​​​Bob Spiel is a dental practice consultant and co-founder of Dentist Partner Pros with over 25 years of business experience, including serving as a hospital and surgical center CEO before entering dentistry 17 years ago. With a mission to build high-performance practices that deliver exceptional service while doing more in less time with less stress, Spiel has transformed general and specialty practices by building leaders at all levels. His firm specializes in associate placement with an 85% success rate, dramatically outperforming the industry’s 75% failure rate. Beyond practice consulting, Spiel has become a vocal advocate for independent dentistry through his podcast “Just Say No to the DSO,” where he and financial analyst Nate Williams expose the predatory practices of private equity-backed dental service organizations and educate dentists about the hidden traps in acquisition offers.

Here’s a glimpse of what you’ll learn:

• [01:31] Bob introduces himself and how dentistry found him through consulting connections
• [03:06] The foundational elements of leadership, teamwork, and systems that make practices successful
• [04:45] Why dental schools don’t teach business management and the “half brain undeveloped” problem
• [05:15] The concept that “dentistry is first a behavioral art, then a clinical science”
• [07:15] How associate relationships are like marriages and the 75% failure rate that shocked him
• [08:14] The premium service approach that achieved an 85% success rate in associate placements
• [12:22] Recognizing the private equity takeover pattern from his hospital CEO experience
• [14:25] The four-step private equity playbook: consolidate, jack up prices, strip costs, harvest cash
• [16:02] Launching the “Just Say No to the DSO” podcast to wage a “guerrilla war” against corporate dentistry
• [18:54] Why financial analyst Nate Williams has never found a single pro-dentist DSO deal in over 100 reviews
• [27:26] The shocking reality: burning down your practice after 5.5 years leaves you better off than selling to a DSO

In this episode…

Feeling tempted by those multi-million dollar DSO offers flooding your inbox? Many independent dentists are being courted by private equity-backed dental service organizations promising generational wealth, stress-free practice management, and the ability to “just focus on dentistry.” But what if these seemingly generous offers are actually sophisticated traps designed to extract maximum value from your life’s work while leaving you worse off than if you’d simply continued building your own practice?

According to Bob Spiel, veteran business consultant and co-founder of Dentist Partner Pros, the private equity takeover of dentistry follows the same destructive playbook used in medicine, veterinary care, and other service industries. Through his podcast “Just Say No to the DSO,” Spiel and financial analyst Nate Williams have reviewed over 100 DSO acquisition offers and found that not a single one truly benefits the selling dentist. The typical deal structure involves massive upfront numbers designed to create “foggy-eyed” decision-making, but the fine print reveals clawback clauses, production requirements, and equity promises that essentially amount to working five years to pay back money you thought you’d already received. Spiel’s analysis shows that dentists would literally be better off burning down their practices after 5.5 years than selling to a DSO and working under their terms.

In this episode of The Marketing32 Show, host Brett Allen interviews Bob Spiel about the hidden dangers of DSO acquisition offers and the broader private equity assault on independent dentistry. They explore the four-step private equity playbook, why 75% of associate relationships fail in traditional hiring versus Spiel’s 85% success rate, and how DSOs are buying influence through dental schools, trade publications, and industry events. Spiel shares his mission to educate dentists about maintaining independence while building successful practices through proven leadership principles, strategic associate hiring, and surrounding themselves with quality service providers rather than selling their life’s work for empty promises.

Resources mentioned in this episode:

• Brett Allen on LinkedIn
• Marketing32 – Performance-based dental marketing with growth guarantee
• Bob Spiel on LinkedIn
• Spiel Consulting – Leadership and practice management consulting
• Dentist Partner Pros – Associate recruitment with 85% success rate
• Just Say No to the DSO Podcast – Education about DSO deals and private equity
• Practice Financial Group – Nate Williams’ financial analysis firm
• Morgan Hamon episode – Previous episode with EAG Dental Advisors mentioned
• Bob Spiel Direct Contact – 208-520-6900 for text messages

Quotable Moments

• “Dentistry is first a behavioral art, and then it’s a clinical science… it’s behavioral art that allows you to practice the clinical science.”
• “Great associates are amplifiers, because they amplify the good. Everything that’s good in your practice gets better when you’ve got the right person. But if you’ve got the wrong person, they’re equally an amplifier.”
• “You could burn your practice down literally at five and a half years and be just as well off as if you’d sold to the DSO at year one… because by the time you look at the clawbacks, by the time you look at reduction in your pay, what they’re doing is they’re giving you five years worth of income now, and then you’re working to pay that back.”
• “Without a dentist in dental practice, there is no dental practice… Why would you sell the work of your hands to somebody else? If you were a master painter, why would you sell your hands to someone else?”
• “There’s been this marvelous fusion between quality and financial gain in dentistry for decades… But it’s because the dentist’s name is on the door. And their reputation is everything to them.”

