Brett Allen (00:24)

Hi, Brett Allen here, host of the Marketing32 show, where I connect with leading dentists, dental influencers, and industry experts to uncover the latest and greatest in dentistry to help your practice grow and thrive. This episode, as always, is brought to you by our team here at Marketing32. We’re the only dental marketing team that I know of with a performance guarantee that if you’re not growing, you don’t pay us. We truly are invested in the practices we work with. We want to add value.

And do ethical marketing for the industry. So reach out to us at marketing32.com. We’ll have a quick discovery call to see if we’re a great fit to work together and we’ll go from there. Quick shout out to Rebecca Herring. She was recently on the show. We talked about how your unicorn team member is actually your practice’s biggest vulnerability. ⁓ we talked also about systems and growth. It’s an awesome episode. I highly recommend you check it out.

And super excited to have a new friend of mine on the show today, Ian McNichol. He is an experienced entrepreneur and is currently the co-founder and CEO of Icon Dental Partners, a uniquely developed multi-specialty DPO dental partnership organization, with dozens of partner practices throughout the country. Icon is an Inc. magazine best in business award winner in several different categories. Ian has been named a top CE leader and consultant by Dentistry Today for five consecutive years.

He’s written numerous articles for industry publications and published his first book, Mastering Practice Growth: The Definitive Guide to Growing Your Dental Practice or Group. Ian has a BS in Mechanical Engineering from Washington State University, where he is he was also a graduate of the University Honors Program. In addition, he has an MBA from the University of Washington. Today he joins us to share insights on the evolving dental landscape and what it takes to build thriving practices in today’s market.

Ian, welcome to the show. Excited to talk with you more.

Ian McNickle (02:10)

Yeah, thanks for having me, Brett. I’m excited to to chat with you and see if we can share some information with folks.

Brett Allen (02:15)

Yeah, I was just captivated where we met recently at the Speaker’s Consulting Network event, the annual summit recently in Santa Barbara. That’s how I saw you on stage and I was like, I gotta talk more with Ian to learn more about what he’s doing at Arc Icon and how your approach to org you know, partnerships with Dennis is really a a a great alternative to what’s historically been the DSO approach. ⁓ yeah. So

Ian McNickle (02:42)

Yeah.

Brett Allen (02:44)

Excited to go deeper with you. Tell us more about how you got into dentistry. I know we were talking a bit back in the day you were in dental marketing. Yeah. And so walk us through that story, how you got to what you’re doing today, and then tell us more about Icon. I I’m excited for everybody to hear about that.

Ian McNickle (02:51)

Yeah, yeah.

Yeah, absolutely. So yeah, I I got into the dental industry after a 10 year stint in the high tech. As you noted, I started my career as an engineer. ⁓ worked for 10 years in the high tech industry. I really enjoyed it. I liked engineering and management positions, but I really had a itch I wanted to scratch just as an entrepreneur. And so kind of 2005-6 time frame, I just quit my job cold turkey and just I’m gonna be an entrepreneur and I didn’t have a great plan. And looking back, I’m like, man, that was dumb.

Brett Allen (03:12)

Yeah.

Ian McNickle (03:28)

But you know, when you’re young and ambitious, you just you just go for it sometimes. And so yeah, first cut company I built was with ⁓ my roommate from grad school. And ⁓ we just had a small little consulting firm for a few years in in in the northwest part of the country. I live in Washington State. And ⁓ he and I partnered up with another guy and and started a marketing agency in 2009. And by 2011, we decided to focus exclusively on the dental industry. And so

So yeah, we we built that company together for for many years. ⁓ and that company’s still plugging along, doing just fine. I one of my former clients, he’s a general dentist, and he built a dental group, ⁓ more of a traditional corporate DSO model. He built it back 2005 to 15 or so. And my marketing company, we used to service their their firm. That’s how we got to know each other. And so when he exited his his his group,

⁓ he had doctors from around the country asking him, Hey, could you kind of coach me how to be do what you did and build a group? And so he started a consulting company and he approached me and said, Hey, would you be interested in being my partner? Because he knew I, you know, as an entrepreneur and knew how to grow companies and I knew dentistry and stuff. And so we were in a nice complimentary skill set. So that’s kind of that was 2018. I started splitting my time from 2018 to 21. I started splitting my time between the marketing company and the and the group consulting company.

