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Dentology Podcast with Dr Alex & Tim Otto


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Transcript – Dentology Podcast with Dr Alex & Tim Otto

Episode Release Date – Monday 8th July 2024

Andy & Chris (00:00.674)
I was excited when we get an international guest. Guests. International. Yee -haw is all I can say. I’m looking forward to this one. This should be good. It should be a hoot. It should be a hoot. No pressure guys that we’re just building you up big time. We’re building it up. Well today we’re very fortunate. We have a double act. We have Dr Alex and Tim Otto and we met Alex and Tim. We both went to a conference over in Florida. We met them and good guys, good fun and since we’ve had some great conversations. So.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (00:06.564)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (00:12.324)
Who did?

Andy & Chris (00:28.738)
It seemed the best thing to do is to get them on the podcast and have a conversation. So we’ve got a husband and wife team, co -founders of Kids Tooth Team Pediatric Dentistry. It’s not that easy to say that. There’s a lot of words in there. Kids Tooth Team. Alcan Dental Cooperative, but also the Kids Tooth Team Outreach, which is a non -profit mobile dental clinic.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (00:39.044)
Yeah, this is my husband.

Andy & Chris (00:47.65)
that provides free dental care to children in rural communities of central Texas. That’s amazing. I remember you telling us about that, Tim. We can talk about that later, but that was amazing. Which is lovely work. So anyway, so welcome Alex and Tim. How are you both doing?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (00:59.204)
Appreciate that. Doing well. We’re doing well. Thank you for having us. A little bit tired. Our two -month -old daughter decided to, on all the nights that we needed sleep, decided to not cooperate last night. So we’re running about two and a half hours of pure sleep. So yeah, we may be a little bit slow, so forgive us.

Andy & Chris (01:03.778)
Good, good.

Andy & Chris (01:10.69)
Andy & Chris (01:15.906)
I hope that’s coffee in those cups then. Yeah, so with a two -month -old we should say congratulations and commiserations on the lack of sleep Yeah, but it’s your second child. So you’ve been there before you knew what was coming Yeah, you just have Who needs sleep anyway, you’ve got adrenaline that’s what that’s what adrenaline’s for isn’t it to get you keep you going In fact, that’s a good for us. That’s quite a nice start point because you know, you’ve got two children both quite young

Dr. Alex & Tim Otto, Alcan Dental Cooperative (01:23.524)
Yes, there you go.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (01:28.548)
It’s old hat at this point. Yeah, somehow it seems easier the second time. Yeah, exactly.

Andy & Chris (01:45.698)
in the intro there’s a big list of businesses. So let’s start with time management. What does that look like? Or the laughing suggests. Yeah, for those of you who aren’t on video. Yeah, perhaps the lack of time management. But seriously, because we’re all busy, some busier than others, we all need to get the big stuff done. So what’s your system to make sure that you do focus on the important things? And

Dr. Alex & Tim Otto, Alcan Dental Cooperative (01:53.924)
What does that look like? Is that a rhetorical question?

Andy & Chris (02:14.594)
It’s not just business, it’s yourselves, your kids. What’s your system to make sure that the big stuff stays at the centre and you don’t get distracted?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (02:23.14)
Yeah, I’m glad you take that to start. Yeah, I mean, it’s really hard. It’s hard to be a mom and work full time and run our businesses. And without having a partnership, I don’t know how any of this would be possible. And also having a lot of help at home. We have a full time nanny and a part time nanny at our house. We have no family around us. So really just relying on.

Andy & Chris (02:41.25)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (02:44.58)
you know, your community of people to help you, having an incredible team at our offices that we can rely on to get a lot of the work done that maybe we used to do ourselves when we first opened. But now we have great office managers and regional managers and people that we can rely on at our offices to help us. But yeah, and personally, it is, it’s hard. Yeah, it’s hard to, you know, manage time for yourself, time as a couple. All of that, yeah, that’s, it’s hard to do.

Andy & Chris (03:07.682)

Andy & Chris (03:11.554)
Do you try to be quite prescriptive over sort of like, I know the work day is the work day, but do you try and say, right, well, you know, I know Sunday afternoon is definitely family time. Is that how you manage to try to manage it?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (03:25.156)
pretty deliberate about when we do have family time that it is family time and we’re focused on the kids. That line has actually become easier once we had kids because if it was just ourselves, that time alone we’d take the opportunity to talk about business, talk about expansion plans or the day’s latest drama. But with kids, it’s actually helped us kind of focus on what’s important and say, yeah, when we’re spending time with our kids, that’s it.

Andy & Chris (03:37.442)

Andy & Chris (03:53.57)

I think a lot of people talk about work -life balance, like it’s something you read in a book and go, that’s how you do it, and you get on with it. But it’s a myth, isn’t it? It’s a lie. And I think it also changes week by week, month by month. Like some weeks or months, you’re literally just doubling down and working hard and not much else gets done. And then you seem to get what feels like a bit of balance, and you go, well, this is nice. And then something else happens and it changes again. And I think being fluid’s quite important, isn’t it, as opposed to being quite rigid?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (04:03.012)
It is.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (04:23.524)
Yeah, I love that term fluid and the fact that you do have these ebbs and flows and sometimes you’re just crazy busy and even inner personally, sometimes Alex is way busier than I am. And sometimes I’m going 80 hours a week and Alex is able to take off the gas a little bit. And, you know, we actually support each other in that and are happy to see that for each other instead of, I think what could easily happen is you become resentful of the other person. But ultimately over the long run, we’ve both put so much time and effort into.

Andy & Chris (04:45.186)

Andy & Chris (04:49.57)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (04:53.43)
this and the partnership is so strong that we know no matter what the other person is doing exactly what they need to be doing in order to make things happen. So yeah, it’s almost…

Andy & Chris (05:01.666)
Mm -hmm. Mm -hmm. Hey what you described then it always sounds a little bit like a peloton Do you know when people are cycling when you’re at the front and it’s harder and people slipping behind and they get a slightly easier ride for a bit and then it’s their turn to kind of move to the front it feels like it’s that sort of arrangement where you both Appreciate one another working really hard, but you also might need a bit of time to find their both will be at the back Do you sort of make sure you’re very good with holidays and time off and stuff like that?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (05:22.596)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (05:29.732)
I think we do actually, yeah. I mean, I think compared to a lot of practice owners who, you know, it’s hard to take even a day off of work if you have your own practice. I think that we’re pretty good about we go to Alaska every year for at least a week. His family’s in Colorado. We go for at least a week every year. And my family’s in Florida, so we see them. So I feel like, yeah, I mean, yeah, you know, of course it’d be nice to holiday for like two months in the summer, but.

Andy & Chris (05:36.386)

Andy & Chris (05:51.17)
It’s funny, isn’t it? Because American… Because you guys traditionally have less holiday than the UK, doesn’t it? It’s much less. I seem to remember someone telling me, you know, if you’re employed, you might get two weeks a year or something. Whereas our guys would go, you know, that’s, you know, I think a minimum here is probably 20. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (05:58.5)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (06:04.74)
yeah. Yep. We quit. Yeah, exactly.

