The Dental Boardroom

In this episode of the Dental Boardroom Podcast, Wes Reed dives into some of the most common and costly business and practice management mistakes dentists make. Drawing from years of experience working with hundreds of dental practices, Wes explains how strong clinical skills alone aren’t enough to build a sustainable, profitable, and stress-free practice.He breaks these mistakes into six core areas, covering everything from management systems and PPO economics to lease agreements, partnerships, financial planning, and KPIs. Throughout the episode, Wes uses practical examples and real-world analogies (including agile software development) to show how intentional systems and financial clarity can free owners from burnout and help practices scale intelligently.This episode is a must-listen for practice owners who want to stop managing reactively and start operating with structure, clarity, and long-term strategy.Key Topics Covered1. Not Adopting a Management ProcessMany dentists manage by instinct instead of by process. Without a clear management operating system including defined roles, meeting cadence, accountability, and decision-making frameworks, practices become reactive, inconsistent, and owner-dependent. Wes explains how adopting even a simple system and iterating over time can dramatically improve operations and reduce burnout.2. Not Understanding the True Cost of PPOsPPOs often increase top-line revenue but quietly erode profitability. Wes breaks down how fee schedules, write-offs, chair utilization, and hygiene profitability impact the bottom line. He emphasizes that PPOs are essentially an expensive marketing channel and that growth without profitability can lead to exhaustion, not success.3. Not Understanding Lease TermsA lease is often the largest non-clinical financial commitment a dentist makes, yet many sign without fully understanding the implications. Wes discusses escalation clauses, renewal options, relocation clauses, and why poor lease terms can hurt practice value or even prevent a successful exit.4. Partnering Without Profit-Split ModelingPartnerships often fail not because of personality conflicts, but because of unclear financial structures. Wes explains why production, ownership, expenses, and profit splits must be modeled and stress-tested before forming a partnership and why aligning accounting execution with the partnership agreement is critical.5. Lacking Financial Planning & Analysis (FP&A)Most practices rely only on historical financial reports, such as P&Ls, which show where the practice has been, not where it’s going. Wes explains how FP&A (or a CFO model) helps dentists forecast cash flow, plan strategically, and turn financial anxiety into financial control.6. Not Using KPIs or KPI SoftwareWithout key performance indicators, practices lack visibility and accountability. Wes highlights the importance of both leading and trailing KPIs, the value of KPI software, and how daily or weekly team huddles around metrics create a culture of ownership and consistency.Key TakeawaysClinical excellence alone doesn’t guarantee a successful practice; systems and strategy matter.A management operating system frees the owner from being the bottleneck.PPO participation must be understood at the procedure- and profitability-levels, not just collections.Lease terms can significantly impact long-term practice value and exit options.Partnerships should be treated like financial marriages, with detailed modeling upfront.FP&A helps dentists make forward-looking decisions instead of relying on gut instinct.KPI create clarity, accountability, and better team alignment.AI should enhance well-designed systems, not replace leadership, processes, or strategy.

In this episode of The Dental Boardroom Podcast, host Wes Read is joined by Megan Shelton (Shelton Solutions) and Michael Anderson (co-founder of Wondrous) for an in-depth executive session focused on one of the most challenging stages of practice ownership: scaling without creating chaos.The conversation explores the concept of “No Man’s Land” the phase where a dental practice is too big to operate informally, yet not structured enough to run like a true organization. The panel breaks down what typically breaks first as practices grow, why culture and clarity often erode before financial performance does, and how intentional systems, leadership layers, and data-driven decision-making can help owners scale sustainably.This episode is especially relevant for dentists approaching $1.5–$2.5M in revenue, adding providers, or feeling increasingly busy, stressed, and constrained despite apparent growth.Key Topics CoveredThe “No Man’s Land” phase of practice growthFounder vs. CEO identity shiftsCulture, values, and psychological safety as scaling foundationsMeasuring quality beyond production and revenueMarketing ROI, lead quality, and tracking systemsOperational dashboards, KPIs, and accountabilityDelegation, leadership development, and team structureCommon myths and misconceptions about growthKey Takeaways1. Growth Without Systems Leads to ChaosWhen revenue outpaces infrastructure, practices experience rising stress, declining consistency, and fractured operations even if production looks strong on paper.2. Culture Breaks Before the Numbers DoTeams feel instability before leaders can name it. Communication breakdowns, confusion, and burnout are often the earliest warning signs of unhealthy growth.3. Identity Must Be Defined Before ScaleClear mission, values, and standards create alignment and serve as a filter for decisions around hiring, marketing, scheduling, and patient care.4. Quality Requires Measurement, Not AssumptionsTrue quality indicators include:Case acceptance consistencyPatient retention and re-treatment ratesTeam turnover and engagementDiagnostic alignment across providersCash flow clarity5. Marketing Success Depends on End-to-End VisibilityMore leads don’t equal better outcomes. Practices must track where patients come from, how they convert, and which channels actually drive ROI.6. Delegation Is Essential for Sustainable GrowthScaling requires owners to let go of certain roles and build leadership layers while maintaining accountability through systems and metrics.7. Many Owners Want Relief, Not More VolumeWithout structure, adding providers, patients, or locations often increases stress instead of freedom.8. A Scalable Practice Can Operate Without the OwnerA key test of operational maturity: if another doctor stepped in tomorrow, what would continue to function and what would immediately break?

