The Dental Boardroom

Hosted by PracticeCFO

Business Entrepreneurship Education

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163

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Jun 2026

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About the show

A place for dentists to find expert insight and information around everything from navigating residency and associate opportunities to being a successful dental practice owner.

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60 recent

June 3, 202654 min

161: The Trusted Transition: Dental Practice Brokers & Better Technology

In this episode of The Dental Boardroom Podcast, Wes takes a break from his discussion of The Five Types of Wealth to tackle an important topic for dental practice owners: buying and selling dental practices.Drawing from years of experience as a dental CPA and financial advisor involved in hundreds of practice transitions, Wes explores why dental practice sales remain an inefficient marketplace, the critical role brokers play in successful transitions, and the challenges buyers and sellers face throughout the process.He also shares the vision behind Practice Orbit, a technology platform designed to modernize and streamline dental practice transactions while supporting brokers, buyers, sellers, lenders, attorneys, and advisors.Key TakeawaysDental practice transitions are complex, emotional, and financially significant events.A skilled broker can provide tremendous value by finding buyers, coordinating the process, and helping avoid costly mistakes.Dentists should carefully evaluate broker experience, incentives, and transparency.DSO offers should be analyzed beyond the headline purchase price.Technology can improve efficiency, transparency, and communication throughout the transition process.The future of dental practice sales may involve a combination of experienced brokers and modern marketplace technology.

June 2, 202640 min

160: The Life Razor - Cut Through What Doesn’t Matter

Wes Read continues his series on The Five Types of Wealth by Sahil Bloom, diving deep into Chapter 4: The Life Razor. Building on the five categories of wealth Time, Social, Mental, Physical, and Financial Wes explores how a single, carefully crafted sentence can become the most powerful decision-making tool in your life and practice. From the cockpit of Apollo 13 to Netflix’s boardrooms, to a late afternoon assembling a hydraulic bed with his son, this episode delivers a framework that is equal parts philosophical and practical.What You’ll LearnWhy your net worth number alone doesn’t define true wealth and what fills the gapThe philosophical concept of a “razor” and how it applies to your personal lifeThe 3 non-negotiable traits of a powerful life razor: controllable, ripple-creating, and identity-definingHow Marc Randolph (co-founder & first CEO of Netflix) used a five-word rule to protect his marriage through startup chaosA step-by-step process to discover and draft your own life razorWes’s personal life razor and the touching story behind it

May 27, 202646 min

159: ES: AI & The Dental Practice

159: Executive Sessions: AI & The Dental PracticeWhat does AI actually mean for your dental practice right now? In this executive session, host Wes sits down with Michael Anderson from Wonderist Agency, one of the nation's largest dental marketing firms, and Dr. Megan Shelton of Shelton Solutions to cut through the hype and talk about what's really changing.They cover the dramatic shift in patient search behavior (ChatGPT now accounts for 20% of all searches and is growing), why the fundamentals of digital marketing still drive AI search results, how AI-informed patients are showing up differently at the front desk, and why the human connection at the center of your practice is more valuable than ever.Wes also shares a powerful framework from Lawrence Ford's book The Difference Between Knowledge, Intelligence, and Wisdom and explains exactly how Practice CFO is approaching AI adoption, client investment strategy, and the future of financial advisory.What You'll LearnWhy 20% of patients are now searching for a dentist via ChatGPT — and what that means for your marketingThe "unsatisfying but true" answer to ranking in AI search: go back to the basicsWhy AI-generated content is not penalized — but lazy AI content is a dead endHow the AI-prepped patient is changing chair-side conversations and silently eroding trustThe knowledge → intelligence → wisdom framework and why wisdom is AI-proofWhy documenting your SOPs is the mandatory first step before any AI automationWhat Practice CFO is doing with client investment strategy in an AI-dominated market

