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Dr Kartik Antani, CEO of Bergen Street Dental Management, joins the Group Dentistry Now Show. Dr. Antani shares lessons learned including:
💡 The importance of asking for help
💡 How to cultivate culture from day one
💡 How he grew his emerging group from 1 to 2 to 3 practices
💡 Cut out the bad actors fast
💡 Humility & open-mindedness and much more.
To contact Dr. Antani email him at kantani@gmail.com. Read Dr. Antani’s article Expanding Your Dental Business from One Location to Two or Three is Easy, Until it Isn’t. – Group Dentistry Now
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Full Transcript:
Bill Neumann:
Thank you to Sunbit for sponsoring this episode of The Group Dentistry Now Show. Sunbit is the preferred buy now, pay later technology for everyday needs and services. Sunbit eases the stress of getting dental care by offering patients access to fast, fair, and transparent payment options. Sunbit’s technology approves over 85% of patients to get their dental care needs today and pay over time with a simple 30-second application process requiring no hard credit check. Sunbit is offered by over 10,000 locations. Visit sunbit.com/dental for more information. That’s sunbit.com/dental.
Bill Neumann:
Hey, I’d like to welcome everybody to The Group Dentistry Now Show. I’m Bill Neumann. Thanks as always for listening in or watching us on YouTube. We are fast approaching the 100th episode mark, and it’s pretty incredible that almost at 100 and every single guest we have on is different and impactful in their own way.
Bill Neumann:
And so the next guest that we have is a little bit different than some of the guests we’ve had in the past, which tend to have these large groups that have 100 locations. And maybe it’s a little bit out of reach for the normal dentists or somebody that’s looking to scale up and maybe has one looking to get to two or three. 100 locations or 500 might be a little bit just out there for some people.
Bill Neumann:
So we’re going to get real on this podcast and we’re going to talk to somebody that has three locations right now, and he actually wrote a really impactful article and I’ll drop a link to that article in the show notes so you can read it. But we’re going to discuss some of the tips and tricks and challenges that Kartik Antani has had. He’s a doctor. His group is Bergen Street Dental Management. They’re based in Albuquerque, New Mexico. He has three locations right now. So Kartik, welcome to The Group Dentistry Now Show. Thanks for being here. And it was great to meet you at the Dykema meeting in person, even though it was for two minutes.
Dr. Kartik Antani:
Thank you, Bill, for having me and letting me write that article too. I think it was really great you let me do that. I got to meet you for two minutes at Dykema, and I think that’s all the time we had just because it’s such a fun, exciting conference and you get to meet so many people. But I’m glad you invited me to chat with you a little bit more. I know you have some great guests here and I hope that your listeners and your audience gets to understand a little bit more about the basic foundation of starting and scaling up.
Bill Neumann:
I may have butchered your name, but last name is Antani, Dr. Antani, correct?
Dr. Kartik Antani:
Kartik Antani.
Bill Neumann:
Kartik Antani. So Kartik, a little bit about your background. You are a clinical dentist. You have, like I mentioned, three locations. The name of the group is Bergen Street Dental Management. The practices are Napa Valley Dental, Los Lunas Smiles, and Rio Rancho Smiles. Are they all in or around Albuquerque?
Dr. Kartik Antani:
Yeah. So common misconceptions as with Napa Valley, that’s actually California. It’s Napa Family Dental of Albuquerque. And then we have Los Lunas, which is about 40 minutes away and Rio Rancho, which is about 30 minutes away. So all of our locations are about 30 to 40 minutes away from each other. It makes like a little triangle around the Albuquerque area.
Bill Neumann:
Okay. And why Albuquerque? I was looking at your LinkedIn profile. It looks like you went to dental school in New Jersey.
Dr. Kartik Antani:
That’s right. So I actually grew up in New Jersey. I was born in India, moved to New Jersey, and lived there from ’98 till 2015. I finished all my school from the sixth grade there, dental school, residency, but we always thought about leaving New Jersey only because it’s not somewhere that I thought I would be long term. At that junction between my master’s program and dental school, I interviewed for a ton of schools, just like every dental student or pre-dental student does. Ended up getting into New Jersey, so I stayed a few more years, and then I got into a residency that I really liked. So I stayed another year, and then I had to make the decision and say that, okay, am I going to relocate or am I going to be in New Jersey for longer? The more you get into your career, the harder it is to move away. So I ended up looking for jobs in Texas. I have some family in Texas, some friends, so I thought let me try Texas. And I got a great job opportunity in rural New Mexico in Roswell where all the aliens are.
Bill Neumann:
Area 51.
Dr. Kartik Antani:
Well, that’s, yeah, close. It’s Nevada, bloody close [inaudible 00:05:40].
Bill Neumann:
Okay. Roswell’s just the other one. Gotcha.
