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The Dental Boardroom

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Rating
★★★★★
5
from
39 reviews
This podcast has
169 episodes
Language
English
Publisher
PracticeCFO
Explicit
No
Date created
2020/06/12
Latest episode
2026/10/20
Average duration
51 min.
Release period
13 days

Description

A place for dentists to find expert insight and information around everything from navigating residency and associate opportunities to being a successful dental practice owner.

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Check latest episodes from The Dental Boardroom podcast


167: Year-End Tax Planning: Sticking the Landing
2026/10/20
Wes Read, host, Practice CFO Duration: 44 minutes A solo walkthrough of the year-end tax planning work that must be finished by December 31st, built around the idea that a strong year of planning only counts if the final execution lands. Wes covers what locks in at year end, the internal checklist Practice CFO runs on every client, and why single tax strategies have to be judged inside the full financial picture rather than on their own. The central point: tax friction is the main brake on financial independence, and most of the levers close on December 31st. Key topics Retirement plan design and funding deadlinesSection 179 and bonus depreciation on equipmentPass-through entity tax electionsTax brackets, phase-outs, and lost deductions Key takeaways Retirement plan design cannot be changed once the year closes, and elective deferrals must clear payroll by December 31st.Financing equipment for a Section 179 deduction can start a debt spiral: deduction now, payments later with nothing to deduct.Missing the pass-through entity tax election is the most common and most expensive oversight on a dental return.Getting income under a phase-out threshold pays twice: lower tax now, plus deductions you would otherwise forfeit. Actions to consider Schedule a year-end projection meeting with your CPA or CFO advisor in October or November, while options are still open.Confirm your W-2, spouse and children payroll, and 401(k) contributions will land on target before the final December payroll run.Have an advisor vet any supplier equipment deal for whether you can actually use the deduction before you sign.
166: Dropping PPOs: The PPO Squeeze
2026/09/21
Participants: Wes Read, host, PracticeCFOMegan Shelton, a practice management consultant specializing in dentistry who previously owned and sold her own dental practiceMichael Anderson, a dental marketing consultant with 13 years in the industry Duration: 60 minutes Reimbursement is flat while overhead climbs, and most owners have at least daydreamed about dropping Delta. This session breaks the decision into three levers, price, friction, and yield, and argues that the fee schedule is rarely the real problem. Friction, the cost of collecting the money, is what owners actually control. Key topics UCR fee schedules and percentile benchmarkingClaim denials, eligibility, and breakdownsPer-plan profitability mathMarketing readiness before going out of network Key takeaways The squeeze is often the cost to collect, not the fee schedule.An 80 percent PPO practice can still be highly profitable.Not every plan delivers the same patient; case acceptance varies by carrier.A practice with no marketing history will struggle to go fee for service. Actions to consider Run a UCR percentile analysis and raise fees toward the 80th to 85th percentile, then resubmit.Pull payer distribution and case acceptance by plan to find your worst performer.Verify eligibility within two days of every visit and get a full breakdown, not a coverage table.
165: Private Practice Isn't Dead
2026/08/18
Participants: Wes Read, host, Practice CFO and Practice OrbitJared Bergquist, a licensed business and commercial real estate broker in Nevada who runs his own brokerage selling dental practices and handling dental real estate across Nevada, Utah, and Arizona Duration: 57 minutes A broker and a CPA walk through what the practice acquisition market looks like right now: where DSO activity stands, what private buyers are competing for, and why the "perfect" practice is the wrong target. They cover building ownership, rent as a percentage of collections, and how staff stability drives both value and a successful transition. Key topics DSO activity and divestituresPrivate practice acquisitionBuying versus leasing your buildingStaff retention through a transition Key takeaways Waiting for a flawless practice is why many qualified buyers never buy one.DSO divestitures over the next five to ten years will create locations, equipment, and patient bases worth pursuing.Owning your building controls the one expense you cannot renegotiate later.A de novo that fails to launch is very hard to sell, because leasehold improvements and used equipment carry little value. Actions to consider Check rent as a percentage of collections against the seven to ten percent target and know what a long lease escalates to.Widen your acquisition criteria to four and five operatory practices and offices with fixable problems.If you are buying, negotiate for the seller to stay on twelve to eighteen months to hand off staff and patients.
