Dr. Killeen shares lessons from Phil Knight’s Shoe Dog, the story of Nike’s early years and how the company managed to grow while constantly struggling with cash. He explains why dental practices can face the same problem: record production does not always mean a healthy bank account. New hires, equipment, and additional operatories all require cash before the financial return arrives. The key is to manage cash flow separately from revenue. We're challenging practice owners to look beyond production numbers and calculate their financial runway, or how long the practice could cover its expenses with the cash available. Before investing in the next big thing, make sure your business has enough cash to keep moving forward.

Today, Dr. Killeen challenges the common assumption that accepting Medicaid is never worth it for a dental practice. Drawing on his own experience as a Nebraska Medicaid provider, he explains how lower fees can still work within the right business model, especially when a practice is equipped to meet demand that other offices may not be serving. Medicaid is not the right fit for every practice, and success requires the right scheduling, staffing, and systems. Rather than relying on assumptions, this encourages practice owners to look at their actual margins and local demand to determine whether Medicaid makes sense for their business.

In this episode, Dr. Killeen discusses what to do when a DSO or private equity group approaches you about buying your dental practice. His advice is to take the call, not necessarily because you want to sell, but because an unsolicited offer can give you valuable insight into what the market thinks your practice is worth. Before that conversation, know your ideal selling price, understand what you would be giving up in terms of control and independence, and have a plan for what you want to accomplish if you decide to keep the practice. The key is to decide what a sale would need to look like before an offer is on the table, so you can evaluate it with clarity rather than emotion.

Dr. Killeen explores a core lesson from Jocko Willink’s Extreme Ownership: everything that goes wrong in your organization ultimately comes back to leadership. Whether the front desk is missing calls, patients are not being reappointed, or treatment acceptance is low, the real question is what the owner could have done differently to prevent it. Taking ownership is not about blame. It is about recognizing where you have the power to make a change. Instead of focusing on what your team is doing wrong, challenge yourself and think, “This is happening because I haven’t...” Your answer may reveal the exact step you need to take to start fixing the problem.

Today, Dr. Killeen tackles one of the hardest situations for a practice owner: a long-time team member who was once great but is no longer meeting the standards of the practice. Loyalty matters, but allowing one person to continually fall short can quietly damage the rest of the team and create resentment. The answer starts with an honest conversation, not an immediate firing. Dr. Killeen explains how to clearly communicate what you are seeing, define the standard, and give the team member a real opportunity to improve. Sometimes people need someone to finally tell them the truth. The important thing is not to keep avoiding the conversation.

Dr. Killeen breaks down a few ideas from Gino Wickman’s Traction and how they apply to dental practices. Weekly scorecards, quarterly priorities, consistent leadership meetings, and clear ownership can turn goals that live in the owner’s head into a system the whole team can see and follow. The key is making those priorities specific and accountable. It's explained why assigning three clear “rocks” to one person, with a due date and regular check-ins, can help a practice stay focused and actually make progress. Pick three priorities for the quarter, put a name and date on each one, and start tracking whether they are on or off track.

A useful huddle should quickly answer three questions: Where is the money? Where is the risk? And what is our focus? Dr. Killeen explains why so many dental practice morning huddles become little more than a reading of the schedule. He also explains why the doctor should not be the one running the meeting. When a team leader leads the huddle, the team takes more ownership of the numbers, priorities, and problems. Keep it focused, repeat the same three questions every morning, and get out in under ten minutes.