Managing the Business Side of Your Practice

modern practice podcast

On this episode of The Modern Practice Podcast, host Gary Tiratsuyan is joined by Dr. Benjamin Turnwald, owner of Benjamin Turnwald Dentistry and founder of Life Goals DDS. During their discussion, Dr. Turnwald shares how he’s scaled his dental practice’s growth, and made it simpler for his staff to manage daily processes at the office.

Providing patients with Text-to-Pay, card on file, and online payment options have saved his team from having to chase down payments and accelerated his revenue cycle.

The conversation continues with Dr. Turnwald sharing how he is now helping dental providers build a team, tech-stack, and business model that future-proofs the practice and helps sustain growth, long term.

Connect with Dr. Turnwald on LinkedIn >>

Discover Rectangle Health’s powerful patient payment solutions, here >> 


Gary Tiratsuyan 00:21

Hello, everybody and welcome back to the Modern Practice Podcast. Really excited for today’s episode is we’re joined by Dr. Ben Turnwald, owner of Benjamin Turnwald Dentistry. Ben has been running a successful and rapidly growing dental practice for over 10 years, and more recently founded Life Goals DDS to help guide dental practice owners and staff to reach the heights he has. And without further ado, Ben, thank you so much for taking the time to join me today. Happy to have you on the show.

Dr. Benjamin Turnwald 00:53

Yeah, of course. Thanks. Thanks for inviting me. It’s a pleasure.

Gary Tiratsuyan 00:56

Pleasure’s all mine. And before we get into the story of your practice, and again, that rapid success, can you talk to me a little bit about your decision to pursue a career in dentistry? Was it something you always wanted to do? Did you have dentists in the family?

Dr. Benjamin Turnwald 01:12

Yeah, for sure. So, I actually grew up on a farm; I was a big science nerd. And I had always had an interest in the sciences. And once I got to college, as I was deciding sort of which path to pursue… I come from a family of small business owners, not dentists, but small business owners. And so, I felt like dentistry was one of those paths where I could still own my own business without being part of a giant organization, which was important to me. Because I have that that interest as well, the business side of things.

Gary Tiratsuyan 01:48

You touched on this just a moment ago… when you entered the dental field, how long were you practicing before you decided it was time to open your own practice or acquire your own practice?

Dr. Benjamin Turnwald 02:03

Yeah, so I sort of bounced around a little bit. My first year out of school, I was one of those lucky people that graduated during the recession of 2009. And I found out very quickly that I was not going to be the type of person that wanted to work in somebody else’s practice for very long. And so, I was actually lucky enough to, through my network, find a doctor that was a little bit older and looking for someone to eventually take the reins over at his practice. And so, I really started that engagement about a year out of school. It all just kind of fell in place for me, but I think I knew before I even went to school that I wanted to own my own practice. So, I was willing to do whatever I needed to get experience, both with the business side of dentistry and also the clinical side, because both are important. And luckily, I had a good mentor in the practice that I had started working at.

Gary Tiratsuyan 03:05

Did you have any doubts or fears when you took that leap?

Dr. Benjamin Turnwald 03:09

Yeah, definitely. I mean, I graduated with a boatload of debt. Like I said, it was during the recession. Patients weren’t willing to do anything, even remotely elective. And in fact, I feel like people were having a hard time even spending money on things that they needed to keep their mouths healthy. So, there definitely was a lot of fear when I took out the loan to purchase the practice, just because I already had a large debt service with my education. So, this was just another giant number. So yeah, there was definitely some anxiety there.

Gary Tiratsuyan 03:43

I hear that. And so, you purchased the practice. When you observe from a management perspective, what did the day-to-day business operations look like?

