Scaling Up Your Dental Practice

Bill Gallagher shares the keys to business scaling: Think bigger, consistency in planning, and harnessing the power of coaching for success.


About Bill Gallagher

Bill Gallagher is a highly rated business coach whose passion is helping CEOs and entrepreneurs manage growth better; restore time, order and sanity to their lives—and get growing again or growing faster. With more than 36 years of entrepreneurial and executive experience and 18 years coaching and training leaders who want to improve their leadership and performance, he now works with leaders and teams in over 28 cities and 13 countries. He has led four companies as CEO/owner and was a partner/executive in two others as they grew from startup to more than $500 million in annual revenue.

About Eric Vickery

Eric holds a degree in business administration and brings a strong business and systems approach to his consulting. His initiation into the field of dentistry was in the area of office management. He managed dental practices for over ten years and has been consulting over 250 offices nationwide since 2001.

About Alex Nottingham JD MBA

Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.

Episode Transcript

Transcript performed by A.I. Please excuse the typos.


That’s evolved into the whole scaling up framework, which brings the best ideas around getting the team right, the people on your team, dialing in your strategy, having a differentiated working strategy, but also a simple strategy, and then executing consistently and optimizing the cash in your business.


This is Dental All-Stars, where we bring you the best in dentistry on marketing, management, and training. Here’s your host, Alex Nottingham. Our topic is the three secrets of companies that really scale. Our guest is Bill Gallagher. Bill is a top-rated business coach with 36 years of experience specializing in helping CEOs and entrepreneurs achieve accelerated growth, regain work-life balance, and optimize leadership skills.


He has a track record of success as CEO for four companies and a partner in two other, he is also the host of the scaling up business podcast. Please welcome Bill. Bill, you are a big scaling up guy. And so for people that are not familiar with scaling up, tell us about it and how you got involved with scaling up. So scaling up is a, is a kind of an open framework.


best practices around high growth companies. And it started years ago by a guy named Vern Harnish, my friend and mentor around the entrepreneurs organization, then the young entrepreneurs organization, and they had a program at MIT called the birthing of giants. And in that program, Vern started to distill and teach the secrets of scale, in particular, a focus on the life and work of John D. Rockefeller.


And from that emerged the Rockefeller habits. And then over time, they realized the Rockefeller habits had a lot of it, but they were missing some of the things that were appropriate for modern. So that’s evolved, modern times, that’s evolved into the whole scaling up framework, which brings the best ideas around getting the team right, the people on your team, dialing in your strategy, having a differentiated working strategy, but also a simple strategy.


and then executing consistently and optimizing the cash in your business. Or, you know, more cash, more profitability, better valuation. You mentioned open framework. What does that mean? Yeah. Well, so there’s a lot of people who talk about and have things around teams and growth and strategy and things like that. And all the ideas are, you know, not particularly new, right?


well-owned and developed and repeated over time. Now there are parts of things that work for different places, but a lot of folks go out and they like rebrand everything and call it their own and say, I came up with this while I was working on this business with my family or whatever. That’s kind of a lot of BS. And what I really have always loved about Vern Harnish and the scaling up framework is Vern is like, I learned this from Jim Collins. I learned this from Pat Lancione. Here’s what we can learn from Marshall Goldsmith. That kind of…


um attribution and honoring um intellectual property creators right i have always had a deep respect for and in truth like those guys learned it from someone else and you know steven cubby teaches us to plan with the end in mind but steven learned that from someone else um so everything’s kind of a remix of everything else and it’s really useful to um you know acknowledge the


whatever crater that came before you, maybe not everything back to the ultimate source, but you know, as far back or as much as, as relevant as you can. Yeah. Tony Robbins before him, it was Jim Rohn. So they all learned from the Napoleon Hill. So on. Yes. So we learned from lots of folks, right? So what are these, these secrets and Eric, if you wanted to jump in as well, you’re welcome to jump in. So you talk about the scaling up method or where it came from Vern and you kind of built on that open framework.


