Larry Guzzardo discusses key insights on practice growth – manage debt carefully, engage in networking and collaboration, and prioritize continuous learning for sustainable growth. See more of Larry at the Practice Growth Summit 2024 with All-Star Dental Academy®!
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About Larry Guzzardo
All-Star’s Head Instructor, Consultant. Larry is a highly sought after dental practice consultant and international speaker. His skill and talent is offering practical, common sense solutions to improve dental practice productivity. He is also a faculty member at the Dawson Academy. Larry has delivered countless presentations including, “Winning Patient Acceptance of Fine Dentistry,” “Working with You is Tearing Us Apart,” and “The Leadership Challenge.”
About Alex Nottingham JD MBA
Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.
Episode Transcript
Transcript performed by A.I. Please excuse the typos.
00:03
Welcome to Dental All-Stars. I’m Alex Nottingham, founder and CEO of All-Star Dental Academy. And with me is Larry Guzzardo, head instructor of All-Star Dental Academy. This interview is part of a collection of interviews focusing on business and personal growth. And what we’re gonna explore today with Larry is production, profits, and growth, make more, work less. When it comes to practice growth, we have an entire event dedicated to personal and business growth for you and your team. And that’s the All-Star Practice Growth Summit.
00:33
this upcoming May 17th and 18th in South Florida. And you can learn more about the event at allstardentalevents.com Please welcome Larry. Hey, it’s great to be here. It’s always good to talk to everybody. And I don’t think there could be a better time for us all to get together. Because I feel like we got through 2023.
01:01
not knowing what was going to happen in that year. We had a lot of headwinds. And my big concern right now is that most of us survived pretty much unscathed. It wasn’t as difficult as a year as we thought it was going to be, you know, but the problem for us is those headwinds haven’t gone away yet. They’re not gone. They’re still there. And so, you know, if I use your analogy about the rubber band, you know, it’s just like you stretch yourself out.
01:31
but you never really come back to where you were before. And so if practices aren’t monitoring themselves, if they’re not paying attention to what’s going on, in their practice, they may not realize that they’ve already started to coast. And this is not the time. This is not the time, warning everybody, this is not the time to coast because we’re not out of the woods. Practices, in my opinion, have two.
01:59
two big hurdles, lots of them, but two big ones, Alex. And one of them is that they don’t have control over their revenue flow. It’s not that they don’t know how to collect, it’s just that they’ve lost their ability to charge because they’re not setting their fees anymore. Somebody else is setting fees for them. There’s a lot of clients who are very heavily reliant on insurance. And because of that, it’s controlling their revenue.
02:27
and it’s doing it more so than it has ever done before because of rising costs. You can’t control your revenue. If you can’t control your revenue, then you’ve got to control your costs. Well, anybody who’s been in dentistry more than about three days knows there’s not a lot of places to cut in a dental practice. You can’t cut your lab because that’s what gets you the quality that you’re looking for. You can’t cut on the materials that you use because…
02:55
That’s what it takes to get the results that you get. Those are two of your biggest expenses. Your other big expense is your staff. I don’t even want to be present if you walk in. Other businesses will do it. They’ll say, oh, you know what? Everyone has to take a pay cut, you know, because we’re having a shortage of revenue or whatever. You can’t do that with your staff. We don’t have enough of them. And we need everyone that we have. So my point here is that when you don’t have control over your revenue.
03:24
and you’ve got rising costs, you’ve got to control those costs, or you got to be able to control your revenue, if I’m making any sense. No, you make sense. And just to kind of add on to that is, I’ve been talking to some dentists about this recently, because as many of you know, we have a hiring service where we help hire team members. And it’s become very difficult. So after COVID, it was easy. It was like tons of people, but then it started to tighten up after that.
03:53
And what it’s not, what’s happening is a limited workforce and they want more money. And one of the things though, before I forget to just to notate, because you’re talking about cutting, I’m going to add something kind of revolutionary. Not only do you have to pay people to have the good people, but you have to invest in them almost like an insurance policy, because there’s this quote that I keep repeating that uncle Jay taught me. Why train people?
