Congratulations to Chris Bentson, who received the 2022 AAO Outstanding Contribution Award. This award honors non-orthodontists with an exceptional record of service to the specialty.
Founder and partner of North Carolina-based, Bentson Copple & Associates, LLC. He has devoted over 30+ years to the industry and has contributed to the orthodontic community by performing practice valuations, providing recruiting services, and negotiating transactions with both buyers and sellers. He has vast experience in practice sales and purchase negotiations, and in guiding practice transitions at all career stages.
A native of Overland Park, Kansas, he graduated from Baylor University and within four years, became part owner of the OPMS orthodontic practice management company. His best friend and mentor, Brett Smith, helped him become a consultant.
Chris spends much of his time working within the orthodontic industry and currently serves as the President of the AAOF (American Association of Orthodontists Foundation), shares his insights with the AAO Future Think Tank, and was the co-chair of the 2022 AAO Winter Conference.
A perennial speaker at AAO Annual Sessions, he has also been a presenter for constituent meetings, dozens of orthodontic residency programs, orthodontic podcasts, study clubs, and AAO webinars. Chris has authored dozens of articles published on the business of orthodontics in numerous trade publications.
He was honored at the 2022 Excellence in Orthodontics Awards Program in Miami on May 22, 2022, as part of the AAO Annual Session.
Orthodontic Products Chief Editor Alison Werner talks to AAO President Dr. Ken Dillehay and Chris Bentson, Partner of Bentson Copple & Associates, about the recent AAO Winter Conference held in January. The first in-person AAO meeting since 2020, the conference was an opportunity for orthodontists at all stages of their career to not only gather information about how practice modalities are changing, but to ask questions of those peers who are leading the way. And this wasn’t a meeting purely focused on how OSOs are changing the practice landscape. It touched on how dual specialty practices—specifically pediatric dentistry and orthodontics—are gaining traction within the industry and how digital technology is changing the orthodontic practice.
In this interview, Dillehay and Bentson, who was a members of the Winter Conference planning committee, highlight the presentations and panels that most resonated with attendees and the questions that got everyone talking. And they remind viewers that AAO members can still access the meeting recordings if they didn’t get a chance to attend in January.
Dillehay closes out the interview talking about what AAO members can expect at the AAO Annual Session in Miami Beach in May, whether in-person or virtually, and offers advice for those planning to be there in Florida.
Chris Bentson is featured in the new, recently-released episode of People & Practice‘s The Survival Guide For Orthodontists podcast, hosted by Dr. Leon Klempner and Amy Epstein. Chris chats about the digital future of orthodontics and how it may shape the industry’s future.
Within this fast-paced episode, Chris Bentson:
– Talks about where the investment venture capital money is found in the orthodontic market. – Addresses the importance of spending time investing in the digital technology that supports orthodontic practices. – Answers questions from listeners. – Encourages listeners to rethink the footprints of an orthodontic office. – Discusses solo practices vs. large corporate practices.
About the Podcast: The Survival Guide for Orthodontists is the podcast that makes YOU the authority in Orthodontics in your community. Get ready for insights on how to compete on expertise and trust against mail order and retail orthodontics. It’s not always about the lowest fees. Dr. Leon Klempner and Amy Epstein, co-founders of People & Practice, know the business of orthodontics. They bring you insights, tips, and guest interviews focused on helping you thrive in a massively disrupted industry. Put more patients in chairs by competing on expertise and trust, not the lowest fees. The podcast is available on the People & Practice website, Apple Podcasts, Stitcher, and Google Podcasts.
Love it or hate it, Corporate Orthodontics is an increasingly common practice model for today’s orthodontists.
In the most recent episode of The Digital Orthodontist: Live video podcast, Chris Bentson joined alongside founding orthodontists at Smile Docs (Dr. Scott Law), Orthodontic Partners (Dr. Jamie Reynolds), and Corus Orthodontists (Dr. Anil Idiculla), to discuss this very important topic. Hosted by Dr. Kyle Fagala, this panel of experts covers Corporate Ortho’s most common criticisms and objections, continuity of care concerns, and typical misconceptions.
