Founder & CEO, Foundation Dental Alliance
Dr. Jim Arnold
Thirty years in dentistry taught me that the decisions that shape your career rarely come with a roadmap.
Foundation Dental Alliance is the resource I wish I’d had when I was making those decisions.

The Beginning
I Didn’t Start With a Grand Plan
I graduated dental school in 1996 with $120,000 in debt. My roommate knew exactly what he wanted to do. I didn’t. I just wanted a job with a dentist I could learn from and make enough money to cover my bills.
My first year out, I made $39,000. My student loan payment alone was $1,200 a month. There wasn’t much left over.
In 1998 I met the woman who would become my wife. I had $6,000 to my name and a quarter million in debt. I spent $5,500 of that $6,000 on her ring.
We got married one year to the day before we bought our first practice together. That year, Sarah and I didn’t watch TV. We listened to every tape and watched every video we could find on running a practice, leading a team, and communicating under pressure.
By the end of it, we had a notebook with twenty-five pages of single-spaced, detailed notes, with every system that needed to change in the practice I’d worked in for two years. We put it on a desk calendar, square by square, according to its “to be completed by” date, and started doing the work.
It worked extraordinarily well. We lost some patients along the way, but we stumbled our way to success.
We made every possible mistake we could make because we were DIY-ing it. We were trying to figure it out as we went.
What Success Cost
Success created
a different problem.
We doubled the practice in our first year. My income went from $39,000 as an associate to roughly $450,000 as an owner.
By almost every conventional measure, things were going incredibly well, but two years later I was burned out.
I was seeing too many patients, moving constantly from room to room and trying to lead a team without really knowing how. I remember coming home and telling Sarah I couldn’t imagine practicing that way for another five years, much less another twenty or thirty. I was only thirty years old.
I can’t imagine doing this for another five years, let alone another twenty or thirty. I’m freaking 30 years old.
Sarah pushed me to change direction. Instead of accepting that this was simply what successful dentistry looked like, I started learning a different way to practice.
That decision led me to Dr. Michael Koczarski, PAC-Live and several years of intensive continuing education. From 2001 through 2005, I spent roughly 250 to 400 hours a year in CE. Over time, I sought out 17 different mentors across clinical dentistry, leadership, communication, business and systems. They didn’t always agree, and that turned out to be part of the education.
Having access to great people wasn’t enough. I still had to decide whose advice applied, how the pieces fit together and what would actually work in my practice.
The Record Behind the Story
Thirty years built more than one kind of record.
31% EBITDA
Built his own multi-location fee-for-service practice group.
250-Practice DSO
Vice President of Clinical Services; dentists in his cohort averaged 39% production growth.
$100M+ in Transitions
Facilitated 60+ transitions that helped launch four successful DSOs.
National & International Educator
Live-patient clinical instructor with the Hornbrook Group. Lectured across nine cities in India.
National Dental Leadership
Peer Review Chairman. International Fellowship Chairman. National Advisory Boards.
Mensa · Rhodes Scholar Nominee · All-American
Six Division I varsity letters. Two state championships. Academic All-Big Ten four times.
The Decision That Changed Everything
I lost $15 million in a single day.
On September 3, 2020, a decision I had believed would create generational wealth did the opposite. I’ve told the full story because what happened afterward changed how I think about ownership, risk, and every important decision since.
Full Transcript
(0:00) I feel like I did everything right.
(0:02) Nineteen years led up to the day that I was going to, like, sell my life's work and partner with guys that I really trust and really respected, and that's what it was all about because I always wanna be in a room full of smart people.
(0:15) People are smarter than me.
(0:16) People are more successful from than me.
(0:18) People that I can learn from.
(0:20) And I've always surrounded myself with those people, and that's the room that I was in.
(0:24) And that's why I decided to partner with them, because they were just great people, and they had an amazing vision that really resonated with me.
(0:30) And so was amazing.
(0:32) I mean, it wasn't all rainbows and unicorns, of course.
(0:34) You know, they were a startup, and they like, there were some things that they had to, like, figure out.
(0:39) And, you know, I was in a position to help them figure those things out because I'm a dentist, and I knew exactly what we needed as as teams, as leaders and teams.
(0:49) So fast forward three years, and holy cow, they grew to 79 practices.
(0:54) It seemed like overnight, it went so fast.
(0:56) And I had a part in probably fifty years 55 of those deals, you know, helping bring dentists through that process.
(1:03) And by the way, I'm not a yes man.
(1:04) So I wasn't just, like, saying what they needed to hear to say yes.
(1:08) I was like, hey, man.
(1:09) Here's the good.
(1:10) Here's the stuff I don't like so much.
(1:12) But what I will say is they have operated in integrity every step of the way.
(1:17) What they said that they would do for me, they've done for me.
(1:21) When I have pushed back, they've said, okay.
(1:24) We got you.
(1:24) It's all good.
(1:25) And so, you know, when it comes time to transition, if this feels right for you, if the deal is right and it feels good for you, I would love to have you join us.
(1:35) But if it's not, it's okay.
(1:36) You know?
(1:37) You can still call me.
(1:38) You can, you know, talk about whatever you wanna talk about.
(1:40) So it was it was pretty amazing that in three years after signing on the dotted line, they're recapping.
(1:47) So a recap is basically where they are selling to a bigger company.
(1:51) You know?
(1:52) They were a boutique PE firm that just grows from scratch up to a certain level.
(1:57) And when you hit that certain level, yeah, like, four or 500 bigger entities that want to buy that.
(2:03) And so it became this big thing, and they sold to, you know, $2,000,000,000 private equity firm.
(2:08) I thought, oh my god.
(2:09) Like, that's amazing.
(2:10) They have, like, unlimited resources.
(2:12) They're too big to fail.
(2:13) Like, this is gonna be really great.
