The Multiple Ladder by Ish Rouf

In this conversation, Peter and Craig interview Ish Rouf, who is the C-suite of his wife’s private DSO. Ish shares his approach to hiring and developing associates, as well as his perspective on valuing and selling a dental practice. In this part of the conversation, Craig and Ish discuss the importance of understanding the revenue makeup of a dental practice when evaluating it for purchase. They also discuss the importance of clear communication and alignment between dentists and associates when negotiating contracts and expectations. Additionally, they highlight the significance of having comprehensive standard operating procedures (SOPs) and scalable systems in place to ensure the smooth operation and growth of a dental practice.

• Hiring associates based on their attitude, willingness to learn, and compatibility with the practice’s values can lead to long-term success.
• Investing in technology and aligning the practice with the right team and systems can increase the value of a dental practice. Understanding the revenue makeup of a dental practice is crucial when evaluating it for purchase.
• Each dental practice is unique and factors such as services offered, fee mix, systems, culture, and technology can greatly impact income potential.
• Clear communication and alignment between dentists and associates are essential when negotiating contracts and expectations.
• Comprehensive standard operating procedures (SOPs) and scalable systems are important for the smooth operation and growth of a dental practice. Focus on simplicity, automation, and smooth operations in your dental practice.
• Profitability is important, but also strive for power and efficiency.
• Consider implementing accrual accounting to align spending and payment dates.

• Have visibility into every aspect of your practice for better decision-making.
• Set goals and incentives for your team to drive productivity and growth.

Ish’s Multiple Ladder

3 – Industry premium (dental)

1 – Year-on-year profitable, with 10% investor return

1 – Group practice with SOPs in place

1 – Multi-state practice with compliance in place

1 – Corporate function already established

2 – Enterprise-grade financial accounting

1 – Centralized reporting and forward-looking analytics

1 – User-/persona-level reporting

1 – Future-proof tech stack

1 – Integration playbook, diligence team, and rollout team

1 – Internal training and coaching library with LMS system

1 – Centralized procurement

1 – Centralized call center

0.5 – Strong recruitment pipeline

0.5 – No key person risk

Bulletproof Mastermind

Ish Rouf