Action Steps

1. Educate yourself about DSO deals by listening to the “Just Say No to the DSO” podcast and understanding the private equity playbook before making any decisions
2. Focus on building leadership skills and systems within your practice rather than seeking external corporate solutions to operational challenges
3. Surround yourself with quality service providers (marketing, accounting, legal, HR) who can provide DSO-level support at a fraction of the cost of selling equity
4. If considering associate hiring, use a systematic approach that treats the relationship like a marriage rather than a typical employment arrangement
5. Take responsibility for practice growth and accept that while dentistry is stressful, you can achieve your goals through smart leadership and strategic partnerships while maintaining ownership

Sponsor for this episode…

This episode is brought to you by Marketing 32, the only dental marketing agency with the Practice Impact Formula™ for predictable growth without financial risk.

With a focus on new patient generation, addressing missed opportunities, and expert scheduling, Marketing 32 has helped over 170 practices in the US, Canada, and Australia. Grow in 30 days, or you don’t pay — it’s that simple.

To learn more, visit marketing32.com and schedule a 15-minute discovery call. If you’re a visionary practice ready for impact, Marketing 32 is ready to help you grow!

Episode Transcript:

Brett Allen (00:03)
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. As you know, we talk all about how 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 that is truly backed by our performance guarantee of if you’re not growing, you don’t pay us. We are really invested in your growth. So if you need help with marketing, grow in your practice.

Reach out to us at Marketing32. Let’s hop on a quick call, see if we’d be a great fit together. Quick shout out to Morgan Hammond at EAG Dental Advisors. We had him recently on the show, talked all about accounting and finances and what you can do to grow your practice and what metrics you need to be at from a financial standpoint in each area of your practice. Check out that episode. Super excited to have Bob Spiel on today. Bob is a new friend of mine. ⁓ He has a mission.

of building high-performance practices that deliver exceptional service with doing more in less time with less stress. His firm, Spiel Consulting and Dentist Partner Pros, transformed general and specialty practices by building leaders at all levels with a special focus on building leaders among owners and associates. Bob had over 25 years of business experience before getting into dentistry, including being a hospital and surgical center CEO.

Bob, welcome to the show, excited to have you on.

Bob Spiel (01:31)
Thanks Brett for to be with you.

Brett Allen (01:33)
Yeah, we had a good conversation with Brighton. Brighton is the CEO at Dentist Partner Pros. If you go back and listen to that episode, we talk all about what you guys do there and how you guys help find associates. But let’s talk about you specifically and how you got into dentistry and what you were doing before and how that ties into Dentist Partner Pros.

Bob Spiel (01:46)
You

Yeah, thank you. How I got in, you know, there’s a phrase that I heard years ago, there are two ways to get in dentistry, either dentistry finds you or you find it. And dentistry found me when I was consulting as a ⁓ medical and mental health consultant. Just happened to have a friend of a friend who knew a guy who’d been in dental consulting for 35 years. He wanted to sell his business. ⁓ I didn’t buy it from him, but he mentored me for a couple of years. The gift that Larry Winterstein though gave me.

was he helped me see dentistry from the outside in, okay, and understand the elements of leadership and teamwork and team building and patient service and excellent communication and really tight systems, okay. Not only work in dentistry, but they make money, they take away stress and they help everything run smoother and ultimately every person, the dentist, the team, the patients all have a better experience.

And Brett, these are all things that I love. They’ve been passions of mine in business since I started when I was in my early twenties. And once I saw that lens, man, I shifted everything away from what I was doing to dentistry. And that was 17 years ago and I haven’t looked back.

Brett Allen (03:06)
you

Yeah, you do a lot with like leadership. I know you talked about processes and when we met at the AID conference, you were talking a lot about leadership and team building.

Bob Spiel (03:16)
I do. Yeah.

Because

it’s the fountainhead, you know, and sadly where I came from in medicine and especially like with hospitals and surgical centers, you’d expect things like teamwork would be really valuable and matter. Sadly, they don’t. Okay, medicine is such a really broken culture and environment that once I found dentistry, was like, I made for this and I’m going to say goodbye to medicine.

Brett Allen (03:27)
Yeah.

Yeah.

Bob Spiel (03:50)
I’ve consulted a little bit in the medical space, but 98 % of my time is in dentistry and I love it.