(2:15) And I get to roll all this money that I just got these millions of dollars back into it and get more money in three to five years when they do it again.
(2:24) And I heard stories about guys who, like, went through four of these recap experiences with Heartland Dental specifically, ended up, like, $70,000,000, a $100,000,000.
(2:34) Now I didn't anticipate that.
(2:36) I didn't even need that.
(2:37) I had a number.
(2:38) I had a number in mind, and this second recap would get me to that number.
(2:44) And, of course, I'm not the kind of guy who's gonna stop working.
(2:46) I'm the kind of guy who's gonna be like, oh, man.
(2:49) Like, I am truly and fully financially secure.
(2:52) Now I can just do what I want to do, what I'm passionate about.
(2:55) Like, take all of those things I wanted to do at 50.
(2:57) Like, the timing is gonna be perfect.
(2:59) And it was.
(3:00) Everything was going so well.
(3:02) Oh my god.
(3:02) Was it six months so much from 79 practice to, I think, a 120?
(3:05) Like, it's like, holy crap.
(3:07) What I didn't realize and what I didn't understand at the time was they had to borrow a lot of money to do that.
(3:13) They actually grew too rapidly.
(3:15) And then this new company, they just had a different philosophy, a different mindset from the PE firm that I ended up partnering with who are still my friends.
(3:24) I have so much respect for them.
(3:25) They're amazing humans.
(3:26) But, you know, when it came time to that recap, we had forty eight hours to decide how much of that millions of dollars are gonna push back into it.
(3:34) And, you know, my private equity friends, they're like, well, we're going all in.
(3:38) I said, well, you know, way more than I do, so let's go.
(3:41) Let's go all in.
(3:42) And, man, again, things seem like they were going so well, but the mismanagement, I think they got out in front ahead of their skis.
(3:50) You know, they got to a point where they had so much debt that when the pandemic hit, oh my god.
(3:57) The shit hit the fan.
(3:58) I mean, everything that was I thought was going so well.
(4:01) My my equity is worth, like, $15,000,000.
(4:03) Like, oh my god.
(4:04) I remember when my kids came home from boarding school at the start of the pandemic, and the six of us are sitting around the dinner table.
(4:11) I I said something that I that I think I said it and god laughed because I said and this was probably 03/13/2020, you know, the day that the the world shut down, the dental world shut down.
(4:26) I told my kids, I said, kids, like, we worked hard.
(4:29) We've done it right.
(4:30) We took care of our team.
(4:31) We took care of our patients.
(4:32) We took care of other dentists.
(4:34) And, like, we're in that, like, top point 5% that, like, saved and, like, made great decisions, and we're bulletproof.
(4:44) You know?
(4:44) We have no debt.
(4:45) We're in a beautiful home.
(4:46) We're all here together.
(4:47) Whatever happens outside with a pandemic, we're gonna be fine here together.
(4:52) And so let's make sure we come out the other end better, stronger, healthier than we've ever been.
(4:57) And so everybody's like, okay.
(4:59) And it's like the next day, we actually had to put up a sign up sheet for our home gym.
(5:03) Like, so that everybody could, like, get their time in the gym because we were all like, hey.
(5:07) We're gonna be amazing when we come out of this.
(5:10) So oh, man.
(5:13) They shut down dentistry for ten weeks, and that was 03/13/2020.
(5:18) On 05/04/2020 is the day that they opened practices back up again.
(5:23) And incidentally, that was literally the five year anniversary of my deal with the DSO.
(5:29) And so my five year commitment, my five year contract, I honored it.
(5:32) I could've walked away at any point, but I'm like, nope.
(5:34) I'm an honorable guy.
(5:35) I'm gonna do the whole five years.
(5:37) I did it.
(5:37) That was the day.
(5:39) And you know what?
(5:40) In twenty four years, I never had a sick day.
(5:42) Not one.
(5:43) In twenty four years, I never missed a day no matter how sick I was, no matter what was going on until that day.
(5:48) That was the day I said, guys, it's the last day of my clinical career.
(5:51) And I it's not like I just sprung it on.
(5:53) They knew it was coming.
(5:54) But it was first day that I actually missed in the office, 05/04/2020.
(5:58) And I thought, man, we're bulletproof.
(6:00) And when the pandemic ends, like, I'm gonna be in perfect position to, like, jump back in and maybe run a company someday.
(6:06) Do something really cool.
(6:07) Like, create all this value for dentists and for patients and for teams.
(6:11) And oh, man.
(6:13) I told you, you tell god your plans and he laughs.
(6:17) 09/03/2020, there was an investor call where the 10 dentists who had equity in the company, the mothership that had rolled millions of dollars into this next iteration, It was an investor call, like an owner's call.
(6:32) I'm like, oh, cool.
(6:33) They're gonna give us all this good news.
(6:34) Like, we grew and all this stuff and your money.
(6:36) You're like, we're gonna sell in six months or something.
(6:39) Like, oh my god.
(6:39) This is gonna be amazing.
(6:41) And so that evening at 05:30, I sat in my office.
(6:44) I got on the call.
(6:45) It was forty five seconds long.
(6:47) It was a recorded message.
(6:49) The recorded message said, oh, hey.
(6:52) We're really sorry, but we mismanaged the company.
(6:55) And the pandemic hit and shut down dentistry, and the bank took everything, and you're screwed.
(7:01) There is no recourse.
(7:02) Your money's gone.
(7:03) Sorry.
(7:04) And hung up, basically.
(7:06) I dropped the phone and just I was stunned.
(7:10) I'm like, are you kidding me?
(7:11) This is my whole career.
(7:12) Like, everything I worked for for twenty four years was wrapped up in this equity.
(7:17) Everything.
(7:18) And I just lost $15,000,000.
(7:21) Like like, wait.
(7:22) What?