Dr. Benjamin Turnwald 03:55

Well, I’ll tell you when I first purchased my practice, or I should say, when I first started working at my practice—because I kind of did a gradual buy-in as an associate, and then partner and then full owner. But back in 2010, I believe it was when I started at my practice, we were still tracking production and collection numbers on a paper ledger, every day. We did not have a website, we did not have a credit card swiper. The clinical part of dentistry and the customer service has always been phenomenal; that is one thing I’m very lucky for. The business side, I think, was run very, very well for many years and then didn’t keep up on the business side. So yeah, I knew as soon as I started working that there was going to be some changes that I would want and often need to make from the business side of things.

Gary Tiratsuyan 04:53

It’s very clear you have a strong business sense and you noticed these pain points and inefficiencies on the business side in dentistry before owning the practice itself. You mentioned that it’s almost as if the industry has been stuck in a different generation, late to adopt tech and modernize. Why do you think that is?

Dr. Benjamin Turnwald 05:20

So, I think there are like, two different paths in dentistry. I think on the clinical side, dentists really like their toys, and we’re really into tech. And I think most of us, we read the journals, and we want to offer our patients the latest and the greatest, I would say, most of us at this point are taking digital X-rays, we’re doing intraoral scanning, we’re probably starting to use AI, we probably have a laser. So, I think on the clinical side, we’re doing really well.

I think on the business side is where we seem to be stuck in the 80s. Like I said, most of us probably aren’t tracking things on paper, but a lot of the inefficiencies from the practice management standpoint, just take up so much of our time. And so one of the ways that my practice used to be, I would say behind or a little bit stuck old school, was we never had an office manager. My mentor was under the sort of philosophy that the owner-doctor should be the office manager so that he or she knows what’s going on and where the money is going; it’s more difficult to have people steal money from you. And so, I adopted that ideology. And when my practice was very small, it was somewhat manageable.

But as I started to make these changes in the practice and modernize it, I became a victim of my own success. And I very quickly started to realize that I can’t be seeing patients four to five days a week, and then also trying to deal with payroll, and accounting and collections and all of that. So, that’s where I think having that experience was actually a positive for me. Because I don’t think very many doctors these days have the experience of being the office manager and also wearing the clinical hat. And so that really taught me a lot.

But it also allowed me to redesign all of my systems and my practice so that we could slowly but surely modernize them at least as much as we could with the technology that is out there. And I think one of the major hurdles that we all have to deal with is the practice management software out there is really dated. Our medical colleagues all seem to have adopted a single EHR that they use, and it plays and plays nicely with, if you’re trying to transfer information to different providers, and I don’t hear a lot of complaints about it. In dentistry, we all have different software. My practice integrated back in 1992, and we’re still using the same software. And it’s still number one. As soon as you start patching everything together like that, you lose efficiency, and your staff gets overwhelmed. And then things aren’t utilized as well as they could be, in my opinion.

Gary Tiratsuyan 08:12

I want to get into how your practice started to evolve. You mentioned it a moment ago specifically around getting paid for the care you and your staff provide. How was it done at the point where you took ownership? And what is the state of the union of how it’s done now?

Dr. Benjamin Turnwald 08:30

This is a system that is actually my most recent; it’s been an evolution over time. This is probably the most recent system that I did a total overhaul on. I think we’re at the point now where a majority of our patients, and we just have to be real, the majority of people, are going to pay with a credit card. I think the days are gone when people carry on a checkbook. Maybe some of your older patients, but I’m finding that even less and less. And of course, cash is just not the best way to do business, in my opinion either, just from a risk standpoint.

So, I think making it as convenient as possible for patients to make payments, whether it’s having the ability to pay online, to do electronic billing, to do payment plans that do auto withdrawal. I think that’s just where we’re where we’re headed, or honestly, we’re probably already there. I think we just need to really embrace that and try to make the system as efficient as possible, both for patients to use it and also for our teams to use it. And I will say, once I made it a possibility for patients to make payments online, I got so much positive feedback on that. Because I think as you as you look at the demographics of your patients as you go younger and younger, less and less of them are going to want to get a paper statement in the mail and have to write their credit card number on something and mail it back. So yeah, I think that was a game changer for us. And it’s automatic. So, it hits the system without someone having to key it in and that type of thing.

