome00:08 The Importance of Systems in Dentistry01:28 Meet Christina Burn: Director of Operations02:30 Common Issues in Dental Practices03:23 Creating Effective Systems05:52 The Why Behind Systems09:58 Implementing and Refining Systems13:22 The 80% Approach to System Development16:02 Specificity in Systems20:32 Living Systems: Continuous Improvement25:11 Conclusion and Final ThoughtsGuest Bio/Guest Resources:Christina Byrne is the Director of Operations at ACT Dental, where she oversees coaching alignment, system development, and operational consistency across practices nationwide. She works closely with dental teams to help them build scalable systems that improve predictability, accountability, and long-term practice performance. In this episode, Christina references ACT Dental resources including the Analyzing Existing Systems document, the master systems checklist, and the systems and checklist support guide available through the Best Practices Association.More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Miranda Beeson, a leadership advisor with 25+ years in dental clinical and admin roles, explains why data should drive decisions. She contrasts fleeting feelings with steady metrics. Short, practical takes cover pausing emotional reactions, checking KPIs like capacity, and using weekly reports to build consistency, accountability, and clearer team conversations.

Most dentists treat sleep as optional until performance drops, patience gets shorter, and focus slips. In this episode, Kirk Behrendt talks with Dr. Uche Odiatu, health and fitness educator for dentistry, about sleep hygiene fundamentals that improve energy, cognition, metabolic health, and daily productivity. You will learn why seven hours is the minimum, why “sleep debt” can’t be repaid on weekends, and the practical habits that make sleep deeper and more consistent. Listen to Episode 1005 of The Best Practices Show!Main TakeawaysSeven hours is the minimum sleep needed for most adults to avoid ongoing sleep deprivation.“Catching up” on sleep over the weekend does not fully reverse the effects of several nights of poor sleep.Morning outdoor light exposure helps reset circadian rhythm and supports falling asleep more easily at night.Daily physical activity builds physiological sleep drive beyond mental fatigue from a long clinical day.Alcohol can make you feel sedated but reduces deep sleep quality and interferes with memory consolidation and emotional regulation.Eating within three hours of bedtime can reduce sleep quality because the body is focused on digestion.Evening light control, including avoiding bright overhead LED lighting and late-night scrolling, supports melatonin and sleep depth.Snippets01:56 Seven hours as the minimum, and how being awake too long affects performance.03:44 Why “sleep debt” can’t be repaid on weekends.06:23 Morning sunlight and outdoor exposure to reset circadian rhythm.09:35 Why sedentary days reduce true sleep drive, even when you feel mentally exhausted.11:28 Alcohol as sedation vs. sleep, and what it does to deep sleep and retention.17:35 Eating close to bedtime and the impact on sleep quality.18:45 Managing evening light by avoiding overhead LEDs after sunset.20:35 Doomscrolling, dopamine hits, and how small amounts of light disrupt physiology.24:10 “Become a sleep master” before chasing other wellness tools.Guest Bio/Guest ResourcesDr. Uche Odiatu has a DMD (Doctor of Dental Medicine). He is a professional member of the ACSM (American College of Sports Medicine), a Certified Personal Trainer NSCA (National Strength & Conditioning Association), and the Canadian Association of Fitness Professionals (canfitpro). He is the co-author of The Miracle of Health and has lectured in Canada, the USA, the Caribbean, the UK, and Europe. He is an invited guest on over 400 TV and radio shows, from ABC 20/20, Canada CTV AM, Breakfast TV, to Magic Sunday Drum FM in Texas. This high-energy healthcare professional has done over 450 lectures in seven countries over the last 15 years.Instagram: https://www.instagram.com/fitspeakers/Website: https://www.druche.com/More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Leaves of absence are complicated, highly regulated, and often misunderstood in dental practices. In this episode, Kirk Behrendt sits down with Alan Twigg, HR expert at Ben Erickson Administrative Services, to explain how leaves of absence actually work, why documentation matters, and how dentists can protect their practices while treating team members fairly. You’ll learn how to identify protected leave, handle medical and mental health requests, manage return-to-work issues, and avoid common mistakes that lead to liability. Listen to Episode 1004 of The Best Practices Show!Main TakeawaysA leave of absence typically applies when an employee will be out for more than one week and may trigger state or federal protections.The reason for the leave determines which laws apply, so employers must clearly document whether the leave is due to pregnancy, medical conditions, mental health, or family care.Mental health conditions are medical conditions and may qualify for protected leave under disability laws.Every leave of absence should have a documented start date and an estimated return date to prevent confusion and legal risk.Medical certifications and job descriptions are essential tools for determining work restrictions and accommodations.Most leaves of absence are unpaid, but accrued PTO is usually used at the beginning of the leave as wage replacement.Employees on protected leave generally must be reinstated to the same role, pay, and hours unless the position is legitimately eliminated.Snippets00:39 What qualifies as a leave of absence versus regular sick time.02:06 Why state and federal leave laws vary by location and practice size.04:18 