(7:23) I came from a middle class family.
(7:24) Like, I I did everything I could to be successful and do it the right way.
(7:31) And they told me in a forty five second recorded call that I was screwed.
(7:35) It was gone no matter what.
(7:37) I immediately called my private equity friends, left them messages.
(7:41) And about five minutes later, they called me back to their credit, and they said, Jim, like, we we're just stunned because they lost even more money than I did.
(7:49) But $15,000,000 went I never even thought like, that wasn't even a thought that I never had that kind of money.
(7:55) But I told my kids we're bulletproof, and all it took was six months for all of it to be gone.
(8:00) So then I had to go out and tell my wife this.
(8:03) And I went out just come stunned, and I, like, stuttered through it.
(8:07) She's like, oh, Jim.
(8:08) That's ridiculous.
(8:09) I'm like, no.
(8:11) Like, legit.
(8:12) Like, we just lost everything.
(8:15) And, my god.
(8:17) Talk about something like a moment that changes your life forever.
(8:20) I mean, it was the worst thing that ever happened to me.
(8:22) I mean, not I mean, I'd I I'm I'm gonna say I I led a barely charmed life, but we also make our own opportunities.
(8:30) You know?
(8:30) I worked my butt off every stage of the way to be the best that I could be at everything I did.
(8:35) And, you know, I did pretty damn well and to get hit with this shocker.
(8:42) You know, I'm the kind of guy who normally just, like, jumps back up and let's go.
(8:45) Like, let's fix this.
(8:47) It'll be fine.
(8:47) You know what?
(8:49) My wife was freaked out.
(8:51) I was despondent.
(8:53) I didn't see a way out, and I fell into the deepest, darkest, longest depression in my life.
(9:00) Like, I mean, like, within an hour, I wasn't sure how I was gonna get through the next year.
(9:07) Like, legitimately, I was like, there's no hope.
(9:12) Like, I can't, like, go back and wave a magic wand and, like, get all that money back that I worked so hard for.
(9:19) And I don't know what the hell I was gonna do.
(9:23) And so, you know, ultimately, started making plans and went through the motions, and I did a cup some things, and I helped do some deals.
(9:31) And but I was just, like, sleepwalking through the whole thing, gained, like, 50 pounds.
(9:37) I went from being in my forties, like, a top 2% triathlete.
(9:41) You know?
(9:42) I was 7% body fat.
(9:43) I was, like, like, really competitive.
(9:46) Like, the stuff I did in my teens and twenties, I'm like, I'm back.
(9:49) And I'm like, wow.
(9:50) This is amazing.
(9:51) And I went from that to 30% body fat and at five foot eight, two hundred and four pounds.
(9:56) And just in such a dark depression, like, I didn't see a way out.
(10:00) Like, I had no idea what was gonna happen.
(10:02) And, you know, the worst part is really just how it impacted my family.
(10:09) I mean, like, I'd never, like, failed at anything.
(10:13) And I felt, like, so guilty and embarrassed and ashamed, and I felt like, my god.
(10:19) Like, the the the pride that I felt about what I built and what I accomplished.
(10:24) I did it right and all this kind of stuff.
(10:25) It was just, like, all wiped away.
(10:27) And I thought, man, people are gonna, like, laugh, and they're gonna say, well, you know what, mister smart guy?
(10:34) You know?
(10:35) Sorry.
(10:36) You know?
(10:36) Stuff happens.
(10:37) And I I didn't wanna tell anybody.
(10:39) I just wanted to crawl into a hole and die.
(10:44) And so you gain all that weight, and you don't wanna leave the house, and you hate what you see in the mirror, and you feel like a failure.
(10:51) You feel like you left you let your family down.
(10:55) It was bad.
(10:56) Well, four hundred and eighty four days ago, thank god.
(10:58) Like, I I was actually in Bermuda, believe it or not.
(11:02) A buddy of mine was putting on a conference there.
(11:04) It's actually Len Len Tao's Supercharge Your Dental Practice Conference.
(11:07) And my friend Matthew said, hey, man.
(11:10) Just come on down.
(11:11) Come hang with us for a few days.
(11:12) You know, it'll be really fun and blah blah blah.
(11:14) I'm like, alright.
(11:15) Yeah.
(11:15) What the hell?
(11:15) I'm just I'm gonna go to Bermuda.
(11:17) I've never been there before.
(11:18) Hang out with my friends to just have some fun and talk to all the speakers and schmooze and network.
(11:23) Whatever.
(11:24) Because I could still go and be gregarious and, like, mean, faked it for four years.
(11:28) When I'm silently dying inside, I faked it.
(11:31) I tried to be normal Jim, even like big fat Jim.
(11:34) I'm, like, still just friendly and talking to everybody and just trying to be me.
(11:38) But that weekend, it was a turning point.
(11:41) Thank god.
(11:42) Because I needed something to change it all up.
(11:44) Well, the first keynote speaker was a a guy named doctor Jeff Buskey, and he had been through something not the same, but similar.
(11:52) The things that so many dentists go through, you know, be it substance abuse and not like an addict, but when you start to what did he say?
(12:03) Sedate, you know, with wine or beer or whatever.
(12:06) You know, just like the end of the day, it's like, oh, man.
(12:08) I need a couple glass of wine.
(12:10) You know?
(12:11) He went through this whole thing where he didn't know what he was gonna do.
(12:15) And through a series of events and mentorship, he turned his whole life around.
(12:20) And he set all this on a stage, and it was so powerful.
(12:24) His story was so powerful, and his new passion he'd he'd done all these things.
(12:28) He was more fit than ever.
(12:29) His his marriage was better than ever.
(12:31) His family was stronger than ever.
(12:33) His practice went from 1,000,000 to 4,300,000 in a three day work week.
(12:37) And I'm just looking at this guy.