The Digital Orthodontist: Live is a video podcast hosted by orthodontist and digital marketing expert Dr. Kyle Fagala. In each episode, Dr. Kyle interviews a well-known orthodontist or member of the orthodontic industry live on Facebook. The show is a mix of traditional interview questions with interactive games for a nice mix of education and entertainment.
Ghost·ing (noun). The practice of ending a relationship with someone suddenly, and without explanation, withdrawing from all communication.
“Ghosting” is a term most of us have heard of and often we associate it with dating, but in the last eighteen months, we have seen this behavior trickle into the interview and hiring process. In the beginning, we thought it was due to the pandemic. Candidates were all scrambling on where they should be and what opportunities would be “safe” post-pandemic, so it was understandable. What we didn’t realize was that this behavior would become what candidates view as “normal” during their job search.
Indeed, one of the largest job aggregation sites, recently confirmed in a survey what we have long suspected – “ghosting”, has become a widespread common practice among candidates looking for opportunities. Let’s face it, the interview process is not always fun; it is often an uncomfortable dance for both the candidate and the potential employer.
So why would a candidate “ghost” a potential employer? The answer is pretty simple and relates back to dating. Candidates hope that by “ghosting” a potential employer that the employer will “get the hint” that the candidate is no longer interested in the job opportunity. In doing this, the candidate avoids a tough face-to-face conversation to tell the employer he/she is no longer interested.
The harsh reality is that our culture of busyness combined with technology allows us to avoid having tough conversations. I am not talking about the texts and emails that fall through the cracks, but rather when we look at our phone and flat out ignore answering or replying because we want to avoid communicating and giving bad news.
Candidates are often afraid that providing any type of negative feedback to a potential employer might come back to bite them in the future and potentially harm their reputation as they look for other opportunities. It might seem easier to just keep quiet and hope that the potential employer stops reaching out. However, the best option is to communicate and simply let the employer know that you are still actively interviewing and you have not made a final decision. It is important to understand that most employers have invested a lot of time, money, and effort to find candidates. If you have lost interest or decided to pull out of an opportunity, providing feedback in a constructive way to that employer can help tremendously as the employer continues to search for a doctor.
So regardless of the reason you decide to decline a job offer, you need to be upfront and honest so that you don’t burn bridges and tarnish your reputation. Providing a reason and being polite with potential employers will help them remember you positively, and, believe it or not, might help you in your future career moves. Below are some graceful ways you can politely decline a job offer:
1) Choose a form of communication that makes you most comfortable when you break the news. If you feel you will become nervous and panicky on a phone call then a polished email would be a better option. However, it is often best when turning down a job offer to use the same method of communication, they used to extend it.
2) When turning down a position it is imperative to be as appreciative and thankful as possible, so preface your rejection with appreciation and start with “thank you”. It is important to remember employers have invested a lot of time and energy into the interviewing process. Ex; “Thank you so much for this job offer and for the opportunity to get to know you and your team better.”
3) It is important to be clear that you are not accepting the offer and why. Again, you want to do this in a gracious manner but be explicit on why you are passing on the opportunity. Ex; “However, I have to decline the opportunity.”
4) Provide an honest, brief, and specific reason you are declining the offer. This is the part most candidates want to gloss over, but the employer deserves feedback on why you are not accepting the position. You don’t have to go into great detail but be prepared to provide a few key points, whether you are going with another opportunity, the practice culture wasn’t the right fit, the location wasn’t ideal, or if the pay was not where you needed it to be. You can soften the blow by providing a detail or two about what you liked about the practice. Ex; “I have decided to accept a position closer to my family in North Carolina.”
5) If the opportunity was a good one, offer to provide them a recommendation with other job seekers. This demonstrates that you care about them and their practice although it wasn’t right for you.
6) Express your desire to stay connected, because you never know where your connections might lead to in the future; orthodontics is a small world. Ex; “Again, I truly enjoyed meeting you and your team and I look forward to staying in touch.”