04:22
and they leave, what happens if I train them to leave? What if you don’t train them and they stay? And if I’m gonna pay a premium dollar, I know you’re all about this, I’m gonna pay a premium dollar for people, the economy is forcing me to do that. Oftentimes they’re really not worth it, in terms of what they’re giving me. So I’m gonna have to invest the insurance policies, investing them so I’m getting that level of production that they’re capable. Because all these ideas we teach people, what we say, they go, oh, that sounds good. Well, how do I implement it? You need your people.
04:51
to be able to do that. So you have, I mean, this is a shameless plug, but of course we have the all-star training, we have coaching, and then we’re talking about this event, the Practice Growth Summit, which is another way to pour into your team to make them raving fans, to learn the what’s new on personal and business growth, but also that this becomes a team, and they’re in it together. We were talking about this in the green room as well. When there are…
05:21
There’s almost like a piggy bank that you have them, you invest in people. And when you push them and you push them and you push them, these events and these things you pour into them is the energy you’ll be able to kind of get a return later. If you don’t, you’re not. The leave and turnover costs are very expensive. Yep, yep. Because we also have the challenge, you know, I don’t know that private equity is going to take over dentistry, you know?
05:46
But they’re making strides in where I worry is the biggest stride that they’re making is that they’re convincing Professionals dentists that they can’t do it on their own, right? You know in in there and and so the dentist has to think do you who’s a better steward of taking care of me? Is that going to be me or some private equity guy? Because we have to remember private equity their business model is buying businesses
06:16
and selling them for a profit. That’s their business model. And so you’re their product. They’re not buying you because they want to operate you and serve the community and serve your staff and take care of your patients. Matter of fact, they don’t even know who any of those people are. And I’ll bet you the biggest majority of the folks who work in for a private equity firm have never met the principals because the principals are on the 38th floor of some New York skyscraper building.
06:46
and they’re looking at a portfolio with a bunch of numbers on it, and they go, why isn’t this number producing better? And so they don’t care if you have to work on Saturdays and Sundays or evenings or Mr. Kid’s soccer game. But my point is, is where they’re making inroads is convincing people that they cannot own their own business. They’re convincing them that you can’t do this on your own, that your quality of life is actually better with us than it is on your own.
07:15
And I’ve never seen a change like this before in my career. Everybody always believed I’m better off owning my own business and controlling my own people. It’s so good to hear what you’re saying because you warm my heart. I mean, that’s what we do here at All-Star Dental Academy. That’s what this event is all about. The vision is that private equity, corporate dentistry, they have…
07:43
the economy is a scale, they have the professional support. And dentists don’t often, and they can afford to have that. So how do you do it in a way that’s affordable? How do you make a system? And we have a system, right? The online training, certainly coaching and the event, those are all ways to give that professional support, to give that energy that you have the ability to compete. One of the things as well, and I’ll talk about this at the summit,
08:13
One of the things is to kind of let the cat out of the bag, but we partner with DPG, which is a member buying club, that when you’re a member at All-Star, you get that included. So with our training, with the buying club, like if you just hang out with us and then be, and this is the other thing I learned with Tony Robbins about modeling and being around the best people, you’re gonna be at an event with you, Larry, and all this great energy for the doctors and the team, that’s gonna rub off. And corporate dentistry,
08:43
They’ll hire some of us to speak for them, but they don’t get this multitude. And I’ll tell you, the private practitioner, if done right, and you’ve done it, you joke, you never help the dentists get on insurance, you always help them get off insurance. What we do is give them the freedom and the tools to be able, when you’re free and you have the support, you can run circles around corporate because you become more the Bloomingdale’s and you’re getting…
09:11
paid very well for your time, you have a good work-life balance, and the other dentists that put their head in the sand or sold out, whatever, it’s all good, not for everybody. Business ownership’s not for everybody. They’re now an employee. They have no power, and sure as hell, they’re making a good income, but sure as hell corporate dentistry is making more. They are capitalizing on that. It’s short-lived. It’s short-lived because anybody can make a lot of money in the short term.