And ⁓ and those were those were really interesting years, you know, to learn a lot about the the the DSO models. And and what I what I really came to kind of realize was the models and the DSOs are pretty flawed. Doctors don’t typically like them very much. ⁓ they’re not necessarily better for patients. ⁓ team members don’t like them a lot either, dental dental office team members a lot of times. And so I was just kind of really surprised at at how

You know, it kind of reminded me of like the analogy I like to explain to people is like taxis, right? Have you ever taken a taxi, especially in the olden days, the customer experience is not good, right? You know, it’s it’s it’s they’re not comfortable. The the drivers are typically pretty grumpy, you know, that because they’re probably not having a fun ex job, you know. And and and but that dominates the industry, like taxis were the option, right? And so anytime you have an incumbent in an industry where the customers are not happy.

Brett Allen (05:22)

Yeah, yeah.

Ian McNickle (05:40)

There’s an opportunity for disruption and innovation. And so to me, DSOs were like taxis. They’re like, okay, there’s the incumbents, but they’re not necessarily providing a great service here. So ⁓ how do we do this better? And so I spent a few years from 2021 to 22. You know, we decided let’s build our own group. And so I really interviewed over 200 doctors, right, over an 18-month period. And I just asked them a bunch of questions, like, you know, what stresses you out about private practice?

Brett Allen (05:42)

Yeah.

Ian McNickle (06:08)

what would you like to delegate? What what do you need help with? and but also, you know, what might attract you to join a group. And so really just try to get try to get an understanding of what exactly would doctors be looking for and could we build something like that. But I also asked him, you know, the flip side of that coin, which was, you know, what horror stories have you heard about groups? I mean, if you’ve been in the dental industry very long, you’ve heard horror stories about people in DSOs, you know, doctors getting screwed, this and that. And so, so asking doctors lots and lots of questions helped me really understand at a deep level.

Brett Allen (06:29)

Yep, yep, yep.

Ian McNickle (06:36)

what they really were looking for and what and what they were not looking for, which is also equally important. And so, ⁓ but I didn’t just interview doctors, I spent a lot of time talking with investors, attorneys, accountants, ⁓ investment bankers, and really trying to understand, you know, from the doctor’s perspective, okay, it’s great to understand what they’re looking for, but then also need to understand how to build something that is going to be legally compliant, that’s going to be attractive for bankers to give us money, that’s going to be attractive for investors to invest in us someday.

There’s a lot of stakeholders and a lot of audiences if you’re going to do this right. And so it took a couple of years to put all that together. ⁓ and once we did, you know, we started recruiting doctors to join us. ⁓ we officially launched as a DPO ⁓ in 2024. And since that time, we’ve grown, yeah, to to a nice, nice little size, nice little growth rate. We’re plugging along. And ⁓ but yeah, we’re we’re in eight states right now. We’re multi-specialties. We have you know general dentists and specialists.

And kind of modeled off of the Seattle Study Club model is kind of our goal. Like in each market, what we’d like to have is, you know, a handful of specialists, you know, 10, 15 general dentists, they’re all collaborating clinically, they’re referring each other and they’re all business partners, right? So that was the idea is to build these multi-specialty clusters around metro areas around the country. And that’s what we’re endeavoring to do, but we do it in a way that’s that’s quite different for the doctor. So it’s it’s been a fun journey. It’s been a lot of work, a lot of stress.

Brett Allen (07:40)

Yeah.

Yeah.