Gary Tiratsuyan 10:20

And when you did implement that change, how did patients that have been with that practice prior to you taking over take to that change?

Dr. Benjamin Turnwald 10:30

I’ve gotten nothing but positive feedback as I’ve incorporated the tech into the collections protocol in my practice. I mean, even from upgrading from the swipers at the front desk to the chip card readers and now we can take Apple Pay and Android Pay, the widget on the website, being able to get a text message to pay, an email to pay, those have all been highly praised by our patients. I don’t think I’ve heard one negative piece of feedback on any of the tech that’s been implemented as far as how to make payments.

Gary Tiratsuyan 11:06

And what’s that do for the staff? Has your staff had that same sort of positive reaction, for saving them time to take on more? How’s that working?

Dr. Benjamin Turnwald 11:19

Yeah, I mean, I think one aspect of it is that all of our teams want to feel like they’re working in a really good practice that’s high tech, and it’s cutting edge. This is just a simple example, but when we got the credit card readers that had the tap to pay, I could just hear the enthusiasm in my business teams’ voice when they’d be like, ‘Oh, yeah, you can use Apple Pay as well.’ I feel like there’s that like cool aspect to it, as well, where they feel like they’re working somewhere that’s cool and hip, and where are you can pay by Apple Pay. So, there’s that aspect.

I will say, whenever you try to implement a new system in general, particularly with technology, for a certain amount of time, it actually takes your team longer to do what they need to do because it’s new. And depending on how complex the software is, they have to get over that hurdle. And then eventually, they can start to appreciate it for the time that it saves them. So, I think changing our payment solutions was no different. I got some pushback, because it didn’t seem to be at the beginning that different from what we had before. But now that we’re going on about a year of making those changes, I would get major pushback if I tried going back.

So yeah, I don’t think that’s necessarily specific to changing your collections. I think that’s just systems in general, which is part of what you have to have a good skill set with, of helping or allowing your team I should say, to have some input whenever you change a system, because if they feel like they’re just getting something shoved on a Monday, they tend to push back a little bit more.

Gary Tiratsuyan 13:07

That makes sense. And can I shift gears here? Staffing shortages, employee retention and burnout hit healthcare pretty hard, among other industries. And if we’re looking at it strictly from a business standpoint, it could be healthcare or any industry… as the owner of an organization, how important is it to you to equip staff with tools that’ll enhance their experience and their workflows and make it easier on them? Do you think it makes a difference in attracting and ultimately retaining that staff?

Dr. Benjamin Turnwald 13:49

Yeah, so I go to a lot of dental conferences and dental meetings, and every single one that I’ve that I’ve gone to, since we were allowed to go back since COVID, that’s the number one thing that everybody’s talking about—being able to keep your team fully staffed, particularly with assistants and hygienists. I will say that I’ve been I’ve been lucky; I haven’t had a lot of turnover. I have had to hire a lot more because I built a new practice in 2020 and I needed to add a lot of employees. So, I felt that pain needing to hire but fortunately, I didn’t lose a lot of people.

But I think there’s a couple of things that I have found have been really helpful for me. I will say first with retention. I think it’s really important to make sure you have a positive, fun team culture, because at this point, our team members have a choice. Everybody is looking for assistants and hygienists, maybe even in front office teams. So, they know that. And so, you don’t want to be losing a really good employee for $1 or $2 more an hour, when really it could have been probably prevented at the core by just taking a look at the team culture. So, things like making sure it’s a fun environment for them, like, do you hear laughs throughout the day? Does everybody get along? Does everybody respect each other? Do we have agreements on how we give and accept feedback? Do you allow time for them to do things together socially? Like, I sent my team to all get their nails done a couple of weeks ago. We’ll go out for happy hours, or we’ll have a barbecue at somebody’s house. We do stuff like that. And I think it’s important for those relationships to develop outside of the office as well. Because, you know, you hear the quotes that we actually spend more time with our coworkers than we do with our families. And so, it’s important that you enjoy the people that you work with.

