Menonomee Park Criterium

My first race of the season was in Menonomee Falls yesterday morning. I had some good hard rides this week, going out on the Tuesday night Trocadero ride and then on the Wednesday lake front group ride. Maybe I beat my legs up a little too much, because things didn't end up going too well for me yesterday. It started with a bad night's sleep, I didn't fall asleep till about 12:30AM, the I woke up at 4:30 and couldn't get back to sleep. I finally did start to doze off again sometime after 6:45, but by then it was almost time to get up and get ready for my race. So, basically, hard rides during the week + no sleep the night before. I got up and got my stuff together and was feeling a ton of pre-race nerves, what's with that? This is a Cat 4/5 road race, nothing on the line whatsoever! But my heart was racing and I couldn't stop fidgeting to save my life.

So, I get out to the race course, it was a perfect day to race, very sunny and about 55 degrees. My goal was to stay right in the top 10-15 riders (out of 66 total), just keep my head out of the wind and go with any potential breaks. As it turned out, the field wasn't letting anything go, so I didn't have to worry about that. I kept checking my heart rate and it was VERY HIGH for me, it stayed between 178 and 186 bpm for the entire race (my max HR is 192). This was annoying me for a couple of reasons: first: I cannot sustain that high of a heart rate for very long, so something had to give; second: my legs felt perfectly fine, I would have rated my level of perceived exertion at about a 7 out of 10. Unfortunately my heart was rating my exertion at about a 9.2 out of 10. Anyway, we came around the starting area and they rang the bell signaling that we were entering our final lap. I was in perfect position, about 4th wheel. I couldn't believe it was already the bell lap, I hadn't even felt like I was racing. I turned to the guy next to me and said "is this seriously the last lap already?" Well, the course was about 1.3 miles long, with no hills. The only tough part of the course was a straightaway on the back stretch that had a fairly strong head/side wind coming at you. As the pace picked up on the last lap, one guy went zipping up past us to put some room on the group, so I picked up his wheel and went with him. We zigged and zagged through the initial turns with the rest of the field not far behind us. We came out onto the back stretch (with the wind) and he started to slow down a tiny bit (understandably), at this point a line of riders started to move up on our right and go past us. I got out of the saddle to accelerate... and that was where the race ended for me. I simply couldn't make the pedals go. I pedaled as hard as I could, but I felt like I was riding my bike in mud. I watched as the main pack rode away from me and into the final corners of the course. Overall I rode a near perfect race, right up until the last half mile. After I lost contact with the group, I just sat up and cruised in to the finish. I am not sure where I ended up, the results come out this week. But I will say that the course was great. I will miss Wisconsin in the spring and summers.

I got home from the race, still a little frustrated with how it ended up, so I decided to take Dirk for a run. We ended up running along the wooded trails adjacent to the Menonomee River Parkway, near our house. We did and out and back run, turning around at the train tracks/little red store in downtown 'Tosa. When we got to mile 8, with only 1 more mile to go before we were home, Dirk pulled me off in to the grass where he proceeded to throw up a few times. It was actually really sad. I kept apologizing to him for making him run with me. It wasn't him who had the bad race after all! We had a nice slow trot back to the house where he walked right into the kitchen and plopped down on the floor. I kept checking to make sure he was still breathing. Fortunately he recovered.

I've got a couple more races scheduled over the next few weeks, so we'll see how it goes. I am pretty sure I used up all my athletic talent when I was 17-18 years old. Oh well, it's still fun to try... kind of.

The Winner Is!!!!!

This is the one that the marketing guru's have dubbed "most professional, most friendly and most memorable". So, I guess that it is the most awesome too. Of course, it won't say "Texas" on the bottom.

Psyche!!!

the image is copyrighted, so I can't get it right now!!!

A Few More Pics

Potential Logos

Here are some of our logo options.

Lone Ranger

Sara took Lily to California to help her mom out with managing some family stuff (surgeries, illness etc.) I have been doing everything I can to stay busy because it hurts my heart to think about how much I miss my little baby. I am so used to waking up every morning and seeing her little gummy smile. Dirk paces the house whining, looking around for the girls. Yesterday, to fill my day, I went on a 20 mile bike ride in the morning. Then I came home, put on my soccer gear and headed over to campus for the indoor soccer championship game (which we lost 4-1). That ended our reign as 3 time intramural soccer champs. Bummer. I ran straight home, took a shower and got my golf stuff together (my new clubs) and went over to New Berlin Hills. I met up with 3 of my classmates (Holtan, Griffith and Eddie) and we golfed 18 holes (walking). Then I came home to take Dirk out for a walk. I considered taking him for a run, but I thought my legs might fall off.