Brett Allen (03:56)
Yeah. And I think maybe it goes back to the fact that in dental school, don’t, they don’t, there’s no, there’s no business management or team aspect to that. It’s all clinical, right? I don’t think they talk about marketing. They don’t talk about internal processes of, of a practice, right?

Bob Spiel (03:57)
Yeah.

you

No, they don’t. Plenty of reasons why. My estimation is because the faculty, A, doesn’t understand those subject matters and B, for licensing purposes, there’s no reason to train on it. And even really, really great schools like Midwestern and Glendale, Arizona has Gary Tackett’s come in once a week teaching practice and management, and it still doesn’t matter. And it’s not a rub against Gary. It’s because there’s no context.

Brett Allen (04:18)
Yeah.

Yeah.

Yeah.

Yeah, it’s not.

Right.

Bob Spiel (04:45)
Okay, so content without context is confusion. And so these students are listening, but they’re not absorbing because they don’t have a frame of reference to understand what he’s teaching. And then they get out into private practice. And the way I put it is that they come with half their brain undeveloped, but it’s the half that’s going to either make or break them. Or the way Larry Winterstein used to put it is dentistry is first a behavioral art, and then it’s a clinical science.

Brett Allen (04:48)
Hmm.

Yeah, that makes total sense.

Hmm.

Yeah.

I like that. Yeah.

Bob Spiel (05:15)
which is

such a great, great point because it’s behavioral art that allows you to practice the clinical science. And the better you are at being able to convert those patient needs into wants, the busier you’ll be, the more service you’ll deliver, the more you’ll receive in the end as well. And everybody’s optimized, but it comes down to behavioral art with patients and also with the team, you know? So that’s where leadership and team building are so valuable components of dentistry that…

Brett Allen (05:23)
Hmm.

Yeah.

Bob Spiel (05:45)
really

work in this environment.

Brett Allen (05:48)
Yes, it’s those intangibles, right? So you saw this opportunity in dentistry. How did you then niche into associates and dentist partner pros and what you guys are doing there?

Bob Spiel (05:54)
Yeah.

Yeah, great question. as you help practices grow, then they run into a problem. And the problem is always one of, I need another one of me. How do I do that?

And so I’d say 15 years ago, one of my clients was growing gangbusters down in Twin Falls, Idaho. And he was saying, you know, there was only so much of me to go around. How do I do this? I had hired in other careers, a thousand people, you know, I used to run some really large operational divisions back in the nineties. And so hiring was something that was kind of innate to me. And then I started bouncing ideas off of people that had been in the industry a long time.

The thing that floored me was this quote from my dear friend Linda Miles, that 75 % of the time, associates fail in a dental practice. And my jaw hit the floor like I can’t believe that. I’ve never seen even that bad in medicine. How can it be that bad in dentistry? Well, unpeel the onion a little bit and you realize a dental practice and the relationship at the executive level of the dentist is one of the most unique executive.

Brett Allen (06:53)
Right.

Hmm.

Bob Spiel (07:15)
environments around. It’s like two executive chefs being in the same kitchen is one of the analogies I use, you know, and either they’re going to get along really well, or it’s going to be combustible, but there’s nothing in between. Okay, so what I what I really figured out was, listen, this is more like a marriage than probably any other relationship out there. So if it is, because it got to fit culturally values with how they view with money, how they communicate all these other things.

Brett Allen (07:19)
Mm.

Yeah.

Bob Spiel (07:44)
then let’s treat it like that and then kind of become mash.com for dentists. And that led to the whole launch of Dentist Parker Pros. I’ve been hiring in my own business for about 10 years. then Brighton is a really great mind. about four years ago, five years ago, we said, we ought to look at this and make it something available for everybody and not just for your clients. And I said, let’s do it. Yeah.

Brett Allen (07:49)
Yeah, that’s cool.

Yeah.

Bob Spiel (08:14)
So we’ve

hired probably about 100 associates over that time. And we’ve got an 85 % success rate, which is vastly different than a 75 % failure rate. Yeah, and it’s because the process works if you handle it correctly.

Brett Allen (08:22)
That’s great. Seven-Hour Failure, yeah, for sure. Huge swing.

Right, and we talked a little bit about that with Brighton. We went into what your process is like and how you guys match dentists. You guys should definitely, if you’re listening, go back and listen to that episode if you’re in the market for an associate trying to make that step in your practice. So you saw this need. You figured out, hey, I can leverage my skill set in making an impact in the industry. That’s really awesome.

Bob Spiel (08:36)
Right.

So.

Right?