Andy & Chris (06:11.234)
25 days 24 days. So the system that we have with our team is they get yeah, they get 25 days holiday plus bank holidays But we also know their birthday on their birthday contractually they get their birthday off, but we also work We work a nine -day fortnight So we couldn’t quite go to a four -day week because there’s lots of evidence that says work in a four -day week Doesn’t impact productivity in some cases productivity increases service levels are maintained So we couldn’t go to four -day week, but we do a nine -day fortnight

Dr. Alex & Tim Otto, Alcan Dental Cooperative (06:22.852)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (06:35.076)
Mm -hmm.

Andy & Chris (06:41.14)
So people get a day off every other week and it’s been really good You know people like a start a new hobby or whatever they want to do with their time But we see no impact or just watch Netflix I wonder how many of our team have started a new hobby that would be quite entertaining It just gives them the choice of what to do. It’s good. So but it does mean over the course of a year You know, there’s a there’s a lot of time not working but it does mean that when they’re in kind of they’re on it because

Dr. Alex & Tim Otto, Alcan Dental Cooperative (06:51.492)
Yeah, unfortunately, yeah.

Andy & Chris (07:08.962)
They get the upside, which is they’re not in every day, which works quite well. Which is, yeah, as you can say, that’s a very different approach to the traditional US. Well, I was just thinking when Alex said, you know, we get a week in Alaska and we get a week in what was the other place? I can’t remember. Colorado. Colorado. Then a week in Florida. And it’s like, yeah, we’ve got a week. And I’m thinking a week.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (07:12.004)
Yeah, yeah, well then you talked about… Go ahead.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (07:24.932)
Colorado and… Colorado, yeah.

Yeah. What can you do in a week? Yeah. And that’s like the most time off we’ve had in five years is, yeah, not even probably a full week, just to go to Alaska probably. Yeah.

Andy & Chris (07:40.034)
Wow. And it always takes ages to get anywhere in America, doesn’t it? You know, you’re Texas, you know, a week in Alaska, you probably spend a day getting there, don’t you? A day getting back.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (07:44.516)
He does.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (07:49.86)
Yep, yep. Day travel there. Even to Florida. I mean, getting from Texas to Naples, there’s always a layover. It’s always a three hour delay at the airport. So it’s a full day getting anywhere. But you talk about the, you know…

Andy & Chris (08:03.234)
Yeah, for now.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (08:07.108)
trying to change that narrative a little bit. So, and building the culture that we want to create and having a team that’s willing to support us and allow us to take time off to have kids and, you know, build a company and expand beyond our borders. And, and it really, we’ve been very intentional about creating that same mentality inside of them. So rather than give the bare minimum two week, you know, paid time off and, and a couple of holidays, we’ve, we’ve expanded that. We give them a tremendous amount of paid time off. We offer them,

Andy & Chris (08:13.89)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (08:37.014)
PPO health benefits, things like that, that a lot of dental practices aren’t doing. And yeah, does it cost you more on the balance sheet? Does it cost you more on the profit and loss statement? Sure. If you look at only the bottom.

Andy & Chris (08:48.866)
but you get the commitment and wanting to be part of the team. How do you recruit? I mean, how do you sort of recruit people? Do you sort of advertise or, I mean, is it people you know or do you put them through a… Well, we were talking to someone earlier on today about the recruitment process that over the years we refined, which is basically we have a coffee and then we find out way more about them than in a formal interview. And I’m just wondering how you guys do it.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (08:52.804)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (09:12.332)
So for the lower, like the clinical team, dental assistants, hygienists, and then of course the front office team, we’ll do kind of a multi -person interview. So we’ll interview them on the phone. We advertise on Indeed over here. Do you guys have that over there?

Andy & Chris (09:28.866)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (09:29.7)
Yeah, so indeed it seems to be kind of it’s become the de facto workforce marketplace, at least for dental industry and a lot of others. But we’ll recruit them, we’ll do a video interview, then we’ll have them come into the office and do an in -person interview, not just with the regional manager, but also with a doctor, with a peer, right? So if they’re a dental assistant, they’re going to interview with another dental assistant, they’ll interview with the lead dental assistant, and then they’ll interview with somebody from the front of office, right? Just to see, because the

Andy & Chris (09:50.21)
Mm -hmm.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (09:59.607)
cultural fit for us is above all else. We can train skills, we can train everything else, but if you’re not a cultural fit and you don’t blend in, it’s never gonna work out. We know pretty fast. We love when people quit after two days. Yeah. Because it’s like that’s the best thing that could happen.

Andy & Chris (10:02.498)
Hmm, yeah.

Andy & Chris (10:09.506)

Mm -hmm Yeah, yeah, but I think if you’ve got but also I think if you’ve got a good culture the tribe reject them Because they just don’t fit the team are like this person’s not one of us It’s not the world and it’s horrible for the team, but also it’s horrible for the team member Yeah, and they just need to be happy somewhere else because they just don’t fit your work. There’s nothing that’s wrong with them It’s not the people for you exactly exactly

Dr. Alex & Tim Otto, Alcan Dental Cooperative (10:20.804)
It’s insane.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (10:25.156)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (10:30.884)
Yeah. Right. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (10:37.604)
Yeah. I think that goes up at every level, even doctors, you know, I mean, it just, we know instantly, like, are you a good culture fit for our practice and how, you know, just fit in with how we’re doing things. Well, that’s it.

Andy & Chris (10:44.882)
Yeah. Yeah. What’s recruitment like in the US? Because it’s quite tricky here sometimes.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (10:53.86)
Yeah, for doctors it’s really hard. I mean, harder even because we’re a specialty practice. So in the States you have to go to two more years of school to be a pediatric dentist. Some of them are three year programs. And so there’s a slight group of individuals that are pediatric specialists, which is what we hire.

And so, you know, in Texas there’s three programs and they only have a certain amount of students. So yeah, you kind of recruit nationally for any position that you have open. And it’s, yeah, that’s more word of mouth and who you know and the connections. There’s still some places that you advertise online in the States, like the Academy of Pediatric Dentistry and some of the state associations. But yeah, doctor recruitment is definitely, you know, can take six to eight months to find a new doctor and get someone who’s a good fit. And then in the States too.

Andy & Chris (11:20.418)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (11:40.374)
to get credentialed with some of the insurance companies, that’s a four to six month process. So you really almost need to know like a year in advance if you need a doctor because it’s going to take that long to recruit them and yeah, get them on board.

Andy & Chris (11:45.698)

That’s a long old time, isn’t it?

And is there, I don’t know, is the split, because in the UK there’s way more women qualifying than men in dentistry. And is that similar in the US? And then because you have to do this extra qualification, and I don’t know why my head’s going in this way, but are most of them women who do that, or men, or is it a mixture?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (12:15.172)
Pediatric there’s been a shift over the past 10 years where the majority I think 60 % of pediatric residency graduates today are female and 20 years ago it was 80 % male. So that’s that’s seen a size new shift I also believe that dental school enrollments are I think the graduating dental students are it’s still it’s about 50 -50 Which is still a shift. It used to be obviously much many more men But I think there is slightly more women going into dental school graduating than men now.