09:41
You know, just let me loose and I can make a ton of money. But is it sustainable? When I do that same thing year after year after year, what we hear, and we hear this over and over again, that’s why clients come to us, is they’re burnt out. Yes. And they’re tired. And they can’t keep the pace anymore. And they don’t like the work challenges. And they don’t like being forced to have to, you’re not proposing enough treatment and you don’t do this often enough. You know what I’m saying? Private equity only exists to make money.
10:11
just like any other business does. But you can make money in dentistry, but you can also have a better lifestyle in dentistry because you can control it yourself. If you wanna take time off to go see your kids piano recital, you’re the owner, you could be okay with it. Your staff will make it work. Call the guy in New York and say, I wanna go to the tap dance routine to watch my kids. I’m gonna take a longer lunch to go do that. They’re not gonna go for it. But my point is is that,
10:41
They’re winning the game because they’re convincing people that they can’t do it on their own and that their lifestyle is actually better with them. And insurance companies are doing the same thing. You can’t get any patients on your own unless you take ours. And we’ll give you all of our patients if you’ll see them at a discount. And now that discount is hurting us because costs are rising and their reimbursements aren’t commensurate with it. And we’re really caught in a squeeze. And so,
11:10
If we’re going to have to pay top dollar to get the best people, and you should, you know, I heard a phrase before, if you pay peanuts, you’re going to get monkeys, you know, for employees. But we know if you pay better, you’re going to get better people. But if you don’t have control over your fees, you can’t hire better people. And so that’s what makes looking at the other guy who says, I’ll just do this for you. But we forget you’re going to take, they’ll send somebody to you, but are you going to like them?
11:41
And if you don’t like them and you keep sending the people they send over back, what reputation are you going to have within that organization? You often say, I love the quote, you, you say something like you work all day and you come home feeling like a dishrag, you say. So what are you seeing? What I love that expression, but I think a lot of dentists are speaking to burnout. They’re working so hard. They’re not seeing not some are not seeing a paycheck. Some are. And some.
12:07
are like, I don’t feel I’m getting paid what I’m worth, what I’m putting in. I don’t feel I’m able to do the quality that I can. What is this phenomenon, this diss rack phenomenon that you’re seeing? What do you mean by this? Well, part of it goes, if you’ve ever heard the phrase, I’m too busy to get organized, that’s what happens in a dental practice. When you can’t control your revenue and your expenses are going up, the natural normal inclination is to say, I gotta get busy.
12:36
And so that means I take every emergency, you know, it means that I am going to see every new patient that comes through the door. I don’t know what happened to my computer here. I still see you. Okay, so I’ll just keep talking. I see you and I hear you. Yeah, keep talking. All right, so you know what I mean? I’m just gonna see every new emergency. I’m gonna stay open later hours. I’m just gonna get busier and see everybody. But what happens then is they’re not being coming.
13:05
comprehensive, you know? And so the treatment planning goes out the window and the examinations go out the window. And we saw this during the last downturn where there was a lot of promotion. Actually, that’s what birthed All-Star was. We didn’t like how the other people in the marketplace were telling dentists, just go ahead and get them all in here. Right. You don’t have to talk to them on the phone. You don’t have to develop rapport with them.
13:32
They don’t even have to like you if they want an appointment get him in this afternoon first thing tomorrow morning You know send out an uber but just hurry up and get him in here And so what happened is is it just created all these people who showed up at the office And nobody knew what was going on and and then 80% of them we never saw again So if I’m making any sense, it’s that the busyness gets in the way of our ability to be comprehensive Yeah, you always say busyness does not
14:01
You always say, busyness does not equal productivity. It’s not productive. And so the reason why they’re burning out and they’re getting tired is because they can’t handle the load. They can’t handle the stress of how many patients they have to see on a regular basis to maintain their revenue flow. We look at it from a point of view, if you did a thorough comprehensive evaluation on every patient, you would write a better treatment plan because you’d have a better diagnosis.
