Invisible DSOs: Retaining Autonomy While Unlocking Practice Value

This episode is sponsored by:

Transcript:

And hello, everyone. My name is Art Wiederman. And today, I have on the line with me Chip Fichtner, president, CEO, and founder of Large Practice Sales. Large Practice Sales is the largest, company that helps in transitions to transition doctors, into the DSO market. How are you doing today, Chip?

Doing great, Art.

Glad glad to hear it. We we’ve had many conversations, you and I, before and, got a lot of interesting things to talk about for our audience today. But I wanna start off because this is important for doctors to understand before we get into some of the other stuff, is the difference between a traditional DSO and an IDSO, which is invisible DSO. And I know that you and I both get lots of questions in the work that we do about this. Can you kind of explain the differences to our audience, please?

Yeah. Absolutely. So a traditional DSO, which have been around for decades, and you might know them as Aspen or Heartland or some of the other big groups, and there are hundreds of smaller ones as well. They are traditionally interested in buying a hundred percent of a practice. The doctor agrees to work for some period of time, and the practice functionally gets homogenized to fit their system. And that’s not a bad thing, but doctors retain full clinical autonomy, but they don’t necessarily retain business autonomy.

And they don’t retain ownership unless they take some ownership at the parent company, any a few of them. But it’s it’s a model that has worked fantastically. I think Heartland will break nineteen hundred practices here shortly.

And, but it’s different from the invisible DSO Invisible DSO model. It’s built on the concept of partnership where the Invisible DSO wants to become your silent partner by buying anywhere between fifty one and eighty percent of a practice’s value for cash upfront.

That cash force will be taxed predominantly long term capital gains tax rates. But the doctor retains ownership and continues to lead the practice. And if you choose wisely, you’d lead that practice with full autonomy, meaning the doctor’s making the decisions as to who to hire, who to fire, what to pay their team members, how to set their schedule, what products to use, what payers to expect.

But the doctor functionally is gaining a silent partner that’s larger that can help them reduce costs on just about everything, like twenty five to thirty percent less for supplies, fifty percent less for implants, ten percent less for team benefits.

And in the case of many of the invisible DSOs, they’re able to negotiate higher reimbursement rates from payers than independent dentists can. And that’s why thousands and thousands of practices have partnered with Invisible DSOs. But the key differential is it’s an owner doctor continuing to lead his or her practice, however they want. And the invisible DSOs are eager to invest in successful practices and not change them. They wanna help them, but they don’t wanna change them, which is the big difference between that and the traditional DSO model of micromanagement and homogenization and lack of full autonomy. So there’s a big difference between the two types of groups. So I’m not saying one is necessarily better than the other because the Invisible DSOs require the doctor to stick around preferably for at least five years, and the longer, the better.

And what I’ve seen with the Invisible DSOs where the doctors have the autonomy to run the practice as if it was a seamless transition is that the dental team seems to stay a lot longer because not a lot is changing. If you go to a DSO that maybe isn’t really a you know, they don’t have their act together, and you and I have seen many of those. There are a lot that do, but there are a lot that don’t. And this and and the dental team gets upset because things are changing and they’re not treated the same way.

They leave. And and a lot of times, the patients have relationships with the hygienists, and they leave. So that that is an advantage of the IDSO. Right?

Yeah. It really is. And the the IDSO’s goal is to not change anything. They they’re gonna invest only in successful practices where the doctor’s leading a successful practice and not try to break what they just spent millions of dollars buying. And the team members, frankly, end up happier in the Invisible DSO partnership because, they end up getting better benefits.

Yep. That’s true. That’s true. Chip, let’s get into kinda what’s going on in the marketplace. We’re we’re, we’re recording this and, just going into the fall of twenty twenty five.

We’re seeing higher price. What’s driving the higher price values in twenty twenty five?

You know, it’s it’s become a world of what I call the haves and the have nots. If you’ve got a practice that’s growing, preferably double digits, and you’re reasonably young, let’s call it below sixty, the values have gone up because many practices are struggling. And therefore, the the practices that are growing in double digit rates have become more valuable, but they’re rare. And, therefore, the Invisible DSOs that are bidding to partner with these clients of ours, for example, paying more to get great practices.

The flip side to that is if you don’t have a practice that’s growing at double digits or, in fact, it’s shrinking, it becomes darn near impossible to get a deal done at all. Shrinking practices are not particularly popular in our world.