Andy & Chris (12:23.97)

Andy & Chris (12:27.618)

Andy & Chris (12:39.778)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (12:45.078)
But I don’t know the exact numbers on that. But you know, pediatrics as a field and profession, I think tends to attract maybe, you know, just women naturally more than men. More empathy. Yeah. Yes, exactly. Yes. wow. It’s often moms that bring kids into their appointments and so moms like, you know, other moms or, you know, someone who’s got that mom touch. Yeah.

Andy & Chris (12:54.85)
Mmm. Yeah. Said bye, man. Yeah. And kinder. Yeah.


Andy & Chris (13:11.458)
Yeah, true, true. Yeah, yeah. I’d like to find out more about your kids tooth team outreach program in terms of supporting the rural communities. But before we get to that, could you kind of just describe because.

Whilst the second most listened country is the US, it’s most listened in the UK. And so people might not necessarily have a grasp on the US dental market, and particularly Texas. And that might give us some context. So when we talk about your outreach program, people get a feeling of what that looks like. So could you sort of set the scene in terms of the US dental market?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (13:43.14)
Yeah, I mean, it’s interesting because specialties, from what I learned in my visit and speaking with you guys and a few others in the UK, specialties are much more common here.

So like pediatric dentists, it’s common for you to bring your kids to a pediatric dentist. For dentures, you would go to a prosthodontist that specializes only in prosths. Same thing for perio, same thing for endo for oral surgery. So it’s highly specialized, whereas in the UK, it seems like general dentists are just that much more generalized and do a lot more of these procedures in -house. I think there’s a trend towards that in the US as income

Andy & Chris (14:04.162)

Andy & Chris (14:20.194)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (14:24.31)
continue to decline and competition continues to increase and the level of sophistication in the market continues to get higher. I think there’s a trend in general dentistry today in the US to do more things, to do all on fours, to do you know, Invisalign and things of that nature. But yeah, that was the biggest difference that I encountered. Yeah, and just you know a lot of in dental school, your undergraduate training, you might not get a lot of experience with pediatrics for example. So general dentistry

Andy & Chris (14:27.746)
That’s interesting. Yeah.

Andy & Chris (14:42.146)

Andy & Chris (14:52.866)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (14:54.166)
just will get out and just don’t necessarily feel comfortable doing you know big complex cases on kids.

And then, you know, a lot of as far as like, you know, Medicaid, I don’t know if you’re talking about that. And, you know, so like the government subsidized insurance in the states is paid for kids. And a lot of dentists won’t accept that because it’s just a low reimbursement. It’s there’s a lot of just like hoops to jump through to get a group for it, which is counterintuitive. You would think, you know, the government wants people to accept this insurance. They would make it easy to get credentialed with Medicaid, but it’s a really complicated process. And so because of that, a lot of specialists and a lot of

Andy & Chris (15:09.346)
Mm -hmm.

Andy & Chris (15:15.306)
Hmm, right, okay

Andy & Chris (15:25.058)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (15:31.094)
general dentists just don’t accept Medicaid. So these low -income kids just don’t really have a place to go. They can go to a community health care clinic, but there’s probably going to be a general dentist there that doesn’t necessarily feel comfortable seeing children, especially if they have 20 cavities on all 20 of their primary teeth.

Andy & Chris (15:47.17)
Mmm. Mmm. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (15:49.284)
And so a lot of times they’ll go and just maybe not get the care that, you know, that they could get in it and maybe somewhere else. So, well, then just another, like from an overarching general comment, I think the state of biz, the business of dentistry in the UK seems to be about.

Andy & Chris (15:56.706)
Hmm. Hmm.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (16:07.972)
15 years behind the US, right? I mean, we’ve got DSOs in the US, we’ve got corporate model in the US, we’ve got really sophisticated business people owning dental practices now and kind of steering the course of dentistry. And that’s been a force that’s been at play for the past 10 to 15 years here. So it’s really changed the landscape from a competitive standpoint, from a marketing standpoint, from a patient retention and attraction standpoint. And from what I understand, the UCL

Andy & Chris (16:23.362)
Mm -hmm.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (16:37.926)
is starting to move that direction, which has massive implications for not only how you practice clinically, but how you run a business.

Andy & Chris (16:46.946)
Mm. Yeah.

Yeah, and yeah, I think you’re right. I think the, so we have dental corporates, you have DSOs, they’re kind of interchangeable words. But historically, we had very few, but quite large corporate DSOs. Whereas in the last, yeah, probably five to seven years, it’s become a much more popular model. I think the challenges is that it very much hangs around the availability of finance. So primarily PE money.

And because that tends to come in in waves and can be cyclical it can have impacts for you know You are very driven by financial markets so the financial markets in your favor You get great growth opportunities if those financial markets that perhaps like they were last year Because inflation in the UK was so high falter that can impact your plan. So there’s an external force that really does Heavily influence how those businesses move compared to a business that has control of its own financing

and its own financial structure and they’re much more nimble because they can grow in a style that they want. It’s interesting to see. So what you were just saying Alex about the need amongst kids, was that the thing that kind of sparked you to start your own outreach program?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (18:02.948)
Yeah, it actually originated when we were living in Alaska. So I did my pediatric dental residency in Alaska. I worked at the Alaska Native Medical Center where they only treat Alaska Native children. And living and working there, we realized these true geographic barriers to care. These kids would be in the villages in Alaska. They would fly them into Anchorage. We would do all their dental work, typically under anesthesia. And then we’d fly them back the next day. And so just addressing, for the first time, really seeing, like,

you know, just again, that expansive geographic barrier. When we realized we’re going to move back to Texas, we’re like, you know, they can figure this out in Alaska. Like we can help in Texas and help some of these kids in the community surrounding us. We’d always owned RVs and, you know, just personally, Tim, you know, raced and we’ve just, you know, kind of been entrenched in like an RV sort of community.

Andy & Chris (18:35.554)

Andy & Chris (18:41.794)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (18:54.116)
And so just naturally like a mobile dental clinic, we thought it would be a great opportunity to be able to get out to the kids who needed us the most. And we, yeah, just basically there’s a nonprofit here in Texas called St. David’s Foundation that has one of the largest fleet of dental vans in the country. I think they have like 12 units and they serve the Austin, the like city of Austin area. And every so often as they upgrade their fleet of dental vans, they’ll donate one of their vans to a nonprofit that’s in alignment with their vision. And so we had already started creating this.

this nonprofit and there’s like the alignment of meeting them and talking to them about their mobile unit and then coming to realize they’re actually donating one just sort of lined up perfectly. And so they ended up donating one of their dental vans to us in 2021. And yeah, and so we basically got their van, wrapped it with our logo. And, you know, during that time we basically had moved and started our first practice in the middle of COVID and we were doing these things. Yeah, exactly. It just ended up weirdly working out in our favor because I think.

Andy & Chris (19:33.026)
Hmm, well.

Andy & Chris (19:38.082)
how cool.