164: Investing in the AI IPO Boom: SpaceX, OpenAI, and Anthropic
2026/08/11
Participants: Wes Read, host, PracticeCFOPaul Lipcius, CFO advisor at PracticeCFO, a CPA and Series 65 investment advisor focused on higher net worth clients and capital marketsHoward Farran, host of Dentaltown, who interviews Wes and Paul in this crossover episode Duration: 71 minutes With SpaceX, OpenAI, and Anthropic all heading toward historic public offerings, dentists want to know whether to chase the hype. Wes and Paul explain why euphoric IPO pricing rarely rewards latecomers, how to capture AI's real growth through the less obvious companies underneath it, and why a doctor's own practice, not a moonshot stock, is still their highest returning asset. Key topics AI mega IPOs: SpaceX, OpenAI, AnthropicCapEx trickle-down and downstream suppliersConcentration risk in the S&P 500The practice as the core wealth engine Key takeaways Euphoric IPO valuations already price in years of unproven growth.The winner is often the second or third mover, not the first to market.Own AI through the picks and shovels suppliers, not just the headline names.A well designed portfolio's job is to be boring, disciplined, and consistent. Actions to consider Cap any speculative bet, a single IPO or crypto, at a small insurance sized allocation.Pick three or four practice metrics to improve this quarter instead of chasing every new one.Pressure test your advisor's fees: ask whether anyone other than you pays them.
163: The Q2 2026 Dental Economy: The Fiscal Squeeze and the AI Shift
2026/08/04
A Dental Boardroom data deep-dive, PracticeCFO A breakdown of the Q2 2026 State of the U.S. Dental Economy Report from the ADA Health Policy Institute, translating national data into what it means for an independent practice. The core tension: dentists feel confident and are busier than ever, yet revenue is flat and margins are squeezed from every side. This episode decodes why, and what owners can do about it. Key topics The confidence versus consumer disconnectThe fiscal squeeze on practice marginsInsurance reimbursement as rent controlAI adoption for the back office Key takeaways Dentists feel recession-proof, but consumer dental spending rose just 1 percent in a year.Overhead and wages are climbing far faster than reimbursements, so owners eat the difference.Packed schedules and two-week waits mask flat revenue, not real growth.AI is being adopted fast for admin and imaging, yet 82 percent refuse it for treatment decisions. Actions to consider Audit your payer mix and renegotiate or drop the worst-reimbursing plans.Pilot AI scribing or insurance-verification tools to reclaim staff hours.Weigh a DSO's back-office scale against your true overhead before ruling it out.
162: Quarterly Investment Update — AI & the Federal Reserve
2026/07/17
The PracticeCFO investment committee sits down for its quarterly market update, digging into how AI is reshaping valuations and where the Federal Reserve stands today. The core message for practice owners: AI is genuinely transformative, but most of the hype is already priced in — so valuation discipline and diversification still decide long-term returns. Hosts & guests: Wes Read (host, PracticeCFO), Brandon Hobson (Chief Investment Officer, PracticeCFO), and Paul Lipcius (PracticeCFO investment committee). What we cover: AI's effect on market valuationsGovernment involvement and regulation of AIFederal Reserve policy and interest ratesPortfolio positioning and risk assessment Key takeaways: AI is groundbreaking, but the hype is largely priced in already.Every prior CapEx cycle eventually reversed and normalized — this one will too.The Fed is holding steady, with a hike now more likely than a near-term cut.New Fed leadership is prioritizing inflation, easing fears about Fed independence.Strong balance sheets and diversification protect wealth better than chasing momentum. Actions to consider: Reassess your true risk tolerance now, while markets are strong — not after a drop.Trim over-concentration in high-flying AI and tech names.Rebalance toward a diversified mix: bonds, some cash, healthcare and consumables, and precious metals.