And obviously you have a lot of experience building many companies still involved in companies and your podcast is wonderful. We’ll put in the show notes, a link to your podcast. And, and I guess you just learned these secrets just on your journey. So I first learned, well, you know, some of the ideas because just like verne learned them and I knew before I was exposed to verne and the old birthing a giants program, but


My business partner and wife went through the birthing of giants program and I was, we had three companies at the time. We ended up focusing on just one of them for some years and I just started to apply them. So when I came into that company, I’m like, we need a BHAG. We need a big, hairy, audacious goal, Jim Collins term for a 10 year transformational goal. We need a set of values to operate from. We need to figure out who our core customer is and what our brand promises are. We’ve got to set targets. We’ve got to do quarterly themes.


We’ve got to do regular planning cadence. We need scorecards and scoreboards. We need daily huddles We need to put in all these kinds of things to run this business Well, if I’m gonna grow it to the place that I’d like to grow it to right So I went to work on applying those and I’ll be really honest I did some of them really well and there was a lot of others that I did poorly some of which cost me millions of dollars of painful mistakes


in that process. So I didn’t do it all perfectly and I still don’t to this day, right? I’m still even now years later, I’m still a student of the process. But I learned it and applied it first as a CEO. Then I started coaching a little bit on the side and then I went full time as a coach. And for 10 years, I’ve been a full time coach all over the world. And I’ve worked with thousands of companies now. And the experience that I have as a coach far surpasses the experience as a CEO.


and has given me a much broader picture of what can go right and what can go wrong in doing some of these things and trying to grow your business. And along the way, I’ve noticed things that work particularly well, what stands out. So we’ve got the 10 Rockefeller habits, and we’ve got four decisions, and we’ve got multiple tools within those. But what are the things that really separate companies that grow nicely from the ones that really scale? And that was kind of the focus of what.


I said would be useful to share with people that I’ve been talking about more lately. What are these secrets of the companies that really scale? And there’s really three things, right? The first thing is transformational goals, like big thinking. It’s really hard to double your company. It’s actually easier to double your company if you’re playing a 100x or a 10x kind of game. So that’s the first one. I’ll talk a little bit more about that.


The other thing is you’ve got to set in like a predictable cadence of working on the business, not leave working on the business until later or last or after every other emergency supplier customer like whatever, which is the more common thing and something I have done sometimes, to be honest. And the last thing is get a coach. You know, no.


high performing athlete ever, even low performing athletes all have a coach and yet in business, entrepreneurs again and again, try to go it alone, try to figure it out on their own. Have a don’t tell me what to do kind of mindset and it just makes your life harder and it takes you longer to figure stuff out than getting a coach. And it’s not because, and obviously this is pretty self-serving, right? I’m a coach. All right.


So I make my living and my money and my fulfillment in life is the work I do as a coach. And so I’m telling everybody to coach. But one, I have lots of coaches myself. And then two is that I’ve benefited from having a coach and I can’t work with everybody. So I’m not saying hire me necessarily, but find somebody that you’re willing to empower as a coach and have that. So,


The first one, right, is that transformational thinking, right? Is that what you want to ask about? Yeah. What I like to do is before we get to the three, cause actually the third we’re going to cover in the, another podcast we’re going to do together, we’re going to go into detail about coaching because I have our president of the coaching. We’re going to, we’re going to go into that and I have a question and I think Eric has his finger up too. Can you just review for those that are listening about scaling up, there are four, just review the four key principles in.


in your methodology. Four decision areas. Yes, four of those. Four decision areas. So people, strategy, execution, cash. So people is, do we have the right people on the team to grow this company, right? Can I attract and retain people? Can I engage people? So it’s getting the team right. Engage people that are right for the stage of growth that you’re at, having enough of them to grow your business. You can’t do anything significant on your own. It’s gonna take a team. And so the first thing to do is to get right the team.


Then strategy is a simple differentiated strategy. So simple is I can say the strategy simply and everybody can get it, everybody can leverage it. It’s not just in my head or in a hundred page document. And there are a lot of big strategy companies that will sell you like a hundred page document, but can you distill it down into some simple, actionable ideas, right? That drive what you do day by day, year in, year out. So simple yet differentiated, just trying to be like everybody else in your industry is painful.


is not profitable. So we’re very interested in being unique, different, owning a particular space, and doing a really good job of that. And then executing well. So execution is about low drama, high profitability. Can we consistently do things again and again in an efficient way without a lot of breakdowns? And the efficiency leads to profitability. The lack of breakdowns leads to customer retention and profitability. It’s that kind of consistent execution.