Andy & Chris (19:48.162)
Good timing.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (19:53.878)
if people were looking to switch dentists or weren’t super happy, it was a good opportunity to maybe come to a new dentist. But because people hadn’t been in the dentist in a year, I was seeing kids with facial swellings almost every week. I would every day see a kid with dental abscesses, just pain. Kids were driving three hours to come see us because I was the only Medicaid provider that was a specialist anywhere near them. And so during that time too, we just realized there’s kids just an hour outside of where we live that really need our help and just…

Andy & Chris (19:59.234)
Mmm. Mmm.

Andy & Chris (20:15.81)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (20:23.782)
aren’t able to come see us, their parents can’t take off work, they maybe don’t understand the importance of dental and oral health care. And so we kind of identified some of these communities that we noticed a lot of kids were coming and driving in ways to see us. And so that’s where we targeted our first like outreach programs. And so we partner with local elementary schools and they help us get all the consent from parents. And so we go park the van at a school and the kids come on the van, we do exams, cleanings, we’ll do all the extractions, we do crowns, whatever.

Andy & Chris (20:25.698)

Andy & Chris (20:29.826)
Yeah, yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (20:53.654)
we can do on the van for them. Fully equipped two operatories. So it’s got a pano, it’s got two wall units, it’s got a sterile lab, it’s got nitrous, full compressor and back system. It’s really pretty impressive what you can fit into a 40 foot RV. It’s a 40 foot long RV. It’s massive. Yeah. And so.

Andy & Chris (21:06.722)
Is it kind of like RV size? Is that what it is?

Andy & Chris (21:13.762)
It is bonkers, isn’t it? When you think about it, you know, you sort of imagine that in Africa. Yeah. You know, in wherever it is, Denta in Tanzania, but not an hour outside of Austin. It’s just like somehow it’s just a massive juxtaposition. Is that wealth that’s in one part that doesn’t translate to an hour outside is bonkers.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (21:21.732)
Yeah. This you have. And it’s great.


Dr. Alex & Tim Otto, Alcan Dental Cooperative (21:32.356)
Well, I think, too, the common misconception is, well, they’re kids’ teeth. They’ll fall out eventually, right? You talk about a cavity or two, right? I was given a presentation to a rural health community symposium and showing them pictures of actual cases that Alex sees where the entire mouth, 20 teeth, black, rotted out to the gut line. Like, severe, severe dental disease an hour away from one of the most affluent communities in the world. So it…

Andy & Chris (21:57.634)
Yeah But even I think in the UK I think the most common reason that kids were in these designs in the UK is to have all their teeth removed in the UK So I don’t think any of us are immune from this like you say you you kind of think it’s kind of a bit in Africa But it’s not it’s actually happening. Do you have fluoridation in the States?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (22:06.308)
Yeah. Yep.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (22:16.132)
It’s funny you say that. Most do, but our specific community, which we didn’t realize until we moved here, does not have fluoride in the water. And so, you know, right. It’s, you know, the American Dental Association wholeheartedly supports fluoride in the water. It is the most cost effective public health measure to prevent decay, but there are some communities you can choose on a local level if you want fluoride in the water. And so like, for example, in our community, there’s just someone who stands up every year and says, you know, fluoride’s bad, don’t do this. And so there’s no fluoride in our water, which I think is a huge

Andy & Chris (22:23.682)

Andy & Chris (22:30.946)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (22:46.086)
reason that I was seeing this kind of decay in our kids and community and you know the the misconception about nutrition and sugar and you know literally donuts are a food group in Texas like kids eat donuts and juice and you know an appearance misconception of like well they’re organic fruit snacks so I’m like organic sugar is still sugar you know so I think there’s just this like misconception about what is good food to eat and what’s not healthy.

Andy & Chris (22:47.778)
Hmm. Yeah.

Andy & Chris (22:56.674)
Sugar, fat, carbohydrates, donuts.

Andy & Chris (23:09.506)

Andy & Chris (23:13.826)
I bet someone’s finally getting reclassified as a protein somewhere.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (23:17.188)
Yeah, exactly. Well, there’s a hot dog in this donut, so it’s good for you. They are delicious. Don’t get me wrong. Not every day.

Andy & Chris (23:20.418)
It’s gotta be okay Wow, yeah Alex obviously Tim is not clinical and join you in in the business. Would you classify yourself as a as a clinician or a business person and could you do what you’re doing without without Tim? How does that how did you get him on board? Yeah, how does that sort of fit together that whole thing?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (23:46.052)
Yes, definitely. I consider myself a clinician. I’ve learned so much more about the business, you know, doing this with Tim, but Tim, the best thing about, you know, being in a partnership like this with your spouse who has an international MBA, degrees in finance and management is that you can completely trust them to take over that side of the business and the practice, which, you know, I think other people who may be like hire an office manager or have someone just in their single location practice.

Andy & Chris (24:15.49)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (24:15.958)
You know, you can’t instill that level maybe of trust that I have in Tim to not just like run the operations but have the overall, you know, business vision for our practices and our companies that…

Andy & Chris (24:25.282)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (24:27.812)
that most dentists don’t have. We don’t go into dentistry because we have a business mind and that’s not necessarily something that interests a lot of dentists. A lot of us in the states will have a practice management course, but it’s useless. Design your dream practice and then that’s all that you do in the course. I definitely consider myself a clinician. When we were talking about maybe doing what we’re doing together 10 years ago, I started

Andy & Chris (24:43.842)
Right, okay. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (24:57.766)
I sat him down and I literally, I poured him a big glass of bourbon and I made him sit and listen to a presentation that I made him. An actual PowerPoint presentation, like a 10 slide Fulblam PowerPoint presentation. It was a prezzy, which I don’t know if you guys ever had prezzy, it’s not in the United States anymore, but it was a prezzy, it was a fancy PowerPoint.

Andy & Chris (25:01.314)
I love this story, it’s superb.

Andy & Chris (25:13.602)
Yep, yep, yep.

Andy & Chris (25:17.634)
Yeah, and what what were you actually selling to Tim Alex? What was what was what was it? Can I just ask a question? Did you stand up to give it?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (25:22.98)
Yes. I literally think I did. Yeah. I was like, feel more comfortable. Just can’t talk until I’m done. Had the quicker in her hand. Yeah. Tim has a tendency to talk while I’m talking. So I’m like, dude, you’re not allowed to talk while I’m giving this presentation. Let me get through this. And then I’m like, I’m sorry.

Andy & Chris (25:27.114)
Was it on a big screen or something?