Dr. Kartik Antani:
[Inaudible 00:05:44]. But ended up working there for a couple of years and my business partner moved out there to Hobbs and we decided to serve the underserved areas of New Mexico. We couldn’t see ourselves living super rural for too long, so we decided to move closer to Albuquerque. Did a little bit of research, realized that this is sort of the lifestyle that works for me for right now. And the more I live here, the more I like it. So I don’t think I’ll be moving away anytime soon. Eventually we ended up in Albuquerque and the fact that we enjoy living here, the weather and the lifestyle, and it’s not the crazy hustle bustle and all the things that we don’t like as we get older, much more simpler lifestyle. It can be crazy if you want it to be, but it doesn’t have to be. So, that’s when we started our group practice here, first in 2017 with Los Lunas, 2018 with the Albuquerque office in Napa Dental, and 2020 in the middle of the pandemic, in the middle of the shutdown, with Rio Rancho. So, that’s our little story so far.
Bill Neumann:
So what made you go from that first practice to the second one in, was it Napa? Was that the second one?
Dr. Kartik Antani:
Right. Los Lunas was the first one. And then Napa Family Dental was the second one.
Bill Neumann:
So talk about what led to making that decision. Why did you go from one to two?
Dr. Kartik Antani:
Well, we always wanted to do a group practice. Ever since I was a kid, I had this ambition to be a dentist and to own a group practice and expand. I didn’t really know much about that. That’s a naive thing to say that when I was a kid, I wanted to be an astronaut. Ended up working out okay. I was actually able to make my dream happen, but it took a while. And when we were thinking about what we want to do, we realized that we don’t see ourselves buying large, expensive practices. We wanted to buy distressed practices first, put in sweat equity and then grow them.
Dr. Kartik Antani:
So our first office was Los Lunas and it didn’t have space or the capacity for even one doctor at that time. So we’re trying to grow this distressed practice and it’s taking time as distressed practices do. They take time to grow. And then it was our turn to think about what’s next. And we did not want to do a second distressed practice. We wanted to buy a practice that was running well for cash flow and for systems and things like that. So that’s when we decided that, hey, instead of growing this distressed practice to two doctors, let’s buy a second practice because eventually we’re going to have to buy one anyway. And it came up on the market. It was a good practice. It worked out to my style of practice and my budget and all of those things. So we went for it. And so we were growing our distressed practice at the same time as taking over this well-established practice. It just worked out that way.
Bill Neumann:
So you start off with the fixer-upper and then you buy the established practice with cash flow. So the practice that you acquired, your second practice, Napa, did that dentist stay on there or what did that look like?
Dr. Kartik Antani:
No, they stayed on for about maybe a month, maybe a little [inaudible 00:09:09].
Bill Neumann:
A while.
Dr. Kartik Antani:
Yeah. And that was part of the transition strategy that I would just start working right away. So it worked out okay for me. In the beginning, it gave me a little bit of time to just tie up some loose ends where I was working and take a couple of CE courses I wanted to take before we started. So neither of the dentists, actually none of the dentists, even at the third practice stayed on really that long, which is one of the lessons we learned. So next time we’re going to have some sort of a different system in place for that.
Bill Neumann:
Yeah. I think you see with some of the DSOs where they’re requiring a minimum of two years for somebody to stay on, and I think especially as you start to scale up, I think you can’t replicate yourself. Maybe you can do that at two locations and possibly three, but beyond that, that’s just not going to work.
Dr. Kartik Antani:
It’s not possible. It worked out okay so far because we were eager to get in there to start practicing dentistry. And then the third location, we already had a provider at that time just waiting. So far it worked out okay, but of course going forwards, I would like to have earnout or some sort of a strategy in place for the next acquisition.
Bill Neumann:
So first one was a fixer-upper, second was established. Doc didn’t stay on super long, only about a month. So talk about the decision to go to the third location during the pandemic.
Dr. Kartik Antani:
Yeah. So when we were taking over the first and second locations, we had one of our associates join us. And this was somewhat of a friend. He was with us in dental school, but he was an international dentist. So he had a ton of experience. And he was working here in New Mexico and he was thinking, well, what do I want to do? So we onboarded him to do some of our procedures, like endo and implants, things that are more intricate and they require more training. So until Dr. Yun and I were able to get that training, we wanted to make sure we had somewhere to go.
Dr. Kartik Antani:
So while we had this third doctor, we realized that we had this opportunity to purchase another distressed practice. So going back to the distressed model. And that’s when we decided that, okay, if we have three doctors and maybe a part-time doctor that comes with the third office, then why don’t we go for it? And we were able to come across a great practice that was not running well, but it had really great equipment. Everything is new. So fundamentally it was a good foundation for us to start with. Of course, then we can build it up from there based on our systems, doctor days and skills, just hand skills and treatment options.
Bill Neumann:
So this is probably a good point to lead in with how you and I connected. You had reached out and wanted to hone your writing skills a little bit. And we were thrilled to have you contribute. So the article, again, drop it in the show notes, the title is Expanding your dental business from one location to two or three is easy until it isn’t.
Bill Neumann:
So let’s talk about the easy part and then let’s talk about the isn’t part. So what happened where all of a sudden we said, okay, we’ve scaled. And maybe it wasn’t easy at all. Maybe the thought was that it was easy. And as you added that second one, you realized, especially because you had a distressed practice and then you had one that was doing really, really well. So it wasn’t like you were taking this, we’re just going to go distressed. Your model was really pretty flexible and fluid, and probably presented some challenges where you knew how to fix up a distressed, but then you’ve got something that has cash flow and like, how do we scale that up? But I’m going to let you talk about it. So talk about some of the challenges or lessons learned.