And the fourth thing is optimizing cash. So, you know, many of the companies I work with have gone through rounds of funding and are doing more. Others have bank financing, some have both. That’s okay, but the less you need it, the more optimized you are to not need cash, to use cash better, to have a stockpile of cash, then allows you to be choosier, to get better funding, to…


Uh, have more control, a whole range of things. If you spend time optimizing your business model for, for cat profit catch. It makes sense. Eric, you want to add? I love just the way your brain thinks and how you speak as a coach. So I really appreciate how you break it down. Here’s from a, from a coach’s standpoint, since I’ve got your ear bill, w you know, we’re dealing with small businesses, the, the dentalists, right? Small business eight, maybe more. It could be, could be DSOs groups that have larger.


issues. Here’s what I hear them asking right now. Well, I’m only this big. I’ve got this much square footage. I don’t want to scale up. So maybe define scaling up for a small business. Like how could that look? Just that’s my first question. You know, so I helped one dental office go through 18 offices from one to 18.


And, but their goal was to be the leading operator on the West Coast, and they’re still working on that goal today. So and competing with some of the national dental groups. And I worked, helped with another one go from one to four offices. And again, they want to own a particular area region and be known for a certain category of customer type of dentistry. Right? So there are.


There’s always something to create, but in each case, thinking about that future state, where do you wanna go? When do you sell or exit this business? Or if you’re never gonna do, are you developing your kids? Are you developing your leadership team? How, like what, think way, way out, right? Not just about the problems of tomorrow or the next five years, but imagine like your whole life. Where does this fit? What would you like? And you know, it’s gonna go.


but not the way you imagine it. But if you spend time actively imagining and thinking about it, you’ll make different choices than if you just try to solve the problems of today. If you try to solve the problems of today, now from the lens of now looking backward only, sometimes you chase things that would be better to walk away from, right? You work on things that would be better to shut down. Yeah, perfect example of that is, doctor has an associate and this doctor, lead doctor as a producer,


is suffering because he can’t let go of how poorly his associate is performing. And it’s, it’s, it’s a two for one because my associate’s not performing. And so therefore I’m not performing because I don’t have the ability to coach this person well, well enough to also focus on my part of the business as well, or Lee get that. So I have a dear friend with a dental practice that, uh, had a toxic associate. I’m like, you know, that associate is not fun for me or you.


but they’re gonna be fine somewhere else. They have a very different set of values from you and they should work somewhere else because what they care about, what they’re optimizing for is not what you are. And they just need to go work somewhere else because they don’t belong in your team. Alex and I just had a client who just went through this very same thing. So my second part of my question is, when you’re talking about in the executing stage, right? Just the strategy, keep it simple and executing. We go through KPIs.


We obviously train, we teach, hey, this is how it’s supposed to be, but we’re not consultants. And so two things are happening. Clients are wanting a manual, turn to page eight and say it like this, which we don’t do. Open ended, right? This open structure, this understanding the concept of what we teach. But also the second part of it is, is we’re not consultants. We’re not coming in saying you’re going to do it just like every single place. You’re going to do it just like this because everybody has different talents and vision and goals and all that. So.


Can you speak to that, the difference between a coach and a consultant on a application executing level, because they’re gonna want something tangible that says I’m gonna do it just like this. How tangible do you get in the executing stage? If you have a consultant who lays out, quote unquote, best practices for you in your industry, then you’re gonna get a lot of cookie cutter BS that doesn’t leave you differentiated, that doesn’t give you a profitable, distinct advantage over everyone else.


They might be really solid things, but it doesn’t make you any kind of a unique business. And so then you end up competing on the same level in the same way with everyone else, and that erodes your profitability and your competitive position. So the simple answer is a coach will lead you through a process to create something unique on your own. It’s not that I never have an opinion on somebody. I’m like, okay, well, if you take that approach, I’ve seen that done a couple other companies in different industries are the same.