Andy & Chris (25:42.85)
is that why you gave him the big large bourbon or whiskey or whatever it is? sensible, clever, clever.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (25:44.548)
Yeah, exactly. Exactly. Yes. Yeah, because at the time he was in corporate America, I was working at a corporate dental office and I had been practicing for five years as a general dentist. So we’d been out, we had an established life. You know, we had our beautiful house and,

I realized practicing for another dentist in a pediatric setting that I really, I loved pediatric dentistry. I wanted to be the best clinician that I could be. And even I was seeing there was things about the business that I would do differently if we owned a business together, but also knowing my limitations and knowing that I don’t know what it takes to start a business and secure financing and do that. And Tim’s been an entrepreneur his whole life and I knew that us doing something together, we could create something really special. And so,

after practicing for a while, I realized I wanted to go back to pediatric residency. So that’s when we gave this presentation to Tim. I was like, hey, I want to apply to residency. I know it sounds crazy because I’ve already been basically practicing pediatric dentistry for five years, but I want to go back to residency. I want to be the best specialist that I can be. In the States, there’s just limitations. Like you can’t go, I go to the children’s hospital once a month. You can’t do that unless you’re a board certified pediatric dentist. The community sort of, you know, parents know.

if you’re a specialist or not. So it’s you know to own your own office as a pediatric dentist you really have to have your specialty certificate. And so to hit to Tim I was like I want to go back to residency so I can do this so that we can then start these practices together and you know. I think that’s a big point too is and it’s a great question for you would you have…

Andy & Chris (27:06.786)
You need to have it.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (27:25.54)
gone out with a mindset by yourself of starting 10 pediatric practices. No, absolutely not. Yeah. I would have, if it was just me, you know, I think I could have probably figured out one practice and it would have been, you know, now looking back at it, it would have just been me working myself to the bone every day to like make it what I wanted it to be. And I’d eventually figure it out, but it would have taken a lot longer. It wouldn’t have been as sophisticated and we wouldn’t have been able to grow and scale nearly to the degree that, you know, we’re able to because of Tim. Yeah.

Andy & Chris (27:32.066)

Andy & Chris (27:35.49)
Yeah, yeah.

Andy & Chris (27:54.114)
And your parents, Alex, are they business people or so did you have any sort of push there or it’s just the fact of you just thought, okay.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (28:01.124)
No, no one’s…

And I had these ideas in my mind because I knew that I would have the support, Tim’s support and ability to help me do this. Yeah, I knew I always wanted to, I loved my dentist when I was little. I remember, yeah, literally coming home when I was three or four years old and my mom’s like, you said you wanted to be a dentist when you were like three years old. And that really shaped, you know, going into pediatrics. I was like, you know, if you can make that sort of impression on a kid and be an adult in their life, that’s proud of them and, you know, helps them to have, help them through hard experiences. I thought that would just be.

Andy & Chris (28:11.618)
Man, yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (28:35.014)
something that was really special and an ability to change kids’ life in that way. To know that you’re here. Weird kid.

Andy & Chris (28:37.762)
Mmm. Yeah to know at three. Yeah, I mean that it’s just like mad. I can’t even remember three And and how does it work for you Tim because obviously

addicts does something which technically none of us are qualified to do. We don’t necessarily understand the science, the medical science behind it. So for you being involved on the business side, I guess it’s easy for you to stay in your lane and not drift into that. But are there lots of conversations in terms of ideas you have that may or may not work in dentistry because of something clinically?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (29:15.236)
Absolutely. And that’s, it’s such a good question that most people don’t land on is the fact that yeah, I can have all these grandiose visions and plan out the perfect business plan and have my materials list. And then I’ll show it to Alex and she’ll go, well, there’s a problem with that is that there’s no way in hell we’re going to do that at our practice. Right. And, and so then it sends me back to the drawing boards. There really is this incredible give and take, between clinical effectiveness and, and business efficiency. Right.

Andy & Chris (29:24.034)

Andy & Chris (29:33.538)

Andy & Chris (29:37.314)
Ha ha.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (29:45.19)
And yeah, it really is. So we’ve always said in our mission and vision, they’re hanging on the walls in each of our offices. Those are not just…

Andy & Chris (29:45.25)
Yeah, that’s a good way of putting it.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (29:56.836)
you know, something cute that we hang on the wall, it’s something that we’re guided by every day. And so we’re a clinic, clinician driven organization, we’re a patient experience organization, everything else follows that. And I think that’s a huge differentiator from a lot of these PE driven groups that are focused on the bottom line above all else. Yeah. Because I could say an additional 2 % on supplies tomorrow.

Andy & Chris (29:59.714)

Andy & Chris (30:09.57)

Andy & Chris (30:14.222)
Financially motivated and everything else follows as opposed to being the other way around you

Dr. Alex & Tim Otto, Alcan Dental Cooperative (30:26.596)
if Alex was okay with putting anything in a kid’s mouth, but she’s not, right? So I can say, hey, look, I found the supply for literally 50 % of the cost, but it’s not Equia Forte. It’s a cheap knockoff brand and she’s not confident. So we’re just not going to do that, right? So those kinds of differences are really what creates such an incredible partnership. And, you know, Tim overhears how I presented a treatment plan or, you know, it’s just really nice to get his business perspective on just.

Andy & Chris (30:29.634)
Mm. Yeah. Mm.

Andy & Chris (30:38.562)


Andy & Chris (30:47.266)

Andy & Chris (30:54.498)
Mmm, yeah, true.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (30:55.46)
It’s not like that. It’s like you’re you know you’re maybe confusing parents by offering them four different options. You know I think just hearing his perspective on… Or when she first… I love telling this story. So we moved into our new neighborhood. We’re opening up a brand new practice. We don’t have two nickels to rub together and we’re trying to make it work. We’re a couple of weeks away from opening and this lady walks by with pushing her kid in a stroller and she says, hey new neighbors welcome to the neighborhood. You know.

know and Alex says, hi you know what do you do what we just we’re opening up a new pediatric dental practice and the lady goes wow I really don’t like the current practice that I’m at and Alex goes well see you later I’m running down the street after giving her the business card

Andy & Chris (31:40.098)

Andy & Chris (31:47.81)
Yeah, yeah, yeah, yeah. All you saw was patient number one.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (31:52.196)
Yeah, exactly. Alex didn’t even think about that. Yeah.

Andy & Chris (31:57.25)
But in a way though, I wonder if that sold the practice though, the fact that you weren’t, you know, you were like so mellow about the whole thing, that it was only when old Mr. Finance came running.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (32:04.548)
Then you know, and I… He’s like, here, I’m gonna get a discount.

Andy & Chris (32:10.114)
Yeah. So where does this go and where does this end up? So at the moment you have you got three practices in Austin and you’ve got a partner practice in Michigan. So that’s where you are at the moment. What’s the plan? Where does this get to over the next three to five years?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (32:25.284)
Yes, I think where Alcan Dental Cooperative comes into play. So we’ve built out this organization as we’ve scaled our own practices to really fill a market need right now in the US, probably very similar to the UK. It’s you either go it alone and really have to make all of these decisions and have to run the business on your own, or you have to sell out, sell your soul to a private equity firm or a large corporate DSO.

And that’s very much been the model in the United States for the past 15 years. And we’ve seen friends who’ve gone through that and who didn’t have a Tim and Alex partnership, who is just an Alex, right? Or just a Tim by themselves trying to do everything and didn’t want to lose control of their practice, but didn’t really have any other options. So we created Alcan Dental Cooperative as an alternative to a DSO. We called it Dental Partnership Organization, where we come in and we do all the administrative functions. We do the HR, the

Andy & Chris (33:03.49)
Mmm. Mmm.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (33:24.838)
the payroll, all the non -clinical aspects of dentistry that dentists really don’t know how to do or learn how to do. We’re pediatric specific, so we know the ins and outs of pediatric. We don’t work in general dentistry or prosthodontist, so we know how to run an efficient practice clinically. We have a cohort of like -minded doctors that work together to improve patient outcomes. So we see that growing to 50 -plus locations over the next five years.

