WHAT IS T-BONE SPEAKS?
T-Bone Speaks is a resource run by me, Dr. Tarun Agarwal, to help dentists like you achieve your dream practice by going from having a dental practice to having a dental business.
You may be asking what's the difference between a dental practice and a dental business? It's unique to each person and isn't exactly what you think it is. But one thing I can say for sure - it's the key to unlocking your true potential.
When you make the transition, you start to earn more money, take more time off, and do more of the dentistry that makes you happy. All this can happen without losing the personality, culture, and beliefs that makes your practice unique.
WHO IS DR. TARUN AGARWAL?
What makes him different from other so called 'Dental Experts'
I'm just a regular guy in my early forties who has learned from the school of hard knocks about building a successful dental business. It hasn't happened without significant challenges along the way and it certainly isn't without ups and downs today.
It's these real life experiences, along with my willingness to openly share the good and bad, that positions me to help you move forward regardless of where you are in your dental journey.
It's rare that anyone achieves any level of success without going on a journey. Let me share with you where I came from, how I got started, and some of the challenges I've faced along the way.
I was born in India and moved to the USA when I was two years old - I didn't have much say in the matter. Somehow my parents chose Rockingham, NC as the place to buy a motel and start our 'American Dream'. Rockingham small rural town that was dependent on two main industries - textile factories and NASCAR. In the 1960's, 1970's, and 1980's it was a thriving small town.
From 1980 til 1991 we lived at our motel. First in room #40 until 1985 and then in a trailer at the back of the motel until 1991. During this time I helped out at the motel - I guess you could say it was my first job.
Living and working at the motel had many positives and of course a few negatives. The main negative was not living in a neighborhood where you could play and interact with kids your age. The positives were learning the meaning of hard work and commitment to your business (after all a motel is a 24 hour business), having your parents around all the time, and experiencing first hand the ups, downs, and challenges of running a small business.
In the 10th grade I got my first taste of entrepreneurship. In an effort to save money, my father wanted to own roadside billboards instead of paying someone else for rent. So together we started a billboard company. He found the locations, built the structures and I managed them. Each sign had 2 panels - 1 we used for our motel. My goal was to find a customer for the second panel so the first panel would become 'free' to us. I prospected for the customers and did the billing and collections.
I didn't realize it at the time - I only complained and made fun- but growing up in Rockingham was the best thing for my career. By the time I graduated high school in 1993 nearly all the textile factories were gone and you could see that NASCAR was getting to big for the city's infrastructure.
The leaders of Rockingham didn't invest in the infrastructure and technology that would create sustainable growth. Put simply, Rockingham was complacent and did nothing to prepare for future challenges.
I knew I wanted to be a dentist from the 8th grade. I watched my dad (a trained dentist in India but not practicing in the USA) make extra money by doing denture lab work. He fondly talked about dentistry as a great profession, but never really pushed me to go to dental school.
Early in 12th grade I noticed a college brochure in my English class for UMKC School of Dentistry for their 6 year dental program. Basically you would take your required undergrad courses in 2 years and were guaranteed admission into dental school as long as you maintained a certain GPA.
This sounded like EXACTLY what I wanted. I quickly applied, got an interview, and in March 1993 I was accepted into the program.
High school came pretty easy for me - I graduated in the top 10 without significant effort. I was convinced college would be the same. My hubris combined with partying earned me a 2.4 GPA my first semester. I was in danger of getting dropped from the 6 year program. Luckily I got my act together. It may have actually been the fear of disappointing my family more than anything else.
During undergrad I started my second business - custom t-shirts and party favors for fraternities and sororities. I kept this business till the end of dental school.
I didn't find dental school terribly difficult academically.. The problem was that I was easily distracted. My vice was gambling (Kansas City has riverboat casinos) and my new found hobby of golf. Between the two I missed lots of classes and clinic time.
I ended up having to spend a few weeks after graduation in the clinic to complete my requirements and finished in the bottom half of my dental class.
Oh, I forgot to mention that I was scared of blood, afraid of needles, and passed out watching a tooth being extracted.
After graduating dental school I joined a DSO practice in Raleigh, NC as an associate dentist in 1999. What attracted me to this was the fact that I was would be the sole dentist at the office. I was lead to believe I would be able to run the office and control my own schedule.
Needless to say it wasn't exactly what I envisioned it to be. Looking back I realize I didn't ask the right questions and/or get enough clarity on the practice structure. I blame myself (my lack of experience) on the failure, but don't regret working there. Today I feel that certain DSO practices can be an excellent starting point for young dentists.
After leaving the DSO practice, I went completely opposite. I joined a private group practice as their first associate dentist. I quickly realized two valuable lessons...
Since the practice didn't truly have enough business to support me and since patients seemed to prefer the 'senior' dentists - I wasn't busy advancing my clinical skills.
The great news here is that I had plenty of free time to read, learn, spend time in community forums (DentalTown), and take lots of continuing education.