(12:38) I'm like, oh my god.
(12:39) Like, once again, I want what you have.
(12:43) Like, I have been I am right now where you were ten years ago.
(12:48) And guess what?
(12:48) Like, show me the way, man.
(12:50) And by the way, there's too many dentists out there feeling the same way.
(12:54) I am committed to helping you spread this word.
(12:58) Whatever it's gonna take, like, I wanna get you in front of everybody I can.
(13:01) I wanna introduce you to all my people and just make sure that your story gets heard far and wide.
(13:08) And you know what?
(13:09) A few weeks later, he's like, hey, Joe.
(13:11) I've been thinking.
(13:12) I'm just gonna take you on as a coaching client.
(13:14) I'm like, oh, man.
(13:14) But, like, I've, like, lost all my money.
(13:16) And he's like, no.
(13:17) No.
(13:17) No.
(13:18) No.
(13:18) I'm just like, let's talk every week, and I'm gonna walk you through the whole process.
(13:21) And holy cow.
(13:23) So much in life, when you wanna make changes, it's so important to have accountability.
(13:29) You know, to have somebody who's actually following up, somebody who's been there, somebody who has experienced what you're experiencing and come out of it better, healthier, wealthier at the end of that process.
(13:41) And Jeff was that guy for me.
(13:44) I owe him a lot.
(13:45) I owe him a lot because he asked me good questions.
(13:49) He asked me good questions.
(13:50) I didn't have any picture.
(13:52) I had no idea what the hell I was gonna do.
(13:53) I didn't have a clear vision for how I was gonna create value.
(13:56) And with, like, just a couple of conversations, I got clarity.
(13:59) I'm like, oh my gosh.
(14:00) Well, I love doing this.
(14:02) And I'm going to combine that with my love for luxury travel.
(14:07) Luxury Dental Retreats was born.
(14:09) I mean, being in the education space as a student and as an educator, I loved both.
(14:15) But I really loved it when it's a small group.
(14:17) When you have a small group of like minded professionals in a room together, you can really go deep.
(14:23) You can get real.
(14:24) You can have real conversation.
(14:25) I always used to joke that I got more value from nine PM till 3AM, having real conversations with people about, like, all the stuff that you can't really say or you're not going to say in a room full of a 100 or a thousand people.
(14:39) I'm like, man, I would love to recreate those rooms for dentists who really want, like, to learn from myself and my friends, my peers, my network, my alliance, these people who have so much offer.
(14:54) Like, I can bring them together in these small groups.
(14:57) Oh my god.
(14:58) We could create magic together, transformation.
(15:01) So then I thought, gosh.
(15:03) And again, this is a product of some really good questions that Jeff asked me.
(15:06) But I'm like, man, I also love luxury travel.
(15:09) I've been doing it with my family for the last twenty five years.
(15:11) You know, I'm a travel snob, and I'm like, put that out there into the world because I enjoy it.
(15:16) Hence, I'm like, oh my gosh.
(15:18) Well, why don't we do all this stuff in really cool locations?
(15:21) I don't wanna go to the freaking Marriott and sit in a conference room.
(15:24) Like, I wanna go to freaking, you know, Dubai or Mexico or Dominican Republic or, you know, wherever, Costa Rica.
(15:35) And, like, get people outside their comfort zone.
(15:38) Get people outside of the the everyday, like, distractions and all that thing and make this a really an intimate setting with amazing people where you have full access and have those real conversations.
(15:50) And, man, luxury dental retreats was just the start.
(15:53) It's so amazing, and we've had a couple of retreats where we got true transformation.
(15:57) Every dentist who has come has gotten, like, massive ROI, you know, not just in terms of dollars and cents.
(16:03) They definitely got that.
(16:04) But, like, return on relationships.
(16:07) You know?
(16:07) Like, what they got was, like, me in their corner for the rest of their careers.
(16:12) And then I realized, well, jeez.
(16:14) Like, there's way more than just this.
(16:17) Like, I'm gonna put together a whole community, which turned into the Foundation Dental Alliance.
(16:23) And you know what?
(16:24) Without those questions, without that clarity, without Jeff helping me get on track in my life because by the way, he gets into body being balance and business.
(16:34) I mean, that's basically, like, let's get healthy in body, mind, and spirit.
(16:38) You get there, it's gonna impact your relationships in an amazing way, and it's gonna impact your business in an amazing way.
(16:45) And so I got, like, really granular on all of that.
(16:50) I started getting up at five in every morning, and I'd have coffee with my wife for twenty eight minutes, talk about our day.
(16:57) And by 05:30, I'm sitting at my desk reading something for personal growth, which I've never been able to focus on those books.
(17:03) Like, I I've got, oh my god, a 100 of those books.
(17:06) I can never get through them all the way because I get distracted.
(17:09) Well, doing it in thirty to sixty minute increments, like, I'd get in, and I'd just keep reading and reading.
(17:14) Then I would meditate, get my my spirit, like, aligned, and then I would journal.
(17:19) I'd start getting all my feelings and thoughts out on paper, actually, on my computer.
(17:24) And then I would go through some gratitude exercise because it's so important be grateful for everything we have even at the the darkest moments.
(17:32) We're still so blessed.
(17:37) And and you know what?
(17:38) Realizing that is what turned everything around.
(17:43) For the first time in four years, I stopped looking back and I started looking forward with purpose.
(17:49) And every day that I sat down at my desk and got into how am I gonna be a better version of Jim in in my mind?
(17:56) How am I gonna be a better version of Jim in my soul when I meditated?
(18:00) How am I gonna be a better version of Jim physically when I went down to the gym?
(18:04) And by the way, like, I got into that not as the athlete that I was because I've always been all or nothing.
(18:11) I'm like, all out.
(18:12) All out or nothing.