Deciding not to move forward with an opportunity or decline a job offer is never easy, but communicating politely and professionally will make you feel a lot better in the end. Ghosting a potential employer can potentially damage future relationships and hurt your reputation, so create a favorable image of yourself that leaves the door open for any future opportunities.
Our first “Residents-Only Live Webinar” was a huge hit! We interviewed Dr. Nic Bisig and he provided exceptional insight and guidance to attendees regarding associate opportunities. He explained the different types of practices/models, income expectations, production-based incentives, digital platforms, and most importantly how to engage with a team to ensure your success. If you didn’t have the opportunity to attend, we hope you will be able to join us next month. We wanted to share Dr. Bisig’s final thoughts and career advice from the webinar with young doctors as they are job searching as we feel it is spot-on for a successful orthodontic career!
Dr. Nic Bisig’s Words of Wisdom
1. Find a mentor if possible. One that is a strong clinician and one that is a leader. It doesn’t always have to be an orthodontist.
2. You don’t need to be a trailblazer. Come in with ideas, but be prepared to practice similar to your employer.
3. Focus on your craft! Learn to get consistently great finishes. The first five years out of residency is still a residency. Trust me when I say “you can barely do anything when you graduate”. The first five years post of residency will determine if you will be a great clinician or an average/subaverage clinician.
4. Be humble. No one cares you’re a doctor except your parents. Be nice to everyone around you.
5. Serve everyone around you. Your patients and your team are always above you. Remember “you eat last” make sure everyone on your team is taken care of before you serve yourself.
6. Pick your leadership style because not being a leader is NOT an option. I chose to be a servant leader/coach based on my personality type and past experience with sports. Use every snap/rep/clincheck/appt to be a learning opportunity for you and that team member. Team members want to do a good job, and they need clarity to do a good job. Don’t be afraid to tell them why you want something done and make sure they understand and move on.
7. BUILD UP EVERY PERSON ON YOUR TEAM. One of the biggest things I’ve learned since being out is the more you raise everyone around you, the easier your day will be. I believe in having seven “mini orthodontists” in the clinic with me at all times. It’s a little harder to work with me, because I insist that our team members understand everything that is happening clinically and why we do it that way.
8. Constantly praise your team! Praise them in each appt, each morning, and each interaction with a patient. Remember that you are only one person and the brand of the practice you are in is more than just the doctor. Team members spend more time with patients than you.
We hope you will join us for the next “Residents-Only Live Webinar” with our special guest attorney, Dan Sroka, in June. Dan will discuss associate contracts and what you need to know before signing one. We will limit this live event to 100 attendees so be sure to mark your calendar. Registration details will be coming soon, so watch your email! This is will be a “live” event, so if you register, we ask that you attend and if you are unable to attend that you let us know so we can offer the spot to another attendee.
A growing orthodontic practice is seeking a full-time associate to join their team in Halifax County, North Carolina.
Halifax County is located in northeastern North Carolina and is often called the state’s “cradle of history”, as it is the birthplace of the “Halifax Resolves”, a document that gave rise to the creation of the Declaration of Independence. The area offers a historical step back into time with its roots deep in American history and culture.
Halifax County offers beautiful lakes, theaters, antique shops, museums, golf courses, and much more. It has all the natural qualities and amenities that make it a great place to live and work. From Lake Gaston to Medoc Mountain State Park, its natural landscape provides a wealth of recreational activities. It is home to Sylvan Heights Bird Park, the world’s largest collection of rare and endangered waterfowl and over 2,500 birds from around the world. The county is also home to some of the nation’s best-preserved early 18th-century engineering at the Roanoke Canal Museum and Trail – it’s the state’s longest museum with a 35-foot single-arch aqueduct and over seven miles of trails to explore.
The county is a great place for business and business competitiveness. It offers easy access to all forms of transportation – interstate highways, airports, railways, and NC and VA shipping ports, making it a mobile community for locals, visitors, and businesses. Being halfway between New York and Florida, manufacturers and distributors can ship their products to over half of the US population in a one-day drive. The region is also less than 90 minutes from three international airports.
