Solving for Dental Practice Profitability: How an $8M Multi-Location Owner Gains Clarity and Reclaims Control- Part 1
2026/02/02
Welcome back to the Shared Practices podcast for a high-stakes episode of Practice Underwater. Today, we sit down with a guest we are calling "Bob," a high-achieving owner who is currently navigating the complexities of dental practice profitability while managing an $8 million mega-group. Bob’s journey is a masterclass in rapid expansion, but as his revenue has soared, his focus has shifted toward the bottom line. This episode explores how an owner can reclaim control over their margins without sacrificing the growth that brought them to the top.
Bob’s story is a classic example of a successful associate to owner transition. After serving in the Air Force and spending a decade as an associate, he opened his own practice in 2015. For the first five years, he grew steadily at 20% per year, reaching roughly $2 million in collections by 2020. However, finding the Shared Practices philosophy during the COVID-19 pandemic changed everything. By implementing dental growth strategies like "retain, open, fill," Bob scaled his new patient numbers from 25 to nearly 90 per month.
Despite this incredible success, the primary focus of today’s conversation is dental practice profitability. With 17 operatories and a central leadership team already in place, Bob’s current EBITDA margin sits at approximately 8%—a figure he hopes to double. He joins Dr. George Hariri to perform a detailed "dental moneyball" diagnostic on his profit and loss statement. They break down his expenses category by category, from his impressively low 3% management cost to his slightly elevated staff compensation of 36%.
Through this transparent look at his numbers, it becomes clear that Bob’s dental practice management has been highly effective at building infrastructure, but requires fine-tuning to maximize returns. They discuss the "ugly duckling" phase of growth where the P&L doesn't always look pretty, but for Bob, that phase has lasted nearly two years. Now, he faces a critical turning point: should he continue with further acquisitions in dentistry, or should he pause to optimize his existing offices?
The episode also tackles the psychological side of the "10-year grind" and the exhaustion that can follow such a meteoric rise. Bob shares the unexpected lessons he learned from a smaller, "ready to grow" acquisition—namely, the beauty and simplicity of a highly efficient smaller office. This realization has led him to re-evaluate his path forward as he balances his entrepreneurial drive with the need for a sustainable lifestyle.
Whether you are just starting your journey or managing a multi-location group, this episode offers essential insights into maintaining dental practice profitability while scaling at speed. Bob’s willingness to share his "underwater" moments provides a roadmap for any owner looking to move from a clinical bottleneck to a true CEO. We analyze the dilution of fixed costs, the power of a centralized call center, and the discipline required to keep management expenses lean while the rest of the practice expands. Join us for this in-depth look at what it really takes to run a high-revenue, high-impact dental organization.
more