(18:13) And you know what would happen historically speaking at any time where I maybe got out of shape or whatever?
(18:19) Within two weeks, I'd be injured.
(18:21) Within a month, I'd be burned out.
(18:23) Within a few weeks, I'd be traveling and get off my routine, and I'm being all or nothing.
(18:28) It just never worked out, and I never really got to where I wanted to be except when I went all in on triathlon, which, by the way, I was doing triathlons with torn Achilles tendon, torn hamstrings, torn rotator cuffs, which herniated discs, but I just, like, powered through it all.
(18:43) This time, I decided I'm gonna do it right 1% daily.
(18:47) I don't have to, like, eat the whole elephant.
(18:50) You know?
(18:51) I just like, one bite at a time.
(18:54) 1% daily in my body, mind, and spirit.
(18:56) And it's it was like magic.
(18:58) Like, the weight started to melt off me.
(19:01) I mean, I'm now four four hundred and eighty four days in.
(19:04) I have not missed a workout four hundred and eighty four days, and I did lose 60 pounds in the process, which is great.
(19:10) But what I really gained was the clarity and the kind of wherewithal and ability and energy and drive to take everything I've done in my twenty nine year career and put them on a silver platter for dentists who need those solutions, who need that clarity, who need that pathway to, again, just having a a fulfilling career where they don't have to DIY it.
(19:37) They don't have to trial and error it.
(19:38) They can follow myself and my alliance and my trusted partners down this path to success and create whatever kind of practice they wanna create.
(19:48) And you know what?
(19:49) Maybe without having gone through this darkness for four years without not without having a purpose and being so out of shape.
(19:57) I mean, I I used to laugh laugh because I would just, again, put on a happy face, and I'd I'd make fun of myself at how fat I had become and how unhealthy I was.
(20:05) And I'd say, yeah.
(20:06) I'm one cheeseburger away from a heart attack, you know, and guess what?
(20:09) Wasn't too far from the truth, I mean, frankly.
(20:12) So now here I am, a healthier version of myself, a more positive version of myself, and a man who is looking to the future with great enthusiasm and hope and excitement for what I've already done for the Denison, my my sphere of influence, and just the potential and all the things I'm gonna do with everybody who comes in and joins the alliance and joins the mastermind and goes to Dubai and goes through a transition process with us.
(20:41) I mean, because I've worn all the hats.
(20:43) I've experienced, I think, just about everything you could do in dentistry.
(20:47) And now I've come through to the point where I can give it all to the dentists who want a piece of that, and that makes me happy.

Beyond the Chair
Building something
bigger than me.
Long before any of that, I’d already learned one hard lesson about ownership.
As my practices grew, I ran into a problem I’d created myself. Too many decisions still depended on me, and I didn’t notice it until I was somewhere that should have had my full attention and it didn’t.
So I changed how I led. I stopped trying to answer every question myself and started developing people who could make good decisions without me. Leaders emerged, decisions moved closer to the people doing the work, and several people who grew during those years eventually became executives inside DSOs themselves.
That experience changed how I measured success. Growth mattered, but so did whether what we’d built could perform when I wasn’t there.
The problem wasn’t my team. I’d built a system that trained good people to wait for me.
Why Foundation Dental Alliance Exists
So I built what I wish I’d had.
Every mentor, every practice, every year of leading a team, and the year I lost everything all pointed to the same gap. There was no single place where a dentist could find the perspective, relationships, and support to make better decisions across an entire career.
Good decisions start with better information.
Foundation Dental Intelligence delivers practical ideas, conversations, and perspective on leadership, growth, practice value, and freedom.
I built Foundation Dental Mastermind so dentists don’t have to figure this out the way Sarah and I did. See how it works →
Full Transcript
(0:0) A lot of people in dental school, they have a pretty clear vision of what they're gonna do.
(0:03) I shouldn't say a lot of people.
(0:04) My my roommate in dental school, he knew exactly where he wanted to go.
(0:07) He knew exactly what he wanted to do.
(0:09) He had a clear vision, and I didn't know anything.
(0:12) I was like, oh my god.
(0:14) What am I gonna do with a $120,000 worth of debt?
(0:16) I mean, this was 1996, so that's probably, like, 400,000 today.
(0:21) I don't know.
(0:21) But it felt like a lot.
(0:23) And I didn't have a clear vision.
(0:25) I just wanted to get a job.
(0:26) Like, I wanted to work with a dentist who I could maybe learn from and pay, you know, pay my bills, all that sort of thing.
(0:32) My first year out of dental school, I made $39,000, literally.
(0:37) And my student loan payment was, like, $1,200 a month, and my condo that I bought was, like, $1,000 a month.
(0:44) And there was, like, no money left over.
(0:46) In 1998, I met my wife, my future wife, I should say, and I have, like, $6,000 to my name.
(0:54) And I had, like, over $500,000 in debt, and I had $6,000.
(0:58) You know what I did with it?
(0:59) $6,000?
(1:00) I spent 5,500 on it on her ring.
(1:04) So it it's so funny to look back to those days and, like, oh my gosh.
(1:09) She all you have is, like, this dream.
(1:11) You know, this dream that you don't even know what kind of shape it's gonna take.
(1:15) You're just kind of, like, flying by the seat of your pants to some degree.
(1:19) And you know what?
(1:20) We got married one year to the day before we bought our first practice together.
(1:26) And that that was a crazy year because we got married, and then we spent, like, eighty hours a week for a year.
(1:33) Like, we used to watch TV.
(1:35) We went a year with no TV where all we did was listen to audio tapes, watch video tapes, go and hear all the gurus talk about how to manage your practice, how to lead and communicate, all that stuff for a whole year.
(1:48) And you know what we came up with?
(1:50) We came up with, a notebook.