Right,

right. And so, you know, some of the social confirmation of what we’ve been doing now is, and Brighton probably brought this up, we’ve got affiliate relationships with quite a few marketing firms like yours, because again, if it works, they grow, and if they grow, they got a problem. And that is how do I have more of me to go around, because I can’t work like eight hours or eight days a week. ⁓ Although the Beatles made you think you could, but you know, in reality, you can’t. So,

Brett Allen (09:10)
Mm-hmm.

Right.

Right.

Yeah.

Bob Spiel (09:28)
You know, we’ve got relationships with Benco and with Burkhart and we just signed the Seattle study club. So, you know, there’s some really good momentum going on and we’re super proud of these relationships, but it’s because there’s nobody else approaching it the way that we are. It’s a premium service. Okay. Some dentists hear the price and they gasp they go, I can’t believe it’s going to cost that much because I can spend a third of this and, know, and think I’m getting the job done. Well, you can either.

Brett Allen (09:36)
Great.

Yeah.

Yeah.

Bob Spiel (09:57)
you know, the phrase back in the day with Midas, you can pay me now or you can pay me later. Okay, yeah, you can do the cheap route. But the cheap route has yielded the 75 % failure rate. Okay, and how many times you have to do that to get it right? Or can you spend once and then have a 5x return on your money? And, you know, one of the observations Brighton made in this whole process was, know, Bob, I finally realized

Brett Allen (10:01)
Yeah.

Right?

100%.

Mm-hmm.

Bob Spiel (10:25)
Great associates are amplifiers, because they amplify the good. And everything that’s good in your practice gets better when you’ve got the right person. But if you’ve got the wrong person, they’re equally an amplifier. And everything that’s bad gets worse. So yeah, so ⁓ nothing good is cheap, and nothing cheap is good.

Brett Allen (10:38)
Right, right, I remember it, ⁓

Yeah, I can speak to that all day long in the marketing space in dentistry. There are these companies that are the lower end budget, the budget approach of, let’s just spend a few hundred dollars a month on your marketing, and we’re going to do all these things. And it’s like, well, what really are you doing? And how much is it moving the needle? There’s a philosophy there that we’re tapping into that I think.

Bob Spiel (10:52)
See

Yeah.

Exactly. Yes.

Let’s go.

Yeah.

Right.

Brett Allen (11:13)
really impacts a lot of things just in business, not just dentistry. But I think the more you recognize you get what you pay for, in the long run, it’s actually probably cheaper to go with you when you consider time, stress. It’s cheaper to go with. Yeah.

Bob Spiel (11:18)
for sure.

I’m sorry.

It is. It is. Well, and just

like you’ve got a guarantee, we’ve got a guarantee. Our guarantee is, if somehow we got it wrong and we’re at that 15 % mark of, oh man, how did we miss that? We’ll go out and find the next one for free. Okay. So yeah, so we’re super confident with our systems and the other need.

Brett Allen (11:36)
Right. Right.

Yeah, yeah, I love it. I love it.

Bob Spiel (11:55)
that I really figured out after a couple of years in the industry was, and to provide a little bit of context, I mean, when I was a hospital CEO some 20 years ago, I noticed that there was this drive towards corporate roll-ups. Okay. And I got out before the Affordable Care Act was passed, but that actually really accelerated the whole thing of physicians becoming hospitalists.

Brett Allen (12:10)
Hmm.

Hmm.

Hmm.

Bob Spiel (12:22)
and

hospitals merging in this whole effort towards getting bigger, because the government was kind of sucking, if I can use that phrase, everything into this vacuum that they’d created with the ACA, demanding that you become part of a bigger organization. So I noticed that was happening in dentistry back in the 2010, 2015. DSOs are kind of a little thing, but they weren’t all that big. And then all of sudden, bam, there was all this free COVID cash floating around.

Brett Allen (12:38)
Hmm

Yeah.

Bob Spiel (12:52)
You know, remember we were like floating in money after we’d recovered and man, were just government largesse was everywhere, you know? Well, money finds money. And so suddenly these DSO groups, PE groups in particular, private equity groups found sit on mountains of cash saying, well, man, we gotta go pick up dental practices, okay? So it reminded me of what happened after the ACA and Obamacare.

Brett Allen (12:52)
Yeah.

Yeah.

Hmm.

Bob Spiel (13:21)
Well, fast forward almost 20 years, if you know any physicians that are in medicine now, they hate their lives. It’s a rough industry. They are now indentured servants. And yeah, there were some early on benefited from it, but they’ve really sold their whole profession to the lowest bidder now. ⁓

Brett Allen (13:25)
you.

It’s a rough industry, yeah.