Ian McNickle (07:54)

But we’re in a we’re in a pretty good place now. So we’re we’re in definitely in growth mode now.

Brett Allen (07:58)

Yeah, t tell us more about the approach that you guys have taken and what you learned from interviewing those two hundred docs that i opened this opportunity to you. I I remember on stage you were talking about how you were talking to investors or or or different groups in dentistry and talk and and they they assumed you were just another DSO that was trying to come up. And yet you l you you helped spin it a little bit and show them, hey, this model is actually a

Ian McNickle (08:20)

Right.

Brett Allen (08:25)

a way better approach to group practice. It’s a win win for everybody, the investors as well as the the practice owners. Talk us talk us through that more and and and and pull back the curtain a little bit more around about Icon.

Ian McNickle (08:38)

Yeah, absolutely. So when I was doing these interviews, right, and talking to doctors, you know, one of the things that was really high on on all of their lists was clinical autonomy, right? I want to be able to do which services I want to do, use the lab I want to use, you know, use the supplies I want to use. ⁓ I don’t want somebody telling me what to do, how to do it, what to what to pick, if I have a quota, I gotta do so many crowns a month, all that kind of stuff, right? And th those are kind of common

Tactics in DSOs is, you know, legally you can’t tell a non a non-clinical person can’t tell a doctor what to do legally. But DSOs are pretty clever in structuring things in a way that significantly limits the doctor’s choices in in many cases, without naming names. And so what what I one of the things I I I want to give benefit of the doubt to a lot of DSOs. I think the vast majority of them when they started.

li very likely had good intentions. Hey, we want to be good for doctors. We want to be good for patients. I think they all started out that way. I I’m I don’t know that to be a fact, but I suspect that that’s probably the case. Yeah.

Brett Allen (09:29)

Course.

Mm. Well, they saw a need for support in

in the industry administrative wise. Yeah.

Ian McNickle (09:40)

Yeah, right. And and so I think I think that they have good intentions when they start, but then over time they become more corporate and less doctor friendly. And so why is that? And because you know, we we developed a business model that the doctors absolutely love our model, which is great. And that that gives us benefit today. But and we don’t have investors, we’re still privately held. And so ⁓ and I’ll kind of explain our ownership structure and how that works. But so the idea was okay, let’s make this as great as we can for doctors, because really what we

Our belief is the number one problem that we have to solve to be successful as a company is we’ve got to have the ability to recruit and retain good doctors long term. Get them in, keep them happy, keep them long term, right? What whatever you got to do to keep the doctors happy. And so everything in our business model, we kind of ran through that filter. Is this better for doctors? Is this going to make them happy or not? And if it didn’t make them happy, if it wasn’t better for them, then we we, you know, tossed it in the in the in the cash, you know, in the trash bin and

Focused on things that would be better for them. And so I’ll give you a couple of examples. ⁓ like when it comes to clinical autonomy, you know, I asked, ⁓ spent a lot of time working with attorneys, with the attorneys as we were designing the business model. And I one of the questions I asked them, and these attorneys had done lots of kind of DSO deals in the past. And I was like, so how do how do these groups become more corporate over time? I know investors come in, they make it more corporate, but like specifically, what is happening? Like, how is it happening?

And they said, well, think about the mechanics of how these groups are designed. You’ve got a holding company at the top, and the holding company owns the assets. That’s where the stock is located. That’s where the cash flow from the practices flow up to the holding company. And so that’s where the economic value resides. Then below the holding company, you’ve got an operating company. And the operating company typically would employ the support team. So, for example, at Icon, we have Icon Management Holdings is our holding company. You have Icon Dental Partners, which is the public brand.

And so the iCondental Partners, that operating company employs me and my support team. And so we are the group that really provides all these services to the practices. So that’s that’s kind of the structure now, how the how the practices interact with the holding company and a support company. There’s lots of different ways how you can structure that, those relationships. But what the attorneys taught me was they said, look, when investors come in, they’re going to invest at that holding company level.