Andy & Chris (33:30.658)
Mm -hmm. Mm -hmm.


Andy & Chris (33:53.89)
Wow. Brilliant. And do you take equity in those businesses or?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (33:54.71)
And we take a very small percentage of equity and that’s the biggest differentiator between us is you talk to most of these DSOs and the PE groups behind them are going to require majority equity, right? At which point, if they decide to sell, you’re along for the ride. There’s nothing that you can do. If they decide to make a decision, you don’t have to say in that. We take a very, very small…

Andy & Chris (34:09.442)

Andy & Chris (34:13.922)

Andy & Chris (34:17.922)
You’re stuck with it. Yeah. The old dragon tag, isn’t it? Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (34:21.156)
Yep, exactly. And allow clinical autonomy, which, you know, I think all the DSOs say, sure, you can practice however you want, but then they come in and they force you to change to all their materials and…

Andy & Chris (34:30.786)
Yeah, but you can’t use that composite.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (34:32.932)
Yeah, exactly. Yeah, within limits. So yeah, the Alcan demo cooperative thing is a lot of fun. We’re going to be up at AAPD. Actually, I’m leaving for Toronto this afternoon. We’re doing a lot of trade shows and things like that. And I’ve just had a tremendous amount of interest in it. So we’re looking forward to expanding that. There’s an education platform that we’re getting ready to start rolling out, which is going to be really exciting. Yeah. Yeah.

Andy & Chris (34:44.834)

Andy & Chris (34:59.202)
I say the training stuff that you showed us was brilliant because it was really good because it was non -judgmental, which I think is always helps, doesn’t it? Because people can sometimes put their own little personalities in, but I loved the way it was designed and it’s very clever and very slick.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (35:03.364)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (35:08.228)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (35:17.764)
Yeah, yeah, so we’re super excited about that. And then continue to grow. I will say, and I never in a million years would have thought that I would end up in dentistry, let alone pediatric dentistry, as my career.

The most rewarding part of the career though is the outreach program and getting to go on the van and see these kids’ faces light up because we go back to these sites every six months. And so these kids are literally running out to the van, big smiles on their faces, because they get to see the dentist on a bus. How cool is that? That is the most rewarding part of my career. So that’ll be a part of what we do forever. Yeah.

Andy & Chris (35:36.578)
Hmm. Yeah.

Andy & Chris (35:42.946)

Andy & Chris (35:49.314)
yeah. That’s neat.

Andy & Chris (35:55.266)
And will you do that? Is part of the growth plan to try and make sure that your partners do something similar? So do you sort of say to them, right guys, you’ve got to go and find yourself a big RV and off you go.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (36:03.844)
Absolutely. And none of them are interested in it. Yeah, here you go. We maybe aren’t going to make them do something that crazy because it’s a tremendous amount of work. But no, I mean, one of our core values is it takes a village.

Andy & Chris (36:17.666)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (36:18.052)
And you have to be, we’re so incredibly fortunate, all of us, right? Just the fact that we’re on this podcast and, you know, are in the stations of life that we’re in, we’re ridiculously fortunate. So, you have to give back to the community and you have to support wherever you’re a part of for this whole thing to work. Yeah.

Andy & Chris (36:31.714)

That’s great. It’s really good. Absolutely. Absolutely. You were saying about the training and the education within Alcan. In the UK, there tends to be a tendency amongst clinicians to always go for another clinical course over business learning. Is that the same in the US? Do dentists tend to lean more towards the clinical side than business learning?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (36:57.796)
It’s a good question. I think a lot of us, after you get to a certain point, it’s like, I’ve taken all the clinical courses six times. I think it’s go two directions. There’s like dentists who kind of like bury their head in the sand and like don’t want to deal with the business stuff. There’s a lot of educators, public health dentists that don’t need to know any of the business, you know, part of dentistry. And so they just, they don’t do that. I think it’s definitely becoming more popular though to go to the business courses. There’s a lot of, you know, organizations that revolve around teaching about the business part of dentistry. There’s actually

Andy & Chris (37:04.514)

Andy & Chris (37:09.474)

Andy & Chris (37:15.682)
Yeah. Yeah. Hmm.

Andy & Chris (37:26.786)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (37:27.75)
some MBA programs that are now you get your doctorate and your MBA at the same time so some dental schools are actually offering business classes or MBA programs that are you know a little bit more sophisticated. But no I think that if you can do it well and not be a sales pitch because I think that’s in the states too it’s a lot of like consultants or you know people who are just trying to sell you something teaching the business classes. So I think the ones that you actually like get takeaways and are valuable people really appreciate but those are harder to find I think too.

Andy & Chris (37:36.706)

Andy & Chris (37:49.986)

Andy & Chris (37:57.346)
It did surprise us didn’t we when we were you know with you guys and the other dentists in in Florida in my head corporate America everybody knows exactly what their bottom line is but So many of those dentists we spoke to they just didn’t have a clue and it was it was fascinating It’s exactly the same UK. It was like, well, it’s transferable across the pond Yeah, yeah, yeah what happens I was fine. It’ll be good

Dr. Alex & Tim Otto, Alcan Dental Cooperative (38:18.436)
Yeah, somehow we get money in our bank account. Tim always says, dentists make money in spite of themselves is what Tim always says. Yeah.

Andy & Chris (38:26.69)
Yeah, yeah. It is, it’s phenomenal. But I also think that I think you do need to be more business minded as a dentist today.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (38:34.564)

Andy & Chris (38:36.29)
than perhaps 10, 12, 15 years ago. I mean, in the UK we have the NHS and National Health Service system which provides people with access to dentistry and over the years that’s become harder to access. The funding available has been compressed, there has been an increase in private dentistry and that whole market has kind of forced people to learn more about business because they do need to sell dentistry which is an unpopular phrase but it’s a truth. Whereas I think in the US because it’s primarily been a private service for

for many years it’s probably something that’s more ingrained in the behavior of people that own dental transices, dental offices. I think dentists are more respected in the states as well. Yeah. Than here.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (39:14.084)
You know, it’s interesting.

Yeah, well, I think the United States dentists are just kind of the gold standard internationally, right? Not saying that egotistically, just that’s kind of the perception that I have, at least from the outside looking in. But I do think we’re kind of migrating more towards your model as you’re migrating towards our model where, you know, it used to be every single dentist was taught that as soon as they graduated, they needed to own their own practice and they needed to hang their own shingle. And if you didn’t, then you were kind of a

Andy & Chris (39:37.954)
Mmm. Mmm.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (39:47.606)
failure unless you went into academics. And now there was a report recently, and I can’t remember the exact percentage, but you know, over half of dentists are not planning on owning or opening their own practice. They want to work as an associate. They want to have that work -life balance that we talked about. Yeah, no stress. They want to go do an eight to five job and go home because anymore, now you’re competing against groups like Kids2 Team, groups like Elkan, where you can’t just hang a single up and watch the patients roll through the door.

Andy & Chris (40:03.07)
No stress. Yeah.

Andy & Chris (40:14.05)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (40:17.51)
or you have to have your marketing on point, you’ve got to have your accounting, your financing on point, you’ve got to have your systems on point. It’s gotten a lot more difficult.