Looking back, this commitment to learning would dramatically transform my life in the coming years.
After my stint as a dental associate I 'hung my own shingle' in 2001. Being young (I was 24) and impressionable, I was mesmerized by the 'dental gurus' telling me that dental insurance was evil and that the being insurance free was the way to go. So I decided to start the practice as a fee for service, cash practice free from insurance. This meant that not only wasn't I in network, I didn't even accept assignment - patients had to pay me upfront and file themselves.
It wasn't until about a year later that I realized that it was the equivalent of practice startup suicide. I was on the verge of bankruptcy and it took an intervention from my wife and father to help me see that taking dental insurance was a necessity to save my practice.
This taught me to keep one eye on the short term - SURVIVAL.
Starting being in network with dental insurance in 2002 allowed me to increase cash flow, start marketing for more cosmetic procedures, and get past the stage of worrying about surviving. Things were going well - in 2003 I bought my first house, in 2005 I bought a fancy new car, in 2007 I upgraded to a 'dream' house, and in early 2008 I bought a brand new large office building. Along the way our family grew with two kids (we now have three - four if you count me).
Then the 'great recession' crash of 2008 hit me like a ton of bricks.
Things got bad enough that in early 2009 I had to sell one of my cars to CarMax to help cover my bills. You see, those cosmetic cases that I was doing dried up overnight. My practice had literally become dependent on those for the profit - I had become a one trick pony. To make matters worse my wife was pregnant with our third child.
This taught me to keep one eye on the medium term - DIVERSIFICATION.
Having scratched and clawed my way through the recession, the practice came out stronger than ever. But now I was developing a new challenge. I was too busy, having to work harder just to feed the beast, and doing less of the dentistry that I wanted to do.
Conventional wisdom told me the key to making more money was to become 'more efficient' and see more patients. Next thing I know I was working multiple columns and running around like a chicken with its head cut off. It was leading to burnout.
Tired of my practice, needing more time off, and unhappy with what things had become - I hired an associate dentist in 2013. By the end of 2015 I had gone through 4 associates and was no better off.
What I learned was that by focusing and listening to others I put my happiness last.
Armed with a new focus on personal happiness - I got crystal clear on what an associate dentist looked like for my practice and went through a painful transition of losing 4 out of 6 team members in late 2015 and early 2016.
I now work less days than ever, do more of the dentistry I want to do, and haven't seen any drop in my personal production. Better yet, my practice functions well without me being present everyday but yet maintains my clinical and customer experience standards.
I've become a dental business.
These experiences taught me to keep my 'third' eye on the long term - FREEDOM.
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WHY I DO WHAT I DO?
HINT: IT'S NOT ABOUT MONEY OR FAME (although they are both nice)
My family & life experiences are the primary motivation behind everything I do.
You see, I wouldn't be writing this today if it wasn't for someone motivating my father to immigrate to the United States in 1977. I likely wouldn't have the drive to be an entrepreneur if it wasn't for someone encouraging my father to be his own boss and purchase his first motel in 1980. I likely wouldn't have the appreciation for constant education if someone didn't inspire my mother to go back to school at age 40 to help give our family a better life.
For my father that person was his oldest brother. For my mother that person was her father.
I hope by openly sharing my experiences that I can motivate, encourage, and inspire you to see a different path, achieve your goals, and continue to dream big.
MY 3 KEYS TO BECOMING A DENTAL BUSINESS
Developing clinical diversity by expanding your portfolio of services.
Implementing 'Patient Centric' frameworks that help patients say yes.
Focusing on personal happiness and developing work-life balance.
WHAT OTHERS ARE SAYING
Thank you for two great lectures. You are very inspiring. I am getting the new SL cone beam unit and will start placing implants again using guided surgery.
You really inspired me! Thanks again.
I attended your lecture "Implants in the CEREC Practice" at the CEREC 30 seminar in Las Vegas.
I was especially moved by your closing keynote in the Venetian ballroom on Saturday. I actually found you more inspiring than Tony Robbins and Emmitt Smith!
Tarun, thanks for an inspiring weekend of learning. Will definitely being identifying our 'champion' and working out protocols. We have already started creating awareness. Your course was the final piece needed.
You do an awesome job and I can't tell you enough how thankful I am that I signed up for the course. You made it such a great learning environment and our team can tell much you care that we learn and understand, but also enjoy ourselves.
If you remember, you sat with me for over two hours and discussed my future in dentistry. Well, I wanted to thank you for taking your time to talk. That made a huge impact on my life, as I reevaluated my goals and what I want out of this career.
You also mentioned that 'you are an average of the 5 people you hang out with'. I have found mentors who will accelerate my career and now surround myself with such people. Since I met you that day, the changes I have made helped me in becoming more confident as a clinician and I enjoy dentistry more each day.
Thanks again for your guidance, you helped me realize what it takes to be great not only in dentistry but also in life!