In this episode of The Dental Boardroom Podcast, we take a deep dive into the Q4 2025 State of the U.S. Dental Economy Report from the ADA’s Health Policy Institute to understand where dentistry stands heading into 2026.Using AI-powered analysis, we explore how dental practices are navigating rising costs, staffing shortages, flat insurance reimbursements, and shifting patient behavior. While many dentists are feeling financial pressure, the data reveal a profession that remains resilient, adaptable, and focused on long-term growth.Despite inflation and operational challenges, patient demand continues to rise, proving that oral healthcare remains a top priority. This episode highlights why 2026 may be a pivotal year for practice owners willing to rethink their business models and embrace strategic change.Key Topics CoveredQ4 2025 dental industry performancePatient spending trends and demandThe “fiscal squeeze” facing practicesInsurance reimbursement challengesStaffing shortages and labor market shiftsDifferences between private practices and DSOsTechnology vs relationship-driven growthDentist confidence and investment outlook for 2026Key TakeawaysPatient Demand Remains Strong: Dental spending is up 9% compared to pre-pandemic levels (inflation-adjusted), showing that patients continue to prioritize oral health.The Fiscal Squeeze is Real: Rising supply and labor costs combined with flat insurance reimbursements are shrinking profit margins across the industry.Confidence is Under Pressure: Many dentists are busy but earning less, leading to frustration and declining economic confidence.Staffing Remains a Challenge: Hygienists are still extremely difficult to hire, while assistant hiring shows slight improvement.Uneven Growth Creates Opportunity: Some practices have excess capacity, creating opportunities for better marketing and patient conversion.Fear Limits Major Changes: Although many dentists want to drop low-paying insurance networks, few actually take action due to uncertainty.2026 Shows Signs of Optimism: More dentists plan to hire, invest in equipment, and restructure networks—signaling belief in long-term demand.DSOs and Private Practices Differ in Strategy: DSOs rely more on technology and automation, while private practices emphasize relationships and personalized care.Patients Value Dentistry More Than Insurers Do: Consumer spending proves that patients recognize the value of dental care, even when insurance does not.

In this episode, Wes Reed continues his series on common financial mistakes dentists make, focusing on retirement planning and investing. He explains how poor decisions around 401 (k) plans, defined benefit plans, debt management, and private investments can significantly impact long-term financial success.Wes breaks down how the U.S. tax system works, why retirement accounts are powerful tax-saving tools, and how dentists can use smart financial strategies to accelerate their path toward financial independence. He also shares real-life examples of mistakes he has seen in his practice and offers practical advice to avoid them.This episode is designed to help dentists make informed decisions, protect their wealth, and build a sustainable financial future.Key Topics CoveredUnderstanding the importance of choosing the right 401(k) strategyHow progressive taxes impact high-income professionalsWhen to Consider a Defined Benefit (Cash Balance) PlanWhy paying off low-interest “good debt” too early can hurt growthRisks associated with private and non-transparent investmentsThe importance of diversification and due diligenceKey TakeawaysUse 401(k) Plans Strategically: A well-structured 401(k) is one of the most effective ways for dentists to reduce taxes and build retirement savings. When implemented at the right time, it benefits both the owner and the team.Consider a Defined Benefit Plan in High-Income Years: For dentists with strong cash flow and high tax exposure, defined benefit plans can allow much larger, tax-deductible retirement contributions. However, they require professional management.Don’t Rush to Pay Off Good Debt: Low-interest, tax-deductible debt used for assets like a practice or home should not always be paid off early. Investing that money can often produce higher long-term returns.Be Careful with Private Investments: Many private deals lack transparency and liquidity. Dentists should avoid investing based on hype and always perform proper due diligence.Think Long-Term, Not Emotionally: Financial decisions should be based on data, strategy, and long-term goals—not fear, pressure, or short-term emotions.Tax Planning Is a Key Part of Wealth Building: Understanding how taxes work and using retirement accounts properly can save tens of thousands of dollars over time.

In this episode of The Dental Boardroom Podcast, host Wes Read continues his series on common financial mistakes dentists make, with a deep dive into tax planning gaps that often lead to paying unnecessary taxes.Wes explains how many dentists rely on reactive tax filing instead of proactive tax planning, causing them to miss powerful deductions and make poor timing decisions. He breaks down practical, real-world strategies such as the Pass-Through Entity (PTE) tax election; overlooked deductions like kids on payroll, home office, vehicles, meals, and travel; and why depreciation must always align with cash flow.The episode also highlights the risks of overly aggressive tax strategies, why meeting with your CPA only once a year isn’t enough, and how a CFO-style, proactive approach can significantly accelerate a dentist’s path to financial independence.Key Topics CoveredCommon tax planning mistakes dentists makeHow the Pass-Through Entity (PTE) tax election worksWhy the timing of tax payments mattersLow-hanging tax deductions many dentists missKids vs. spouse on payroll (and when it makes sense)Home office, car, meals, and travel deductionsRisks of aggressive tax strategies like misused R&D creditsProper vs. improper use of depreciation (Section 179)The difference between reactive CPAs and proactive, CFO-style planningKey TakeawaysPTE tax election is a major opportunity: Dentists in high-tax states can significantly reduce federal taxes if payments are made correctly and on time.Cash timing determines deductions: Tax deductions only apply in the year money actually leaves your account.Small deductions compound: When combined, kids on payroll, home office, vehicle use, meals, and travel can create meaningful tax savings.Spouse on payroll requires retirement planning: Without a 401(k) or defined benefit plan, it can increase taxes instead of reducing them.Depreciation isn’t free money: Misusing Section 179 can create future cash flow problems.Avoid crossing the line: Aggressive or poorly justified strategies increase audit risk.Tax planning follows cash flow planning: Taxes are a subset of cash flow—not the other way around.Proactive advice matters: Dentists benefit most from advisors who specialize in dentistry and meet multiple times per year.CFO-style planning accelerates wealth: Integrated tax, cash flow, and financial planning lead to faster and more sustainable financial independence.