Andy & Chris (40:18.69)
Hmm. Yeah. Yeah It’s true isn’t you got to get all that stuff together. Hmm. How many pediatric practices are roughly in the States? Is there a lot of them?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (40:29.38)
There’s 12 ,000 active pediatric dentists and I would say probably around 6 ,000. That’s a very wide, it could be between four and 8 ,000. I can’t remember the number, but let’s call it 6 ,000 independent pediatric offices in the US. Yeah.

Andy & Chris (40:41.73)

Wow, that’s a big old target for Elka. But also to put it into context, in the UK we have around about 11 ,500 dental practices in total. Yeah. So at your top end it could be 8 ,000 pediatric practices. We have 11 ,500 total. Total practices, yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (40:54.787)
So we have as many, yeah, that’s wild.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (41:03.412)
How many pediatric practices do you think there are specialized pediatric practices only?

Andy & Chris (41:08.546)
If any five I wouldn’t even know to be honest. I think it’ll be less than 50. So I do know There’s a dentist over here Cunel Patel. He’s got a group of practices love teeth and he has a he’s got love teeth kids

Dr. Alex & Tim Otto, Alcan Dental Cooperative (41:11.46)
my gosh.

Andy & Chris (41:24.898)
And that’s the one that I know I know best. I know him quite well. So he has a specifically designed a practice with, you know, soft toys and games consoles and, you know, AstroTurf. It’s it’s fully designed for children. But that that stands out because it’s it’s a rarity. Yeah. It’s such a rare occasion. You might pass a dental practice that kind of has a kid sign hanging next to the name. They are they are few and far between. I think they quite often try to do that. I suppose you said it.

earlier on to him, the generalists who try to cater for children, the pediatric side, so they’ll have a soft playroom with an Xbox, and in their head, they’re a pediatric practice. But actually, I just happen to be a general dentist who has an Xbox.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (42:07.428)
That’s all the time you get in a pediatric.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (42:13.124)
Yeah, yeah. And that’s typically what we see too. I mean, it’s, yeah, there’s, there’s a huge difference between a bespoke design pediatric practice and a general dentist that sees patients. But interestingly enough in the, in the U S 73 % of, of pediatric patients are still seen by general dentists. So there’s a tremendous room for expansion in the pediatric space as well.

Andy & Chris (42:21.986)

Andy & Chris (42:32.35)
Hmm Hmm Yeah, yeah, I love the the most important piece of work you do is the outreach stuff I love the fact that all the other things you do are

important but it’s the outreach that really kind of gets you going. So along a similar line if you could take one learning for each of you from your entrepreneurial journey what’s the one thing that you would take that you’ve as your main takeaway? Tim would have filmed Alex’s presentation.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (43:06.916)
Yeah, that’s right. I wish I’d have saved it. Somewhere in the world I bet. Yeah, I mean to me…

Andy & Chris (43:10.178)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (43:19.652)
Yeah. Business ownership is just so much more than I thought it was going to be. You know, I think in dental school, at least in the States, you’re kind of taught like, go be a business owner so that you can like take Wednesdays off and like work less and have an associate do your work for you. And the reality is like being the business owner. Yeah. Yeah.

Andy & Chris (43:24.61)

Andy & Chris (43:36.93)
Yeah, because that works. They lied to you. It was all a lie.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (43:42.5)
It’s all a lie. It’s like, wow, this is, you know, at the end of the day, you’re responsible for everything. If an associate calls in, you go in. If, you know, like if there’s issues, you’re, Tim’s out the practice fixing something, you know, it’s like, yeah, exactly. At the end of the day, it’s all on you and it’s so much more work and pressure. And it’s also very rewarding and to see, you know, to be able to.

Andy & Chris (43:49.602)

Andy & Chris (43:54.402)
If the light bulb doesn’t work, it’s you. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (44:05.796)
create jobs for people that are incredible on our team and yeah, to be able to be in the position to have an outreach program. Like most in the states, like this is something that no one does because they don’t have the ability to do that. But having these practices, having the outreach program.

Andy & Chris (44:13.858)

Andy & Chris (44:20.578)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (44:23.908)
Yeah, it’s a lot more work than I thought it was gonna be, but having a partner to do this with, yeah, it’s just been incredible. Yeah, I would say very much the same thing. And I read a quote the other day that was really good and I can’t remember it, so I’ll butcher it, but it essentially said, you’re not entitled to the fruits of your labor, you’re only entitled to the work itself.

Right? Meaning, if you’re working to get that brass ring, to get that Porsche, to get that car, if you’re going in dentistry or opening your own practice for that, all the wrong reasons and you probably won’t be successful.

Andy & Chris (44:47.266)

Andy & Chris (44:55.49)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (44:57.988)
If you’re going into practice wanting to change things for the better, wanting to create a better work environment, wanting to create a better culture, wanting to enhance your community, that’s the reward in and of itself. The rest will come, or maybe it won’t, right? You’re not entitled to it, but yeah, the hard work for me is the most important thing. If you’re going in for work -life balance to own your own practice, turn around and walk the other way, right? The hard work is at the end of the day,

Andy & Chris (45:11.466)
Yeah. Mmm. Yeah. Mmm.

Andy & Chris (45:23.106)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (45:27.942)
day the only thing that that counts.

Andy & Chris (45:30.466)
Was it our account that you said was money follows the event? Yeah. Was it? Well, we’ve always tried to go with that and the fact of don’t strive to make money because that can sometimes lead to not maybe good decisions. But if you make good decisions, then hopefully money will follow the event. Yeah. And you just keep, you do the right, you do the right thing. Like I say, I think over time, if you keep doing the right thing, people see value in that and you get rewarded for it.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (45:34.404)
Yeah. Yep.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (45:47.172)
Totally. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (45:54.916)
Yeah, and that’s so easy to do with kids. Like you’re gonna do the right thing for these kids and you’re never gonna recommend something that you don’t truly believe that they need or recommend what’s best for them.

Andy & Chris (45:59.298)

Andy & Chris (46:05.538)
On a person, is it quite hard when you’ve sort of like, you’ve treated a child from young to then they become 18 and I’m assuming they then have to move on to another practice? So is that not going to look like a, it must be quite hard in a way. If you’ve seen someone grow up to then say, well, I can’t see anymore, you’ve got to go somewhere else. It must be quite tricky. It’s almost like a graduation ceremony. It’s almost like an emotional, heart -wrenching moment, I imagine.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (46:23.364)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (46:29.7)
It is. I know. We take pictures together. And luckily we have some wonderful general dentists in our community. So it’s like, I personally tell them where I want them to go after me.

Andy & Chris (46:41.282)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (46:43.076)
But it is, yeah, you get to see them, you know, and it’s so cute. We have like pictures, we take pictures of them in their patient chart. And so some of my patients, like they’re little toddlers and now they’re, you know, teenagers. So it’s so cute to just like see them grow up. But also, yeah, now they have this lifetime of, you know, great oral health habits. They enjoy going to the dentist. They’re not scared. It’s so nice to like just be the dentist. You know, I always say my goal is for them to never know that I actually gave them a shot. You know, like they leave and they’re like, she never gave me a shot. You know, they have no idea what we’re doing.