161: The Trusted Transition: Dental Practice Brokers & Better Technology
2026/06/03
In this episode of The Dental Boardroom Podcast, Wes takes a break from his discussion of The Five Types of Wealth to tackle an important topic for dental practice owners: buying and selling dental practices. Drawing from years of experience as a dental CPA and financial advisor involved in hundreds of practice transitions, Wes explores why dental practice sales remain an inefficient marketplace, the critical role brokers play in successful transitions, and the challenges buyers and sellers face throughout the process. He also shares the vision behind Practice Orbit, a technology platform designed to modernize and streamline dental practice transactions while supporting brokers, buyers, sellers, lenders, attorneys, and advisors. Key TakeawaysDental practice transitions are complex, emotional, and financially significant events.A skilled broker can provide tremendous value by finding buyers, coordinating the process, and helping avoid costly mistakes.Dentists should carefully evaluate broker experience, incentives, and transparency.DSO offers should be analyzed beyond the headline purchase price.Technology can improve efficiency, transparency, and communication throughout the transition process.The future of dental practice sales may involve a combination of experienced brokers and modern marketplace technology.
160: The Life Razor - Cut Through What Doesn’t Matter
2026/06/02
Wes Read continues his series on The Five Types of Wealth by Sahil Bloom, diving deep into Chapter 4: The Life Razor. Building on the five categories of wealth Time, Social, Mental, Physical, and Financial Wes explores how a single, carefully crafted sentence can become the most powerful decision-making tool in your life and practice. From the cockpit of Apollo 13 to Netflix’s boardrooms, to a late afternoon assembling a hydraulic bed with his son, this episode delivers a framework that is equal parts philosophical and practical. What You’ll Learn Why your net worth number alone doesn’t define true wealth and what fills the gapThe philosophical concept of a “razor” and how it applies to your personal lifeThe 3 non-negotiable traits of a powerful life razor: controllable, ripple-creating, and identity-definingHow Marc Randolph (co-founder & first CEO of Netflix) used a five-word rule to protect his marriage through startup chaosA step-by-step process to discover and draft your own life razorWes’s personal life razor and the touching story behind it
159: ES: AI & The Dental Practice
2026/05/27
159: Executive Sessions: AI & The Dental Practice What does AI actually mean for your dental practice right now? In this executive session, host Wes sits down with Michael Anderson from Wonderist Agency, one of the nation's largest dental marketing firms, and Dr. Megan Shelton of Shelton Solutions to cut through the hype and talk about what's really changing. They cover the dramatic shift in patient search behavior (ChatGPT now accounts for 20% of all searches and is growing), why the fundamentals of digital marketing still drive AI search results, how AI-informed patients are showing up differently at the front desk, and why the human connection at the center of your practice is more valuable than ever. Wes also shares a powerful framework from Lawrence Ford's book The Difference Between Knowledge, Intelligence, and Wisdom and explains exactly how Practice CFO is approaching AI adoption, client investment strategy, and the future of financial advisory. What You'll LearnWhy 20% of patients are now searching for a dentist via ChatGPT — and what that means for your marketingThe "unsatisfying but true" answer to ranking in AI search: go back to the basicsWhy AI-generated content is not penalized — but lazy AI content is a dead endHow the AI-prepped patient is changing chair-side conversations and silently eroding trustThe knowledge → intelligence → wisdom framework and why wisdom is AI-proofWhy documenting your SOPs is the mandatory first step before any AI automationWhat Practice CFO is doing with client investment strategy in an AI-dominated market
158: The Richest Dentist You Know Isn't the Wealthiest
2026/05/07
In this episode, Wes Read continues his deep-dive review of The Five Types of Wealth by Sahil Bloom, a book that profoundly influenced his thinking as a financial planner who has spent his career helping dentists build meaningful lives through their practices. Wes covers the book’s preface and Chapter 2, unpacking the research on money and happiness, the philosophy behind redefining wealth, and Sahil Bloom’s powerful framework: the five types of wealth that truly define a fulfilled life. What You’ll Learn in This EpisodeWhy money matters but only up to a point. Wes walks through three core findings from the research on money and happiness, including the concept of declining marginal utility.The Pyrrhic Victory. The story of King Pyrrhus in 280 BC and what it means to win the battle but lose the war, and how this applies directly to the pursuit of financial success at the expense of everything else.Wealth inequality by the numbers. A candid look at Federal Reserve data on how wealth is distributed in America and what it means for dentists trying to cross from labor income to capital ownership.The comparison trap. Why “there’s always a bigger boat” and how excessive comparison is one of the greatest enemies of happiness.The 90% rule. A striking stat: 90% of all the time you will ever spend with your children happens before they leave home. The Five Types of Wealth are defined: Time Wealth: The freedom to choose how, where, with whom, and when you spend your time.Social Wealth: The depth and breadth of your meaningful relationships; the #1 predictor of happiness.Mental Wealth: Connection to higher-order purpose, lifelong growth, and a healthy relationship with your mind.Physical Wealth: Your health, fitness, and vitality; the most entropic form of wealth requiring consistent daily habits.Financial Wealth: Assets minus liabilities, but with a twist: your expectations are also a liability. The seasons of life. How your priorities across these five categories will naturally shift over time, and why balance, not perfection, is the goal.
