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  • 3 Apr 2020 2:34 PM | Anonymous

    By Timothy A. Brown

    A family member received a letter last fall announcing the sale of a dental practice. Our company did not act as the broker for the selling dentist. I recognized the name of the purchaser because I happened to have met her last spring when she was starting her search for a dental practice. A lovely person with a

    great attitude. She found the right opportunity for her through one of our competitors and she completed the sale. When I saw the letter announcing her name as the purchaser and the retirement of the previous owner, I was shocked at the terrible quality and the lack of sensitivity. It was one of those

    traditional “dear patient” letters and it was photocopied on low quality paper with a photocopied signature of the outgoing dentist. And the overall message was bland. No energy! Nothing to make a patient feel ‘good’ about the change. It was also insensitive to long-term, loyal patients who at least

    commanded the simplicity of striking out the “dear patient” and writing in their first name because they were friends with the dentist. An opportunity missed.

    I felt obligated to reach out. So, I did just that. I called her and said that I was disappointed in the letter and that it could have been written and presented in a much better format. She conceded that it was the staff that made all the arrangements and that she just let the process flow. I reminded her that as the

    new business owner (who is now heavily invested) that she should take the lead on these matters. I did not reprimand her, but I made it clear that our firm would have recommend strongly against the lowenergy message and the quality of the mailing.

    In addition, the letter announced an open house at the practice and because I had been to that practice a number of years ago, I cautioned her that it was quite small and the facility itself was extremely dated and that I did not think it was the right place to hold a reception. I asked if she renovated since she took

    over, which might have changed my opinion, and she said no.

    That is when I stepped up my game. I said “Dr., cancel this event. We will find a much better facility and we will do a second mailing to the patients announcing that due to overwhelming demand, we had to delay and move the reception to a larger facility.” I offered to host it at my country club in an effort to

    help her communicate with her patient base that she is a classy individual and that they are worthy of a reception at a nicer facility than a very dated (wood paneling!) 1980s dental office.

    She agreed with most of my observations, but decided to let the reception proceed. It transpired last month. At the end of the event, she sent a message saying “it went very well today, but Tim I’m really looking forward to the much bigger and better event that you are going to help me plan for the Fall of

    2020.” My firm did not sell the practice to this young lady, but she is the kind of individual I want to work with. She accepted my advice and now we are going to help her deliver an impression and a message that is worthy of her style and also to show some respect for the outgoing dentist.

    I am paying it forwards. I believe she will tell a lot of people that the broker who sold her the practice offered no help or advice on this very critical event. Do not underestimate the significance of a Career Celebration. I will co-host an elegant function at the Missiissauga Golf and Country Club which will

    commensurate with her style and suits the well-established patient base. It is never too early to plant seeds in my business even if it’s too late to reap a harvest. Timothy Brown is Chief Executive Office of ROI Corporation Canada’s national professional practice and brokerage firm.

    Timothy Brown is Chief Executive Office of ROI Corporation Canada’s national professional practice and brokerage firm.


  • 16 Mar 2020 4:45 PM | Anonymous

    DMC is aware of today’s announcement from the Royal College of Dental Surgeons of Ontario (“RCDSO“) in response to the COVID–19 pandemic. The RCDSO “strongly recommends that all non-essential and elective dental services should be suspended immediately. Emergency treatment should continue” and that “The College will revisit this recommendation in the first week of April.”... Click here to read article

  • 15 Jan 2020 3:12 PM | Anonymous

    Access to Oral Health Care for Individuals with Developmental Disabilities: An Umbrella Review

    Keith Da Silva, DDS, FRCD(C)

    Julie W. Farmer, RDH, MSc

    Carlos Quiñonez, DMD, MSc, PhD, FRCD(C)

    Prepared for the Federal-Provincial-Territorial Dental Directors Working Group

    October 2017


  • 15 Jan 2020 3:11 PM | Anonymous

    Canadians with developmental disabilities often suffer from poor oral health and are faced with many barriers that limit timely access to oral health care. These barriers contribute to poor oral health and associated inequalities.