This is a fantastic opportunity for an orthodontist in a welcoming community, filled with southern charm, rich history, and mouthwatering dining options. If you are interested in learning more about this practice opportunity, please forward your CV and letter of interest to [email protected] and [email protected].
The new census data will show us that our nation is experiencing stagnate growth, with an aging population and a declining birth rate. With fewer births, more deaths, and uneven immigration the 2010-20 decade was the smallest decade of growth in U.S. history including the Great Depression of the 1930s.
Let’s look at what factors have contributed to the slow growth rate in the U.S. population.
Declining Fertility Rates and More Deaths Unfortunately, the past decade reveals a nation with unprecedented growth stagnation and a steep decline in the under-18 population. As our nation continues to age and baby boomers reach retirement, the gap between births and deaths narrowed with the number of births outnumbering deaths nationwide by fewer than 1 million for the first time in decades. Between 2010 and 2019, our millennial generation aged into adulthood resulting in an astonishing decline in our under-18 population, and the census projections indicate that our 65-and-over population will have a higher growth rate than our youth in the next decade. If any of you have listened to my lectures in the past you have heard me reference this as the “graying of America.” The newly released data shows that thirty states saw decade-wide population losses in their youth led by California which lost over 400,000. However, Texas gained more than 500,000 young people. We also saw four states Vermont, Maine, West Virginia, and New Hampshire have more deaths than births last year.
Immigration Our population growth not only comes from natural births but also from foreign immigration. The estimated number of people moving to the U.S. annually from other parts of the world has steadily declined in the last four years. In 2016, the final year of the Obama administration an estimated 1,046,709 people moved to the United States from abroad. In 2019 that number fell to 595,000 due to the federal restrictions during the Trump administration.
Our states also experience population growth and loss by “domestic immigration” or “out-migration” this is when residents move from one state to another. In the past decade, the Northeast lost 2.5 million residents who moved to other regions in the U.S., led by the state of New York which lost over 1.3 million residents over the past nine years. The second-largest exodus of residents due to out-migration is the Midwest, with over 1.6 million people relocating to other states. Of those 1.6 million, over 865,000 residents left the state of Illinois. California ranked third in out-migration losing over 912,000 residents but gained over 1 million foreign immigrates from abroad. Why did these states (California, New York, and Illinois) experience the biggest domestic out-migration shift in the nation? Demographers suggest that we saw this population shift due to the states’ high tax structure and unaffordable housing. Many of these residents relocated to other parts of the country that offered a better economy with lower taxes and affordable homes.
On the flip side, other states benefited greatly as residents crossed state lines. Texas takes the top spot gaining over 1.1 million domestically and another 818,000 coming from abroad since 2010. The state of Florida also saw tremendous growth with 1.2 million residents moving in from other states. Five other states grew by 15% including Utah, Idaho, Nevada, Colorado, and Arizona. The data also shows that Oregon, Washington, North Carolina, South Carolina, Georgia, and North Dakota grew by 10%. States that experienced moderate growth included Virginia, Tennessee, Oklahoma, South Dakota, Minnesota, Nebraska, Montana, and Massachusetts – the only New England state to benefit from out-migration. Four states including West Virginia, Illinois, Connecticut, and Vermont showed absolute population losses over the decade. The state of West Virginia exhibited population losses for seven years in a row, while Illinois and Connecticut did so for six years, and New York for four years.
What Do These Demographic Trends and New Data Show Us? It certainly indicates that we have an aging workforce. Perhaps more impactful is the shifts in state populations that will likely have consequences when the U.S. congressional districts reappoint seats based on the new census data. After all, the constitutionally mandated purpose of the decennial census is to apportion members of the U.S. House of representatives in each state based on population. Right now, the projected redistribution of our population indicates that Texas could gain three seats and Florida could gain two. Five other states could gain one congressional seat including Arizona, Colorado, Oregon, Montana, and both Carolinas. A whopping ten states are projected to lose a seat including; Minnesota, Illinois, Michigan, Ohio, Pennsylvania, New York, Rhode Island, West Virginia, Alabama, and most notably California which could lose a congressional seat for the first time in history.