And they’re going to make changes to that document, you know, subject to your board’s approval. And then once that document has been updated, that’s the law of the land and everybody has to live by it. And so anything

Brett Allen (11:49)

Yep. Right.

Ian McNickle (11:55)

that you do not want to have changed as much as possible, pull it out of the holding company agreements and use what we call a decentralized legal structure. So what we did is all the things that define the doctor’s controls, autonomies, you know, everything that they really, really liked about their private practice, we pulled it out of the holding company agreements.

And we made them individual agreements between each practice individually and our operating company individually. And so that way, no board can come in. Any change to the holding company agreements have no bearing on how the doctors interact with us, which is awesome. Right. ⁓ so that was one of the many we made a ton of innovations to our model that we looked at, okay, how are DSOs doing it? And that’s kind of a flaw in their design, is they they they concentrate too much at the hold code level.

Brett Allen (12:28)

Yeah, yeah.

Yeah.

Ian McNickle (12:41)

And it makes it too easy for an investor to come in and change things that they’re not going to like. So we we we took as yeah, we took as much as we could possibly out of that hold co level and decentralized. Now the agreements are the same, you know, between the practices, just for fair and consistency, right? So they’re the same contracts and agreements and everything and terms, but they are not in a place that can be changed by some because you know, you could be cynical, like an our company, for example, I’m the only person on our board of directors who’s not a doctor. Everybody else is a doctor.

Brett Allen (12:45)

Centralization of power, yeah.

Ian McNickle (13:09)

We did that on purpose because I wanted to put my money where my mouth is and show the doctors who partner with us, like, look, you know, just trust Ian to do the right thing is not a great business model. I mean, I I do the right thing, but they don’t know me. They don’t know they don’t know that for sure. And so, how do we make sure doctors really have a seat at the table? Well, you give them most of the seats, right? And that’s what we did. So you could be cynical and say, okay, well, yeah, Icons set up great for doctors today, but what happens if an investor comes in and cuts a really sweetheart deal for all these doctors on the board?

Brett Allen (13:22)

Sure, yeah.

Ian McNickle (13:37)

And they kind of screw everybody else over, you know. Pardon my French there, but that’s possible. I got I mean our doctors wouldn’t do it. We have great doctors on our board, but they wouldn’t do that. But you’re a brand new doctor, you don’t know them, you don’t know me. How do you know? Right. So the fact that they’re practicing doctors, they’re part of the group, they’re they’re gonna have to live with whatever they they agree to, just like everybody else, that should give them some some comfort. But what really gives them comfort is knowing that how we’ve structured this, even if an investor kind of tried to come in and give them a some kind of sweetheart deal.

Brett Allen (13:40)

Right.

Mm-hmm.

Ian McNickle (14:05)

There’s very little that they can impact at the at the board level because of so much has been decentralized, right? So it really not only makes it a great experience for our doctors who partner with us today, but also in the future, those things can’t change, which is awesome. You know, it’s lots of things like that that we did.

Brett Allen (14:08)

Right, right, right.

Yeah. Yeah. I think I think that was super interesting when we were talking over lunch that that’s how you structured it. What are some other things that you’ve learned working with doctors this way in the group? What’s the what’s the benefit and and what are some of those ⁓ value ads that you’re seeing with icon that are helping doctors unlock that next level of growth or whatever it is that they’re ⁓ wanting out of a group practice?

Ian McNickle (14:37)

Yeah.

Yeah, you know, that that’s a great question. So there’s there’s a handful of reasons that that practices and doctors typically ⁓ want to partner with us. you know, one of them would be to get help, right? I’m I’m I’m burned out, doctors burned out. I’m like, man, ⁓ HR and recruiting and you know, hygienist wanting a million dollars a year and does all these things, right? are stressing them out. And so think how I explain to doctors is think of us as a large extension of your non-clinical team. So when we partner with the practice.