Bob Spiel (13:50)
But this is what happens in corporate roll-ups, and in particular with private equity. The private equity game can be described in four simple steps. Consolidate an industry. Okay, till you reach a tipping point, doesn’t have to be all. But if you can get a third, then suddenly you’ve got this massive amount of volume that starts to steer everything in their direction. So consolidate an industry, jack up,

Brett Allen (14:07)
Mm-hmm.

You got a strong on it. Yeah.

Bob Spiel (14:19)
prices, strip out cost, and harvest cash.

Brett Allen (14:25)
Hmm.

Bob Spiel (14:25)
Okay,

that’s their game right there. Okay. ⁓ And I challenge anybody who’s listening to this that is in the DSO space. Can you name me one service industry that’s gotten better because of private equity involvement? Okay. I don’t know of any. All right. I’m in the, today they’re buying out plumbers. They’re buying out HVAC companies. They’ve already wreaked havoc in, you know, the veterinary space, et cetera. And the game.

Brett Allen (14:38)
because the SR.

Bob Spiel (14:55)
that the game plan is still the same. So as I saw this roll up start to happen inside dentistry, in particular after 2021, it was kind of like, man, dentists are great decision makers if they have the right information. Okay, well, if that’s the right information, they don’t make good decisions. And there’s this whole FOMO thing going on and dentists telling the dentists and finally decided, you know what?

Brett Allen (15:21)
Yeah.

Bob Spiel (15:25)
We may not be able to fight them head to head, but we can wage a guerrilla war and start a podcast. So I reached out to very good friend of mine named Nate Williams, who runs a fantastic financial and financial accounting group, okay, out of Medford, Oregon called Practice Financial Group. And Nate’s out of the same cloth as I am. ⁓ He used to work for Kane Waters. He saw kind of their whole…

Brett Allen (15:32)
Mm-hmm.

Bob Spiel (15:53)
thread towards these bigger and bigger groups. And he said, we got to do something. So we started a podcast, much like you have called Just Say No to the DSO. Okay. Yeah. Yeah.

Brett Allen (16:02)
Yeah, I’m glad we’re going this route with the show today, talking about

it. You exposed this to me at the AID conference, which is perfectly up with what they were talking about, Alliance of Independence. I had no clue that this was actually happening in the DSO space, and that dentists are unaware of some of the traps and some of the challenges with all of this.

Bob Spiel (16:10)
What the?

Yeah. Mm-hmm. Yeah.

Mm-hmm, yes.

Mm-hmm.

Very, very unaware of the traps and the challenges. And their challenge is this, Brett, because the DSOs, because of the private equity groups that are really behind, they’re the odds behind the curtain, okay? ⁓ Massive amounts of cash. And so what have they done with the cash? They’ve bought off the industry magazines. They’ve bought off the trade shows. They’re buying off the dental schools.

Brett Allen (16:31)
Yeah.

Yeah.

It’s

Bob Spiel (16:58)
In fact, they’ve already launched a dental school at High Point University. That is purely for that DSO. Okay. Heartland Dental started that. And by the way, they have no entrance requirements.

Brett Allen (17:03)
⁓ interesting.

Interesting.

Everybody gets in.

Bob Spiel (17:17)
I don’t think everybody gets in, but it’s kind of like, man, if you’re willing to pay us the money, we’ll push you out there. We’re very happy to take your half a million bucks, push you out there and then work for us, okay? So Nate and I launched this podcast, we’re now in season three and we’re doing everything we can to try to peel the curtain back and expose the fact that

Brett Allen (17:19)
But it’s.

You’re in.

Bob Spiel (17:44)
The offers that they’re providing are not what they say they are. And that their job really is to make you think you won the lottery, when in reality, they’re gonna take your practice for nothing. Okay, now Nate is one of the best analysts I’ve ever worked with. I’ve got an MBA, I know how to analyze stuff. Man, Nate eats numbers for lunch and dinner. Okay, the guy is brilliant. And he’s reviewed over 100 DSO deals, because…

Brett Allen (17:54)
Hmm. ⁓

Bob Spiel (18:11)
Once these things all started, he’s got about 350 clients at PFG, all right? And all of them got offers, okay? Not all of them took them seriously, but there were enough that did that they’d knock on his door and say, Nate, would you please review this? Because man, it sounds amazing, you know? They want to give me 25 million bucks for this practice. I can’t believe it. I’ve got everything in front of me, generational wealth, my kids are taken care of.

Brett Allen (18:28)
Yeah.

Bob Spiel (18:38)
all the stress I’ve had as a dentist, boom, you know, I just won the lottery. Would you please review this and tell me if this valid, all right? And Brett, he’s never found one that was pro dentist.