May 7, 202645 min

158: The Richest Dentist You Know Isn't the Wealthiest

In this episode, Wes Read continues his deep-dive review of The Five Types of Wealth by Sahil Bloom, a book that profoundly influenced his thinking as a financial planner who has spent his career helping dentists build meaningful lives through their practices.Wes covers the book’s preface and Chapter 2, unpacking the research on money and happiness, the philosophy behind redefining wealth, and Sahil Bloom’s powerful framework: the five types of wealth that truly define a fulfilled life.What You’ll Learn in This EpisodeWhy money matters but only up to a point. Wes walks through three core findings from the research on money and happiness, including the concept of declining marginal utility.The Pyrrhic Victory. The story of King Pyrrhus in 280 BC and what it means to win the battle but lose the war, and how this applies directly to the pursuit of financial success at the expense of everything else.Wealth inequality by the numbers. A candid look at Federal Reserve data on how wealth is distributed in America and what it means for dentists trying to cross from labor income to capital ownership.The comparison trap. Why “there’s always a bigger boat” and how excessive comparison is one of the greatest enemies of happiness.The 90% rule. A striking stat: 90% of all the time you will ever spend with your children happens before they leave home.The Five Types of Wealth are defined:Time Wealth: The freedom to choose how, where, with whom, and when you spend your time.Social Wealth: The depth and breadth of your meaningful relationships; the #1 predictor of happiness.Mental Wealth: Connection to higher-order purpose, lifelong growth, and a healthy relationship with your mind.Physical Wealth: Your health, fitness, and vitality; the most entropic form of wealth requiring consistent daily habits.Financial Wealth: Assets minus liabilities, but with a twist: your expectations are also a liability.The seasons of life. How your priorities across these five categories will naturally shift over time, and why balance, not perfection, is the goal.

May 4, 202647 min

157: 30 Dinners Left - Why Money Isn't Wealth

Most dentists are hitting their financial goals and still feel like something is missing. In this episode, Wes Read (CPA, CFP, and founder of Practice CFO) steps back from the balance sheet to ask a bigger question: what does wealth actually mean? Kicking off a new multi-episode series, Wes introduces the book The 5 Types of Wealth by Sahil Bloom, a framework that redefines wealth across five dimensions and challenges high-earning, time-poor practice owners to intentionally design the lives they keep deferring.What You’ll LearnWhy financial success and true wealth are not the same thingThe five types of wealth: time, social, mental, physical, and financialThe “arrival fallacy” is why reaching your goals won’t create the satisfaction you’re expectingHow to break the cycle of marginal thinking and start building your designed lifeThe math exercise that changed Sahil Bloom’s life and Wes’sWhy dentists in particular are vulnerable to being rich on one dimension and bankrupt on the othersThree questions to take inventory of your own wealth right nowThree action items to start this weekKey TakeawaysFinancial wealth is one of the five.Time wealth, social wealth, mental wealth, physical wealth, and financial wealth. Most successful dentists score very high on one and are quietly bankrupt in at least one other, often wealthy.The arrival fallacy will keep moving the finish line.Reaching a financial milestone does not produce lasting contentment. The assumption that it will be the arrival fallacy. Recognizing it is the first step to escaping it.A designed life beats a default life every time.If you don’t intentionally author your life, thousands of others are waiting to do it for you. The opposite of a successful life isn’t a failed life. It’s a default life.What gets measured gets managed.The reason most practices run well financially is that everything gets tracked. How much are you tracking the other dimensions of your wealth? The book gives you a scorecard to do exactly that.Marginal thinking is the enemy of blueprinted life.Skipping the gym once is harmless. Skipping it 9 out of 10 times compounds. The aggregation of small neglected decisions is what separates the life you designed from the life you actually lived.The 1% framework works.The coach of Team Sky didn’t demand a breakthrough; he asked for 1% improvements across every variable. Small, consistent, intentional gains compound into transformation.

May 1, 202643 min

156: Build the Practice or Build the Life? The Reinvestment Decision Every Dentist Faces

One of the most persistent tensions in dental practice ownership is deceptively simple: should you reinvest surplus cash back into the practice, or distribute it to yourself? In this executive roundtable, Wes, Michael, and Megan break down the capital allocation framework every dentist-owner needs, from defining “enough” personally and professionally, to tracking ROI on every dollar invested in people, equipment, and marketing.Key Topics Capital allocation is the most important strategic decision every dental CEO makesWhy every financial plan starts with a personal budgetDefining “enough”, lessons from Jack Bogle’s book, and the Shelter Island storyWhy money becomes psychological and “enough” becomes a moving targetTreating your dental practice like a micro-stock, when the internal ROI beats the S&P 500Where the first dollar of surplus should go: people, systems, or equipment?The CBCT trap, six-figure equipment sitting unused because training was skippedWorking capital “sleep insurance”: how much cash to always keep on handTracking marketing ROI and holding your agency accountable like a CMOThe annual practice roadmap: aligning personal goals with business investmentPractical example, how to allocate $200K as a growing dental practiceWhy maxing your 401(k) early outperforms most practice reinvestment past the optimization pointKey TakeawaysPersonal financial planning should drive the conversation before practice investment decisions are made.Every practice has a breakeven point, 100% of collections cover overhead until that’s met. The surplus is where strategy begins.Your practice is a micro-stock. A dollar invested there can beat the S&P 500 until the practice is fully optimized.Invest in people before equipment. Great team members multiply results; equipment amplifies existing leaks.Working capital target: 75–100% of one month’s collections sitting in the bank at all times.Track ROI on every dollar, marketing, equipment, coaching, or you’re flying blind.Start your 401(k) early. A 40% first-year return from tax savings is nearly impossible to beat.Attack one bottleneck at a time. Spreading dollars too thin creates friction, not momentum.