Brett Allen (15:05)

Yeah.

Ian McNickle (15:13)

You know, the doctor still owns their clinical entity in our in our business model. So their PLLC or S Corp, whatever their entity is, that clinical entity, they still continue to fully 100% own that entity. And the entity owns the patient records and charts. So there’s a nice firewall between clinical and non-clinical controls. What our team does is we come in and we say, Hey, we’re gonna help with HR, we’re gonna run payroll, we’re gonna help with recruiting, we’ll take over IT and cybersecurity and you’re

through marketing stuff and we do all the financials and and the bookkeeping and accounting and pay the bills, like all these different things, right? Help with leases and and and legal. And so as much of the non-clinical stuff as we can offload from the doctor and the team members, we we do that to to really free them up. Right. So the delegation saves doctors time, reduces their stress. Now the DSO model, when that happens, team members get real nervous. boy.

They’re taking over a bunch of the accounting or bookkeeping or whatever. That means my job’s about to go bye-bye. In our model, because the doctors have full control over their practices, we can’t affect their hiring and firing. So our doctors have full control over clinical, first of all, like what services do they provide? What labs and supplies do they use? You know, that’s totally up to them. Their team employment, right? So hiring and firing of their team members, setting their pay and benefits, setting their work schedules, 100% up to the doctors, exactly like private practice.

Even the doctor’s own work schedules. A lot of times when you go to work for a DSO as a doctor, they kind of give you a work schedule. Not so with Icon. With Icon, our doctors again fully control their work schedules. They want to take a month off. They can take a month off, but they’re the owner of the practice, right? We’re their business partner. So I tell the doctors all the time, like, look, I’m not your boss, I’m your business partner, right? So we we control certain things on our side of the house. We’re gonna do the payroll and the banking and all these things that we have to do as part of being on a platform.

But they really it it it it looks, feels, and functions very, very much like private practice, with a few exceptions that we talk about when they join us, you know, some stuff that we just have to standardize and centralize. But other than that, it’s pretty a la carte. And so getting help is a big reason, just the power of a group, right? Negotiating power, better you know, pricing from supplies and labs, better reimbursements from insurance companies, ⁓ more more I guess access to technology.

Brett Allen (17:13)

Right. Yeah.

Ian McNickle (17:20)

So we have a technology team and they just can vet all kinds of different technologies. You know, when you’re a private practice doctor, you don’t have time to go out and research all the different softwares and technologies and things that are out there. You know, there’s so many. And the and the pace of new stuff coming out with AI is just crazy. And so our team can kind of analyze, vet, run pilots. And if something looks really, really good, then we can roll it out to the doctors and say, hey, we think you should use XYZ software because here’s what it’s going to help with. Now they don’t have to.

Brett Allen (17:29)

Sure. Yeah, there’s so many.

Ian McNickle (17:48)

They could say, no, I don’t want to. That’s fine, because it’s again, they’re they’re largely running the ship. But we can say, well, we’ve piloted this in five or ten practices. Here’s what’s happening. Here’s the results. We think they’re really good. And if you’re unsure about that, hey, why don’t you pick up the phone and call Dr. Smith and talk to her about, you know, her experience with using this or whatever. Right. So because the doctors are all business partners, right? And so

Brett Allen (18:05)

Yeah, yeah.

Ian McNickle (18:10)

A lot of the a lot of the the the benefit of this group has to do with with collaboration, with reducing their stress and workload. ⁓ there’s also a a financial component, right? With because we’re relatively small, I mean, today we’re only at 27 locations. We’re we’re pretty small compared to some of these Goliaths that are out there. But we’re we’re only been live a couple of years, right? So 27 locations in a couple of years, not not bad, but I think we’ve got a pretty healthy growth rate in front of us over the coming years. But ⁓ but we’re already big enough.

Brett Allen (18:26)

Sure.

Not bad. Yeah.