Brett Allen (18:42)
Yeah.

⁓ man, in the fine

Bob Spiel (18:54)
Not

one. In the fine print, exactly. And that’s where the devil is in the details, okay? What their hook is, is they want to give you really massive number. And that number is so big that you kind of get foggy-eyed. You know, I liken it to showing up at this cocktail party. Okay, and you’re a married guy or a married gal, the most handsome man or most gorgeous woman in the world comes up to you, you know, and starts to come on to you. And you’re like, I can’t believe this is going on. And suddenly you lose all sense. Well, that’s what that number…

Brett Allen (18:58)
Yeah.

Yeah.

Bob Spiel (19:24)
that the PE groups and the DSOs are trying to create for you is a sense of, you know, just losing all ration whatsoever to then say, mm-hmm.

Brett Allen (19:29)
Amen.

Yeah, remember you talking about that. You’re talking about

in your presentation, these clawback clauses that they put in. Like, first off, they require you to stay for so many years. They require you to hit so many certain numbers.

Bob Spiel (19:44)
Five years typically now, yeah.

So many

minutes. Yep, that’s right.

Brett Allen (19:50)
Yeah, and then there’s

these things that if you’re not hitting those, then it’s like, well, boom. Yeah.

Bob Spiel (19:56)
Yeah, or by the way, if we just find something that you may have done wrong, or there’s this charge over here, like Nate actually knows of somebody who got charged with sexual harassment, okay? The guy got fired and he lost all his equity, okay? And you consider also the fact, Brett, that you signed these agreements with non-disclose, non-disparagement, and non-competes, okay?

Brett Allen (20:08)
⁓ yeah, heard about that.

Yeah.

Bob Spiel (20:25)
So what this means is you can’t open up shop in the same time you’re working in. You can’t talk about what actually happened or they’ll sue you, the pants off you. And the other piece is, I would say non-compete is not as close, not as disparaging. Okay. So you basically have to just go someplace else. your host, that guy is like totally, totally messed up. Okay.

Brett Allen (20:33)
Yeah.

Yeah. You’re a host, yeah. Yeah.

Yeah.

Bob Spiel (20:55)
And there’s no mystery to this. This is the private equity game. All right?

Brett Allen (21:01)
You would think like, yes, private equity, it’s all about the money. Money comes in, they’re trying to be profitable and they’re just seeing a way to take the cash grab. But you gotta think there’s somebody with ethics in there, somebody that’s like, okay, yes, we got it. Yeah.

Bob Spiel (21:06)
Mm-hmm. Yeah.

Well, and there may be, but

here’s the problem. That even if somebody enters into this with ethics and I could name the name of one DSO, okay. That really started with great intent a few years ago. Here’s the issue. They got bought out. And then the next PE guys in line know nothing about dentistry. They kick the people who know something about dentistry. Okay. And.

Brett Allen (21:32)
Yeah.

Bob Spiel (21:46)
And suddenly you’re back in the same bed as you hoped you weren’t going to get in. Okay. It’s like a good friend of mine who’s not a dentist. actually owned a company that sold to Walmart and Michael’s and you know, all these craft stores found a fantastic PE group that he loved out of out of Salt Lake City. Really good synergies with them, respected the family name behind it, et cetera. Spent a year with them. It was excellent. Boom. What did they do? They sold to another PE group.

Brett Allen (21:51)
Hmm, yeah.

Mm-hmm.

Mmm. So you never know what’s coming. Yeah.

Bob Spiel (22:17)
And

within six months, he said, I quit. I know I’m giving up 4 million bucks, but I’m out of here. Because I want out because I can’t stand to work with you guys. here’s the other rub is not only, and this is the fifth leg of the PE strategy. Okay. It’s not just consolidate, jack up prices, strip out cost, means peel people out. Okay. Or get junior associates in, in dental practice who are just a turn, you know,

Brett Allen (22:24)
because I won out. wow.

Bob Spiel (22:47)
⁓ just a turnstile, okay? And then turn it into a mill, but the fifth leg of this is now sell to somebody else. Okay, and this is hold this recap idea. And that’s where the DSOs and the PE groups are so hot on giving this massively big number because the big number is in equity. Okay.

Brett Allen (22:48)
Mm-hmm. Yeah, turn and burn.

They’re getting a steal, yeah.

Bob Spiel (23:13)
Yeah,

yeah, so, you know, they’ll give you today it used to be about 50 50 maybe 60 40 40 in cash 60 in equity as Money is no longer free That number is keep getting smaller and smaller and smaller. So today is like 25 % Maybe 30 % is in cash. The rest is in equity Okay, but the reality is that equity is just a promise

Brett Allen (23:30)
Mm-hmm.