Dr. Kartik Antani:
Yeah. I mean, I can go on for days if you want me to, but I’ll talk about the easy stuff first, because that’s like three things and we can get that out of the way. So financing is easy for a young doctor that’s been producing as an associate, especially if you have a couple of doctors putting in together. So financing is easier when you’re starting out and it gets more difficult as you start to scale up. Reliable production is easy, because it’s just your hands. You know what kind of dentistry you do, hopefully it’s excellent or at least an A, A+ maybe, hopefully. So you know that your post-op issues and things like that are going to be a little bit less. It’s just you and maybe one or two other people.
Dr. Kartik Antani:
So all of those things are easy because you can control those. And you have a ton of help in the beginning because the bank wants you to close on it. The broker wants you to close on it. The real estate guy wants you to close on it. Everyone’s helping you out because they want you to have success. At that point, your success is also their success. As you scale up, you start to have issues in terms of the number one is of course going to be, who’s going to produce dentistry? Who’s going to be your doctor? That’s the number one trend across every organization, whether it’s three like us or 300 or 1,000. The doctor relationship is the most important part. And that gets more difficult as you scale up.
Dr. Kartik Antani:
We made the mistake of just keeping on doctors that weren’t the right fit and not just doctors, but also team members. When you’re new, you are relying on the team members to guide you. And because of that, sometimes they getaway with bad attitudes or bad habits, and that comes with experience and just having that confidence and that gumption to cut the cord. If you’re a bad actor, good luck somewhere else, it’s not going to work with us. So, that’s one thing we learned is not to hang onto bad actors too long.
Bill Neumann:
And do you feel with the way the economy is, well, the job market, so to speak, where it’s hard to find people, I mean, did you felt like that lended itself to hanging on to people that you should have cut the cord with earlier?
Dr. Kartik Antani:
No, I don’t think so, because right now it’s different. But before the pandemic, when we had a job opening on Indeed or something, we’d have 30, 40 applicants. Yes, doctors are a little bit more hard to find, especially in New Mexico, but that wasn’t the reason why we kept bad actors on too long. It was just a matter of me not being a good enough leader at that point. And I still don’t think I am. We always have to learn. But because I couldn’t see that by letting someone go, it may save the whole culture. I couldn’t see that far ahead. And all we cared about at that point was who can fill the seats and do dentistry or be the assistant that helps with endo or all these procedures. We kept them on too long. I know I had a hygienist that we just tried to coach and coach and coach, but it didn’t work out.
Dr. Kartik Antani:
But because I wasn’t able to see that far ahead about company culture and what’s important, we just kept them on too long. And the more we kept them on, the longer we kept them on, the more toxic it became. And when we had to let some go, it was like a breath of fresh air. Your level of suffocation just goes away and not just yours, but your team members respect you way more. If you let someone go, that’s a key employee, you let them go because they’re being disrespectful to others or they just don’t fit the culture, it’s a breath of fresh air. But to get to that confidence level, to let someone go, who is a top producer, or who’s been in the office for eight years and the patients love this person, they only come to see that person, it’s very difficult to do that.
Dr. Kartik Antani:
I think COVID helped because at that point COVID just kind of made decisions for us. It was a really sad situation with the world and the amount of debts and all of that. But COVID was a great, big reset for our group. I’m sure other guests have felt the same way. And it helped us become better leaders, because we had to make decisions that we otherwise would not have felt comfortable with.
Dr. Kartik Antani:
Now we’re seeing that, you’re right, because of the labor shortage, we’re not able to attract as many candidates, just like everyone else out there. But again, there’s a blessing in disguise here too, because now we can really hone in on what we want to do as a company. Instead of just hiring any random dentist that we can find, now we can find doctors and do it slowly that fit the vision, that they fit the culture. So now, at this point, you’re right, Bill, it is a matter of just scarcity out there, but we’re even learning from that. Why go and hire people that may not be the best fit? Let’s slow it down a little bit and try to find better people, better visionaries.
Bill Neumann:
So how do you go about that? Does the hiring process change a little bit? Now I know you said some of these people had been there during the acquisition, so they could have been there. You talked about having the relationships with the patients for eight plus years, but what are you doing differently to really find that needle in the haystack, so to speak, that person that’s going to fit the culture and be around for the long term?
Dr. Kartik Antani:
Right. The one thing we’re doing is just making our culture better internally because when you have the right people in the right seats and they enjoy working with you, they appreciate what you do for them. They feel like their ambitions are being fulfilled and they feel that it’s a good place to work. They attract people just like them. So now just like a lot of other groups out there, we have this internal process of, if you find someone that fits a position that we have open, you’ll be awarded for that. You’ll get a little bonus for that. And so will the other person, like a sign on bonus sort of.