Ian McNickle (18:37)

even at our our limited size now to to offer some pretty good negotiating power and some pretty some pretty beneficial pricing and stuff like that for these practices. So it’s it’s been a it’s been a really good experience for the doctors because it’s kind of they get their cake and eat it too. They get the they keep the best of what makes private practice enjoyable, the culture, the control, run it how you want to run it, your your branding stays the same, but they get the best of what the groups can offer, which is the purchasing power, the expertise.

Brett Allen (19:01)

Sure.

Ian McNickle (19:02)

centralization of services, the potential upside financially, because if a group grows significantly ⁓ over time and may and can manages their debt properly, the doctors can have an extremely good financial outcome. Now there’s no guarantee of that. And there’s lots of ways groups screw that up. They they get way too much debt, they too much pay high interest rates, they pay too much cash up front. There’s lots of things groups do to ⁓ screw up the financial outcome.

Brett Allen (19:26)

To fund the deals there. Yeah.

Ian McNickle (19:29)

In some cases, not always. I mean, there’s been lots of doctors who’ve made lots of money in DSOs and DPOs, but more recently with with the higher interest rates after COVID, there hasn’t been a lot of great outcomes. And so doctors are like, well, you know, I don’t know. I don’t know if that stock’s really going to go up like that. And really what it’s a function of is, you know, the growth rate of the group. So if you’re 10 locations and you go from 10 to 20 to 30 to 40 to 50, that can be done in a couple, two, three years, right? But if you’re already a hundred locations to go to two to three to four locations, that doesn’t happen.

quick as quickly, right? So the growth rate naturally slows down as you get bigger. And so the return on the stock is just, it’s going to be less and less the bigger the thing gets, typically, right? ⁓ you know, if you’re if you’re these big boys over a thousand locations and there’s half a dozen groups now, they’re like a thousand locations or more, their growth rate is pretty slow compared to a little guy like us, right? So the stock potential, like when people join us, and I I don’t want to up play up, you know, play up the stock too much, but I just want doctors to understand

Brett Allen (19:58)

Yeah.

Yeah, right. Yeah we were talking about

Right.

Ian McNickle (20:25)

When you join a group that’s like below 50 locations, there’s still pretty significant upside on the stock potential, right? If the group’s growing at a decent rate, managing their debt properly, et cetera, et cetera. ⁓ the potential’s a lot much there’s a lot more upside potential in a group that’s in that situation versus a much bigger one, right? And that’s true of any company, right? I I tell this story sometimes and it’s it’s a true story and it it’s it’s funny, but it’s it kind of makes me cry. ⁓ so I graduated from Washington State in 1995.

Brett Allen (20:26)

Right.

Earlier on, yeah.

Ian McNickle (20:52)

Bachelor’s in Mechanical Engineering, one of my buddies graduated same year ⁓ degree in English. And he’s like, I don’t know what I’m gonna do. And he lived in Seattle. So he went to work for some company that was that was selling books out of a warehouse. And you might guess who that company was. And so I saw him eight or nine years later and he was retired. And so he was one of the early employees at Amazon. And he was just working in the warehouse, then he got promoted into management. And I saw him at a football game back in Pullman.

Brett Allen (21:05)

⁓ wow, yeah.

Yeah. That’s awesome. Yeah.

Ian McNickle (21:19)

And he’s Yeah, man, I’m retired. I’m like, you’re what? For 30. What are you talking about? You know? So yeah, I sold my stock. And and I, you know, and I knew that was insane, right? So he was one of the early employees at Amazon. So, like, you can go work at Amazon today, you know, 30 years later since they, you know, since they launched, and you can still make a really good income, have a great retirement, make a bunch of money on the stock. Like you’ll still do well if you go work at Amazon today. But the opportunity was much, much greater back in the 90s and early 2000s, right?

Brett Allen (21:21)

You retired? Yeah. Amazon.

Sure.

Sure.

It sure.

Yep.