So, I think that the team culture is, is really, really important. And for me, what I found was that I hired a couple of key players throughout the years who were just fun, quality employees who really made a positive impact on the culture in my office. And those are the people that you have to really double down on, and make sure that their ideas are taken seriously and implemented. Because they tend to be the ones who can if, if you’re not maybe a super-fun, outgoing person yourself. Like for me, for instance, I put on my business hat when I get to the office. And so, I might not be the one who’s always joking around as much. But I will, in the right environment, join right into that culture. And so, I think hiring smart is part of it. I’ve always said that he that I have hired on personality and not on skillset. Most of the people that have worked for me had zero dental experience. And I hired them just because they were they were fun, and they were bubbly. And they were constantly smiling. And I knew they’d be someone that I’d want to work with every day. And so, I think that that is another important aspect of it.

And then also just making sure that they’re heard. I think when you’re going through periods of growth or change, I think instead of just dropping bombs on your team at a meeting, it’s to alternatively be like, ‘Okay, here’s the problem that we’re facing. How do you guys want to solve it and make it a discussion?’, as opposed to ‘Here’s what we’re going to do.’ I found that a lot of times, they come up with better ideas than what I could have come up with in my little vacuum at home on the weekends. And then it tends to get implemented faster, and tends to stay more implemented, because your team was the one that came up with it, as opposed to them just being told to do something. So, I think those few things are probably the keys that I attribute to my success of not having a lot of turnover. And who knows when the labor market is going to turn around? I think that, for the doctors out there that are really struggling with retention, I would just take a long hard look at how it is to work in your office and start to change from the inside. And that will attract people on the outside to come in. And then you’re not having the turnover. And it’s not the cat chasing its tail.

Gary Tiratsuyan 18:35

That’s brilliant. And I think you’ll get a bunch of hits on your website, people looking at your career section for sure, after that, I have no doubt about it. Great insight there. And if we take a step back and look at the way you’re implementing and developing the culture within your organization… strengthening and giving your staff the tools to succeed and for your practice to succeed and make the patient’s lives easier and make the staff’s lives easier. We don’t have to get into exact figures. But what kind of impact do you think that makes on your revenue cycle?

Dr. Benjamin Turnwald 19:15

As far as, like the patient experience on the team?

Gary Tiratsuyan 19:19

Yeah, how you have you built and equipped your staff to manage the practice?

Dr. Benjamin Turnwald 19:25

Honestly, aside from doing good clinical dentistry, I think that’s literally everything because your team is who your patients are going to interact with the most. And so, if you have a team who is friendly and caring, and they have high psychological ownership of the practice, where they individually act like owners—for instance, something as small as there’s a little piece of impression material on the carpet or a little piece of paper on the carpet—it warms my heart when I see my team members bend over and pick that up instead of just walking by, because small things like that are what our patients notice. They want to make sure they’re in a clean, organized space. And I think people are impressed when they walk in and they’re greeted by name, even if it’s their first time. If you look at my Google reviews, I can’t believe how friendly everybody is. It’s just friendly, friendly, friendly, friendly, and so that goes down to the team.

I think I can be the friendliest dentist in the world, but if the person who answers the phone, the first time someone calls, has a scowl on their face, and then they have a scowl on their face when you walk in, and you’re ignored when you walk in, or you’re locked in a room for a half hour waiting, I don’t think it really matters how friendly the dentist is. It’s a team. It’s a team sport. And so yeah, I attribute the growth and the success of my practice to them. Other than the clinical side, which honestly, I don’t think patients can always appreciate it until their crown lasts 20 or 30 years. So, it’s not an immediate  something that they’re necessarily grateful for, because they don’t really know. But if you can give your patients the ultimate experience, each and every time that they come in, that’s something that they won’t forget. And that’s something that they tend to tell their friends about. And so, I think that having raving fans in your patients, and having them refer their friends and family to you can just be such a catalyst for growing your practice.