And here’s kind of how it went. So think about that. How are you going to avoid that pitfall? Um, that’s a useful thing to do, but you know, you hire a consultant who comes in and creates your, we, we’re a big advocate of playbook. Not to that, like, look, a playbook, um, is like learning your scales and jazz is like, whatever, when you go actually and execute the play on the field, things go differently, just like when I get out there and play, I have some idea about where we’re going.


but then I can kind of play with it, I can riff on it. And so having a playbook to open a new store, a new clinic, a new what office is one thing, having a playbook to operate it day by day, having processes for things, being consistent refining those over time is fundamental to medicine, is fundamental to aviation, is fundamental to engineering, to military, to like sports, like any arena, let’s create consistent things and develop a playbook, but I won’t give it to you, right?


I will help you to create your own. But let me jump in here. It’s really hard to get you guys off of the coaching. We’re going to do a whole podcast and just coaching guys. Okay. So just to kind of jump in, we were talking about those four disciplines. You call them. Okay. The, in terms of scaling up and a smaller businesses does not want to grow beyond its physical location can still benefit greatly by the principles becoming more efficient, more effective, more profitable.


everything that is covered in that model. Let’s be the number one. Maybe I just want to be one. So what am I going to be known for? What are people going to say about this business, this practice? What am I going to sell it for in 20 years? Not the dollar amount, but the kind of person, what’s the legacy that I’m imagining and creating? So if it’s going to be that, and I’ve been through many different dental offices in my lifetime, and that my kids had different kinds of.


the dentist and they had orthodontist and things like that. And there are some that really stood out. And then there are others that, you know, they were just sort of disposable, run-of-the-mill kinds of places. And, you know, there were some that really attracted me and then some that really repelled me. I went to one that was recommended in San Francisco for a long time and like, this person is the dentist for all of the high society and they’re really the best dentist in San Francisco. And this is, you’re getting, it’s great that you can even


go to this person and they’re fantastic. And I found most of my visits to be really unpleasant. Painful, difficult, unnecessarily burdened. I’m like, that’s not my dentist. And somebody else said, you should try my dentist. Everything’s great. They’re so laid back. And so I went to that dentist for a while and then I moved to a different town and it became a little harder to go with them. But then the…


the hygienist or somebody went over and they recommended another place and I went to this other dentist and I’m like, oh, I love that one. And then that person changed. And then the other doctor, a dentist there, I was like, oh God, that guy’s a drag. Like his whole, like he doesn’t care about me in the same way. And I don’t care anymore about my hygienist. Like I’m out of there. And then I found another one. And then, and then, and then somebody bought that one and I hated the way they ran that place. I’m like, you know, people have strong feelings about their dentist.


Right. Strong connections. What’s the vibe? Um, I’m from California, right? What’s the vibe for your place? You know, what’s the feel for the thing? Right. And that’s beginning with the end of mind you were speaking about as well. Is you got to know that’s your vision. What do you, what’s your core values, your core purpose, and then you build from there, what, what that looks like. And I, and I think the scaling up technology allows you to create the life that you choose and you have the resources there.


You mentioned playbook and I know your podcast, you mentioned that quite a bit. Tell us what is a playbook, tell us about that and how that can benefit business. A playbook, right, think about what is a playbook. A playbook is usually a book of multiple plays. They are different sequences of events against which different team members will do different things in a consistent way in a coordinated fashion to achieve some particular end. So.


We could have within a playbook for operating your standard operating procedures, you could have how do you open and close a clinic? You could have how do you schedule someone? You could have how do you welcome and handle a patient? How do you, you could have all these different kinds of things and you could script them out and you could teach what to say and to make sure that people said certain things in a particular way and offered certain services that you wanted to emphasize.


So you could do all those kinds of things and made people aware of your advantages and like that kind of thing. But you’d want to do them not in 20 different ways and then every time a team member changed, you like did everything in a new way and every time somebody came from another office, they brought over the good and the bad habits out of their office. No, you want them done your way if they come from some other place. So develop and then and it’s not static, right? Once you create it, you’re continually.