It also indicates that, over the next decade, the two factors that contributed to our nation’s slow growth rate – low birth rates and increased deaths – will continue as the population ages. As baby boomers continue to age into retirement our nation will depend on the youth populations to increase, which will most likely come from immigrants and their children. The census bureau projects that after 2030, immigration will account for more than half of our nation’s population growth. This means as we head into the next decade immigration is something, we should all pay attention to because it will be a vital contributor to our nation’s economic health. As our nation continues to age and our population growth stagnates, the 2020s will become a crucial period for all of us to understand the role of immigrants and how they fit into our society and workforce.
As an orthodontist, it is important to understand and pay attention to the changing patient population around your practice. For example, if your target market is based on adolescents watch the population shifts in your elementary and middle schools; if your target market is based on income and jobs in the area be aware of companies’ growth and/or relocation status; or if you experience a population boom from immigration understand those new resident’s ethnic background. As a practice owner understanding the population shifts and demographic character changes in your community is extremely beneficial if not crucial as it allows your practice to make adjustments in marketing for future patient acquisition.
We get at least one inquiry a day about associate compensation either from an associate/employee orthodontist or a potential employer. In the past, the answer to this question wan average salary range, but the pandemic changed the compensation model for many employers. Now in 2021, instead of “What is the average annual salary for an associate?” we are hearing “Is it better to have an income guarantee (salary) or be paid based on a commission of production/collections?”
One of the first questions I ask a potential associate/employee is “What is most important to you when you consider your overall compensation model?” This is somewhat of an emotional question for many associates because often these two models offer ‘certainty’ versus ‘incentive.’
What you have to ask yourself is, “Am I comfortable taking a risk for more income potential?” “Do I want to be compensated more when I increase production?” “Or do I prefer to have a higher daily rate out of the gate and know exactly what my income will be on an annual basis?”
When considering your compensation model – consider these three areas:
1. Direct Compensation – Income guarantee which is paid either as an annual salary or a per diem
2. Indirect Compensation – Benefits such as health insurance, continuing education, association dues, licensure reimbursement, and PTO
3. Deferred Compensation – Retirement plans such as 401K or profit-sharing
When looking at these three factors you must decide what is most important to you.
Let’s explore the two most popular types of compensation models in the orthodontic industry – production-based (PB) vs income guarantee (IG). It’s critical to understand the difference between these models in order to make an informed decision that’s best for you and your long-term plans and goals.
If you are a highly-motivated orthodontist, the PB compensation model may be very lucrative but you should also understand the model and formula on which you will be paid. I am receiving an increasing number of calls from associate doctors that are being offered to shift to this model after 12 months of employment. This provides you an opportunity to understand what your income potential will be, since you can examine the previous production average for the prior twelve months, minus adjustments (discounts, write-offs and insurances, and your benefits), and calculate the percentage you are being offered with the adjusted production.
Currently, the most popular model is a hybrid model of both an IG (income guarantee) and a PBI (production-based incentive) plan. This is a shift we have seen employers make post-pandemic. Many potential employers are offering a lower IG rate but a higher PBI plan. How does this plan work and what exactly do you need to know?
First and foremost, you must understand the production goal and what metrics are available for you to monitor this goal. Second, recognize, how many days per month you will work to meet this goal.
As an example, let’s say your potential employer sets a $100K monthly production goal, and you are working 16 days/per month. Simply divide $100K by 16 (clinical days worked) which equals $6,250/per day. To meet your goal, you must produce $6,250/per day which equals about 1.2 starts per day.