14:30
If you spent more time with the patient, the person who’s looking for more comprehensive care is also looking for time with the doctor who can explain. If I look at what’s going out on the marketplace, dentists are being taught not to talk to their patients. It’s literally just the opposite because they’re having it all set up where other people do all of this for you so that only the doctor has to walk in and go, yep, that’s right, that’s a broken tooth. It needs a crown and let’s get them on the schedule.
15:00
Well, that works if all you’re wanting to do is maybe a single tooth on a patient. But if you wanna do bigger cases, a patient’s gonna need more than that. Again, you know, Alex, if I’m making any sense. Oh, you make a lot of sense. It’s in the way of all their planning and all of their organizing, and there’s no time for training. And so it creates its own vicious cycle that they can’t get out of. With the cat chasing the tail. It’s just.
15:27
or the dog chasing the tail. It’s just this cycle. And I really appreciate how you really laid out the issue. I believe that the issue is even more important than just the solution, because people are throwing solutions all over the place. You have to eventually the solution, but if you don’t identify the issue, because typically we go, oh, I want that technique. I want a bonus system. I want the ability, how do I cut expenses? How do I increase revenue? Those are all great tactics.
15:56
But if you don’t know what’s happening, you don’t know what are the drivers, you don’t know the root cause, then you’re just, you know, there’s this Heather likes to send to me, she thinks I’m positive, like I’m, and she’ll get mad and she’s like, you’re toxic positivity. And I’m like, no, I address the issue, I see what it is and it sucks, but let’s do something about it. That’s a good attitude. But I’m not Pollyanna where I don’t wanna see anything negative. I don’t wanna hear about it.
16:25
Um, you know, so, but there is, right, but there is a toxic positivity whereby I don’t want to see anything negative. I don’t head in the sand. So we have to acknowledge what is, we have to know the issues. And I think you did a really good job defining them. So tell me just for the, for the listeners, they’re going to come see your presentation of the practice growth summit, production profits and growth, right? Make more and work less. What are they going to learn, uh, in your presentation?
16:56
Well, part of some of the things that we’re talking about is some of the things that they actually can do to stay ahead. One of them is enjoying some of the economies of scale that the DSOs have and the private equity guys have by being a member of a purchasing plan. Like All Star, yeah. I mean, one thing they have over us is that they do have purchasing power and they use it with insurance companies. They use it with suppliers.
17:22
They use it with equipment sales, people and technology. So we need some of those advantages too. But we could do it independently on our own. We don’t have to join a DSO to do it. Right. So we’ll talk about some of those kinds of things. The dentist needs to learn how much debt they can actually afford. It’s amazing to me, dentists today have no fear of debt. No, none whatsoever. And in a business, I believe you have to get
17:51
comfortable with debt, but now they need to be taught what’s affordable. Because of them not having any fear of debt, they buy this, they buy that, they borrow for that, they borrow for this. It’s the car, it’s the home, it’s the practice, it’s the CBCT, it’s the laser, and all of a sudden their cash flow’s dried up. So they need to learn. Yeah, and also, and I love when I hear, I lose my mind. Heather will talk with a dentist.
18:19
and they’re complaining about all these issues, staff-related issues, broken appointments, turnover, call conversion, open time, you know, the lists go on. And they say, I just bought a new scanner or a milling machine, and I can’t afford to train my team. And I’m like, like, that’s a problem. It’s like you, with the cart before the horse, if you build it, they will come.
18:48
No, I hate to break it to you. If you build it, doesn’t work that way, they will come. My whole family are doctors, I’m the black sheep lawyer, but they all believe I’m the best. My dad’s a Panky trained dentist. He was the top producer for the dental, extreme makeover dental lab. He did a whole, an ultimate makeover campaign in South Florida, he was on CBS. I mean, top notch stuff, but the, it wasn’t just build it, they will come.