April 28, 202625 min

155: 2026 Q1 Financial Market Update

In this episode, host Wes Read uses an AI-generated summary of the American Dental Association Health Policy Institute's Q1 2026 State of the US Dental Economy report to unpack what's really happening inside your local dental clinic and why it's a surprisingly accurate lens for the entire American economy.Your local dentist is fighting an invisible war: global supply chain disruptions, international tariffs, a crippling labor shortage, and flatlined insurance reimbursements all while keeping smiles healthy. This episode digs into the data, the contradictions, and the survival blueprint emerging from the Q1 2026 ADA report.Key Takeaways68% of dentists are confident in their own practice, but only 32% trust the national economy. They're operating in a microclimate: recession-resistant but not inflation-resistant.33% of practices report not being busy enough, even though total dental spending is up 4% YoY and 11% since pre-pandemic. Slow growth gets absorbed by existing capacity, leaving empty chairs.Supply costs rose 6% in one year, while insurance reimbursement stayed completely flat. The "fiscal squeeze" eliminates any ability to pass costs on to patients.Nearly 40% of practices lack adequate hygienist staffing. Over 90% of those hiring called it "very or extremely challenging." One practice got one application in 9 months from a tattoo artist.Dental assistants are a different problem: a large applicant pool, but candidates are shallow, and ghost interviews and ignore callbacks. Some practices pay 17% recruiter fees just to poach from competitors.Fully staffed clinics aren't paying wildly higher wages; they're offering health insurance and paid leave. In a revenue-capped market, comprehensive benefits are the competitive moat.Tech investment accelerated well beyond plans: 16.9% intended software upgrades in Q4 2025; 24.4% had already invested by Q1 2026. Automation is becoming an economic necessity.

April 23, 20261 hr 4 min

154: The Hidden Ceiling: How Doctors Cap Their Own Practice Growth

Most dentists are brilliant clinicians, but somewhere between $1M and $3M in collections, growth stalls. Not because of skill, not because of ambition, but because every decision still runs through the doctor. In this Executive Session, Wes sits down with practice management consultant Megan Shelton (Shelton Solutions) and marketing strategist Michael Anderson (Wondrous) to break down what it actually takes to build a leadership team that lets you scale, whether you’re going from one practice to three, or from $1.5M to $3M under one roof.What You’ll LearnWhy dentists keep hitting the same ceiling and what’s actually causing itWhat a fractional COO, CFO, and CMO look like in a dental practice contextThe four most dangerous clarity gaps inside a dental officeHow to identify and build your “Janine,” the internal operator who frees the doctorThe financial fingerprint of undefined leadership (and exactly where it bleeds on your P&L)Why DIY isn’t always bad and when it becomes the bottleneckThe difference between training people to execute and training them to thinkHow job descriptions, SOPs, and KPIs connect and why most practices get all three wrongKey TakeawaysYou can only scale what is clear.Role clarity, expectation clarity, decision clarity, and culture clarity; without these four, everything keeps surfacing to the doctor.The fractional model works.A fractional COO, CFO, or CMO gives a $1–5M practice access to executive-level thinking without the $250–500K salary. The doctor still has to engage but they’re no longer doing the day-to-day administration.The financial fingerprint of poor leadership:Payroll creeping past 28% of collections (GP target: 26–28%)Supplies & labs drifting toward 8–9% (target: 5–6%)Doctor distributions quietly shrinking even as W2 stays the sameBuild your “Janine” your internal operator.It doesn’t require an MBA. It requires someone bought into your vision, is hungry to grow, and is willing to hold the line. Promote from within, give them authority in front of the team, and back them publicly.SOPs before AI.You can’t build agentic workflows on top of chaos. Your SOPs are the blueprint. Claude can put them into a pretty format, but garbage in is garbage out.Less is more financially.Retain earnings in the business. That retained capital is what funds the hire that buys back your highest-value hours. A doctor doing $400–600/hr chairside should not be doing $25/hr administrative work.Stop being the hero.If you want everyone to bring decisions to you, keep being the person who has all the answers. If you want scale, train your team to think and celebrate when they do.

