Empty Schedules vs Elite Dental Practice Management for the Ambitious Dentist | Alejandro Pt. 2
Shared Practices | Your Dental Roadmap through Practice Ownership
Dr. George Hariri | Shared Practices Network
4.9 • 559 Ratings
🗓️ 4 August 2025
⏱️ 44 minutes
🧾️ Download transcript
Summary
In this episode of Practice Underwater, Dr. George Hariri consults with Dr. "Alejandro," a solo dentist who has navigated dental practice ownership in the Midwest for over 20 years. Four years ago, Alejandro made the leap to drop Delta Dental and transition to a fully fee-for-service model. While this shift elevated his clinical freedom and defined his dental practice ownership style, it brought new challenges to his dental practice management, including patient attrition and staffing shortages.
For any ambitious dentist evaluating their own dental business strategies, Alejandro’s journey offers a transparent look at the realities of fee-for-service dentistry. With $1.13 million in collections and an active patient base of 875, Alejandro has successfully established himself as a productive solo doctor. However, to reach his stretch goal of $1.5 to $1.6 million, he must evolve his dental practice ownership systems to address his primary bottleneck: keeping the restorative schedule full without compromising his "one patient at a time" philosophy.
Here is your survival guide to optimizing a productive solo practice:
- Navigate Network Drops: Understand the hurdles of requiring patients to prepay for services when going out-of-network.
- Expand Hygiene Capacity: Recognize how relying on a single full-time hygienist mathematically limits your restorative growth.
- Define Your Clinical Box: Maximize dental practice profitability by focusing heavily on the specific procedures you actually enjoy, such as crown and bridge or night guards.
- Clarify Your Vision: Avoid the pressure to build a mega-group if your true passion is performing high-quality restorative dentistry four days a week.
Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.
Transcript
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| 0:00.0 | Welcome back to practice underwater. |
| 0:05.3 | I'm here with our real doctor, fake name, Alejandro. |
| 0:09.4 | I really like the name, but we won't get into it again. |
| 0:11.5 | If you listen to the first part, we did have a little bit of back and forth about how much we enjoyed the name Alejandro. |
| 0:16.8 | But for anyone who didn't listen to the first episode, I'm going to go ahead and just kind of walk through maybe that discussion that we had with Alejandro. Maybe it was last week, |
| 0:24.9 | maybe was before that. And then for anyone who did listen, this may be a little redundant, |
| 0:28.9 | maybe a reminder. But Alejandro is somebody who's been a practice owner for 20 years. |
| 0:33.9 | Alejandro bought the practice 20 years ago, and it was marketed as a fee for service practice, |
| 0:38.8 | but it actually was not. It had, I think, maybe like one insurance plus Delta. And over the years, |
| 0:45.7 | Alejandro just worked in the practice, took the insurance. And then about four years ago, |
| 0:51.1 | shortly post-COVID, Alejandro dropped in, dropped Delta and went fully |
| 0:56.3 | fee-for-service. And that was a pretty impactful moment for Alejandro in their practice, |
| 1:01.9 | because he went from maybe having a lot of patients to having, you know, there was patients who left. |
| 1:08.2 | And Delta, we talked about it on the last episode, but they don't make it very easy to go out of network. |
| 1:12.1 | and ultimately led to patients leaving. And that was four years ago, right? So, you know, |
| 1:16.0 | the aftermath of that has already been spelled out, whatever impacts that it would have, |
| 1:20.1 | have already whoever's left, has left, whoever's staying, has stayed. And it's kind of not really relevant today, but it was a big part of how we got to where we are today. And Alejandro's practice, |
| 1:24.7 | two front desk team members, two assistants, one full-time hygienist, and four-day-a-week hygienist, and we're about to have a second full-day-a-week, or second hygienist start two days a week this summer. And so, you know, that's where Alejandro's at. And last |
| 1:29.8 | episode, we really talked about, you know, I really tried to get to understand Alejandro as a dentist, |
| 1:44.5 | what his goals are. Really, Alejandro, in the simplest sense, I would very, very squarely call |
| 1:50.4 | Alejandro productive solo personality. And, you know, that would be the Vision Avatar that we would |
| 1:55.7 | assign Alejandro. And what he wants, that would be the vision avatar that we would assign Alejandro. |
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