Dr. Kartik Antani:
As far as doctor recruitment goes, right now, most of the doctors that want to work with us are because they have met me or they have seen our posts online or chatting with you or reading the article. So they understand that, look, I’m tired of working in a group practice that’s all about the production. And I’m tired of seeing 40 patients a day and just my back hurts all the time. I would like to do something better, then they’re welcome to chat with us now. But that being said, we’re being more selective even in that hiring process.
Bill Neumann:
I want to put a pin on the back hurt though, because I want to get back to some of the stresses, whether they’re emotional, physical, mental. I know we want to cover that, but let’s go through some of these other lessons learned here because it’s really interesting. Again, you’re right. We could spend a couple days on this. Maybe we’ll bring you back for a part two or three, at least three, since you have three locations. So maybe we’ll do that.
Dr. Kartik Antani:
Yeah. Sure. So the first lesson I learned personally, was get help and keep getting help. Don’t be in that scarcity mindset because as you’re starting out… And I’m hoping that some of your audience are people that are one location trying to go to two and they might relate more than someone who’s at 50 locations with 30 years in the business trying to go to 55.
Bill Neumann:
We have plenty. So, that’s great. This is perfect.
Dr. Kartik Antani:
So the first thing I would recommend is get help and keep getting help. So when you have that scarcity mindset that I have to make payroll, and I think this payroll is going to be put on my personal credit card because insurance hasn’t paid yet. And all the different challenges that you have with starting out. I remember when we first started in 2017, 2018, at that point, we had two locations. Both of our servers crashed within the same week. So, that’s a ton of stress. And while you’re going through all of these stressful moments, you kind of build up some walls. You say that I won’t be able to afford help. Find a way to get help. Talk to people. There are consultants, coaches out there. There are groups out there. Talk to people. There’s free information out there. You just have to look for it. Make it a point, make it a priority to get help and keep getting help. And the more you scale up, the more help you’re going to need.
Dr. Kartik Antani:
So, that’s lesson number one is what I learned is that you have to make sure that you… There’s no reason to blaze a trail here. There’s no reason to reinvent the wheel. Make a good business happen based on what other people have already done. And you may have to pay for that information or that expertise, or you might have to network for it. Or you might have to just go look it up yourself.
Bill Neumann:
So where did you find some of this help?
Dr. Kartik Antani:
So a lot of the Facebook groups have a ton of information that you can just search for. There are some groups out there, DEO, Dykema, all these conferences. You’ll talk to a lot of people that will help you. I think Henry Schein has a DSO conference that I learned a lot from. I’ve only been there once, but I learned a lot from. And just information out there. I mean your podcast and a couple more of the podcasts, this is free information. You can learn from the speakers. And some of them are industry leaders or some of them are coaches that can give you ideas just to coast by. And then as you build up your revenue, then start to find better help. But always look for help. It could be something as simple as asking your friend or sending someone a message on Facebook. People do that to me sometimes. They say, “Hey, I saw your post about this or that. Who do you recommend?” You just got to find the help.
Bill Neumann:
So it is out there. You’re right. And it doesn’t always have to cost you money. There is a lot of free information out there. Not all social media is bad. There is some great groups out there where you can get great information, whether it’s on LinkedIn or on Facebook, or like you mentioned, any one of the number of conferences. I mean, Dykema had some great speakers at their conference, but it’s taking the time and then listening and trying to apply some of it. I think this industry is pretty unique in the fact that a lot of people tend to share. So you’re getting information from people. Not everybody’s playing it close to the vest. Some people are, but for the most part, it’s not like somebody is worried about you taking their secrets, so to speak, and then using them. A lot of it is the execution. So the information’s out there. It’s how do you execute?
Dr. Kartik Antani:
The execution’s difficult too. I read a lot. I listen to a lot of podcasts. Not only dental books, but I read books outside of the industry about business, Built To Sell or The Automatic Customer, so many different books out there. E-Myth, that’s a classic. So, so many books out there that we can learn from, but it’s the implementation that’s hard, just like EOS Traction. They mentioned that, that you can have the information in your head, trying to get someone to actually do it is difficult. And you can get help for that too. You can have people implement for you. Or in our case, we had some employees that were just the right fit for us. So we had to find the employees that are the right fit.
Dr. Kartik Antani:
When you start to have this help, that you yourself can’t do everything, you should be humble enough to know that, that you’re not… Just because your title is CEO or you’re a dentist, doesn’t mean everything and you shouldn’t know everything. If you’re the smartest person in the room, you’re in the wrong room. So get the help out there. And that could be something as simple as a new assistant that knows something about endo or something about scanning more than you do, or your current team members do. It could be simple as that. It doesn’t have to be some great big business coach out there that’s only willing to help you if you pay them millions of dollars or thousands of dollars or in your case, whatever it may be. The help is out there. It’s free. You just have to open your mind to be able to first find the issues that you need help with the most, go get the information, then implement it. And implementation is the hardest part of that.
