Breaking Free: Escaping Corporate Dentistry and Creating a Practice You Love

I mean, the dental assistants are pushing you to be productive. The owner is pushing you to be productive. The schedule is set up for you to be productive. So in this case now, you don't necessarily have an opportunity to build a relationship with the child in pediatric dentistry or the parent for that matter. In fact, you may never see them until they're sitting in your chair. Someone else might have done the examination. Someone else might have presented the treatment plan and you're just doing what you're being told within a time allotted to you, or at least you're trying to. Welcome to Austin, Texas, and welcome to the Phil Klein Dental Podcast. On today's episode, we're diving into a topic that so many dentists can relate to, feeling stuck in a system that doesn't quite fit. Maybe it's the grind of corporate dentistry. or just that sense that your work doesn't fully reflect who you are or why you got into this profession in the first place. Our guest today, Dr. Mark Kogut, knows that feeling all too well. He's been inside that rigid, impersonal system, and he's also learned how to break free from it to create a practice that truly aligns with his values, supports his team, and makes a real difference in people's lives. Dr. Kogut joins us to talk about his new book, Breaking Free, How to Escape Corporate Dentistry and Build Your Dream Practice. We'll get into what inspired him to write it and what the title means to him personally. We'll also explore what holds many dentists back from ownership, how mentorship can change everything, and what first step to take if you're feeling unfulfilled in your current role. So if you've ever wondered what it would take to reclaim your freedom and build a practice that feels like yours, This conversation is a great place to start. Before we bring in our guest, I do want to say that if you're enjoying these episodes and want to support the show, please follow us on Apple Podcasts or Spotify. You'll be the first to know about our new releases and our entire production team will really appreciate it. Dr. Kogut, thanks for being on the show. Thank you for inviting me. I'm really looking forward to our conversation. Yeah, we're very happy to talk to you. And this all kind of came up because you have a book that came out and the book is very interesting. And I think it's a great title. Tell us what the title is so we can all hear it from you. How to Escape Corporate Dentistry and Build Your Dream Practice. Yeah, so we all want to do what you just stated in your title. So that's why we have you on the show. So to begin this episode, let me ask you this. What inspired you to write Breaking Free? And what does the title mean to you personally? I wrote the book because I am no longer practicing clinical dentistry. And I wanted to help other people have an experience very much like the one that I had. I started my career as an associate in a practice. It wasn't corporate, but it was a private practice, but it wasn't my practice. And it was a great experience in the sense that I had opportunities to learn things clinically, to learn how to interact with patients, but in a somewhat different way than what I wanted to work. I learned how to work with people on our team, and I learned some of the business of dentistry. the way I wanted my practice to be. So I think all learning is good, even if it's not exactly what you want. So I wrote the book in a sense to tell my story. How did I, quote, break free from this practice as an associate to have my own practice? And I believe most of us and going to dental school are looking to have our own practice or at least have a vision of what they might want their practice to look like. And I, at this point, hadn't really seen anyone else that was doing that. And so I wrote the book to help people see that this is possible, even though we live in a time right now where so many of the young people are going into practices as associates. The practice that you first went into, that you said you learned clinical stuff, you learned about the business end of the practice. Was that after you were a pediatric dentist? You were already a specialist? Yes. After dental school, I went directly into a pediatric program. And after two years, was now ready to go out and hopefully learn something about dentistry as a new dentist in practice. So what did you not like about the practice? where you felt like this was not what you wanted to do for the rest of your career? And how long were you there until it took you to make that decision that I need to, quote unquote, break free from this? I went into the practice with the thought that I would be there forever. I always felt like I was enough of a people person. that I wanted to not be in a solo practice cloistered all by myself with my small team. And I was given a great opportunity to join a practice that had been in existence for about 10 years. And it had a large team and it had great access to new patients. So, I mean, how could I say no? I was given an opportunity partly because the owner was, in a sense, a very hands-off person. And one of the things that is pretty innate for me is I'm pretty much systems oriented. And so one of the first things I learned is that we really have some pretty ineffective, inefficient systems. And one of the things that I will have to give praise for is the owner being somewhat hands off was more than happy to let