157: 30 Dinners Left - Why Money Isn't Wealth
2026/05/04
Most dentists are hitting their financial goals and still feel like something is missing. In this episode, Wes Read (CPA, CFP, and founder of Practice CFO) steps back from the balance sheet to ask a bigger question: what does wealth actually mean? Kicking off a new multi-episode series, Wes introduces the book The 5 Types of Wealth by Sahil Bloom, a framework that redefines wealth across five dimensions and challenges high-earning, time-poor practice owners to intentionally design the lives they keep deferring. What You’ll LearnWhy financial success and true wealth are not the same thingThe five types of wealth: time, social, mental, physical, and financialThe “arrival fallacy” is why reaching your goals won’t create the satisfaction you’re expectingHow to break the cycle of marginal thinking and start building your designed lifeThe math exercise that changed Sahil Bloom’s life and Wes’sWhy dentists in particular are vulnerable to being rich on one dimension and bankrupt on the othersThree questions to take inventory of your own wealth right nowThree action items to start this week Key TakeawaysFinancial wealth is one of the five. Time wealth, social wealth, mental wealth, physical wealth, and financial wealth. Most successful dentists score very high on one and are quietly bankrupt in at least one other, often wealthy. The arrival fallacy will keep moving the finish line. Reaching a financial milestone does not produce lasting contentment. The assumption that it will be the arrival fallacy. Recognizing it is the first step to escaping it. A designed life beats a default life every time. If you don’t intentionally author your life, thousands of others are waiting to do it for you. The opposite of a successful life isn’t a failed life. It’s a default life. What gets measured gets managed. The reason most practices run well financially is that everything gets tracked. How much are you tracking the other dimensions of your wealth? The book gives you a scorecard to do exactly that. Marginal thinking is the enemy of blueprinted life. Skipping the gym once is harmless. Skipping it 9 out of 10 times compounds. The aggregation of small neglected decisions is what separates the life you designed from the life you actually lived. The 1% framework works. The coach of Team Sky didn’t demand a breakthrough; he asked for 1% improvements across every variable. Small, consistent, intentional gains compound into transformation.
156: Build the Practice or Build the Life? The Reinvestment Decision Every Dentist Faces
2026/05/01
One of the most persistent tensions in dental practice ownership is deceptively simple: should you reinvest surplus cash back into the practice, or distribute it to yourself? In this executive roundtable, Wes, Michael, and Megan break down the capital allocation framework every dentist-owner needs, from defining “enough” personally and professionally, to tracking ROI on every dollar invested in people, equipment, and marketing. Key Topics Capital allocation is the most important strategic decision every dental CEO makesWhy every financial plan starts with a personal budgetDefining “enough”, lessons from Jack Bogle’s book, and the Shelter Island storyWhy money becomes psychological and “enough” becomes a moving targetTreating your dental practice like a micro-stock, when the internal ROI beats the S&P 500Where the first dollar of surplus should go: people, systems, or equipment?The CBCT trap, six-figure equipment sitting unused because training was skippedWorking capital “sleep insurance”: how much cash to always keep on handTracking marketing ROI and holding your agency accountable like a CMOThe annual practice roadmap: aligning personal goals with business investmentPractical example, how to allocate $200K as a growing dental practiceWhy maxing your 401(k) early outperforms most practice reinvestment past the optimization point Key TakeawaysPersonal financial planning should drive the conversation before practice investment decisions are made.Every practice has a breakeven point, 100% of collections cover overhead until that’s met. The surplus is where strategy begins.Your practice is a micro-stock. A dollar invested there can beat the S&P 500 until the practice is fully optimized.Invest in people before equipment. Great team members multiply results; equipment amplifies existing leaks.Working capital target: 75–100% of one month’s collections sitting in the bank at all times.Track ROI on every dollar, marketing, equipment, coaching, or you’re flying blind.Start your 401(k) early. A 40% first-year return from tax savings is nearly impossible to beat.Attack one bottleneck at a time. Spreading dollars too thin creates friction, not momentum.