April 21, 202650 min

153: Cost Segregation Tax Strategy for Dentists - Part 5

The final episode of the cost segregation series. Wes covers the grouping election, the one tax election that determines whether building losses can offset practice income or get suspended indefinitely. Includes the self-rental asymmetry, how to execute the election, five pros, six cons, and when to make it.Key Topics Covered1. The Self-Rental AsymmetryRental income from a building you operate in a non-passive (taxable)Rental losses from that same building are passive (trapped)Result: a $300,000 year-one cost segregation loss cannot reduce your W2 or K-1; it is suspended until the building has future taxable profit2. What the Grouping Election DoesIRC Section 1.469-4(f): elect to treat the building LLC and practice S corp as one economic unitLosses in the building LLC that become non-passive can now offset W2 and K-1 income directlyExample: $400,000 building loss reduces $1M of practice income to $600,000, saving $150,000–$200,000 in taxes in year one3. Qualification and TimingQualifies when: same ownership percentage in building and practice, dentist is the only tenant, same locationMust be elected on the original tax return for the first year of building ownership; it cannot be made retroactivelyCPA must attach a disclosure statement identifying the grouped activities alongside Form 85824. Five Pros of the Grouping ElectionLoss utilization: building losses offset W2 and K-1 in the year they are generatedCost segregation amplification: first-year bonus depreciation becomes immediately usable instead of frozenFixes the asymmetry: losses become non-passive, matching the non-passive character of building incomeSimpler participation: one shared material participation test for both activitiesPredictable: no annual suspended loss ledger to manage5. Six Cons of the Grouping ElectionOne-way door: binding in all future years; can only be undone by a material change in facts (e.g., selling the practice)Partial sale complexity: selling the building without the practice creates complicated suspended loss treatmentForfeits passive shelter: building losses can no longer offset passive income from outside rental propertiesDSO or partner disruption: any equity sale that misaligns building and practice ownership breaks the grouping1031 exchange complications: a grouped building is harder to roll into a like-kind exchangeSemi-retirement trap: when practice income drops, the non-passive characterization no longer helps and can hurt6. Best-Case ScenarioDentist buys practice without building, grows income into the top brackets over 5+ years, then buys the buildingCommissions cost seg study in year one of building ownership, makes the grouping election, and offsets peak practice incomeWorst case: buying practice and building simultaneously at low income — better to wait for a higher-income year7. When to Make and When to Skip the ElectionMake it when:Buying the building with a long-term operating planHigh practice income and a cost seg study ready to deployNo near-term plans to sell, partner, or transition ownershipSkip or defer when:Income is low, preserve deductions for a higher-bracket yearYou own other passive real estate and need building losses to stay passiveA DSO transaction or partnership is within the next few years

April 16, 202645 min

152: Cost Segregation Tax Strategy for Dentists - Part 4

In this episode of the Dental Boardroom Podcast, host Wes Read, CPA and financial advisor at Practice CFO, delves into the advanced mechanics of cost segregation and how dentists can use it strategically to optimize long-term tax outcomes. He explains the key differences between bonus depreciation and Section 179, explores how state tax rules can impact overall savings, and shares what to look for when selecting a qualified cost segregation firm.Wes also highlights how cost segregation can play a role in building purchase negotiations and why aligning tax strategies with a broader financial plan is critical for sustainable growth.What You’ll LearnHow cost segregation works and why it’s more than just a tax-saving tacticWhy front-loading deductions can create long-term tax problems if not planned properlyHow multi-year tax planning helps optimize savings and avoid future tax spikesThe impact of rising income on tax brackets and the loss of valuable deductionsHow to align tax strategies with actual cash flow to avoid financial mismatchesWhy state tax rules can significantly change the outcome of your tax strategyHow cost segregation can influence building purchase decisions and negotiationsWhy taking a holistic, long-term approach is essential for maximizing financial outcomesKey TakeawaysBonus depreciation allows you to create losses and offset other income, while Section 179 only reduces income to zero and requires election.Cost segregation can accelerate 30–40% of a building’s value into shorter depreciation schedules, increasing early tax deductions.Front-loading deductions without a plan can result in significantly higher taxes in later years.Multi-year tax planning helps smooth income, maintain lower tax brackets, and preserve valuable deductions.Large early deductions may reduce future eligibility for benefits like QBI and child tax credits.Financing equipment while taking full Section 179 deductions can create a mismatch between tax savings and future cash outflows.State tax laws may not follow federal bonus depreciation rules, reducing total expected savings.Choosing the right cost segregation firm is critical look for engineering-based studies, detailed reports, and audit support.Avoid firms that use contingency pricing or promise aggressive results without proper analysis.Conducting a cost segregation study during the purchase process can improve negotiations and reveal true after-tax costs.Allocating more value to shorter-life assets increases depreciation opportunities, while land provides no depreciation benefit.The party who pays for tenant improvements receives the tax benefit, making structuring decisions important.Tax strategies should always be aligned with a broader financial plan to avoid unintended long-term consequences.