me create systems. to improve the practice. And I will also say, thankfully, he was usually very good. Almost every suggestion that I made, he allowed us to implement. And of course, he left that to me because, again, he was hands off. But one of the things that I didn't really have an influence in was on team or at that point, I would say staff selection. I think the thing that really opened my eyes and in a sense made me feel like, okay, this really is something that I don't like and I need to leave. And that was when one day a young lady came into the office looking for a job. We weren't advertising for a job. We didn't have a position at the time. And she spoke to the dentist owner who by the time the conversation was finished, she was hired. You know, we didn't know anything really about her. I will say she was very nice, had a very good disposition, and that probably is what sold him on asking her to join the practice. But my personal belief is that it's really important to have people that are congruent with your vision. And there never was a stated vision, a mission statement. There were never any stated values. I was learning at that point from one of my early teachers or mentors. I was working with Avram King, who was talking about these issues, and I resonated very much with what he was teaching me. We'll be getting right back to our guest in a second. But first, when it comes to the final step in indirect restorations, cementation is crucial. That's why thousands of top clinicians rely on Therisem by Bisco. This dual cured calcium and fluoride releasing self-adhesive resin cement is ideal for looting crowns. bridges, inlays, and onlays, with no need for a primer. TheraseM forms a strong bond directly to zirconia and most dental substrates. Its easy cleanup, convenient delivery system, high radio opacity, and continuous calcium and fluoride release make TheraseM a top choice among dental cements. For cases where you choose to apply an adhesive separately, Duolink Universal Adhesive Resin Cement is the perfect solution. Compatible with all dental materials, it works seamlessly with Bisco adhesives, such as Z' Plus and porcelain primer, ensuring optimal strength and adhesion. It's time to get the most out of your indirect restorations with Bisco's Advanced Dental Cements. To learn more, visit bisco.com. So how long did you work there until you realized that this wasn't a good fit? I'm going to say those feelings were probably beginning at year five or six. By year seven, I knew I needed to go. And I was blessed, again, because of my teacher. Avram referred me to someone who helped me go through a strategic planning process because I wanted to leave the practice, but I didn't want to burn bridges. And I wanted to create a plan such that this change would be not only good for me, but for... the person who owned the practice that I was leaving. And fortunately, you know, when you have a plan and all of these things are done in a very intentional fashion, I can honestly say, and because I have the information, because it was an interesting separation, you might say, but I know for a fact, his practice grew when I left and my practice grew as well. So there must have been some time period where you felt like you've gained enough clinical expertise from the experience in this practice to feel confident to say okay the values don't match up with mine there's no mission for all the reasons you just mentioned but you had enough confidence to make that break away because you felt like you had the clinical competency that you gleaned from working in that practice for x number of years five years so that plays a part right when you feel like you've gotten the clinical expertise that you went there for now i could say i want to make a change I would say absolutely, yes. First of all, I would say the training program in pediatric dentistry that I was in, I thought was exceptional. And I felt I left that program with very good training from a clinical perspective. And I would say probably based on my family history, the family has always had a small business. There was an entrepreneurial spirit that I had. But I will say at that point, you know, being still a fairly young practitioner, my biggest concern at the time was probably, do I have the resources to make this kind of change? And I would say because of having a mentor like Avram King and then later on being referred to someone who helped me with a strategic plan. I was able to overcome that obstacle, which early on felt like it was insurmountable. And I assume, Dr. Kogut, from the get-go, when you started your own practice, it was always fee-for-service. You didn't participate in third-party insurance, obviously. Yes, I have always been, even till the point at which I sold my practice in a private fee-for-service practice. And that mentor that you're talking about. advised you probably to stay away from third party compensation. Am I? Absolutely. Yeah. You know, it's interesting because I do a lot of podcast interviews and many of the dentists that I talk to say the same thing. They just recommend strongly to the younger people that are getting out and starting their own practice. And even ones that have been practicing a while to make that switch to fee for service only and not participate in the third party. payment plans because they just don't compensate appropriately. And then you can't do the dentistry that you want to do. And you're handcuffed in some ways. And