155: 2026 Q1 Financial Market Update
2026/04/28
In this episode, host Wes Read uses an AI-generated summary of the American Dental Association Health Policy Institute's Q1 2026 State of the US Dental Economy report to unpack what's really happening inside your local dental clinic and why it's a surprisingly accurate lens for the entire American economy. Your local dentist is fighting an invisible war: global supply chain disruptions, international tariffs, a crippling labor shortage, and flatlined insurance reimbursements all while keeping smiles healthy. This episode digs into the data, the contradictions, and the survival blueprint emerging from the Q1 2026 ADA report. Key Takeaways68% of dentists are confident in their own practice, but only 32% trust the national economy. They're operating in a microclimate: recession-resistant but not inflation-resistant.33% of practices report not being busy enough, even though total dental spending is up 4% YoY and 11% since pre-pandemic. Slow growth gets absorbed by existing capacity, leaving empty chairs.Supply costs rose 6% in one year, while insurance reimbursement stayed completely flat. The "fiscal squeeze" eliminates any ability to pass costs on to patients.Nearly 40% of practices lack adequate hygienist staffing. Over 90% of those hiring called it "very or extremely challenging." One practice got one application in 9 months from a tattoo artist.Dental assistants are a different problem: a large applicant pool, but candidates are shallow, and ghost interviews and ignore callbacks. Some practices pay 17% recruiter fees just to poach from competitors.Fully staffed clinics aren't paying wildly higher wages; they're offering health insurance and paid leave. In a revenue-capped market, comprehensive benefits are the competitive moat.Tech investment accelerated well beyond plans: 16.9% intended software upgrades in Q4 2025; 24.4% had already invested by Q1 2026. Automation is becoming an economic necessity.
154: The Hidden Ceiling: How Doctors Cap Their Own Practice Growth
2026/04/23
Most dentists are brilliant clinicians, but somewhere between $1M and $3M in collections, growth stalls. Not because of skill, not because of ambition, but because every decision still runs through the doctor. In this Executive Session, Wes sits down with practice management consultant Megan Shelton (Shelton Solutions) and marketing strategist Michael Anderson (Wondrous) to break down what it actually takes to build a leadership team that lets you scale, whether you’re going from one practice to three, or from $1.5M to $3M under one roof. What You’ll LearnWhy dentists keep hitting the same ceiling and what’s actually causing itWhat a fractional COO, CFO, and CMO look like in a dental practice contextThe four most dangerous clarity gaps inside a dental officeHow to identify and build your “Janine,” the internal operator who frees the doctorThe financial fingerprint of undefined leadership (and exactly where it bleeds on your P&L)Why DIY isn’t always bad and when it becomes the bottleneckThe difference between training people to execute and training them to thinkHow job descriptions, SOPs, and KPIs connect and why most practices get all three wrong Key TakeawaysYou can only scale what is clear. Role clarity, expectation clarity, decision clarity, and culture clarity; without these four, everything keeps surfacing to the doctor. The fractional model works. A fractional COO, CFO, or CMO gives a $1–5M practice access to executive-level thinking without the $250–500K salary. The doctor still has to engage but they’re no longer doing the day-to-day administration. The financial fingerprint of poor leadership: Payroll creeping past 28% of collections (GP target: 26–28%)Supplies & labs drifting toward 8–9% (target: 5–6%)Doctor distributions quietly shrinking even as W2 stays the same Build your “Janine” your internal operator. It doesn’t require an MBA. It requires someone bought into your vision, is hungry to grow, and is willing to hold the line. Promote from within, give them authority in front of the team, and back them publicly. SOPs before AI. You can’t build agentic workflows on top of chaos. Your SOPs are the blueprint. Claude can put them into a pretty format, but garbage in is garbage out. Less is more financially. Retain earnings in the business. That retained capital is what funds the hire that buys back your highest-value hours. A doctor doing $400–600/hr chairside should not be doing $25/hr administrative work. Stop being the hero. If you want everyone to bring decisions to you, keep being the person who has all the answers. If you want scale, train your team to think and celebrate when they do.