Nope. No. And and as a as a broker myself, and I I I am a broker not in your world. I broker individual practices even in the single practice, arena.

Buyers are looking and they say there’s something wrong with this practice if it’s not growing.

So yeah. So so the the what you’re saying is is that the the practices that have their management act together, that they’re maybe they’re marketing, they’ve got good case presentation, and they’re growing by double digits are the ones that are gonna get the higher values if they choose to go to market with with with someone like yourself.

Yeah. And and and it’s kind of interesting. So we’ll close a little over a hundred and forty million dollars of Invisible DSO partnerships this quarter.

So there’s no shortage of eager bidders, and several of those transactions will occur at over ten times EBITDA, which is a big number.

That is a big number. Yeah.

And growing.

So it’s yeah. I’m not promising everybody gets ten times EBITDA. But if you get a reasonably good sized practice and it’s growing and you have relatively young doctors and then you’re in a reasonably exciting geography, we’re doing that this quarter right now. So it’s it’s grow your practice, keep an eye on your margins, and you’ll have no shortage of bidders. I think one of our clients this quarter had eleven qualified bidders to choose from.

Yep. Because we’re we’re far enough along in the game of consolidation in dentistry that the good players know what they want. And if it’s a good practice, they’re gonna go after it because there’s a lot of people going to market, not with you probably, who are not ready and not doing well. So that that’s interesting point. Chip, let let’s kinda bring out your crystal ball for a minute. Well, be I I saw on the news this morning that Christmas is a hundred days from today, which so we’re getting close there. So what is your forecast for the the market and consolidations in twenty twenty six?

You know, I I think it’s interesting in that I think we will continue to see growing practices get high values. But I’m very concerned that if we have the much predicted recession, that practice collection will decline, and that automatically makes you virtually unsellable.

The flip side to that is the growing practices will be even more valuable.

I don’t think the, the volume of transactions is gonna go down. I think it’ll again be a slight to quality. If you have a growing practice, it’s gonna continue to be valuable. But I think a lot of practices are at risk that their collections could decline.

You know? The consumer is pretty stressed right now. If you look at the default rates on student loans, you look at the default rates on automobile loans, you look at the record level of credit card debt, I think the consumer is pretty stressed. And I’m not saying dental is gonna be a victim, but it’s certainly possible.

Well and you you’ve got, you know, unemployment.

The I I saw a statistic the other day that for the first time in a long time, there are actually more people looking for work than there are job openings.

And it’s not widely reported, but, yeah, I I think that, you know, time will tell, and, hopefully, our leadership in Washington will will help with these things, maybe lower interest rate, but we’ll see. So here’s an interesting thing that that you and I have talked about, recently.

So, Delta Dental of Wisconsin recently purchased a forty location practice in Wisconsin.

What what does that mean? I mean, you’ve got an insurance company who is basically paying providers, buying the providers that they’re paying. What do you think about all this? Let’s talk about that for a minute.

First of all, that is not the first dental insurance company to purchase a DSO or own dental practices.

That’s been going on for a long time.

However, it’s interesting that in this Delta purchase of, I believe it was Cherry Tree, there’s been a lot of noise that has been brought up about it. And I’m not sure why anybody is surprised because let’s look at the majority of the medical practices in the country.

Many of them are owned by many. Thousands of them are owned by insurance companies. This is not a new concept, and it’s certainly not new to medicine. And, I don’t think anybody should be surprised, and I think you’ll see a lot more of them.

Yeah. I mean, you you’ve got issues like, you know, conflict of interest and potential reduced competition, antitrust issues, impact on independent practices that that might be squeezed because the these these practices are are because they they have such buying power, they’ve got lower overheads and stuff like that. So so I guess that is some of the issues that, some people might be looking at, but it is it is very interesting that this is going on in in the marketplace.

So talk about If you look at the if you look at the MDs, though, seventy seven percent of the MDs have been consolidated, and then they’re either owned by insurance companies, large hospital groups, pharmaceutical companies, etcetera.

So it’s this is not a surprise, and and I expect you will see a lot more of it.

Yeah. I mean, it’s all about making money in in a lot of cases for sure. So we chatted a little bit, but let let’s maybe pick two or three of the attributes that you’re seeing in the practices that are getting the best valuations. Say, what are the things that you’re seeing that that a doctor listening to this, interview can say, okay. These are the things that I really need to focus on.