19:15
They don’t know unless you can market and you make it known. So the carpet for the horse. And I think part of it is that this comfort zone. We’re comfortable with milling machines. We’re comfortable with the sales rep sells us on, oh, this is so, you know, the shiny object. You need those things. But if you don’t, it’s like buying a business. If you don’t have a way to fund it, if your team isn’t trained and they’re not good on the phone, it’s just an afford, it’s like, wow, they don’t see it, do they?
19:45
It’s a poor thing. Like if you can’t solve a sizzle, you know. No, you gotta. If you don’t understand those things. And I just realized, I don’t know, it’s human nature. We all think differently. And so I have to appreciate that. But I’m gonna tell you something. I’m looking to learn how do the best leaders and managers and CEOs think. And that’s how I’m gonna condition myself to think. And if you’re listening and you want to be
20:14
better at business, what do I do to do that? And then I’ll tell you another thing, which is even scarier, I know this already. I’ve seen this before, okay? Repetition is a mother of skill. I have seen things multiple times, and it took me like the seventh time, eighth time, it’s like, oh, now I get it. And we forget and go back to old habits. So, I mean, look, it’s just important that you have both. You need to be reminded about things.
20:43
and you need new things, a combination. But it’s always you’re tracing only the new, you miss out on the fundamentals. So sorry, I’ll step down off my rant box here. Larry, let me ask you this. Because you covered a few of the things you’re gonna learn. People love your numbers and your systems because you show exactly where you need to be. We’re always asking Larry, what are your percentages? Because you’ve been a top consultant in dentistry for a long time and your measures that everybody uses, they should say the Gazzardo method.
21:13
What, tell me about just growth in general. Why is growth important? You’re alluding to it about the rubber band. Why, tell me, what do you define growth as and why is it important? That is a great question. For me, growth is when we learn and progress together. Right. When we do it all together. Cause we can’t, we already know this already that I can’t do it without you and you can’t do it without me.
21:42
So if I grow and you don’t, you’re just gonna pull me back. And it’s vice versa. If you grow and I don’t, I’ll pull you back. And so the team is not gonna win in that environment. So growth is when we learn and we progress and we do it all together. Because without it, we’re really not a team. We’re just a group of people who work together. And we might hit some highlights in the short term, but it’s not a sustainable model. Right.
22:12
And let me ask you this final question, because you’ve been doing seminars for years, coaching for years. I know many of your clients are looking to come as well in your influence. Why should dentists, so this event we’re talking about is for dentists and team members, practice growth, how to grow your business as well as personal. Dentists listening, dentists that are struggling, need help, dentists that are doing great.
22:41
Why should dentists and team members come to this event? And of course, because there’s a time commitment, certainly money. Some are local. Some aren’t. Why do you recommend this, in your opinion? Well, beyond some of the obvious things, that when you just get away, you actually can relax because you don’t have the distractions and the stress of when you’re at home, and particularly all the interruptions and all of that.
23:11
When you’re together alone in an environment like the summit, then you can get together with your team and you can actually make an action plan. And you can actually work out some details. You know what I mean? So that when you get back to work, you can get started on it right away. The planning has already been done. So there’s nothing to have to organize once you get back. But more than that, Alex, what I like is I said kind of like the huddling. It’s just that I’m there.
23:40
You know, I can’t tell you how many teams will pull me aside and say, we’re trying to work something out and we need your help. And I’m there to do it for them. And you’re there and Heather’s there and Eric’s there. I was thinking about that. Yeah. All of us are there and they, they get our experience and you know, we, we love to do this. I’m hoping that I’m conveying this to people as I’m talking to you, but that’s what we like most about what we do is getting to help you solve these problems.