Yeah, until it’s realized you don’t have, yeah.

Bob Spiel (23:38)
until it’s realized, yeah, you know, and

here, I wish I was making this stuff.

Brett Allen (23:45)
It’s hard to believe, right? But yeah, but well, we and we were we were talking about before the show. It’s not just an exits where you get this big this big offer that makes your eyes glaze over like your saying, but also in these groups that are positioning themselves as like, hey, be part of our group or we have this support infrastructure you can tap into will integrate your practice. You still own your practice.

Bob Spiel (23:45)
I really do. It is, I know. I really wish I was making this stuff up.

Yeah, it’s growing.

Hmm.

Brett Allen (24:14)
but you get access to all the amenities of a bigger corporate group. You’re seeing the same kind of things happening. You’re seeing the same kind of, ⁓ ultimately, those deals go sour.

Bob Spiel (24:18)
Mm-hmm. Right.

Mm-hmm. Well…

Well, they do. And here’s the reality, because they make this claim that we will allow you just to practice dentistry and we’ll do the rest. Okay? I’m sorry. But when you are the dentist in the dental practice, you’re the person that your team’s gonna go to. You know, you’re the leader. All right? ⁓ You’re the leader. So it’s a nice hook.

Brett Allen (24:48)
You’re the employee, yeah.

okay.

Bob Spiel (24:58)
but it doesn’t work, it’s not real, okay. ⁓ So.

Brett Allen (25:02)
⁓ So what

kind of recommendations can we give our listeners? Those that are in these positions, they’ve either gotten a good letter, yeah.

Bob Spiel (25:07)
Yeah, yeah. Thank you. First and foremost, educate

yourself and educate your friends. You know, ⁓ why, what, just say no to the, number one thing, just say no to the DSO. And our payback, because Nate and I fund this personally out of our businesses. Okay. We don’t have any sponsors. We don’t have anything. paying to get this out there. ⁓ So our payback really bread is when we get.

Brett Allen (25:18)
Just say no to the DSO. Probably great. Yeah.

Bob Spiel (25:35)
conversation or email from somebody saying, you know, I tore up the offer, or I’ve just decided to go off on my own, you know, and chart another path. But yeah, number one, just, know, the DSO become educated, educate your friends, don’t take the hook, don’t believe the lines, but then accept responsibility for your practice and realize, you know, it is a stressful job.

Brett Allen (25:39)
Yeah.

Mm-hmm.

Bob Spiel (26:04)
Every job in America today is stressful, all right? But through license and talent and ability, you can continue to grow your practice, grow your leadership talent, expand your marketing, hit your goals, all right? The old fashioned way, which means you just buckle down and do it smartly, okay? Find great people to surround yourself with, I think is actually one of the biggest keys of all.

Brett Allen (26:22)
Mm-hmm.

Bob Spiel (26:30)
Because again, they promise, you know, we’ll do marketing, we’ll do HR, we’ll do legal, we’ll do this, we’ll do that. You can find folks that can do that really well for a heck of a lot cheaper than selling 51 to 60 % of your practice. Basically for nothing, okay? Because here’s the rub that Nate found is you could burn your practice down literally at five and a half years and be just as well off as if you’d sold at the DSO at year one.

Brett Allen (26:43)
me.

I remember you showing this,

Yeah.

Bob Spiel (27:01)
And

kept working, okay? Because by the time you look at the clawbacks, by the time you look at reduction in your pay, by the time you look at all these guarantees that they have, but they’re all attached to different ⁓ multiples that have to hit or benchmarks you have to hit, what they’re doing is they’re giving you five years worth of income now, and then you’re working to pay that back.

Brett Allen (27:25)
Yeah.

Bob Spiel (27:26)
Okay, and that’s the difference between what they’re paying you and what you would have paid yourself. So that’s the number right there that you’re paying it back. If you just work for six more months, you’d be better off. And you own your practice, you can continue to grow it, you can actually sell it now for what it’s worth, all right, instead of for promises. And you chart your own course. So Nate and I put it this way, own the work of your hands.

Brett Allen (27:38)
Hmm.

Yeah.

Bob Spiel (27:54)
Why

would you sell the work of your hands to somebody else? If you were a master painter, you know, why would you sell your hands to someone else? Without a dentist in dental practice, there is no dental practice. Okay, yeah.

Brett Allen (28:04)
Yeah, it’s a great analogy.