You know, I think the first and foremost thing that every dentist should be doing is reviewing their financials, their performance for the prior month within fifteen days of the end of that month. It always surprises me how many doctors, are getting their financial statements three and four months later. And to me, you can’t run a business unless you’re looking at the numbers on a daily basis. But in the worst case, you should at least be looking at the previous, month’s numbers within fifteen days of the end of the month.

And so to me, once you start focusing on and we see this all the time with people that I talk to. And then I’ll we’ll look at them, and we’ll do their numbers and say, hey, doctor. Your margins are not what they should be, and your costs are out of whack here, here, and here. And that’s part of the service that we provide to anybody, and that way we will evaluate their financials, tell them what their practice is worth.

And as a part of that process, we’ll give them some pointers on where they may be out of whack. But it it is shocking the number of doctors that I talked to a year ago who actually listened when we said, hey. You’re overstaffed. You’re paying too much for supplies.

You need to you need to look at what your people are doing and figure out how you can either reduce headcount because you’re not gonna reduce salaries.

And they come back a year later and go, okay. I listened to you. Do my numbers again. Let’s see what we got. And the answer is when the doctors start paying attention to the numbers, their practices improve every time.

And so that to me is the most important thing that any doctor could be doing is looking at their numbers and understanding what their numbers mean and understand what their margins are and where they may be overspending. And nine times out of ten, they are overstaffed.

Yep. And and you’re you’re talking to a CPA, a dental CPA, so you’re you’re you’re hitting my you got my attention, Chip, and you’re absolutely right. The doctors that work not only in their business, but on their business are the ones that are gonna be the most successful and looking at their margins and and using tools like DentaMetrix and Dental Intel and and working with with with good coaches, and and and that’s that’s what you need to be doing, doctors, because if you get higher margins, it’s all dentistry is all about cash flow. If your cash flow and your profits are higher, then your valuation’s gonna be higher and your profits gonna be higher.

So before we go on with some of the other things I wanna talk to you about today, I want you to talk a little bit about large practice sales. And I want you obviously, I want you to get out the contact information. I’ve known Chip for many years. You know, he is the biggest, His company is the biggest, broker in the country, the most successful.

Some of the valuations that I have seen Chip and his team come up with are astronaut I mean, astronomical. I mean, we see that you were talking about ten tiny EBITDA. I see a lot of four, five, six, seven time EBITDA’s, and and and you you just continue to, just just get really, really great valuations for your clients. So would you be so kind as to talk a little bit about what you do?

And then I want you to give out your contact information and how people can get ahold of you.

Yep. Absolutely. So large practice sales dot com, pretty easy to remember, is our website.

And you can contact us through that very easily or shift at large practice sales is my personal email, and I answer everyone personally.

And what we specialize in is, as our name suggests, larger practices.

Our smallest clients will have a million eight in collections if they’re a GP and a million five in collections if they are a specialist.

But, part of what has made us successful in getting high values for our clients is that we built a track record with the Invisible DSOs because we’ve done business with dozens of Invisible DSOs over the last eight years. And we we had a symposium recently of forty two CEOs of some of the biggest Invisible DSOs in the country.

We sat them down in Dallas for two days, back in June, and we said, hey. We’re we’re entertaining you guys. We’re picking up the tab. In in trade, we want you to go back and look at all the practices we’ve partnered with you over the last eight years and tell us how they performed relative to practices brought to you by other brokers or that you bought directly.

So about thirty days later, we got that information, and they said, yeah. You were right. Your practices performed better than practices we bought directly or bought through the little brokers.

And so that has helped us get higher values for our clients because they perform better for the Invisible DSOs once they become a partner. And so we’re able to go with a client, and they know that we’re representing the client fairly honestly.

And then we have a track record of bringing them the best doctors. And so part of that’s our selection process, and part of that comes from knowledge. You know, some of the best fields we do for our clients are we know something that nobody else knows. So for example, we had a client in Tampa several years probably three years ago, And he came to us.

He had an offer of nineteen million dollars, and he was about to sign it. And I said, don’t do that. And he said, why? I said, because how many bidders did you have?

He said, one. I said, okay. The answer is you’re a big practice.