    Trillium Health Partners, Credit Valley Hospital site is able to address these barriers in part, by being equipped to provide timely access to the operating room for treatment under general anaesthesia for adults with special needs.

    This service is available for a subset of individuals with developmental disabilities. who can be affected by a broad range of physical, developmental, cognitive, sensory and behavioural impairments. This includes conditions such as intellectual disabilities, communication disorders, cerebral palsy, autism spectrum disorder, fetal alcohol spectrum disorder, attention-deficit/hyperactivity disorder, motor disorders and/or sensory deficits.

    In the clinical setting, poor oral health status may be related to difficulty in obtaining an accurate diagnosis. These patients may have limited ability to describe pain or articulate their symptoms. They may not co-operate, or be resistant with oral health care professionals. They present with complications such as limited mouth opening, oral aversion, deficient swallowing reflex, excessive saliva production, a strong gag reflex and lingual interference that can limit intra-oral access. They may also experience high levels of anxiety and fear related to dental procedures and a lack of coping skills to tolerate discomfort and pain.

    Many have complex medical and behavioural issues, often related to congenital anomalies and associated co-morbidities and may not be safely treated in an isolated setting like a stand-alone dental office.

    There is a need for promotion of collaborative and interdisciplinary care between oral health care professionals, other health care providers, personal caregivers and agencies that work with individuals with special needs.

    I am on medical staff at Trillium Health Partners and have been granted access to the operating room to provide routine dental treatment for special needs adults under general anaesthetic.

    As with all surgical staff, administration and booking of operating room time is through the private office of the surgeon.

    Please find my contact info below and on the accompanying referral pad.

    Thank you for your kind referral.

    Steve Lipinski, DDS, D ABDSM

    O:905-828-9894          Fax: 855-395-0788                                                                          


  • 14 Jan 2020 5:07 PM | Anonymous

    TAKE A SELFIE—See what it reveals about you as a leader

    By

    Timothy A. Brown

    One of the most commonly asked questions of people in my position is “what is your top practice management advice or tips”?

    Appraisers and brokers are obviously aware of very successful business practices as it is our responsibility to uncover them on a daily basis when we are performing appraisals and selling practices. We also uncover some inefficiencies and, quite frankly, bad practices that we make recommendations about to our clients. These management “issues” might be a quick fix and something that will not take long but others may take months or years to modify and while doing so, it could be detrimental to a successful sale. We make recommendations to fix these concerns should if time and willpower to get it done are available. If not, it may impact the eventual sale price but not be worth the time, money and energy for the current owner to invest in before selling.

    We are not practice management consultants. There is a plethora of people that do that for a living and most have worked in a dental office at one time or another and offer their services through a multitude of social mediums, mostly focusing on efficiencies and staff training. Despite what these management gurus might tell you, tread this path with caution. There is no silver bullet to eradicate practice management issues. If you have dug yourself a hole, you will need to pick up a shovel and dig yourself out.

    I am a firm believer in the theory that good practice management is really a top down principle and is explicitly linked to effective leadership skills. You need to take a selfie. Are you a good leader? There are many books out there on great leadership that are readily available for all of us want-to-be or current leaders and most of the research on the topic would suggest that inefficiencies, low morale, or a toxic culture is probably created and/or permitted by the leader/owner of the business.

    “Success is never owned, it is rented, and the rent is due every day.” This quote by Rory Vaden emphasizes the need to be and continue to be a leader daily.

    Many business owners have big egos. That is what causes us to take risks and become business owners.

    Taking a regular selfie of ourselves as business owners is an important exercise. We need to see how the world views us and be brutally honest in our assessment of the culture we have built and how we have allowed it to shape not only the environment of our business, but also ourselves to some extent. This is not an easy task. When culture is eroded through a lack of leadership, tired leadership or amateur leadership, no systems can save you. Have a good look at yourself. Only you as the figurehead can rewrite the systems that you have allowed to be laid down. Maybe go over to the mirror right now and take a picture. What kind of leader are you?