24:09
Because there isn’t a cookie cutter approach to how it’s going to work in your office. You make a really cool point. Well, I was thinking, as I was thinking too, it’s so special just to be able to meet you and the other speakers. And there’s the networking time, the time in between the speeches. What I say often, I have five steps to an all-star practice. The thing about events, when done properly,
24:39
It’s a point of transformation. It’s where you never know what’s gonna spark somebody and help take their vision to the next level. Many of my coaches would not be here today if they didn’t have their dentist invest in them. And it’s really important as well. Dentists will always benefit from these things. They eat this stuff up, it’s great. The team gets to see others that wanna be there. Certainly being on the beach is not a bad thing, being in Florida, South Florida,
25:08
It’s something you don’t know that will trigger, that you said that’s out of the office, and then there’s the time and networking meeting and what inspires him. He’s like, wow, I gotta put that into play. I’m so inspired. He’s, you know, he or she is saying this. So I think there’s some magic that can happen with that. And so I’m glad you touched on that. Right, but how many times will staff members tell us there’s ideas that they had, things that they were hoping to try or whatever, and then they heard another office that was doing it.
25:35
And now that office is there, and so they can go talk to those people. You know, I mean, there is, when we talk about networking, what I mean by that is the fact that maybe I might say something that would spur an idea. Another office will say, well, we’ve been doing that, we just loved it. The office across the aisle goes, we’ve always wanted to do it, but we’re afraid. I need to talk to you. And Larry, come help us figure this out. So that part of it, I feel like sometimes more happens at the coffee breaks.
26:04
And when you’re standing in line at the elevator going up, you know, then sometimes what happens in the seminar. But that’s the collaboration. I think, you know, all this remote work and having to stay home and being locked down, we’re getting over all of that. But we thought we could survive without one another. And what we’re learning is that we need each other now more than ever. And I don’t care for traveling. You know, my nature.
26:34
I love people, but this is so easy just to remote, or whatever, but there’s something so special when you get to meet with people and do it. And then my, you know, I have my D side then my I side’s happy. This is the desk profile when I’m at events. All right, so thank you, Larry, so much for sharing. And I’m gonna put two links available in the show notes. So if it’s on YouTube, it’s in the description. If it’s in podcast, Apple podcasts, or Spotify in the show notes. But…
27:03
There are two links I want to give you. One is to the event, which is alls You can look at it and see if it’s something that you can come to. We definitely want you to come. But this is a limited size event. It’s, you know, we only have maybe a hundred maximum that we can fit. And we only have like 30 at this point in this recording, it’s 30 early bird tickets left. I mean, it’s going fast. So, and I know everybody will work. So that’s one option.
27:30
The other thing I want to do, because we have a following of, gosh, tens of thousands across the world, we put together an e-book. We’re launching it. Well, and this podcast has already launched. But I’m going to put the link below where you can download the practice growth e-book. Whether you can come or not, the e-book is going to highlight some nuggets of wisdom from all of the speakers. They’re just nuggets, but they can spur something. And we have other.
27:58
podcasts and training that can spur. I mean, of course we have our dental practice excellence webinar you can do and learn more. But this is a nice list that you can kind of look through, learn about some of these things. So it’s a practice growth guide. And our intention is every year we do a practice growth. That’s the goal. We move it all around the country. This is the only time it’s gonna be in Florida for a long time. So we allow that opportunity. And then we take the nuggets of wisdom, like a short paragraph of all these great speakers and it’s a nice.
28:28
a gift that we all can learn from whether we come or not. So that link will be there as well. Yeah. Yeah. And you brought up another good point that I think is worth mentioning is that at the Lagomar, where the event is being held, this is not GTE Arena. You know what I mean? Right. Because there won’t be thousands of people there. No. That’s what facilitates all the huddling and the networking and talking to people. That’s how you get to meet the people that are in the seminar, because it’s not a huge event.
28:58
It’s an interesting thing. What a lot of teams like is we’re going to do a two or three hour breakout in one of the sessions. We’re going to split up by admin, hygiene, assisting doctors. So that will be kind of cool to kind of get that experience. There’s going to be a lot of modalities, a lot of fun. So definitely check out the Ulst Check out the link for the e-book on practice growth. Either one or both would be great. We hope to see you there. Thank you again, Larry, for being on the program.
29:26
And until next time everyone, go out there and be an All Star.