You should not be signing a nineteen million dollar deal without having had multiple bidders to understand what your options are. And so we, got him to come on as a client with a promise that I would get him at least ten million dollars more or he could pay me nothing.

And we got him forty two forty two million dollars, and that was after having eleven bidders chime in. And the bidder that, was about to steal him for nineteen million, I called him up and said, you should be ashamed of yourself. I said, would you like to raise your bid, or would you like to get out of the process? And he raised his bid on one call from nineteen million to thirty million.

And the reason we ended up getting the doctor forty two million, ninety five percent of which was in cash, was because we knew a particular invisible DSO that was about to recapitalize, meaning they were gonna sell to a bigger investor at fourteen times EBITDA. So we knew they could make a short term investment at the bargain price of ten and a half times EBITDA and make an arbitrage of three and a half times EBITDA in about ninety days. So a lot of it has to do with knowing who wants what, when, where, and why, and knowing what kind of practice they want in a particular geography that they will pay up for.

A good example recently is the DC metro area, which is hosting the AAOMS oral surgery conference this weekend, is probably the most consolidated place for oral surgeons. So if you’re an oral surgeon in Washington DC, you’re one of the last of the independent, and, therefore, your practice is very, very valuable. We had a client there this quarter. We had eleven qualified bidders, and we ended up getting him three million dollars more than I thought we could just because the people who weren’t in DC wanted to be there, and those that were already there wanted to bulk up their footprint. So just knowing what’s happening, and guiding clients to, particular invisible DSOs that have a specific need at a certain moment in time, that’s kinda how we pull off our biggest values.

Alright. So so you said large practice sales dot com, is that the best way? And once they go on that website, they can find out how to get ahold of you?

Yes, sir. Absolutely.

Alright. Got a couple more things I wanna talk to you about today. So we talked about what the attributes of the most valuable practices are, and we might have touched a little bit on this earlier, but but I wanna hit the hit this hard.

What causes values to decline? What are the things that you’re seeing in a practice if a doctor again is listening to this recording that they might be doing to sabotage the value of their practice?

You know, I don’t think anybody consciously sabotages No.

The value of their practice.

Are the things that are that are gonna decrease the value?

You know, they’re they’re not paying attention to numbers, number one. They’re not providing true leadership and management to their team members. You have to set goals with your teams. And I’m a big believer in goal based compensation.

Meaning, hey. If we get x number of new patients this month or we we produce x this month, everybody gets a bonus.

So I think, there’s a lot of leadership and management, that that could be applied to many practices that would make them better.

In addition, I think the the practices need to focus on customer service.

That’s not something new or innovative, but, there are practices where you’ll call and get put on hold, and that’s a problem, or you walk in the door and wait in line to see somebody. And so a a focus on customer care or patient care, not just clinically, but from a customer service standpoint, I think really pays off for a lot of practices. And it’s just not that far. It just takes a little bit of leadership, and and I am not a practice consultant, so I’m no expert at that.

But, then looking at your team staffing, one of the things we see is what we call value creep where you may have an office manager that’s been with you for twenty years who’s gotten a, you know, five percent raise each year for twenty years, and all of a sudden, he or she is making a hundred and twenty five thousand dollars a year for a position that really should be paying seventy five thousand dollars a year. Yep. So we see some compensation creep there. And, you know, that’s challenging because you’ve got somebody who’s been a loyal team member for twenty years, but now they’re coming to you, and they’re making a hundred and twenty thousand, and they want a five percent raise.

Well, guess what? They’re out of the market, when you could replace that person for less. And And sometimes turnover is a good thing. A lot of times, it’s not, but, sometimes turnover can be a good thing and change a stagnant practice into a vibrant practice.

Another thing that doctors could be doing is there are various groups out there that help independent practices negotiate with payers, and it’s worth looking at that. Many of them will do it on a contingency basis such that they get paid only if they are able to increase your reimbursement rates. And I I talked to doctors who, you know, haven’t even talked to their insurance company about higher reimbursement rates for years. And that’s something that every doctor should be doing is having a consultant talking to their payers, and many doctors will do it directly and say, hey.

Look. I I haven’t gotten a reimbursement boost in five years for this procedure. It’s time. And it never hurts to ask.

And the same thing is true from your vendors. The major vendors in the dental space are battling each other hard right now, in that Henry Schein, now, with KKR as an investor, is getting sharper with their pencils. And Patterson, which is now owned by a private equity firm, is getting sharper with their pencils. And if you haven’t asked your supplies vendor recently, to update your pricing, lower, it never hurts to make that call.