And also, I think, preventing burnout and preventing turnover, because usually your biggest fans tend to refer people who are also going to be your biggest fans and are going to be fun to work with. They pay their bills, they show up for their appointments, that type of thing. So yeah, I honestly attribute the success of my practice to patient experience. And that’s another area where I love helping other doctors improve that because we talk about being stuck in another generation; people are petrified of the dentist because of how they experienced it as a child. And so, I think if we can change that, that’s another area where we can really turn these perceptions about going to the dentist, which again, just makes everybody’s lives better, especially for our patients. Even if we can decrease a few people’s anxiety just a little bit, I see that as a win.

Gary Tiratsuyan 22:38

Absolutely. And I think word of mouth, those referrals are definitely that nontrackable type of free marketing. You deliver this exceptional experience through and through. It just happens organically. And it’s key to growing any business and the perfect segue because we’ve spoken a lot about the practice and how you scaled for growth. But I want to shift to Life Goals DDS. Tell me about the organization.

Dr. Benjamin Turnwald 23:09

Yeah, so I formed Life Goals DDS a couple of years ago, as the pandemic was raging. And I was finding that, as I mentioned before, I was kind of a victim of my own success with the practice. As the practice grew, I was the office manager and I was seeing patients full time. And like a typical dentist, I’m the person that I wanted an A-plus on everything. And so, I was trying to modernize my practice. I was I was trying to innovate and change the business side of my practice and practice management. I was trying to give my patients the ultimate patient experience. I was also trying to do some really complex dentistry. And of course, I wanted to do it really well. And what I found was that I was burning the candle at both ends, and eventually got to the point where I needed to make a decision.

I decided that I could probably help more people by focusing on the business side of dentistry and finding help for my patients to replace me on the clinical side. Because I feel like I’m a unicorn and most doctors are more into the clinical side of dentistry, and prefer not to really touch the business side. They have their business managers for that or consultants or whatever. And so yeah, I decided that I was going to sort of start to shift the pendulum and focus more on practice management, helping other dentists, decreasing the amount of patients that I saw clinically. So here I am, and although I do see patients here and there—family and friends in particular—most of my time now is focused on helping other dentists get what I got out of my practice, which was making it more efficient, getting my time back. So, I had time to do the things I enjoyed and slowed down the pace and ultimately got out of the burnout cycle.

Gary Tiratsuyan 25:12

Where can our listeners learn more about Life Goals, DDS?

Dr. Benjamin Turnwald 25:16

So, you can go to my website at Or you can find me on LinkedIn, Benjamin, Turnwald, DDS. And yeah, I post free stuff every once in a while. And you can also join my mailing list too.

Gary Tiratsuyan 25:34

I’ll drop both the website link and link to your profile in this episode’s description. As we wrap up here, so then I want to lean into some of the key areas of focus—life goals. I’ll start with team development. Can you touch on some of the obstacles you see in front of the practices you consult? And your approach to building a team of rockstars?

Dr. Benjamin Turnwald 26:02

Yeah, I think it’s just like in dentistry, we talk about things being comprehensive. I think it’s a comprehensive solution. As I mentioned earlier, I think the first thing is to take a long, hard look at the culture and your practice. And make sure that you really have a fun, supportive work family type culture, because you can spend all the money on the ads or trying to find these people. But if they’re not going to stay with you, then it’s kind of all for naught. And so I think that that’s the first thing and that’s one thing that I do help with.

Second, I think once you have that culture in place, it’s portraying it in the ads, or the posts, or whatever it is that you’re doing to attract the talent. So, I think testimonials from your team and a lot of pictures and just truly showing what your practice is all about, instead of maybe having someone go to a generic website. I think those are probably the two most important things for team culture.

And then also, I think, one thing that a lot of practices struggle with is implementation of new systems. And so sometimes, just having an outside facilitator to come in and help these practices, just talk it through as to why we need to make some changes and make sure that the team is involved in it, I think makes a huge difference in the success of it as well.