Bill Neumann:
Right. I think it’s some great points there. And you mentioned something, Kartik, which I think is important. A lot of times we think that, especially with what we do here, that it’s all about the business side. And you mentioned scanning, and you mentioned bringing on a clinician that actually maybe was a better implantologist than you are. So, again, surrounding yourself with successful people that can complement what you do. And I think we often miss that here. It’s not just about the business. It’s really the clinical expertise that you can bring to the patients. It’s a great point.
Dr. Kartik Antani:
Right. And when you’re in the chair and you’re worried about your patient’s health or your hygiene check that’s going on down the hall that you don’t want to be late for, the big picture things get lost because your day is so full of stress from your actual job, that you don’t have time to think outside of the mouth or outside of the operatory. So that’s why getting help is very important. And, like I said, it’s so much out there that it’s like a fire hose. You can consume all of that, if you want to. Implement it, that’s the hard part.
Bill Neumann:
So let’s go through some other lessons learned.
Dr. Kartik Antani:
So we talked about cutting out the bad actors quickly, which we didn’t do, but now we’ve learned. And then that helps you cultivate your culture from day one. When you have employees walking out because they don’t feel like they want to work here anymore, or you have associate doctors really upsetting the staff, it’s not going to work. So cultivate the culture from day one. And it’s difficult to do that. Again, when you’re oblivious to what’s going on because you’re treating patients, and then when you’re not treating patients, you’re trying to duct tape things together from falling apart. So you might be oblivious to what’s going on. So you have to trust your team and their judgment.
Dr. Kartik Antani:
You have to replace the bad actors and the people that are not a good fit for you as soon as you can. And it might be a little bit difficult with staffing shortages or, hey, I don’t want to let this doctor go because this doctor’s producing a million dollars a year. It’s not worth it. You may have a little bit of a revenue downturn, but your profit will probably be still the same because you’re doing less dentistry, but you’re not paying someone to do it for you. And because you don’t have toxic people, the rest of the team becomes more fortified. So, for sure, cut out the bad actors fast.
Dr. Kartik Antani:
And that’s my next little snippet that I’ve learned is that you have to be humble. A lot of doctors, they graduate school and they think that they know everything and we don’t. Then we start opening up a practice and we’re like, oh yeah, I got this. This is not that difficult. And it might not be. Having one office may not be the most difficult thing in the world. Dentistry is overall, a pretty stable business. You may make a lot of mistakes, but you’ll probably be okay. You’re still going to be okay, better than most of the world out there. You’re not going to be famished and out on the streets. But if you want to scale up, you have to be humble. And that means you have to really have that clear vision of what are you, even if you’re the best doctor in the world. You’re like globally recognized or whatever. If you’re not humble, it will ultimately be your downfall in my opinion.
Dr. Kartik Antani:
So another lesson learned is when you go from being an associate, who’s a top producer and you don’t have much responsibility to a business person, now you have mouths to feed and your leadership skills are literally the difference between people having to go find different jobs or go without jobs. So you have to be humble. And that’s a big lesson that we learned. I don’t want to say that I was a very high ego or rude person to begin with, but internally, in your mindset, you should know that, okay, maybe I don’t know everything. Let me go find out. And that’s being humble to me is when you open yourself up and be vulnerable to others to guide you. That’s important, I think, and one of the lessons that we learned.
Bill Neumann:
That’s great. Great point. What else you got?
Dr. Kartik Antani:
You got to be a good dentist. So when we start building a group, we always want to think, okay, how many more days till I’m not seeing patients anymore? It’s not going to happen. At least not immediately. Dentistry is a profession. One, it’s very difficult to get into. Not everyone that applies gets in. Two, the stress of dental school is very high. So if you make it through that and make it through your boards, great job, you did something really great. Why would you want to give that up? Yes, it’s stressful. But in order to create a good group, you have to be a good clinician. In my opinion, that means you don’t have to be a super GP. I don’t do any endo. It’s not my thing. Sorry. But giving up some things that you’re not great at to do things that you are great at, referring things out that you may not be good at makes you a good clinician too, because you care about the outcome for the patient.
Dr. Kartik Antani:
So you have to be a good dentist. Yes, at some point I may not be able to see patients anymore, but until that day comes, I have to be the best dentist as I can be. If that’s your vibe, that’s your culture, your staff will trust you more. Your patients will trust you more. And any other associates you bring on are going to follow in that pathway, where they try to be the best they can as well. You don’t want associates who are not caring about how great their dentistry is, because that’s a recipe for failure down the road. Again, it’s like duct taping things together and not doing it correctly. So you have to be a good dentist first and foremost. So if anyone that’s watching and saying, oh, I can’t wait to be three offices. I can stop seeing patients. That should not be your motivation. Eventually the time will come that you have to give it up, but not anytime soon.
Dr. Kartik Antani:
And it’s a great profession. I mean, people are trusting you to use little jet engines or little high-spinning engines, millimeters away from their nerves and their arteries and inches away from their brain to make small, intricate, little millimeter-wide designs in their mouth. They’re trusting you with that. There’s not a lot of other professions that have that sort of, I don’t want to say prestige, but the privilege to do that. Microsurgery. We were going to talk about stress later. That’s part of the stress, but you’re still getting to do something really cool. When I was a kid in high school, thinking about what I wanted to do, I never knew my hands would be capable of making such small movements in such small spaces. I mean, this is a talent that you work hard for. Keep improving your dentistry, for sure, but then also be a good leader.