Ian McNickle (21:47)

And it’s

the same with any company, right? Same with same with my company, same with if you would have joined Heartland, you know, back when they were 50 locations, well, now they’re like 1900 locations, right? You’d have rode that wave with them. And I I’ve met doctors who rode that wave and made a ton of money working at Heartland on their stock. But that was in the past, right? And so it’s it’s a function of like how big are they, the growth rate, the debt, all that stuff. So I I don’t get too much in the weeds. I try to explain to doctors at a high level how it works, but it just but I don’t I don’t ever promise returns like, hey.

Brett Allen (21:50)

Yep.

Yeah.

Yep. Yeah. Right.

Ian McNickle (22:15)

We think it’s gonna be pretty good. Can’t promise it, guarantee it.

Brett Allen (22:16)

Well, it’s g it’s gotta be a

value add to make sense. Yeah. And I and like you said, there’s a lot of great things about what you guys are doing that makes those who join your group you know, add that value. ⁓ so d do most of your practices I guess in a D PO they they’re they’re joining the organization, they’re staying in their practice, they’re not exiting. I guess that’s right. Yeah.

Ian McNickle (22:21)

Yes.

Yeah. It’s fun.

Yeah, yeah. Yeah. Most of

our doctors are very much mid-career. I would say 80% of our doctors are in their 40s and 50s, maybe 10% in their 30s and maybe 10% in their 60s and 70s. ⁓ so most of our doctors, yeah, they’re planning to work seven, 10, 15 more years or whatever. And so it’s we’re not an exit play. Like a lot of times a doctor will sell to a DSO. It’s like the end of the career. Okay, I got a few years left. I’m gonna sell to a DSO and get as much as I can, and then I’ll just hold my nose and just, you know, suck it up and deal with it and then leave is when I can leave.

Brett Allen (22:44)

Right. Right.

Yeah, exactly. Yeah.

I

I I recently had Bob Spiel on the show and we talked all about he’s he does the podcast Just Say No to the DSO. He talked all about how those the these deals are structured with these clawbacks, and it’s actually oftentimes way more profitable and better for the the practice owner to just work five years and exit selling to an another private dentist than to sell to the DSO. But yeah.

Ian McNickle (23:09)

That’s a terrible way to end your career.

It it can be. It it totally depends

on the structure. But you’re right. I mean, there’s earnouts, there’s clawbacks, there’s all kinds of ⁓ tricky things that they put in those agreements. And we don’t have those. We don’t have earnouts, we don’t have clawbacks like that. So it’s it’s a very fair and balanced kind of an approach. And so, but you’re right. I mean, you you definitely in some DSOs you would be better off staying in private practice, but in other cases you could make a lot more. It just really depends. ⁓ it’s very, very deal specific.

Brett Allen (23:34)

Right.

Right.

Yeah.

Mm-hmm. Yeah. Yeah.

Well, this has been fascinating. I mean, I I’ve got a bunch more questions for you. Maybe we should do a part two, but ⁓ we’re we’re about out of time. I always close the show with ⁓ what’s that gold nugget? What’s that one thing if we could help our listeners have this epiphany today would have a a ripple effect for them and a big impact for them? What what would you recommend?

Ian McNickle (24:02)

Sure.

Yeah, I mean, the thing that we see that generally drives the most performance growth over time is, and this is not rocket science, like this is something that’s that’s pretty common knowledge, but a lot of times it isn’t practiced. And it’s, you know, if you don’t track something, you’re not really going to improve it, right? And so what we encourage practices to and what we do with our practices also is like, what are the key performance indicators, right? Those KPIs that that you’re trying to improve. And it, you know, it could be.

Brett Allen (24:32)

Mm.