(1:52) 25 pages, single lines, just filled with the things that we had to do and change in this practice that I've been in for two years.
(2:01) And, you know, it was crazy because then we took all of that.
(2:04) We divided it into 25 systems.
(2:07) And you remember those big desk calendars?
(2:09) We had a big desk calendar with the little squares on it, and every single thing, every single line item, we put on a square, on a date and said, by this date, we're going to implement these changes.
(2:21) We're gonna do all of these things.
(2:22) And you know what?
(2:23) It worked extraordinarily well.
(2:26) But we also made every possible mistake we could make because we're, like, DIY ing it.
(2:31) We're trying to figure out as we go.
(2:33) And, oh my gosh, the plethora of mistakes we made, and we lost patience, and all these things.
(2:37) But, you know, we stumbled our way to success.
(2:39) I mean, in the first year, we doubled the practice.
(2:42) I mean, we did lose some patients, but we doubled the practice.
(2:45) The patients got what we were doing and understood that we were just taking things to another level.
(2:50) And and it was amazing.
(2:51) You know, we worked so hard.
(2:53) Oh my gosh.
(2:54) So hard.
(2:55) And, you know, my income went from 39,000 to, like, 450,000 as the owner.
(3:01) It's like, wow.
(3:02) This is amazing.
(3:03) But guess what?
(3:04) After two years of that, I was so burned out because I was seeing so many patients.
(3:09) We had a really low fee schedule, and and it was like, I was just pinballing back and forth.
(3:14) I was on, like, roller skates every single day, and I'm dealing with a team that I didn't hire.
(3:19) I inherited them, and I love them.
(3:21) You know, they're like family after three years as an associate in our office.
(3:25) So I had all these relationships, and I knew what to do.
(3:28) I knew what to say.
(3:29) I was doing it all in integrity.
(3:31) And guess what?
(3:32) Every single patient was saying yes.
(3:34) Oh, my god.
(3:35) Which is a great problem to have, but it was a problem.
(3:38) Because I would go home exhausted at the end of every day after 40 or 50 conversations with people who have anxiety and trying to manage a team of seven women who, like, needed things from me that I didn't have yet.
(3:51) I didn't have all of those skill sets.
(3:53) I was just learning them by trial and error.
(3:56) And so honest to god, I, one night, came home and said, I I don't know how much longer I can do this.
(4:01) I mean, we are making more money than we ever thought possible.
(4:04) We both grew up very middle class.
(4:06) You know?
(4:06) Our our parents had great jobs.
(4:08) They worked hard.
(4:09) They had integrity.
(4:11) They showed us the right way to live life, the right way to treat people, which, you know, is so important for every kid, you know, to have that great foundation that, you know, makes sure that you not only work hard, but you're respectful and you're appreciative of what you have.
(4:27) So we started with that.
(4:29) And we knew from day one, as long as you treat people right, as long as you always make it about the patient and take care of your team, success will follow.
(4:37) And it did.
(4:37) But that night, I came home and said, I can't imagine doing this for another five years, let alone another, like, twenty or thirty years.
(4:45) Like, I'm gonna die at the chair, and I'm, like, freaking 30.
(4:49) Like, what the hell?
(4:50) I I had no idea how strenuous dentistry is.
(4:53) I mean, it's physically demanding.
(4:54) It's mentally demanding.
(4:55) It's emotionally demanding.
(4:57) And then you're worried about money, and you're worried about your team and this patient.
(5:01) And if something isn't perfect, by the way, nothing is ever perfect.
(5:04) But when you're looking at things through five times magnification, you see that, like, tiny, tiny little thing, you're like, oh my gosh.
(5:10) You know?
(5:11) One of the one of the things that changed my whole life was Yeah.
(5:15) My wife actually decided, look.
(5:18) You shouldn't just be a general dentist, like, just doing all this bread and butter stuff.
(5:22) She's like, why don't you go out and, like, learn how to do, like, smile makeovers and all the stuff that's fun?
(5:26) I was like, oh, that's a lot, though.
(5:28) I don't know.
(5:29) And she's like, no.
(5:30) Just just go do it.
(5:31) That's more you.
(5:31) So okay.
(5:32) So I went to one of those discus dental extravaganzas back in 2001.
(5:38) Actually, I think right before September 11, in fact.
(5:41) And I remember I was in a a side room.
(5:44) Michael Kaczarski was doing the bread, butter, and caviar cosmetic dentistry.
(5:47) I'm looking at this.
(5:48) I'm like, man, this guy's so young, and he had a practice exactly like mine five years ago.
(5:52) Now he's, like, at the top.
(5:54) He's doing all these big cases.
(5:55) He's teaching.
(5:56) I'm like, oh my god.
(5:57) Like, at the first break, I couldn't even wait.
(5:59) I ran up to him like, oh my god.
(6:01) I'm like, right where you were five years ago.
(6:03) Like, how do I get to where you are right now?
(6:05) He's like, oh, well I'm like, can I come visit your office?
(6:09) He he was like, okay.
(6:11) I guess so.
(6:11) But right now, why don't you just go across the hall, sign up for pack live?
(6:15) Like, you need to take the hands on course to learn how to do a 10 veneer kiss.
(6:18) I'm like, okay.
(6:19) Done.
(6:20) I went across the hall during the break, signed up for Pac Life, went back into the room, and loved the rest of it.
(6:25) Like, oh my god.
(6:26) I have a new vision, and I have hope.
(6:28) I have hope because if I knew that kind of work, I'm not gonna see 30 or 40 patients in a day.
(6:33) I might see two or three, and I can really spend time with them.
(6:37) And it wasn't like I felt like I was rushing through dentistry.
(6:39) I mean, I've always been efficient.
(6:42) Without rushing, I could be very efficient, and I figured out how to, like, balance and how much I talk to a patient, all that sort of thing.