Mental health as a protected medical condition.07:38 Pregnancy and disability protections explained.10:40 Why every leave needs a defined return date.13:27 Risks of replacing an employee on protected leave.14:21 Medical certification and job descriptions.17:38 Accommodations and undue hardship.19:29 Health insurance and benefits during leave.20:55 Using accrued PTO during a leave of absence.24:27 Medical release and return-to-work requirements.27:33 When a leave of absence is not legally protected.30:40 Documentation tips to protect the practice.Guest Bio/Guest ResourcesAlan Twigg is an HR specialist with Ben Erickson Administrative Services, where he advises dental practices on employment law, compliance, and human resources best practices. He works closely with dentists to help them navigate complex issues such as leaves of absence, accommodations, documentation, and employee relations.Guest resource mentioned:https://bentericksen.com/alan-twigg/More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Marketing costs can easily drift without clear benchmarks, clear goals, or reliable data. In this episode, Kirk Behrendt continues the Metric Monday series with practice coach Ariel Siegel to break down marketing percentage as part of overall overhead. They explain what marketing percentage actually measures, why the benchmark matters, how internal and external marketing must align, and how to evaluate return on investment using real practice data. If you want to understand how much you should be spending on marketing and how to know whether it’s working, listen to Episode 1003 of The Best Practices Show!Main TakeawaysMarketing percentage measures the total percentage of revenue spent on both internal and external marketing efforts.The general benchmark for marketing spend is around 3%, depending on whether a practice is in growth or maintenance mode.Effective marketing fuels new patient growth while also strengthening the practice brand.Internal marketing systems and patient experience must align with external marketing efforts.Tracking return on investment requires comparing marketing spend to new patient numbers and resulting production.High marketing spend without strong systems can result in poor conversions and wasted dollars.Snippets00:56 What marketing percentage measures01:44 The 3% benchmark and why it varies03:07 How marketing impacts new patient growth and branding04:22 Why more new patients is not always better06:52 Using ROI to evaluate marketing effectiveness08:12 How to respond when marketing percentage is too high10:03 Using call and conversion data to diagnose marketing performance11:34 Final Thoughts on Marketing StrategiesGuest Bio/Guest ResourcesAriel has a master’s in healthcare administration and several years of dental experience in all aspects of the administrative roles within the dental office. Her passion is to work with dental teams to empower team members to realize their full potential in order to better serve patients, improve office systems to ensure a well-functioning team/office, and to help everyone have fun in the process!More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Poor communication can quietly undermine trust, case acceptance, and long-term relationships with patients — even when the clinical work is excellent. In this episode, Kirk Behrendt sits down with Dr. Christian Coachman, dentist, dental technician, and founder of Digital Smile Design, to identify the most common communication mistakes dentists make with patients and teams. You’ll learn why context matters, how confidence and humility work together, why “selling” erodes trust, and how practicing communication changes outcomes. If you want patients to understand you, trust you, and move forward with care, listen to Episode 1002 of The Best Practices Show!Main Takeaways:Communication skills have a greater impact on patient trust and case acceptance than clinical outcomes alone.Failing to give proper context is one of the most common communication mistakes dentists make with patients and teams.Asking better, more complete questions leads to better answers and more efficient collaboration.Confidence without humility sounds arrogant, while humility without confidence sounds weak; effective communication requires both.Dentists rarely practice communication skills, which leads to repeated mistakes over long careers.Explaining dentistry by “thinking out loud” or using jargon confuses patients and erodes trust.Showing patients visual information builds trust more effectively than selling or persuading verbally.Snippets:07:35 Why communication determines how far you go in dentistry.08:18 The problem with not giving patients enough context.13:27 Why poorly formed questions waste time and limit answers.20:44 Confidence versus humility in patient communication.26:46 Why dentists need to practice communication like a clinical skill.33:49 How selling dentistry destroys trust while showing builds it.38:09 Why love and trust come from communication, not clinical work alone.Dr. Christian Coachman Bio:Dr. Christian Coachman is a dentist and dental technician known internationally for his work in dental communication, treatment planning, and interdisciplinary collaboration. He is the founder of Digital Smile Design and has spent decades working inside dental practices, observing patient interactions, and teaching clinicians how to communicate more effectively with patients and teams. He lectures globally and consults with dentists seeking to improve trust, case acceptance, and long-term patient relationships.Digital Smile Design: https://digitalsmiledesign.comDr. Christian Coachman on Instagram: https://www.instagram.com/chriscoachmanMore Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/ Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com