You must also consider the conversion rate in the orthodontic practice. If it’s 60% then you will need to see at least three new patient (NP) consults each day. When an employer hires you, they not only want you to see current patients – which is where the IG comes in – but they also expect you to see NP consults. Can a new orthodontic graduate handle three to four NP consults per day? I am sure many of you look at this and say “Of course I can. That’s easy. I can see two new patients in the morning and two in the afternoon, right?” Well, that depends…
Let’s do a bit more math. How many patients are in the clinic? If there is an average of 50 clinical patients/per day it will allow you to spend more time with each NP consult to warrant a good conversion. But what happens if you are expected to see 80-100 clinical patients/per day? This might cause a bit of a struggle for a new graduate – balancing the clinic and spending the appropriate amount of time with NP exams/consults.
So, what are some things you should note when visiting a practice to ensure you can handle the patient flow and hit your production goals? Ask any consultant and they will tell you systems, systems, systems! A practice expecting you to hit high production goals must have good systems and teams to help you meet expectations.
The difference between a well-trained Treatment Coordinator (TC) and a mediocre one can be detrimental for a new graduate. If you have a great TC and you see three-to-four NP consults/ per day, you will most likely be looking at a 70% conversion rate – which makes your target income potential reasonable. If you are considering joining a practice, ask to examine the schedule – not just for that day, but for the week and month. Find out how many NP consults the practice normally sees on a daily or weekly basis, to make sure you have a reasonable opportunity to start new patients. Another consideration is the practice’s target market. Is the practice marketing and advertising to patients who are willing to commit to treatment or are they marketing to attract shoppers? This is important to know before you join, if the majority of your income is production-based.
If you join a well-established orthodontic practice with a well-trained team that attracts the right new patients, participating in a PB compensation model versus a higher IG can be very lucrative.
Based on recent trends, the odds are good that associate compensation will continue to shift toward productivity. The more you produce the higher your income potential. Specifically, with DSO and OSO models, paying based on production bonuses shifts the risk from the employer to the associate and helps maintain healthy productivity.
So, as you interview for potential associate opportunities be sure to weigh the differences between any production-based or income guarantees you may be offered.Do your homework and ask questions of your potential employer to understand whether or not the offer works for you.
Following President Biden’s executive action signed in January, the Education Department extended pandemic relief for about 41 million federal student loan borrowers through Sept. 30, 2021.
In March 2020, borrowers were granted a reprieve on their loan payments and interest was set to 0% and collections of defaulted federal student loans were paused. Congress initiated this relief in the CARES Act. Before Biden’s executive action, the relief was set to expire on Jan. 31.
All of the deadline changes have been challenging for many borrowers. Research from the Pew Charitable Trusts found that 40% of borrowers did not know when their loan payments were set to resume. The research also found that borrowers are struggling financially due to the pandemic: Almost 6 in 10 borrowers with paused payments reported to Pew that it would be difficult to begin making their payments if they had to do so in the next month.
There are still a number of details surrounding student loan repayment that have not been clarified. The Education Department had previously confirmed that borrowers in an income-driven repayment plan would not have to recertify their income before Jan. 31, noting that these borrowers would be notified individually of a new recertification date. However, the Biden administration has not yet addressed how the latest extension of relief may affect that, so it is important for buyers to stay informed. If you’re not sure what types of student loans you have, contact your loan servicer to find out. If you have an online account with your loan servicer, you can also check there to see whether the benefit was applied to your account. To find out what type of loans you have, follow these steps:
After you log in with your username and password (FSA ID), you will be able to see your loan(s) listed on the StudentAid.gov Dashboard.
Click “View Details.”
Scroll down to the “Loan Breakdown” section. If your loan(s) is owned by ED, you will see “DEPT OF ED” before the loan servicer’s name. These are the loans eligible for the 0% interest rate.
The extension of the payment freeze has provided relief to borrowers in the short term and offers a longer runway before repayment starts, but what happens next? Will there be permanent relief with permanent loan forgiveness? Some democratic congress members support a plan to cancel up to $50,000 of outstanding federal student loans per borrower, although Biden’s proposal is only canceling $10,000 in debt for students who work in national or community service.
Right now, it is unclear what the Biden administration will do next but borrowers should pay attention. Our biggest piece of advice is, if you can afford it, keep making payments or even increase your monthly amount during this period to pay off your loans faster and lower the total cost of your loan over time.