Dr. Kartik Antani:
That’s my next lesson that I learned. You have to be a good leader. Otherwise, it’s going to crumble apart, just like having a bad associate. So while you’re working on your dentistry skills, make sure that you’re paying attention to what people around you need. Now you’re in charge of a lot of lives. It’s not just you going home to your family. Now your employees are depending on you for their families too. And you have to keep that in mind, that whatever decision you make for yourself, for your associate, for your partner, that has to fall in line with what is your value towards life. So that’s important that you have to be a good leader. And it’s not something that we learn. No one teaches you leadership skills in dental school. Most people go their entire careers not really knowing that they’re being a good leader or not.
Dr. Kartik Antani:
People will tell you at some point and say, “Hey, Doc, I love to work here.” Or you’ll have people reaching out to you, word of mouth that, “I would like to work for you. I’d like to partner with you because I’ve heard good things.” That means you’re maybe on your way. You’re not ever going to finish that journey, but you should try to be a good leader. And that comes, in my opinion, more from listening than talking about it. So if your employees are bringing issues to you, listen first, that’s what I’ve learned because I was not always like that.
Dr. Kartik Antani:
In our first few months of ownership, even the first year, it was either my way or the highway. And all that does, first, you don’t know everything. So if you make a mistake, it’s like, oh, it’s all on you. And two, there no buy-in. If you tell someone do something, they’re going to think that it’s an order. But if you ask them, “Hey, here’s the problem we’re facing? How do we solve it? What options do you have in terms of solutions?” And by listening to them, by being a good leader, then you might be able to get better results. So, that’s a pretty good lesson that I’ve learned. [inaudible 00:35:20] my humbleness too. You have to be able to listen and take criticism and all that.
Bill Neumann:
And listening is not easy. It’s a lot easier to talk than it is to listen.
Dr. Kartik Antani:
Yeah, for sure.
Bill Neumann:
So anything else before we get into the stressors, because I think it’s a really interesting point that you make about, again, you kind of mentioned the physical stress or pain that dentists run into quite a bit. But any last lessons learned, and then we can move to that. I know it’s all intertwined, but-
Dr. Kartik Antani:
Yeah. I would say that it’s really difficult to do the day-to-day stuff while keeping your vision. So you have to try to find that balance. Don’t do what I did, which is work continuously 24/7, because I wasn’t actually finding any balance. And there’s a point of diminishing returns. Just because you’re working on a marketing plan at 10 o’clock at night, doesn’t mean you’re doing a good job at it. So find the balance between your professional life and your personal life and within your professional life, find the balance between the day-to-day things, as well as the longterm vision and things, right?
Dr. Kartik Antani:
It’s not easy to do. Balance is hard, but try to go for it and always keep in mind your goals, your why, as they say in Simon Sinek says, know your why. Our whys change as we go through the journey. So keep an open mind, but know somewhat of what you want to do or why you’re doing something and that why can change. So don’t be stubborn, be flexible as times change and as your body changes and your mindset changes, but definitely know your why as you continue to go down this journey.
Bill Neumann:
This is great stuff. I’m going to make sure we try and bullet all this out for the show notes, because there’s a lot of really solid information in here. And I think our audience is really going to appreciate it. You mentioned earlier, you hope this would resonate with some of our audience. And we kind of look at the makeup of who listens and comes to the website. And we have a lot of what I would call DSO curious docs. I have one location and I want to get to two or three or four, whatever that is. So this is really perfect for them. And I think this might be a really good refresher for some that have scaled up pretty quickly. And maybe you’re going through some challenges. There’s that point where you get to, whether it’s three or five, and then all of a sudden things may start to almost kind of go backwards. So that motivation and fun and the scaling up and the revenue growth may start to trend down and you hear that that happens a lot.
Dr. Kartik Antani:
It’s happening to us right now. We’re short on doctors, so our revenue’s down, but profits are about the same, if not more. But, of course, we want to scale up. But again, keeping why in mind is important. So instead of just hiring some random person to drill millimeter holes, inches away from someone’s brain, probably a good idea to slow it down a little bit and that’s okay. It’s not ever going to be just straight up. And that’s one thing people should realize too, that you’re probably going to have some times when you have to step back a little bit. Nothing wrong with that.
Bill Neumann:
Let’s get to the stressors. I mean, again, we talked about the physical, but dentistry is… When it comes to clinicians, and my background is I worked for a dental manufacturer, so I worked with quite a few dentists and the back issues. And I can’t tell you how many dentists that I knew that retired early, whether it was physical or mental and then ended up working for a company that was, whether they were a KOL or they were… But they didn’t want to be a clinician anymore. And again, some of it was a combination of the physical and the mental. So talk to me a little bit about that. How do you get past some of those issues? And then what are you seeing with maybe some of your peers out there?