You might be surprised, because they’re they’re in a battle right now. So Well, and and You know, not not huge numbers, but it can add up.

Oh, no. I I mean, on the supply side, I know that it is it it’s cutthroat, and there’s procurement companies out there that that go out and and tell the doctors we can get you a fifteen to thirty percent lower, and they can. So it’s it’s tough. I mean, it it’s so, yeah, you’ve gotta manage your business. And if you’re not managing, you just show up and hope everything’s gonna be okay.

When you talk to my friendship, you might be getting a lower valuation. So I got some specific targeted questions for you that I want you to address.

So do you think that IDSO, Invisible DSO investors, are concerned about ortho cases, starts, you know, declines in a recession?

Yeah. Absolutely. Because we saw that in o eight, o nine.

In fact, we saw in o eight and o nine.

Yeah.

Yeah. And we saw it. It was interesting. I’m looking at some ADA data recently, and they talked about how the the average collection of dental practices, the o eight zero nine ten all dropped, which I didn’t realize.

Ortho was particularly affected. And then then ortho average case starts in twenty two. National declined by eight percent. They declined another six percent in twenty three, and they declined another five percent in twenty four. So if you’re an ortho only Invisible DSO, many of them are having challenges.

The Trifecta Invisible DSOs, those which partner only with Pedo Ortho and Oral Surgery, are doing great because they have those locked in referral networks where the pedos in the family refer to the orthos in the family, and they both refer to the oral surgeons in the family. So you’ll see many of the dental trifecta groups, even though their ortho components sometimes can get hit, with double digit growth, you know, across hundred, two hundred, three hundred million dollar revenue businesses. So double digit growth is powerful. The the pitot ortho guys have done better than the ortho only groups only because they have the pitot to feed their orthos.

But it’s, it’s a concern of everybody that if we have a recession and if we have collections declines, that’s gonna be challenging for everyone.

Because ortho is not mandatory. It is optional, and, I guess they’re just gonna have to do more marketing. And, I mean, ortho has has been become very challenging with the competition with general dentists and all this kind of stuff over those years. I remember back in o eight and o nine, Chip, my CPA practice, my dental CPA practice, I talked to all my clients, and we saw an average decline of five to fifteen percent in most all of those practices.

Had a couple that did better, but not many. It was a it was a tough time. So, didn’t didn’t have any to close, didn’t have any to bankrupt, but they were just down, and they they came back. So another thing that we you and I talked about and that we’ve seen is, the prevalence of discounts for all on x or all on fours, whatever they’re being called today, at, like, eighty nine ninety five per arch, in other places other than the big city. So talk about the all on fours and how that’s coming into play in your, in your world of invisible DSOs.

Well, you know, the all on x or all on four business is certainly a growing business as as, evidenced by the marketing dollars spent by folks like ClearChoice and Nuvia, and that they’re driving new awareness of the fact that you can have a beautiful smile within twenty four hours as they promote it. And that has become a bigger and bigger business.

However, what’s happened is because it’s a very high margin business. I mean, probably the average, full arch replacement, as I call it, probably the average fee nationally is twenty two thousand dollars per arch. Whereas we’ve started to see some very aggressive discounters coming into the space, particularly, in some of the bigger cities. And if you wanna see an example, go to bionic smile dot com in Las Vegas, and they are promoting their eighty nine ninety five per arch.

So if you’re charging twenty three thousand per arch and you’ve got a new competitor in town that’s promoting eighty nine ninety five per arch, and I’m sure there’s a difference in quality and everything else, but it’s a problem. It’s a real problem. And so that’s something that doctors need to be prepared for because it’s coming. I mean, we we’ve seen it in the ortho business where the there are now at least a hundred that I can identify.

Ortho practices, pitching twenty nine ninety five ortho cases. And, you know, the national average case is gonna be close to double that today. So What’s it? You’ve gotta if you’re in the if you’re in the all on x or all on four business, it’s something you need to keep your eye on. Now it’s it’s certainly, penetrating the big cities and, hopefully, not yours, but, it’s something to keep keep an eye on.