It’s evolving over time as you learn, as you get better, as the world changes, as what, as technology changes, medicine changes, right, like that. That helps. Do me a favor. Let’s review those three secrets that help companies scale. It can be vertical, horizontal, what have you. And then tell us, tell us the listeners of how we can learn more about, about you, Bill. So, simply said,


Look, I took over a company in 2002 and I laid out the BHAG and all these kinds of things. I wanted to two and a half times grow the company and I worked on that for the next six years and as we were approaching the goal, it seemed very far off and then the whole economy rails off and we nearly went under. And looking at the failure, the possible failure, likely failure of the business,


thinking about losing my house and all that financial catastrophe of a bankruptcy in the Great Recession, I set a different goal. I said, well, if we’re going to reinvent this business, let’s stop with the things I’ve been struggling with for the last six years and let’s reimagine this as a much bigger business instead of just trying to get to this number, let’s try to get to 10 or more times that. So my new goal was let’s get to 250 million. And that was a much bigger number, much bigger game.


And I started to reimagine everything along with the team, right? Wasn’t just me on in the ivory tower, but all of us working together What would it be like to 10x this business or 100x this business? What kind of systems will need what production will we need? How would we sell to people? What would our packaging look like whether like and then that goal that we’ve been working so hard for We quickly sailed through that in a couple of years. So


When I changed the game and started 10x or better thinking, 100x is actually much better than 10x, and I started thinking about it from that standpoint, imagining how to work every aspect of the business, we sailed through the doubling goal easily. So even if you’re one location, it doesn’t have to be 10x in terms of footprint. It could be 10x of value, 10x of revenue, 10x of product, could be 10x anything, but.


10x or better will make doubling a piece of cake by comparison. It’s still excellent. And as you’re speaking, I’m taking notes for our next podcast of what to, to ask you, uh, you mentioned before, so just summarizing the three, the three, the second one is create getting consistent about working on your business. Most people, the first one is think bigger. The second one is get consistent about the way you work on the business. So playbook, right? No.


That’s well, it’s embedded. But the key thing is people go to work on their business after every customer, after every prospect, after every supplier, after every employee, and they don’t prioritize it. So when I say work on the business first and get a consistent rhythm going, I’m talking about doing an annual plan on a consistent basis, on time, ready to go, either just before or right at the beginning of the year. I’m talking about doing a quarterly update. And then


creating quarterly priorities and plans and a theme every quarter. I’m talking about having a weekly meeting to check in on how we’re doing on the quarter goals and see are we tracking them. I’m talking about daily huddles for each and every shift or for the whole business to open the day and get on the same page. I’m talking about that kind of consistency with dashboards, scoreboards, things like that that tie together and that keep you on track to that big, hairy, audacious goal. So we got this big thing and then life happens, things break down.


go faster, sometimes slower other times. But we can’t adjust if we’re doing that weekly meeting, that quarterly planning after everything else, and sometimes we forget to do it, and now we’re operating with nothing, we’re just going through the motions, and who knows how we’re doing, you know? So scoreboards, scorecards, metrics, it’s not complicated, but it takes being proactive, right? I know that my quarterly plan is ready.


almost without fail three weeks before the start of the quarter. And most of my teams are ready by the second week of the quarter. So somewhere between three weeks before and two weeks after the quarter turn, people have a plan. Well, you know, everybody knows their role. It’s interesting. It, I’m going to make a note, again, other note about doing versus dabbling, like making sure you stick the things and see it through. We’ll talk about that in the next podcast. And, and the last is, is coaching, which again, will be the next subject.


to is your website., yep. And you also have Scaling Up Business is your podcast. Wonderful podcast. Thank you. And we do it every week. We’ve got hundreds and hundreds of episodes. It’s on every platform where you’d find it. Scaling Up Business is the podcast. And we do an interview, we do tips, we do lots of things like that. And it’s not specialized like yours for dentistry. It’s much.


broader, but sometimes that’s useful. Like, you know, I helped a telecom company have a huge breakthrough by looking at what Subway Sandwiches did. You know, so pulling ideas from other sources could be fantastic. Oh, absolutely. And you’re still doing that short little episode before the big episode? We do, we do like a short episode on a Tuesday and we do the longer interview or discussion on Wednesdays. Wonderful. Well, Bill, thank you so much for joining us.


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