(6:48) But that was something that was exciting.
(6:50) And so sure enough, from 2001 until 2005, I was doing, like, two hundred and fifty to four hundred hours of CE every year.
(6:58) I was dragging my team all over the country.
(7:00) I was spending probably a 100,000 to $200,000 a year on travel and tuition and all of the things.
(7:08) And and driving my team crazy, of course, because, like, oh my god.
(7:11) Like, shouldn't we just, like, stay home and implement some stuff and then, like, go to another thing?
(7:16) So, I mean, it was an adventure.
(7:17) Let me tell you.
(7:18) And our our income actually got cut in half during that time.
(7:21) But I had faith.
(7:23) I had a vision.
(7:24) I'm like, you know what?
(7:25) However long it takes, like, I am going to transform this practice into one where I can spend as much time as I need with a patient to get to know them, spend time with them.
(7:34) And I know patients liked me and stuff.
(7:36) They didn't get as much of me as I would have liked to have given them.
(7:40) And by the way, when you wanna do these big cases and charge 10,000, 20,000, $50,000, well, you gotta be in relationship with them.
(7:48) You gotta understand them.
(7:49) They gotta feel safe.
(7:50) They gotta feel like you're the person.
(7:53) You're the one.
(7:54) You're the only one who can do it for them.
(7:56) And guess what?
(7:56) That's not even enough because your team has to be that team.
(8:00) You know, when you wanna do fee for service dentistry, it's a whole different ballgame from the standpoint of leadership, communication.
(8:08) You gotta have your act together.
(8:10) And, like, a a dental practice is only as good as its weakest link.
(8:14) Because when you're talking about people spending a lot more money out of pocket because you're out of network, they've got to see the value.
(8:22) You have to be able to create value through your conversations, through how you make them feel.
(8:27) Not just what you say, but how you make them feel.
(8:29) You make them feel safe.
(8:30) Make them feel heard.
(8:31) Make them feel like they're a person and not just another number, which tends to happen sometimes in these, like, high volume practices.
(8:38) And again, in dentistry, it's great.
(8:40) You can practice it 50 different ways.
(8:42) Like, whatever floats you broke.
(8:43) Like, there are great PPO practices.
(8:45) There are even practices doing really good Medicaid work.
(8:48) But you have to have efficiency of scheduling, efficiency of clinical, and just have it all lined up, and and you can do it.
(8:57) That having been said, we have a choice.
(8:59) We get to do it the way that we wanna do it.
(9:01) And at a very early stage in my career, said, you know what?
(9:04) There is no way I'm gonna work with an insurance company, give them 50% of what I do.
(9:09) I work way too hard to, like, discount my services 50.
(9:13) And by the way, then I'd have a ton of things that I would lose money on.
(9:17) So I was like, nope.
(9:19) We are going to set our fee schedule.
(9:21) We are going to make our relationship all about the patient, and their relationship with the insurance company is theirs, not ours.
(9:29) So that is really what gave us the freedom to build the practice that we wanted because we could spend money on technology.
(9:35) We could spend money on CE.
(9:36) We could spend money to retain the best team possible, and that's what we did.
(9:41) I mean, we created what I called the best dental team on the planet, and then we built a second best dental team on the planet.
(9:48) And then we built a third best dental team on the planet.
(9:50) We just use the same playbook.
(9:52) Now the practices were all different.
(9:54) You know, they're different spaces, different people, different overall vibe, but the systems are what remain the same.
(10:00) And the systems and the communication of the team, that's what a buyer is gonna look at at some point.
(10:07) I don't care whether you're buying your first practice today or you've had it for five years or you're looking to transition next year.
(10:13) Like, you gotta always be thinking about that.
(10:15) You know, begin with the end in mind and then reverse engineer it so that when it comes time to sell, whenever that is, you've got an asset.
(10:24) You don't just have a job.
(10:25) Too many dentists just have a job.
(10:27) They go to the office and they do what they're using.
(10:29) They're working in the practice instead of on the practice.
(10:32) What did I do?
(10:33) I brought in amazing associates.
(10:35) Associates that didn't necessarily wanna own, but they wanted to be in a great space where they could do great work and there were no there's nobody telling them go faster or do this or say that they need that.
(10:45) And, you know, it's just like, look.
(10:47) Come home.
(10:48) You know?
(10:49) Let's let's work together.
(10:50) Let's be a team.
(10:51) And and so that's what we built.
(10:53) So jumping ahead a little bit, I also had four kids during that time.
(10:58) I was in state leadership, then I was in national leadership.
(11:01) I was teaching with the David Hornbrook group.
(11:03) I was on the road 25, 30 weekends a year.
(11:06) My life was beyond crazy.
(11:08) And about that time, my wife and I decided to get into an Ironman triathlon.
(11:12) You know?
(11:12) We had both been athletes our whole lives.
(11:14) You know?
(11:14) I was an all American runner in high school and ran division one in college.
(11:18) You know?
(11:18) Talk about competitive.
(11:19) I was pathologically competitive.
(11:21) I had this drive.
(11:23) I never wanted to be just a runner.
(11:24) I never wanted to be just a dentist.
(11:26) I never wanted to be just anything.
(11:27) I wanted to be the best that I could be.
(11:29) Didn't always mean that I'd be the very best one out there, but I would reach my full potential no matter what that was.
(11:35) And so with my team and with the people I work with, I have that same expectation, but not from the standpoint of you have to be as good as me at this or whatever.
(11:43) It's just like, what can I do to help elevate you to the best place you can possibly be?
(11:49) And you know what's awesome?
(11:50) All of the office managers that worked with me over the years, they're all now executives with different DSOs doing really cool things.
(11:56) They have big jobs.
(11:56) They're making a lot of money.
(11:58) They feel respected.
