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Hey there, dental professionals and industry enthusiasts.

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Picture this. It's October, and you're in the

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middle of one of the most transformative

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experiences of your career. You're at the Becker's

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Fall Future of Dentistry Roundtable in the vibrant

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city of Chicago, fresh off an incredible 3

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days at the Hyatt Regency. Imagine yourself inspired

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and invigorated after attending captivating keynote sessions by

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none other than the legendary boxing world champion

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and CEO, Lila Elite, and the extraordinary professional

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basketball player, Caitlin Clark. See yourself engaged in

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lively discussions, exchanging ideas, and collecting a stack

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of business cards from fellow dental experts and

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potential partners. You've networked with over 350

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attendees and learned from more than 80 speakers

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who are at the forefront of dental innovation.

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You sat in on educational

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sessions exploring topics that elevate dental care as

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a critical element of whole person health. You've

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witnessed firsthand how digital technology is revolutionizing

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patient outcomes

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and how both large DSOs and independent practices

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are flourishing.

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Get ready to transform your career and don't

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miss out on this incredible opportunity. The Becker's

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fall future of dentistry roundtable is from October

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30th to November 1, 2024.

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Get registered by going to beckersdental.com

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and clicking on the events page. Hello. This

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is Arianna Portolatin with the Becker's Dental and

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Dia Silverview podcast.

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I'm thrilled to be joined today by Ray

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Caruso, the CEO of Lone Peak Dental Group.

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Ray, thank you so much for being here

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today.

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Yeah. Happy to be here. Thanks for the

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invite.

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Yeah. To start us off, can you introduce

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yourself and tell us a little bit about

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your background?

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Yeah. Sure. So my name is Ray Caruso.

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I'm the CEO of Lone Peak Dental Group.

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I've been the CEO

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for 7 years with this group. Before that,

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I was the COO

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of

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Decision 1 Dental in Chicago with AJ and

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his brother, Mike Acierno.

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Mhmm. And,

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I was with him for about 5 years

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and helped them grow from very small DSO

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to

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oh, I don't know, 17 to 20 before

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it, it moved over to the Smile Brands

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operation.

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And, before that, I was the well, I

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started out actually at the front desk of

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a dental office

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in, in Springfield, Illinois, my hometown, and it

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was a a Heartland office.

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And back then in 2000, they had

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29 practices, I think. And by the time

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I left, I was the regional director, and

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we had around 375.

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So,

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really great run-in that 11 years. I learned

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a whole lot, which really helped me,

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propel to, you know, go work with AJ

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and Mike, and then, of course, to be

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the CEO of this group. So lots of

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fun.

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Yeah. Yeah. Definitely. Thank you for that. And

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what are some of the biggest issues that

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you're following in the dental industry this year?

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No. When I'm around my peers,

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a lot of things that we're talking about

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is growing same store sales.

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At this time, there's not a whole lot

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of dental offices for sale

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and people are very cognizant

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of EBITDA and what last year's revenue numbers

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were

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and are you being compressed

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in your margins because of salaries and all

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the other expenses that continue to go up.

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And most of us were contracted with payers

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and we rarely see increases in their fees.

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So the only way to increase the revenue

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is either add more patients to the day

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or provide additional services. And

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that could be challenging in both cases, adding

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more patients per day,

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could be just as easy as stopping no

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shows, but I mean, most of us know

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that's never gonna happen.

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So we need to work on being more

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efficient with our time

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and not lower the quality of our service

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because patients will feel that pretty quickly. And

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I'm not talking about the actual dental treatment.

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I'm talking about the quality of service that

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they feel, the customer experience, if you will.

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And then additional services that sounds great, you

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know, like, oh, let's add an endodontist or

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let's add an ortho day or or any

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of those things,

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which is a great long term strategy. It

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does help grow revenue,

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but you have to be super diligent

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and execute extremely well

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because you may get the additional revenue and

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you may get the additional services,

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there's a lot of talk about same store

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sales and how are we growing, how are

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we improving

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what we currently have between our four walls,

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you know, adding doctors, adding more days, adding

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more hours, you know, any of those things

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that can be done easily,

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you know, we're we're all looking to to

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see how we can improve that.

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Okay. Yeah. That makes a lot of sense.

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Moving on to our next question here. I'm

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curious. What are the, what are you most

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excited about when it comes to dentistry right

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now, and what makes you nervous about the

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field?

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Yeah. Well, it's

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it's funny. The the thing that I'm most

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excited about, I'm also most nervous about, but

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that's part of my strategic vision that I

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really can't share that on the podcast. But

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what I what I can share as far

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as like my excitement

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in in this industry and in dentistry

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is the

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is the ability for us to to continue

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to grow and provide better opportunities for doctors

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than they can get if they were just

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on their own.

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We

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I know what my company does, I know

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what the 2 companies that I worked with

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before does. You know, they they ensure that

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that the doctors have patients, that the got

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that the doctors have training. They have great

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CE.