you're not financially satisfied, nor are you professionally satisfied from the standpoint of the kind of dentistry you're restricted to do. I agree with that. I feel like one of the keys to this, and this is one of the things that we talk about in the book, is that having a very clearly stated vision, values, and mission is really important for your selection process of team. And helping them to understand the why of the practice is so important because so much of this private fee for service is related to your ability to communicate with your patients. And this was never something that was happening when I was an associate. We rarely had team meetings. We rarely took the team to continuing education, except whatever might be local. And that was, of course, in the days when a lot of these CE requirements were not yet in effect. But I always believed, being a lifelong learner, that there's always something to learn, especially, at least for me, as a leader. to become the best leader I could be. I do want to ask you this. So you made that leap. Now, you have no goodwill. You have no patience of record when you start this practice. And then you're now not even taking insurance. So, you know, one way to get patients is to sign up and say you participate with an insurance company because you automatically get a list. You'll be on a list where patients will call you. And you didn't even have that going, which was a smart thing to do, obviously. But how do you deal with that initial time period where there's just no patients? Nothing but debt and no money coming in. Well, I will say what you just described is not quite the case that I had. I did actually have some patients that went with me. And this was an agreement that I made with the owner of the practice because during the time that I was in training, after I got my dental license, but was now in a program, I was moonlighting. And so when I came to his practice, I did bring some people with me. And fortunately, we were in a location that had more than enough patients. And so I did actually start with having a small practice to begin with. But in answer to your question of how I would do that today, I think this goes back to proper planning and trying to understand How big a facility can I create now? How can I equip it? How many team members, you know, can I afford to have? And I think that's all something that can be strategically planned in order to manage the problem of having more expenses than income in the beginning of the practice. Yeah. So in your book, Dr. Kogut, you talk about the residency day versus the real day. Can you explain that concept, what you mean by that, and how it comes to play in the life of a dentist? What I'm trying to describe there is two different types of situations for practice. When you're in your residency, you're being fairly highly controlled, not so much relative to productivity, but learning. You have staff, faculty that are there. available to help you understand what you're doing, why you're doing, how you're doing. And once you finish your residency, and now you're in private practice, you know, there's an expectation, you know, by your employer, whether it be corporate or whether it be private, that you know what you're doing, at least clinically. And at that point, they now put on top of that expectations of how fast you're going to work, how good you're going to do it. What is your productivity? And it feels very different in a number of areas. One, you're working with different people, okay? In a residency program, the dental assistants, for example, are also part of the teaching faculty. And by the way, some of the best things I ever learned were not taught to me by a dentist, but rather a dental assistant that had years of experience. And I'm this new kid on the block that doesn't know dip, all right? But that's not the case when you're in your, you know, real day. I mean, the dental assistants are pushing you to be productive. The owner is pushing you to breathe productive. The schedule is set up for you to be productive. So in this case now, you don't necessarily have an opportunity to build a relationship with the child in pediatric dentistry or the parent for that matter. In fact. You may never see them until they're sitting in your chair. Someone else might have done the examination. Someone else might have presented the treatment plan. And you're just doing what you're being told within a time allotted to you, or at least you're trying to. So it's a very different feeling. And that didn't feel good to me. You know, I feel like I'm enough of an outgoing person. I like to talk to people. You know, I like to talk to the children. In fact. Now that I'm no longer doing clinical dentistry, one of the biggest things I miss is the interaction with the children, you know, and watching them grow up. Pediatric dentistry is very special in a whole lot of ways, and I could expand on that at some point, but I miss that, and I miss my team. But you still need that balance, Dr. Kogut, because running a dental practice is running a business. Productivity is important because you have to pay the bills, but of course... For you, it was very important to follow through that case from beginning to end and not just be handed over a patient that was in the middle of treatment with someone else and you were just continuing on with the service. You wanted to develop a relationship with the patient, watch that patient grow, keep the relationship with