Dr. Kartik Antani:
Everyone that I talk to, almost everyone is at some point stressed out. And it could be a high-volume Medicaid office where it’s physically demanding or it could be a high-level fee for service office. I have friends everywhere and they’re stressed out, because it’s a physically stressful job. We know that. There’s no one going to not approve of that, but it’s also a very mentally and emotionally draining job. You’re taking care of people all day, whether it’s people that are in pain, whether people, they may not have pain, but they maybe have fear of going to the dentist. A lot of emotional things, even with your team members, you never know what’s going on with their life. They could be coming in to perform to the best of their ability, but they could be stressed out at home. And sometimes that comes out at work.
Dr. Kartik Antani:
So sometimes they need you to be a sounding board. And you’re kind of absorbing all of this every day from your patients, from your team members. And what do we see online is we see people talking about success. This dentist I know drives a X, Y, and Z. Yeah, but they could have financed it for 10 years and paying monthly on it and hating it. You don’t know. So in order to get past these hurdles, let’s talk about physical first. Physical, for sure. I cut down on the number of patients I see per day only because it’s not possible to do your entire career seeing 40 patients a day. It’s not going to happen. I don’t know how other people do it, but I couldn’t. For me, it was kind of getting to the point where I couldn’t sleep at night because of the back pain or the hip pain or whatever. So, for sure, I stopped seeing that many patients.
Dr. Kartik Antani:
Two, get some help. So physical therapy, going to the gym, chiropractor, all of those things are important. Not everyone may agree with all of those, but whatever you agree with, go do something physical that takes care of your body. So those are two things that I’ve done for the physical stress of it. Just cut down. I would rather do more treatment on fewer patients and still generate the same revenue. And that just comes from of a matter of realizing that your physical pain is not worth it to go through all that pain.
Dr. Kartik Antani:
Two, make sure that you use the best materials that you can get because in dentistry you have to be quick, not just for the patient comfort, but for yourself as well. So don’t cut corners on buying cheap things, because you’re just going to have to do things over and over again. And you’re just going to be more physically irritated and so will the patients. Those are simple things that you can do. Now, physical discomfort can be annoying, but it can be taken away by cutting down on the number of patients, physical therapy, all of that. The underlying cause of a lot of our stress is what we don’t talk about a lot, which is mental stress, emotional stress. We hear people complaining about dentistry. We see posts online that this happened today and what should I do about it?
Dr. Kartik Antani:
But that’s only maybe just the tip of the iceberg. The stress that someone keeps inside all day long and then it just snowballs out of control, no one shares that online or a few people do. None of my friends are going to come up to me and say, hey, I’ve got depression or I hate this. I hate that. They’re not going to do that, because they don’t feel comfortable doing that. And so forget about friends. What about strangers? Some random person that you met once at a conference or someone posting on Facebook groups is not going to come out there and say, okay, I really need some help mentally and emotionally, because you aren’t that sponge that’s taking in all the negative energy for the most part. And if you’re a cosmetic dentist or if you’re doing dentistry that’s not stressful, then great. But for the most part, this happens all the time.
Dr. Kartik Antani:
You’re absorbing all that energy and you can’t let go of it. You can’t go to your staff member and say, I’m really stressed out today. They’re going to lose faith in you. And they’re going to say, I hope my next paycheck is on time. You can’t go to your patient and say, hey, listen, I can’t do your two crowns today because my back really hurts from the previous extraction I just did. You can’t do that, because they don’t feel that they’re in the best place. Well, if my doctor’s back is hurting, is he going to be able to fix my tooth correctly? You can’t go to your business partner and say, hey, man, I don’t really know what I’m doing. Yeah, let’s see how it goes.
Dr. Kartik Antani:
With my business partner, I’m sure he’ll watch this at some point, maybe, he understands that because we have that open communication. But if you have investors or if you have private equity folks or whoever, you can go up to them and say that, hey, I’m really stressed out. That’s not the way it works. It just doesn’t. I don’t think it’s even dentistry. I think a lot of people have this built up. Dentistry is relatively a straightforward job. And so it’s a great profession, but there is some really high-stress jobs out there. They don’t have any freedom. In dentistry, we have the freedom to choose. And when I was seeing 30 or 40 patients a day and my back couldn’t take it anymore, I had the freedom to choose, to go into business on my own and set my own schedule. I can do a crown in 30 minutes, but I usually block out a little bit more time because I want the freedom to talk to the patient, have a little bit of a break between the next patient. Why not? So we have to respect our freedom as well in terms of…
Dr. Kartik Antani:
So whenever we get down in the dumps about, ah, I don’t like being a dentist anymore, or why did I open up offices? Think about the positives in your life. There’s a great book called The Gap and the Gain, which is one of my favorite books. And it talks about that, that our mindset is to get into the negative zone, the gap mindset, initially. We have to get out of that mindset into the gain mindset, the positive mindset. Yes, I have to do crown preps and, yes, my back may hurt, but guess what? I get to do crown preps on people. No one else can do that or very few other people can do that. Yes, there are some serious challenges to owning a business, but it’s not like owning a restaurant where your profit margins are so slim that you may be a month away from being bankrupt.