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They have,

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plenty of patients

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and patient flow. They've got great team that's

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trained and

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and ready to go. So I just love

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that that's gonna continue and the consolidation is

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gonna continue.

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And you're gonna find that more and more

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dental companies focus on their people

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and ensuring that they're investing in people more

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than just, hey, how can I create EBITDA?

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Because really, if you invest in your people,

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you're gonna get the EBITDA.

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It just might take a little bit longer,

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but at least it's the right way to

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do it.

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What I'm most nervous about

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is

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not everybody plays by the same rules

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in in our space, and,

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not everybody thinks that way. Now it can

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be very helpful because if people don't like

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where they're working, they'll typically go elsewhere.

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But

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the rack and stack

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of of EBITDA,

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the putting together dental practices

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and

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trying to take it to market

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and selling it at a high value

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and having it fail doesn't work out real

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well for those of us who are doing

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it great, and I think the majority of

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us are doing it the right way.

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But anytime a dental company doesn't go well

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or it gets handed back over to the

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bank because they can't

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beat their covenants,

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it doesn't doesn't play well for the rest

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of us. So that's what I'm most nervous

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about.

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Okay.

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And last question here. In your opinion, what

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will the most effective health care leaders need

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to be successful in the next 2 to

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3 years?

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Loaded question.

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Everything.

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I mean, you have to know your business.

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You have to know,

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your external and internal environment.

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I mean, you even need to have

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your your hand on, or or your your

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thumb on the trigger of technology.

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There's so much changing so quickly

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that,

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we have to keep our eyes open to

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every single thing.

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I will tell you and I'll tell every

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leader that's in my space,

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stay in your lane,

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be the best at what you do. Don't

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try to be everything for every

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everyone.

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You do not have to have every single

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specialty under your under your belt. You don't

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have to if you're a general dental and

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you've got 15 or 20 or 50 or

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a 100 general dental offices, don't go jumping

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in the pedes thinking it's gonna work. We

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buy pedo practices from general dental companies all

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the time because they fail. So just stay

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in your lane, do the best of what

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you be the best of what you do,

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and,

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and then, yeah, keep your eyes on the

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trigger of how can you make your company

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and the 4 walls that you have as

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great as possible as you're adding and growing.

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But too often people just

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want to grow at the sake of growing

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and

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they're adding EBITDA while they're losing EBITDA at

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the backdoor

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of their

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current operation. So I think that's where

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our, effective leaders in health care are gonna

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have to always be. Like, look internally

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as you're looking externally.

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Don't grow too fast.

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Okay. Yeah.

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And just a quick follow-up question. I know

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you mentioned technology earlier. Are there any particular,

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pieces of new technology that you're paying attention

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to right now in the dental field?

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Yeah. Sure. I mean, RCM is all over

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the place. Anything that can

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that that can take monotony,

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eliminate monotony from our people

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because people don't like doing things that are

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monotonous. There's very, very few people that like

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that.

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And so what happens is those things get

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kinda pushed off to the side and they

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don't get done.

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And therefore, you have accounts receivable problems or

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you have general exchange problems or whatever it

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is that you have because of that monotony.

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So anything

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whether it's and I I don't need to

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name name companies, but any of these AI

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tools where they can write back into your

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system, they can post and payment payments for

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you automatically,

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they can submit

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remits and do all of that stuff for

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you automatically.

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I'm all for,

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I don't think anybody

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even in our AR team

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really loves what they do.

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They love the people that they work with,

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but I don't know if posting payments all

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day long is the most fun thing you

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can be doing.

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Okay. Yeah. And I know you mentioned, you

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know, not growing for the sake of growth

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and kind of staying in your lane. When

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you're thinking about that, when does a leader

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such as yourself

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know the exact time when it might be

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good for a company to add additional services

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or expand in some form?

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Yeah. Expanding

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in some form, like, first of all, like,

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when you have 75 practices, you're always gonna

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have a couple that are needing help, and

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you'll never be finished. It's the whack a

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mole game. We're constantly playing it. You know,

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as soon as this one's fixed and this

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one breaks, it's happening, you know, whatever.

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So you're still, like, growing

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continuously

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is is the right move.

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Growing at a rate that's faster than you

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can integrate, not the right move. Okay. Growing

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at the rate that's faster than you can

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handle,

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grow and say, okay. We'll figure it out

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later.

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Yeah. Sometimes it works. I wouldn't say that's

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the best way to to go. You know,

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make sure that you've got the ability to

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integrate and manage what you're bringing into the

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group before you bring it in. And that

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can be a 2 edged sword because sometimes

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people build up

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their corporate team to handle things and then

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they don't bring it in. So they're extracting

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EBITDA because of all these people. And then

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sometimes you bring in something too fast and

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you don't have anybody

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to fulfill those roles. So it it can

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definitely be a 2 edged sword.

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Okay. Well, thank you so much for joining

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us today, Ray. It's been a pleasure speaking

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with you, and I look forward to connecting

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with you again in the future.

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Alright. Well, thanks a bunch. It was my

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pleasure. Appreciate you asking.