    Timothy Brown is Chief Executive Office of ROI Corporation Canada’s national professional practice and brokerage firm.



  • 25 Oct 2019 12:46 PM | Anonymous

    The Corporate Service Organization (CSO) phenomenon began in the early 1980s founded (in part) by Dr. Howard Rocket and his company Tridont Dental Centres*. One of the great successes of that organization in the early stages was its corporate culture. Dr. Rocket personally met with every single dentist joining the organization and he attended all business meetings. He attended every grand opening and ribbon-cutting ceremony at all the new locations. Tridont offered its team members phenomenal continued education and held 1980s style conventions and functions that anyone who attended will remember! I went to one – wow! Everyone was treated like family in the early years. *http://archive .macleans.ca/article/1981/9/14/department-store-dentistry

    As the company grew, the culture supported by the founders diminished as the company spread out; it could no longer build new and became less able to maintain their existing relationships. Things started to fall apart. Tridont peaked at 107 dental offices with about 500 dentists and 2,500 staff. About a decade into the business plan, after going public, the company went bankrupt and shut down. I believe the culture collapse was the largest part of the failure.

    Let’s look at today’s various CSOs that are growing in the Canadian dental marketplace and talk about culture collapse. It is a phenomenon that rapidly growing companies are unable to control after a period of time. The founders and the early adapters cannot support the growing number of invested parties and relationships become sterile and impersonal as the focus fixates on the financial side. Imagine a CSO generating hundreds of millions of dollars of revenue, while investing hundreds of millions each year in growth, all the while trying to serve the needs of associates, partners and employees, not to mention patients. It is a massive challenge.

    The mandate of the senior managers and the founding partners/investors is to follow their business plan, raise capital and continually invest in the marketplace. This is a natural maturation that all corporations attempt to achieve at one time or another. But after the early stages, when relationships are formed with the founders/early adapters, the later adapters will discover that they are not part of the same club. They are not part of the same inner circle. They feel isolated even though they are fully invested in the business model and they are financially successful, they do not feel they are part of it. They were not there in the beginning stages when the ball started to roll and as the snowball grew, more and more people got behind it until the lineup was so long that you do not feel you are helping but simply following the leadership.

    I have spoken with many dentists who have sold to a CSO. Some fulfilled their long-term contract obligations and reported great success in the relationship. On the other hand, many (in particular those who joined the organizations later in the cycle) feel they have just become a number and they were just another spoke in an otherwise massive spinning wheel.

    Dentistry is and will remain a hands-on, personal service profession. This belief system cannot be taken away from the practitioner. Surveys indicate that the very large majority of dentists entered the profession to “Be My Own Boss”.

    You cannot buy culture nor invent culture. Leaders who crave culture are often found trying to manufacture it when they notice some dissention in the ranks. This is often the beginning of the end for many organizations. Particularly when it starts to disillusion those who were there at the beginning and when they see resignations and turnover at the executive level. At this point, they start to realize that will have trickle-down effect and the result is often another faceless corporation, which may be very profitable, but one that people do not want to work for.

    As a business appraiser and broker who primarily focuses on health care practices, we have also looked at other non-dental CSOs that are substantially larger than some focused on dental. The businesses that seem to have the greatest challenges rely upon a dominant, highly skilled labor force. Health care is a perfect example. Let’s look at the medical doctors. What is the culture of the medical doctor working in the present government-controlled, bureaucratic health care system in Ontario and other parts of Canada? I think we know the answers.

    The CSO is here to stay in Canada and will likely double in size and ownership/control over the next 3 to 5 years. The culture of each of these CSOs will evolve and some will fail while others will thrive. Much like my experience in the 1980s, I predict the early adapters will eventually suffer a collapse of culture.