the parents, and of course, work with team members that are in alignment with your mission as a dentist. I totally agree with that. We'll be getting right back to our guest in a second, but first, when it comes to digital workflow equipment, it's important to partner with companies that provide premium products with unparalleled service, all at an affordable price. That's why you should check out Shining 3D Dental, a company that offers a complete and integrated suite of high-quality and easy-to-use digital dental equipment. Their local offices are based in California and Florida, so you get in-time comprehensive support. In fact, Shining 3D Dental can furnish your office with an entire suite of digital equipment for under $27,000. This includes their AoralScan 3 wireless intraoral scanner, Metasmile 3D facial scanner, and the Acufab 3D printer with its post-processing equipment. Plus, the Shining 3D Dental digital workflow solution includes cloud storage, synchronization, and software for consultation, analysis, and design. So whether you're taking... Absolutely true. You know, fee schedules can be different, especially in a private fee for service practice. You know, I mean, one of the big complaints you hear all the time is insurance companies don't pay what you're worth. So that that's a You might say some leverage right there that can help you to get past, you know, the economic concern. But I think, too, you know, at least what I have experienced from other people that have been in, especially in corporate dentistry, is the schedules are not necessarily, you know, built for effectiveness. They were built. primarily on production. And I have to say it may not even be efficient the way they're practiced. In the 42 years that I was in practice, and of course, the majority of those were in my private practice, we spent a lot of time in team meetings talking about how do we make the experience better for our patients, but not just them. How do we make the experience better for us so that at the end of the day, we don't feel burned out? One of the biggest things that has an impact on how you feel at the end of the day and how our patients feel at the end of their appointment is your schedule. And we, almost every team meeting, we had some discussion of what can we do to make our schedule better? And that was a huge amount of time that was spent on that. And it made a huge difference. And some of the things we did were pretty unique. And we almost always ran. very close to being on time because we worked on that so much. That's system. Right. Now, what do you think the biggest emotional blocks are holding dentists back from pursuing ownership? Because keep in mind, ownership is not for everyone. Someone may fit better in a DSO, some corporate organization where they only want to work a certain number of hours and they don't want any responsibility. They don't want to deal with HR, infection control, regulatory, inventory, dealing with the lease and a million other things that you know is involved with running a practice. So it's not for everybody. But for those that want to pursue ownership and they feel like they're ready to, they have the clinical expertise like you thought you had when you left the corporate practice, what's holding them back, generally speaking, emotionally? Well, first, Phil, I want to agree with you that it isn't for everybody. The person you just described has one job and that's to work in the practice. If you want to become an owner, you just took on a whole second job because now not only are you working in the practice, you're working on the practice and that's a different job. So yeah, I totally agree. And there's nothing wrong with having that perspective. But I do believe there are some people that feel like they have a calling to do things in a certain fashion. They have their own idea of how they would want to be treated and how they want to treat their patients. And those are the ones that I feel are going to want to be out and own their own practice. So in answer to your question as to what is one of the biggest stumbling blocks, I think it's fear. And that encompasses a lot of different things. It may be they still feel like they're not clinically adept enough. Or maybe they don't feel like they have enough business acumen. You know, we didn't learn any business in dental school, you know, and it is a business. And there are a lot of moving parts. Am I good enough? Am I a leader that's strong enough? Do I have a vision? Can I think of what it would look like if it was the best it could be? You know, these are all things that I think, you know, hold people back. But I believe all of these things are learnable. And in most cases, I believe having a teacher like I had or a mentor who's right there by your side for a period of time can help. you to overcome these aspects that all are related to fear. We'll be right back with our guests. But first, a quick shout out to Flow Dental, a sponsor of today's show. When it comes to digital imaging, Flow Dental provides every accessory you need to take that perfect image and the barriers you need to keep your patients safe. To view their entire product line, visit flowdental.com. Yeah, no question about it. It's interesting because I had a recent conversation on a podcast episode. with a doctor who came from Cuba at 18, 18 years old, didn't know a word of English. He ended up going to UAB, University of Alabama, and he found a mentor. And that mentor