Dr. Kartik Antani:
So you have to think about the positives when you address the negatives. And that’s been a big change for Dr. Yun and myself as well, my business partner and myself, that we’ve changed our mindset. And that’s the number one way that I personally am trying to fight some of these negative things that come across my day every day is to be more positive about it. So physical, mental and, of course, emotional is close related to mental. If you’re not in a great mental state, if you’re stressed out all the time, you’re not going to be able to express your emotions correctly to the people that you love.
Bill Neumann:
Right. And that’ll affect the culture certainly of your organization. Really some great tips there. What was the name of that-
Dr. Kartik Antani:
The book?
Bill Neumann:
… book that you mentioned?
Dr. Kartik Antani:
The Gap and the Gain.
Bill Neumann:
The Gap and the Gain?
Dr. Kartik Antani:
And the Gain.
Bill Neumann:
Okay. All right. Great. That sounds really interesting. We have a couple more minutes left here. So as we kind of wind this down, I want to hold out one last question, but anything you want to mention before we start to wind this down?
Dr. Kartik Antani:
No, I mean, it’s part of the journey. So I’m sure if you have me on next time, I’ll have more stuff to say or if someone reaches out to me based on their specific situation. Everyone’s going through a different part of the journey. You just have to be open-minded, listen to people that know more than you and be humble and just know that step backs are a part of this journey. If you can’t take criticism or if you can’t take a drop in revenue without being positive about it, maybe you should consider just staying at one location or partnering up with someone that can weather the storm. That’s basically it. I mean, you’re going to find your way, it’s just you have to be willing to accept the negatives along with the positive. And there’s a ton of positives out there. I mean, I wouldn’t change this for anything else, but you have to be thick-skinned about it.
Bill Neumann:
Well, that’s some great advice too. And I’ve heard it from a couple of other people too. When you’re in the industry and you go to some of these conferences, one of the first questions is, how many locations do you have?
Dr. Kartik Antani:
It doesn’t matter.
Bill Neumann:
It’s a great point. It’s like, well, yeah, if you’re miserable and you have 10 locations or you have 10 locations and three of the 10 are doing well and the rest aren’t, I mean, what does it really matter?
Dr. Kartik Antani:
If you want to just do it mathematically, the question shouldn’t be, how many locations do you have? It should be, what’s your EBITDA?
Bill Neumann:
Right.
Dr. Kartik Antani:
What’s your profit? Because I know some doctors making more profit from one location, than we do a three. And the second question that should be the most important is, how happy are you? Two questions that matter the most, right?
Bill Neumann:
I think that’s great. That leads to my final question, which is, what do you see as the future for Bergen Street Management? Where does Bergen Street Dental Management go from here? Do you stay at three? Are you looking to expand or what?
Dr. Kartik Antani:
We definitely want to expand, but we want to do it in the right way. We want to learn from our past mistakes, for sure. We don’t want to repeat those mistakes, but also learn from others. We see so many folks out there that are cobbling together practices to make a group, to try to flip to someone else. It doesn’t work in the long run. This is part of the passion of why we do these things. So we want to scale up, for sure, but we want to do it in a stable manner with the right people, the right associates, the right clinical partners, and continue doing it that way. If you were to ask me, where do you want to be in five years, I’ve got some ideas, but not at the cost of stability and happiness. So we’ll scale up, but the right way or as right as we can make it. I don’t think there’s a correct way to do 100% everything correctly, but the best we can do is what we want to do.
Bill Neumann:
Kartik, thanks a lot for this. I think we’ll wrap it up now. If people want to get in touch with you, and like I said, I’m going to drop a note, actually a link to the first article that you did with us, Expanding your dental business from one location to two or three is easy until it isn’t. You had a bunch of lessons learned here today, which were really great. But how do they get in touch with you if they just want to reach out to just find out what you’re up to or if they have any specific questions?
Dr. Kartik Antani:
Sure. I know you’re a big LinkedIn person. I’m trying to be more active on LinkedIn. So you can try to reach me there. The best way to reach me is my email address. It’s kantani@gmail.com. You can look me up on Facebook. My cell phone number is (848) 565-5070. I don’t have a crazy automatic calendar system or a website that you need to go through. You can reach out to me in any of those three ways, Facebook, email, or cell phone, top three ways to reach me. You can try LinkedIn, but I don’t know if I’ll ever get back to you.
Bill Neumann:
You’ve been pretty good on there. So again, it’s Dr. Kartik Antani, and you can find him on LinkedIn. If you find him on Facebook, he’s actually got some, he’s like an amateur photographer too. So he’s got some really cool pictures that he takes typically of the New Mexico landscape, but really, really beautiful pictures there. So thanks again for being here today. This is great stuff. And again, his email address, his contact info will be in the show notes with a link to the article. And I am sure we’re going to have him on the podcast again. And maybe he’ll write another article for us. But I appreciate your time today.
Dr. Kartik Antani:
Thank you for having me, Bill. I really appreciate it.
Bill Neumann:
Yeah, this was a lot of fun. And thanks everybody for listening in or watching us on YouTube. Until next time, this is The Group Dentistry Now Show. We’ll see you later.