153: Cost Segregation Tax Strategy for Dentists - Part 5
2026/04/21
The final episode of the cost segregation series. Wes covers the grouping election, the one tax election that determines whether building losses can offset practice income or get suspended indefinitely. Includes the self-rental asymmetry, how to execute the election, five pros, six cons, and when to make it. Key Topics Covered1. The Self-Rental Asymmetry Rental income from a building you operate in a non-passive (taxable)Rental losses from that same building are passive (trapped)Result: a $300,000 year-one cost segregation loss cannot reduce your W2 or K-1; it is suspended until the building has future taxable profit 2. What the Grouping Election Does IRC Section 1.469-4(f): elect to treat the building LLC and practice S corp as one economic unitLosses in the building LLC that become non-passive can now offset W2 and K-1 income directlyExample: $400,000 building loss reduces $1M of practice income to $600,000, saving $150,000–$200,000 in taxes in year one 3. Qualification and Timing Qualifies when: same ownership percentage in building and practice, dentist is the only tenant, same locationMust be elected on the original tax return for the first year of building ownership; it cannot be made retroactivelyCPA must attach a disclosure statement identifying the grouped activities alongside Form 8582 4. Five Pros of the Grouping Election Loss utilization: building losses offset W2 and K-1 in the year they are generatedCost segregation amplification: first-year bonus depreciation becomes immediately usable instead of frozenFixes the asymmetry: losses become non-passive, matching the non-passive character of building incomeSimpler participation: one shared material participation test for both activitiesPredictable: no annual suspended loss ledger to manage 5. Six Cons of the Grouping Election One-way door: binding in all future years; can only be undone by a material change in facts (e.g., selling the practice)Partial sale complexity: selling the building without the practice creates complicated suspended loss treatmentForfeits passive shelter: building losses can no longer offset passive income from outside rental propertiesDSO or partner disruption: any equity sale that misaligns building and practice ownership breaks the grouping1031 exchange complications: a grouped building is harder to roll into a like-kind exchangeSemi-retirement trap: when practice income drops, the non-passive characterization no longer helps and can hurt 6. Best-Case Scenario Dentist buys practice without building, grows income into the top brackets over 5+ years, then buys the buildingCommissions cost seg study in year one of building ownership, makes the grouping election, and offsets peak practice incomeWorst case: buying practice and building simultaneously at low income — better to wait for a higher-income year 7. When to Make and When to Skip the Election Make it when: Buying the building with a long-term operating planHigh practice income and a cost seg study ready to deployNo near-term plans to sell, partner, or transition ownership Skip or defer when: Income is low, preserve deductions for a higher-bracket yearYou own other passive real estate and need building losses to stay passiveA DSO transaction or partnership is within the next few years

Podcast reviews

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5 out of 5
39 reviews
★★★★★
Reza Arz 2026/04/05
Informative
The information provided here is wonderful. This can provide a well informed and educated approach for every dentist to set their practice in the futu...
★★★★★
wordscapestodiefot 2026/02/25
Helpful
Many of the topics related to things that I have gone through or am going through right now. I enjoyed his perspective and took away a few nuggets of...
★★★★★
Drtomfish 2026/02/01
Clear and Concise
Good information presented in a clean and concise format!
★★★★★
rkrev24 2025/01/11
Just what I was looking for!
This show is super practical and inspiring. Love it! They cut through the noise, hit a wide range of important dental topics and insights, and host so...
★★★★★
drewdawgn 2025/01/08
Very helpful.
Learned a lot while listening to this.
★★★★★
Bry154678910 2021/03/02
Informative.
Worth a listen. Learned a lot. Give it a go
★★★★★
Cheff Drew 2021/03/02
Great podcast!!!
Love the knowledge this team has provided me and my business. An entertaining lot as well!
★★★★★
DP the ET 2020/12/02
Amazing dental podcast!
A great dental podcast to increase best practices around dental practice strategy, management, and maximizing profitability!
★★★★★
sydneywoolery 2020/11/16
Educational and entertaining
I would listen all day if I had the time! Highly recommended. The PCFO team knows what they’re talking about.
★★★★★
Kristin Lee AK 2020/10/23
Great stories, great advice!!
As a wife of a practice owner, I greatly enjoy listening to a variety of dental related podcasts to continue our learning progression. This podcast an...
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