said to him, after working with him for two years, he paid off his school loans, go start your own practice, go fee for service. He's an aesthetic dentist. That's what his thing is, his aesthetic dentistry. And he's doing fantastic. And what he did was, He literally bought a practice where everyone had insurance and he decided to get rid of all of it. And what he did was he took the lab bills and showed it to his patients and said, you want me to do a veneer on you? Let me show you what my lab bill is. And he would show them the lab bill. And then he said, this is what your insurance is going to pay for this. So we can't do this because your insurance reimbursement barely covers the lab bill. I'm going to make $10 on this veneer. We have options, but if you want the best solution, I'm going to have to not accept the insurance and you're going to have to pay me separately. And he said about 80% of his patients decided to do it. They said, you know, for my aesthetics and my mouth and my future, I'm 40 years old or whatever, however the patient was he was talking about, for the rest of my life, I'm going to have a beautiful result and I'm willing to pay for that. So like you said, it's a mindset, right? It's a mindset that the dentist has to have going in. I agree with that. I agree with that. In fact, That's one of the things that I talk about in the book. It's something called the Mobius method that maybe we can talk about later on. Yeah. Yeah. We'll definitely cover that on a future podcast. So let me ask you this. If a dentist listening today feels unfulfilled in their current role, what's the very first step they should take to resolve that or just change the course of where things are going at the moment? For me, and what I would say about this is that think about what it is that you really want. What would make you happy? What would it look like if it was the best it could be? What kind of relationships do you want with your team, with your patients, with your community? And can you get that in the situation where you currently reside? If that's not possible, then... It's probably time to begin thinking about what it would be like if I left this circumstance and created my own practice that's congruent with what I believe, you know, how I feel about things and what this vision of what the best it could be would look like, because I believe it's possible. If I wanted to start a practice and move out of what I'm in, I want to get out of corporate dentistry. I'm not happy. I don't feel fulfilled. I have a choice, right? I could work as an associate in someone else's practice with the option of possibly buying it down the road. So maybe I work with an older dentist who's five to six years away from retiring, and he or she introduces me to the patients of record, and I do my thing there. So that's an option, right? The other option is to buy someone and they're gone the next day and you just take it over. And then the other option is to start your own practice, open up a space and equip it and get going that way. So, I mean, I think a mentor really plays a role here, but what are some of the things quickly as we wrap up this podcast that should be kept top of mind when making that decision? Well, I feel like one of the most important thing is certainly being true to yourself. Any of the examples that you just gave can lead to a very successful situation for you, and you can make it your own. There are different ways to do that. You know, if you're buying an existing practice, there may be all kinds of things that you have to change, different systems. People might need to be working there. Different patients might need to be attracted. you know, sudden changes because, well, the patients that are already there have a certain expectation. But I do believe in the example that you previously gave, this dentist that now is doing aesthetics over time taught his patients why he needed to make certain changes. And I think, of course, just being honest with your patients and educating them and, of course, delivering the very best quality. service that you can, can help them make that transition. Yeah, no, I think that's well said. And one of the things to keep in mind also is location, right? Where you want that practice to be. What's the patient demographic around that office? If you want to comment on that, and we have another two minutes. Okay, well, I agree with you, location can be very helpful. An interesting thing about pediatric dentistry, though, is a significant number of your patients, if you're not involved with the insurance, frequently will come from pediatricians. And so establishing a good relationship with pediatricians would probably be one of the first things I'd suggest that you consider. It's been a great conversation, Dr. Kogut, and I do want to recommend to our audience the book. The name of it is Breaking Free. How to Escape Corporate Dentistry and Build Your Dream Practice. Where is that available? And it's available on Kindle for the massive sum of 99 cents. So I hope people will take some time to look at it. And if they have some questions, maybe consider contacting me. I can be contacted at markcogut at gmail.com. And I would be happy to try and help answer some questions that may come up. If they've read the book. Yeah. And Kogut is K-O-G-U-T. So it's K-O-G-U-T. Very good. Thank you very much, Dr. Kogut. We'll look forward to having you on future programs. Thank you, Phil. I enjoyed being here with you.