Andy & Chris (46:48.802)

Andy & Chris (46:55.266)

Andy & Chris (46:59.81)
Mmm. Yeah.

Andy & Chris (47:07.874)
Yeah. Yeah. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (47:13.03)
So it’s great and wonderful.

Andy & Chris (47:13.666)
I never thought about it. I was because I was only suddenly thinking that if you if you in the UK and you go to a dentist, the only reason you stop going to the dentist is either you’ve moved away, you die, you hate them. But yeah, or they die. But but with that pediatric thing, actually, there’s a point where you cannot go anymore. There’s an end moment. I just thought that might be that must be really tricky. So you’ve known him for 15 years plus, I’d imagine. Yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (47:23.3)
Yeah, or they die. Or they die.


Dr. Alex & Tim Otto, Alcan Dental Cooperative (47:37.38)
Yep, yep, for sure.

Andy & Chris (47:38.658)
We’ve got to the point where we’re going to ask two questions. We’re going to get four answers to the two questions. You both get to answer them. So our first question for you is if you could be a fly on the wall in a situation, where would that be and who’d be there? Go on Alex, you can go first.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (47:44.452)
Thanks for listening.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (47:54.884)
I get to go first. We had to think about these a lot. I sat there and… Thank you for providing them in advance, by the way, because this would be a terrible question to ambush people with. Yes. God. No, we literally sat and had a glass of wine and were thinking about this.

Andy & Chris (48:00.866)
Well, and that’s why we provide it because the risk is there’s lots of arms and lots of staring up in a I don’t know

Dr. Alex & Tim Otto, Alcan Dental Cooperative (48:14.468)
But yeah, I just, you know, we live in Austin. Probably the most famous person that also lives in Austin is Elon Musk. And so we were just talking about him, like how interesting just to be a flying on the wall on like a normal, one of his normal days, like who he talks to, the conversations he has, the decisions that he makes. I think he would just be a very interesting person. I don’t know that I would want to have a conversation with him, but to be a flying on the wall.

Andy & Chris (48:20.226)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (48:38.628)
in the conversations that he’s having. Just to watch it, it would be really cool. Yeah, yeah. And I would take it back a little further and I love history and you guys will laugh when I say American history because, you know, it’s about that compared to yours. But.

Andy & Chris (48:39.81)
just to watch. Okay, cool.

Andy & Chris (48:55.65)
No, that’s great 1776 is when it starts

Sorry for any Native Americans, I didn’t mean to offend you.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (49:02.756)

I would say I would have liked to have been a fly on the wall during any of the conversations between the founding fathers when they’re talking about how to form the most perfect government that man has thought of, right? And the incredible depths of thought they went to and the research and the level of reading and education they went through and then to try and sound that out and parry back and forth between each other to create what hadn’t been created before would just have been

Fascinating. And it’s a really nerdy answer, but that’s…

Andy & Chris (49:41.602)
No, I think it’s a great way just thinking about it. Can you imagine that trying to knock out the Constitution between like X number of people? It’s bad enough in a business meeting isn’t it when you’re trying to get like four points in an agenda and everyone’s got one no, I think this is what Kim. I don’t know. I’ve never really thought about it. I don’t think we dwell on those things because once something’s been created, it’s just there There was a point where there was a blank piece of paper and somebody said right, so

Dr. Alex & Tim Otto, Alcan Dental Cooperative (49:50.148)
Dr. Alex & Tim Otto, Alcan Dental Cooperative (50:03.332)

Andy & Chris (50:04.93)
What’s the first thing we write down and how that evolves? Because so often in life when things are just there, it’s just there and very few things in life now are brand new. They’re evolutions of what’s gone before. Whereas when you start something from scratch, like you say, it’s just what were those first few conversations like? And did you write them down? Sorry, Tim, you’ve got me going now. So did you write them down and then say, well, what orders that then?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (50:25.796)

Andy & Chris (50:28.45)
Yeah, no, I want that as number two. Yeah, where does bare arms come into this? You know that sort of whole thing. It’s fascinating. Yeah, I never thought about it And our our follow -up question is you’re given the opportunity to sit down and have a glass of wine with somebody who would you like to? Meet they can be dead. So yeah, they can be fictional as well. Yes. I don’t think anyone’s ever chosen a fictional person Who would you go with?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (50:28.884)
Yeah, absolutely.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (50:47.556)

Dr. Alex & Tim Otto, Alcan Dental Cooperative (50:53.892)
My answer was Walt Disney. As a pediatric dentist, he’s someone that you’ll see his inspiration just in all of our practices. When I give presentations on culture, I always talk about the Disney philosophy. I just think it would be a really interesting man to have met with and had a glass of wine. Yeah.

Andy & Chris (51:11.202)
Yeah, no, great. I mean, he’s

I think he doesn’t always get the credit that he deserves. I think people see Mickey Mouse and theme parks, but he bought something to the world that had never been seen before. Because prior to that, you had fun fairs where basically you had to pay like ride by ride. And his concept was the family should come together, pay once and enjoy a day out. And that transformed the way that families experienced entertainment together. So yeah, I don’t think he always gets the credit that perhaps he deserves at times.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (51:24.42)
Exactly. Absolutely.

Andy & Chris (51:43.668)
Just thinking Alex with a big set of ears. Yeah Do you do you do you say excellent excellent I suppose it’s an entertainment. I mean, yes, it is isn’t it? I suppose it’s it’s children to keep it entertained. That’s quite funny Who you having your glass of wine with him?

Dr. Alex & Tim Otto, Alcan Dental Cooperative (51:44.516)
Yep. yeah. We dress up for all the holidays for the kids. So yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (52:00.196)
Exactly, yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (52:04.484)
you know another historical american figure teddy roosevelt all day long he’s you know i mean he’s best known for his brashness and you know being a part of the rough riders and and you know being a manly man but what most people don’t know about him is how prolific of a writer he was and what an incredible scholar he was and and to have those

two sides of a coin, right? And be able to coexist together and create a life like he did is just fascinating to me. So that’s who I would sit down and have a glass of bourbon with.

Andy & Chris (52:35.106)

Andy & Chris (52:43.938)
Brilliant. It’s been an absolute joy. Thank you for your time. We know as business owners, there’s lots of demands as we’ve talked about today. So making time available for us, we’re really grateful. And I think, like I say, primarily we’ve got a UK audience. They’re going to be fascinated by the work you do, how you position it. And if we inspire people to do a version of their own outreach, that would be an amazing thing as well. Definitely. Definitely. Yeah. So it’s been really good. Really enjoyed your time. Excellent.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (52:47.524)
Really has, yeah.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (53:09.06)
Absolutely. Yeah. We’ve been a lot. We’ve been really looking forward to this and our first international podcast and we get along great. Yeah. So we were, we really had a lot of fun today for sure. Thank you guys.

Andy & Chris (53:15.618)

Andy & Chris (53:21.09)
Brilliant. Thanks guys. Thank you. Good to see you both. Keep well. Cheers.

Dr. Alex & Tim Otto, Alcan Dental Cooperative (53:24.868)
You as well.


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