    Timothy A Brown, CEO & Broker of Record of ROI Corporation, Canada’s largest and longest standing appraisal and brokerage company.

    6.3.6
    6.3.6
  • 19 Oct 2019 3:10 PM | Anonymous

    I just had to send this to you to say Thank You for your training.  I have attended your CPR courses via Halton Peel Dental Association.  Your videos coupled with your stories and instruction really send home the message about how to recognize people who need help.  Here is my story.  I was having dinner with my daughter, her fiancé and my granddaughter on Sunday night.  My daughter cut off a piece of meat, then my granddaughter needed attention so my daughter shoved the meat into her mouth and helped my granddaughter.  All of a sudden my daughter started choking, able to cough a little  then nothing – could not cough, could not breathe and the look of panic on her face was terrifying!  I ran behind her, wrapped my arms around her and started abdominal thrusts.  She really started to fight me, she was pulling at my arms but after 3 very violent thrusts she spit out the meat!!  Oh my gosh!!  I am so thankful for your instruction.  I think the videos that you use really hit home how to assess someone in need.  My poor daughter’s ribs are still sore but she is alive to be able to tell me about it.

    Thank you, from the bottom of my heart.  Without your help, I may have lost a daughter.

  • 19 Jul 2019 12:48 PM | Anonymous

    I met with a business owner last week who completed a very emotional soul search about selling his business. The decision hurt. It really hurt!

    The company was founded over 40 years ago. The original owner and his wife made their first product in their home garage using war-time machinery. The current owner and his wife bought the business from them in the 1990s. Today, they employ over twenty-five equivalent full-time employees and generate millions of dollars a year in a metal/machine-related business. The company also employs family members.

    They also bought a building during one of the expansions several years ago and managed to pay off the mortgage in less than 10 years. They have room to expand and the business continues to be fully booked three to six months in advance with orders from all over the world. Total estimated valuation of the operating business, equipment and machinery, inventory and real estate is $10 Million.

    The owners are now preparing for a sale. He was talking to me about the top three and most obvious options he has to sell to—family members, the management team and his competitors. This article is about family. The breaking point with family came after a staff function held at the company. The owner asked a family member to stay and help clean up after a staff pizza and beer party on a Friday afternoon. That’s when it happened: his son went to the punch clock and punched back in to get extra time on his pay sheet. Clean up took less than 20 minutes. Then he punched out and went home. The owner has taken great strides to treat all staff equally—even his children. And like all other employees they are required to keep a timecard. The owner told me this story in a private setting and he shook his head and wondered, "How is this next generation ever going to learn to think and act like an owner?” What does it say to an owner when a family member stays a little late to clean up from a staff party and punches in to get an extra 20 minutes on the weekly timesheet?

    Family business owners have struggled with the next generation for generations. There is something different this time around. Baby boomer business owners are between the ages of 55 and 75, give or take a few years on each end. We think

    differently than our parents and grandparents did.

    The bottom line is this: We do not want to be partners with our children and we do not want to be their bank. Our parents and grandparents encouraged us to become their partners and in many cases they borrowed against their homes or

    lent us the money in order to allow us to buy them out over time using a variety of partnership structures. I am sad to say that my informal research indicates that baby boomers do not want to follow this path. We raised this entitled generation and as baby boomers we blame ourselves for the attitudes of the next generation behind us. What is also patently obvious is baby boomer business owners are not interested in complicated partnerships or long-term phase-out/transition structures. We want a cash offer and we want out—period. It is the “cut and run” or clean break phenomenon that I have talked about for years. It is not easy to stick around and watch a new owner run your company. It is not easy to be their partner.

    As a baby boomer business owner looking toward a timeline for an exit, it is very important to come to some very difficult decisions or come to grips with the fact that you probably do not want to partner with the next generation and that you do not want to be their banker.

    Take the money and run.

    Timothy A Brown, CEO of ROI Corporation, Canada’s largest and longest standing appraisal and brokerage company.



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