⁓ Yeah. Well, and so much

of it is the doctor-patient relationship and relationship with the team. And these DSOs are going to come in and probably say, you’ve got to fire this person. You got to hire this person at a lower rate.

Bob Spiel (28:15)
Good thing.

⁓ yeah, yeah. And not

only that, but they’ll start to give quotas. And, you know, have a 27 year old MBA tell a doctor who’s in his 50s, okay, I need so many crowns today from you. Okay. And, you know, that’s not anecdotal. That happens. All right. It does. And it’s because, see, the way I look at it is this, Brett, that there’s been this marvelous kind of fusion between quality

Brett Allen (28:26)
Yeah.

Yeah,

And then, yeah, that happened.

Bob Spiel (28:51)
and financial gain and dentistry for decades. But it’s because the dentist’s name is on the door. And their reputation is everything to them. Okay? And it’s also a highly competitive environment. So they know they’ve got to deliver really great results. And the best dentists that I know of, and not only train their eyes and their hands, but they believe that, you know, if I do good work, and I’m smart, the dollars are going to take care of themselves. All right?

Brett Allen (28:58)
Mm-hmm.

Mm-hmm.

Bob Spiel (29:19)
But this trade-off has happened very successfully to the point where frankly…

Brett Allen (29:23)
It’s starting to affect everybody, yeah.

Bob Spiel (29:25)
Well, and there’s hardly no problem that a patient can show up with it. A dentist can’t either solve themselves or refer to somebody else. Okay. But now you throw instead of this, this goal of making money.

Brett Allen (29:33)
Mm-hmm.

Bob Spiel (29:41)
And it changes the entire reason you’re there. It changes the entire focus, the efforts. Everything is now money driven. All right. And not that money is bad. I personally think money’s great. But if it’s done with the right reason and it’s not the reason, it’s not the mission, it’s like Simon Sinek said, profit is always a result. It’s a byproduct. Okay. ⁓

Brett Allen (29:45)
Money changes everything.

Byproduct. Right.

Bob Spiel (30:09)
but when it becomes the God.

Brett Allen (30:12)
Hmm.

Bob Spiel (30:13)
then everything changes. And sadly, that’s what PE does. You can’t tell me otherwise. Stephen Covey taught this years ago, you get what you reward. Okay. And if the reward is financial gain and money and especially money to be siphoned off to send to the PE group, what are they gonna focus on? Production and, you know, full speed ahead?

Brett Allen (30:15)
Yeah.

Hmm. ⁓

down.

Yeah.

Bob Spiel (30:42)
Dan

the torpedoes, we’ll just keep going on. So that’s why I’m passionate about this, because not only is associate hiring something that’s a weakness we have in the industry, but there’s a big hole that’s been blown in the boat of dentistry, and that’s by DSOs. We’re trying to save that and solve it. One practice at a time.

Brett Allen (30:46)
Yeah. Yeah, this is…

Yeah.

I’m glad we… Yeah, thank you so much.

Thank you so much, Bob. This has been awesome. I’m glad that the conversation went this direction. I know this is a big part of what you’re doing and giving to the industry. ⁓ Where can people go to connect with you? What are your next steps? What are you…

Bob Spiel (31:16)
Thanks, great. ⁓

First, Justin out of the DSO. You ⁓ can hear Nate and I ad nauseum. ⁓ I always laugh and people say, man, I’ve listened to everything twice. I’m like going, really? Yeah, people binge listen to it. One guy said, man, I listened to the whole thing coming back from Europe. ⁓ But that’s the first way. ⁓

Brett Allen (31:20)
Okay, that podcat.

wow. ⁓

well.

Bob Spiel (31:42)
You know, they can reach out to me at Bob at SpielConsulting.com. And that’s spelled S’s and Sam, P’s and Peter, I-E-L, consulting, all one word.com. Or frankly, Brett, I don’t mind. I mean, I love this industry and I love working with dentists. They can text me as well. Okay. At 208-520-6900. But anything we can do to help dentists, you know, really control their future and keep this industry.

Brett Allen (31:58)
Awesome.

Awesome, we’ll put all that.

Bob Spiel (32:13)
as I think the best part of healthcare that’s out there, but keep it independent and growing. All right? Yeah.

Brett Allen (32:17)
Yeah, yeah. We’ll put all of

that in the show notes so you guys don’t have to worry if you’re driving. Don’t worry about writing it down. You go to our website, you get all this info from Bob there. Thank you again, Bob, for coming on. Thank you for the great conversation and the work you’re doing. It’s been great. All right, everybody, until next time on the Market32 Show, have a great day.

Bob Spiel (32:31)
Yeah, you’re welcome, Brett. Thank you.