Oh, no. I I I definitely see it. You’ve got a lot of practices and a lot of companies that are coming out, and and and and are specializing in implants and all this kind of stuff, and they’re they’re doing lots of TV and radio advertising. I’m seeing a lot of that here in the Southern California market.

But, yeah, I mean, a a lot of these companies might just be pricing low for market share. You’re right. They’re probably not using the best materials and not using the best labs and not using the, you know, the the highest paid doctors. And and and, again, it’s like anything else. You get what you pay for. So but it sounds like the market is ripe, Chip, to kinda put a bow on our conversation today, that the market is ripe if you have a really good practice, one point eight million and up. What’s the minimum number of operatories that usually the the buyers are looking at?

You know, it doesn’t matter, honestly. They’re they’re looking at the bottom line. You know, we’ve we’ve, our our biggest transaction last year was sixty two million dollars for a single office GP.

Our biggest transaction in in twenty three was forty three million for a single office, and he was more than a GP. He was multi specialty. But, so the number of the chairs, frankly, is irrelevant.

It’s a matter of what you do in those chairs.

Yeah. So so doctors, if and, again, when whenever I speak, and I speak all over the country, when I ever when I talk to doctors about should you sell to a DSO or an invisible DSO, you always have to think about the why.

Why are you doing it? But the the best thing for you to do, if you’re if, you know, you go to your dental societies, you’re talking to your buddy, your buddy sold to x y z that owns seventy five practices, and and and they’re having a great time. Number one, don’t don’t just talk to one because these DSOs are pretty smart. They know that a large majority of the doctors are just gonna talk to one, and they’re gonna give them a a deal that’s gonna sound like more money than they’ve ever seen in their lives.

But they know that when a Chip Fitchner gets involved, that that price is going up. So never sign a letter of intent if you’re just talking to one person. Chip, I guess the best advice to put a bow on this is is that if a doctor’s thinking about it now a year, three years, five years, they should just give you a call and talk to you about it. Right?

Yeah. Absolutely. I I talk to every doctor who wants to talk to me, and, you know, my pitch to the doctors is the Invisible DSO option may or may not be right for you, and you may or may not qualify. But it’s certainly something every doctor should understand because, ultimately, if you’re big enough, you’re either gonna join one or compete with many because, you you know, we’re achieving values that are far higher than a doctor to doctor transition.

You know, we we did multiple transactions this quarter where the practices were valued at three times collections Whereas in a traditional doctor transition or sale to an associate, you might get eighty to a hundred percent of collections if you’re lucky.

That’s right.

Let’s have a conversation. Let us tell you what the value of your practice is. It’s confidential.

It costs nothing, and you’re obligated to nothing. It’s worth learning.

Absolutely. So, again, Chip, I wanna thank you for your time today. Got a lot of great information. It’s obvious that you are the premier, person who knows about what this market is, and and I I truly, from just seeing you in action, know, that if a doctor gives you a call, they will have an opportunity to to garner hundreds of thousands, if not millions of dollars more depending on the size of the practice than if they tried to do it on their own.

So, again, large practice sales inc is the website, and that’s the best Yeah.

No. No. It’s it’s large practice sales dot com.

I’m sorry. My bad. Large practice sales dot com.

That’s the thing.

That’s why I don’t run the Internet, Chip, because I didn’t get it right. Large practice sales dot com. And, any final closing parting words you wanna talk about, before we let you go today?

The only thing I would remind doctors is that every transaction that we do today, post COVID, has what’s called an earn out. And an earn out basically says that they are going to pay you today. You’re gonna do a deal on a value today. However, that value will be adjusted up if you grow in the two years post partnership, and and you’re gonna get paid additional purchase consideration, if you grow in the two years after getting the help of your partner to grow. And it’s it’s the earn out, which is hunger doctors to what we do. You know, of the billion dollars that we’ve done in the last thirty months, a hundred and fifty million of that were for doctors in their thirties.

And these doctors that were young or are young are eager to access the resources of a partner to go build an empire without personal risk. And they can own up to forty nine percent of that empire without going to the bank, and, they get a great partner to build what their dreams, are.

Alright. Well, listen. Chip Fichtner, founder, president, CEO of Large Practice Sales. Again, large practice sales dot com, ladies and gentlemen. If you wanna find out, you know, what your practice is worth, are you a candidate for a DSO transaction or an invisible DSO transaction? Thank you so much for your time today.

Thank you for yours, and have a great week.