Gary Tiratsuyan 27:32

I’m on right now. And what I love is that there’s this whole story here. You paint the whole picture of creating efficiency, utilizing the right systems, having the right team and a happy team in place, and ultimately elevating the patient experience. And all that factors into high-growth, high-profit and profitability, like you’ve experienced in your own practice. So, if we look at an established practice with the existing processes and systems in place, before they speak with you, what would you recommend be their first step in assessing the business side of the practice?

Dr. Benjamin Turnwald 28:11

Well, one of the things that I usually advise people to do is to make sure that you have your executive board put together. And so that’s always something, even if someone doesn’t work with me, if they need a referral to put together their executive board, I’m always happy to help with that. But you know, it really does take a team. You need a good accountant, you need a financial planner, you need a good attorney just for certain things, an HR company, and then honestly a mentor, whether it’s clinical or business or both. Being able to pick from different brains, different ideas, I think is super important. I don’t know if it’s necessary as a precursor, but it’s definitely something that I suggest that practice owners start to develop over time. Because I really think that that is one of the things that really contributed to my success.

And for those people that are our doctors that are familiar with the Pankey Institute… I myself have not experienced the Pankey Institute. But I know that a few of my mentors are graduates of there and each and every one of them told me that one of the core philosophies of the Pankey Institute was, there’s a younger generation below you and it’s very important for you to be a mentor and pass on your knowledge so that we can leave each generation of dentists, at least one step ahead of where we started. And so, I’ve absorbed that philosophy and have tried to pay it forward in that same attitude as I have been blessed with my mentor. So that’s part of the reason as well why I started Life Goals DDS.

Gary Tiratsuyan 30:07

Love that. Definitely recommend all of our listeners tuning in today to connect with them and to take in all the insights you can. I just have one more question I like to ask all of our guests here on the show. And you you’ve touched on it a little bit, as far as mentors, mentorship—what is the best bit of advice you’ve received to drive and motivate you to reach the heights you have?

Dr. Benjamin Turnwald 30:37

That’s a tough one. I would say, probably, when you trip and fall or when something doesn’t go as well as it should, to see it as an opportunity to grow and learn from it. I think I’ve made a lot of decisions over the years that turned out to not be the right decision. But I can tell you now, having owned the practice for as long as I have that I’m not going to make those mistakes again. But I think that they are important in my in my learning process.

And I think along with that, a doctor had told me a few years ago, and this makes so much sense to me, is that when you’re making a clinical decision, that’s kind of how our brains are trained as dentists, and you research, research, research the heck out of something to try to make sure you’re making the right decision for your patient or your patients. But when it comes to making business decisions, a lot of times you’ve got to go with your gut. There’s not a whitepaper on it. There’s not a solid Google search you can do. I mean, of course, you want to do your due diligence. But a lot of times you’ve just got to go with your gut, and nobody’s going to die if it doesn’t turn out. And then you just learn from it and you move on. And so that’s part of what I like to do as well, as I like to share my failures with other doctors and small business owners because there’s no reason that they should have to make the same mistakes that that I have. And I think I think collaboration is key.

Gary Tiratsuyan 32:10

Absolutely love that. And I don’t remember which athlete it was that said, ‘If I don’t lose, I don’t learn,’ and what you just said just reminded me that. Love that. Thank you so much for all the insights you share today, and I really appreciate you taking the time to join me. I hope we can get together again real soon.

Dr. Benjamin Turnwald

And yeah, thanks for having me. It was fun.

Gary Tiratsuyan

For our listeners tuning in today, if enjoyed the episode, hit that like and subscribe button on your favorite streaming channel. And be sure to leave a review and let us know what you’d like to hear discussed on future episodes of the Modern Practice Podcast. Thanks for tuning in. Till next time, everyone.

Editor’s note: This interview has been edited for length and clarity.

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