(11:59) They feel like all that hard work, all the flying around the country, and doing all these things every weekend, like, really paid off in a big way.
(12:05) And by the way, they're still my family, you know, all these years later.
(12:08) But we got an Ironman Triathlon, and that was, like, twenty hours a week.
(12:13) And that was about the time where I decided, you know what?
(12:15) I'm not gonna, like, do dentistry for the rest of my life.
(12:19) I was like, you know, there's gonna come a time where I wanna parlay all of my experience, all of my knowledge, all my relationships into something bigger.
(12:28) You know?
(12:28) I don't wanna live my whole life with one career.
(12:31) And as great as being a dentist is, as much as I love changing lives, you know, through so many different ways that we can do that as dentists, I knew that I could have a bigger impact on the industry by taking all of that knowledge, all of that stuff, thousands of hours of CE, all these amazing relationships, and figuring out how to put it all together so I could make a bigger impact.
(12:53) And I thought, you know what?
(12:54) I wanna be doing that by the time I'm 50.
(12:57) That's why when I got to 45, it's like, you know what?
(13:00) Hey.
(13:00) There's gonna come a time where I need to sell to somebody.
(13:03) Well, I've built something really big, really profitable, and we were on a 31% EBITDA, which is not very common.
(13:09) And I realized, well, I'm gonna sell to a DSO.
(13:12) You know?
(13:12) And that was just like, which DSO?
(13:14) And, you know, when I found the right one, when I found the people that had integrity, who had a shared vision with me, the ones that I felt comfortable with, the ones that were consistent, when I asked them a thousand questions, they answered them the same way consistently all the way through the process.
(13:29) That's when I decided, okay.
(13:30) It's the right time.
(13:31) Believe it or not, I'm 45.
(13:32) I've got this machine going back to triathlon.
(13:36) That's when I started doing less dentistry.
(13:38) Because I realized when I get to that point, I can't be the essential person.
(13:43) I can't be the one doing all the production.
(13:45) And by the way, I love my associates, and I wanna elevate them and make sure they're successful.
(13:49) So anyway, 2015, took the plunge, you know, sold the practices, and and, you know, it was super emotional.
(13:58) I didn't expect it to be, to be honest.
(13:59) I I thought, oh, well, hey.
(14:00) This is such a great financial opportunity.
(14:02) It's gonna give me some freedom.
(14:04) I can move forward with my career and do something different within the industry.
(14:08) But, oh my god, the night before that we were actually signing to pay for my daughter who was 14 at the time, said dad.
(14:14) Are you sure?
(14:15) Like, this is, like like, everything.
(14:17) I mean, you've been doing this for so long and, like, everybody knows you and stuff.
(14:21) I'm like, I think so.
(14:23) And so, you know, I could've never done it without my friend Brian.
(14:28) You know, he at the time, I thought, wow.
(14:30) He's just this great guy, and he's, like, helped engineer this plan.
(14:33) He's helped me get a good deal.
(14:35) And even though he's on the other side of the table, I feel really comfortable, feel really confident in in in Brian.
(14:41) And because of that, I felt comfortable with the guys he was working with.
(14:44) And I couldn't have gotten to the finish line without him despite the fact he was on the other side of the table.
(14:49) So fast forward ten years now, and, hey, man.
(14:53) Like, when I thought about all the deals I was a part of, you know, I did my deals privately, corporately.
(14:58) I was a corporate executive for a year for a practice or a group with 240 practices.
(15:03) Like, I saw the good, the bad, and the ugly.
(15:05) And there was a lot of ugly, a lot of stuff where things weren't being communicated on high to boots on the ground at all.
(15:12) And I was, like, trying to bridge that gap.
(15:16) And so now looking forward at the alliance, what I have built, this group of unbelievably talented and brilliant people are there to, you know, eliminate the guesswork, you know, give Dennis a path, a path towards clarity, confidence, and freedom.
(15:36) A path that allows them to, you know, again, start, build, scale, exit from graduation to retirement.
(15:44) We've got their backs covered, and I couldn't have gotten there without all these crazy experiences that I had in the past.
(15:51) And understanding, like, what dentists go through on a daily basis from, you know, the day they walk out of dental school with a ton of debt to the day that they contemplate, you know, selling their life's work and transitioning into whatever's next.
(16:06) So I feel really fortunate.
(16:09) I feel really excited and really hopeful for the future because the next generation of dentists should not have to go through all of those stages, all that grief.
(16:18) They should have a playbook for whatever kind of practice they wanna have with people who actually care.
(16:24) And the way we pay it forward, you know, the people who helped us is we pay it forward to dentists going through that process now.
(16:32) And it's gonna be more smooth from graduation to retirement than it's ever been before.

Where I Am Today
The work is different now.
The purpose isn’t.
After thirty years in dentistry, I’m no longer interested in building something simply to make it bigger.
Today, my work is centered on helping dentists make better decisions at the moments that matter. Sometimes that means getting the right people around them. Sometimes it means stepping away long enough to see their practice and career differently. Sometimes it means protecting what they’ve spent decades building before a transition. And sometimes it simply means sharing an idea, conversation, or lesson that helps someone see the next decision more clearly.
That’s what Foundation Dental Alliance has become.
Foundation Dental Intelligence
Ideas, conversations, and perspective for better decisions.
Explore IntelligenceFoundation Dental Mastermind
Proximity, structure, implementation, and accountability for dentists ready to move from knowing to doing.
Explore the MastermindLuxury Dental Retreats
Small groups, exceptional destinations, and enough distance from daily practice to think differently.
Explore RetreatsFoundation Dental Transitions
Clarity, leverage, and optionality before and during one of the most consequential decisions of a practice owner’s career.
Explore TransitionsI can’t make the important decisions for another dentist.
But I can make sure they don’t have to make them alone.
Explore Foundation Dental Alliance