Ian McNickle (24:43)

It could be lots of things. It could be, of course, revenue growth and profits and margins. It could be those things. It could be cutting costs, but it could be employee satisfaction. It could be I I want to make as I’m a doctor. I want to make as much money as I did last year, but work 20% fewer days. Okay, well that’s a that’s a great goal. So let’s so set the goals, make a plan and then and then have a consistent kind of an ongoing accountability group, whether it’s other doctors you’re working with, whether if you’re part of a DPO like ours, our team obviously would work with our practices.

on regular basis, weekly and monthly, to help them implement these things. But I would say if people are really looking to drive performance in their practice, figure out what those what those metrics are, track them, and then develop a plan to improve them. There’s lots of great consultants and coaches out there who can help with those things. Or if you’re part of a group like ours, of course, we provide that that stuff in-house, but you don’t track it, you won’t improve it.

Brett Allen (25:31)

Yeah, I love that. What you focus on grows, right? ⁓ there’s so and this is this is why we started Marketing Thirty Two and focused in on dentistry back in twenty eighteen, was we saw a need, like you were talking about in the beginning, you saw a need in the market for a better group structure. We saw a need for better marketing in terms of what’s tracked, what’s actually driving revenue for the practice. And is the marketing company held accountable

Ian McNickle (25:53)

Yeah.

Brett Allen (25:56)

To the right leading metrics that are gonna contribute to growth. ⁓ I I think there’s a lot, there’s a lot of great dental marketing companies. ⁓ but there are a losso also a lot of fluff companies out there that focus on different metrics that aren’t really important to the practice, like how many engagement posts got, or how many followers you got, or what’s your ranking, and all these different vanity metrics that are important for marketing.

Ian McNickle (25:58)

Yeah.

Yeah.

Mm-hmm.

Brett Allen (26:23)

But are these really contributing to phone calls, bookings, and production, right? So we and I’ve said this on the show before, we have a a ⁓ practice management integration that ties all of that together so we see the full marketing equation from dollars spent to production. But yeah, I love that. What you focus on, it really matters. And are we focusing on the right things? Yeah. Yeah.

Ian McNickle (26:28)

Right.

Nice.

Yep.

Absolutely. Yeah, that that’s

that’s what I see. And that’s what any coach or consultant’s gonna help a practice do. So we do with our practices is we do a deep dive analysis and say, hey, doc, here’s eight or ten things we think we could really help to move the needle, but what do want us to focus on? So the doctor tells us, because we work for the doctor, right? So we say, hey, what do you want us to focus on? And they set the priorities and then that’s what what that’s what we work on. So it’s it’s a partnership. It’s cool.

Brett Allen (27:03)

Yeah.

Yeah. Well,

good deal. This was this has been fascinating, Ian. I know that you’re a w a wealth of knowledge and there’s way more we could talk about that goes into the administrative side of practices and and especially from a group perspective. I’m I’m sure there’s way more we could glean from you and I’d love to do a part two sometime. But thank you for coming on today. Thank you for sharing what you’ve shared and I really appreciate it.

Ian McNickle (27:17)

Yeah.

Sounds good.

Appreciate the time. Thanks, Brett.

Brett Allen (27:36)

So ⁓ I guess before we we go, do you have a place where people can go if they want to get in touch with you or if they w are curious about joining Icon? Like wh where should we send them?

Ian McNickle (27:48)

yeah, just go to our website, you know, icondentalpartners.com. It’s icon, right? So icondentalpartners.com. There’s a contact us button on there. There’s a little form people can fill out. they can just email me directly if they want to. It’s just E N I-A-N at icondentalpartners.com. So yeah, happy to chat with anybody if they have questions or just want to kick the tires and learn a bit more, happy to chat. So appreciate the opportunity.

Brett Allen (28:04)

Okay. Yeah.

Great. Yeah, we’ll put that in the show notes. But ⁓ again, thank you. This has been great, Ian. Thank you for coming on.

Ian McNickle (28:16)

Thanks a lot.

Brett Allen (28:17)

All right, everybody, until next time on the Marking thirty two show. Have a great rest of your day and a great rest of your week. Take care.