Overall it was a fun day. And it kept me busy. I crashed hard last night, so that was good.

I have my 1st bike race of the year this Saturday. I am also making headway on my practice startup. I have the location narrowed down to a couple of intersections in some nice busy areas. I am looking forward to getting out there to seal the deal.

Cycling Update

I put 83 miles on this week, which is good for what I am used to. I did a 52 mile group ride on Wednesday. About 40 people showed up and we ended up heading West towards Holy Hill. Our speeds started off comfortable but as soon as it got hilly some of the pro riders in the group decided to hammer us. I got into the front group of about 15, after getting gapped and bridging up a few times. Finally that group of 15 started splintering off and the 3 top riders (all pro's) rode away. So, the 12 of us regrouped and started a FAST paceline to finish the ride. We had one guy who kept getting dropped, so we had to pull back a few times and let him get back in. We averaged around 25-26 mph for about 20-22 miles of riding (from about mile 20-42). There were some stop signs in there too though. I felt great all through the ride (except when I got dropped off the front group). But I was definitely one of the stronger riders out there.

This morning I got up at 6:00 and headed out to Pewaukee for a solo ride. I decided to to the last 10 miles at race intensity (which is hard alone). I hammered up "hospital hill" and tried to maintain my HR over 170 for the rest of the way. I came pretty close, with a few dips down into the mid-160's. I definitely wanted to throw up. So, that was a pretty good ride.

I am hoping that I can place well in my few races that I end up doing in the next few weeks.

Neighborhood Smiles

So, unfortunately the guy I am working with on this project has the same name as I do. I might consider changing my name, just for business purposes. I am thinking of something along the lines of Slasher.

Sara, Lily and I made the 3 hour drive up to Wausau yesterday and met with Tim and one of his PDA coaches, Christine. Tim showed me his office, explained how and why things were set up they way they are (using David Ahearn's Design Ergonomics model). We talked to Chris about the role of the PDA coaches in the practice and what to expect from them. Tim and I talked about the sequence for getting my practice open. We discussed timelines, goals, marketing etc.

At this point I am going to be planning to go up to Wausau after I graduate to get some hands on and some training time in Tim's office. That will give me a good leg up when I get ready to start my own. I am also most likely going to be attending the PDA continuing ed. course in Dallas this July. That will be my crash course for the practice management side of things. That will also get me familiar with the team that will be working on my practice with me.

Right now we are just waiting for the demographic analysis to come back from Scott McDonald, at doctordemographics. He should have that ready to go early this next week. Tim and I will then go over that, pick out a few sites to zero in on, then get in touch with a local commercial realtor in the area. After that, (probably some time in late April or early-mid May) we will take a trip down to the area to come up with a final selection. Basically we are looking for a spot for the dentist:population ratio is ridiculously low (over 1:3000). That will give me the best opportunity to get as many patients as I can, as fast as I can. This will in turn allow me to start achieving the growth and goals I will have set with my PDA coaches.

I am not going to get into the actual dollar amount of our production goals because it is very hard to predict, and at this point, it seems kind of personal. But I will say that the stated goal from right now is to have my office open by the end of summer. As soon as I am booked out 2 weeks in advance and my hygiene team is getting into a rhythm I will be looking to bring in a partner (should be in 6-12 months from opening). That partner will come in as a buy-in, not an associate. When we are both busy we will start looking in the surrounding areas for the next spot to place a practice. The goal is to have 4-5 practices, all within 15-20 miles of each other. The timeline for that goal is 5-10 years, but a lot of that will depend on outside factors though.

So, I have a rough draft business plan for "Neighborhood Smiles" that was created by Vicki McManus. She is the President of Productive Dentist Academy (PDA). Her and Tim have come up with this business model and have been messing with it and tuning it up using Tim's practices in Northern Wisconsin. Right now Neighborhood Smiles exists on paper only. The first Neighborhood Smiles will be opening in San Antonio, Texas within the next month or two, by a fellow named Rick. Ironically, Rick used to be a Comfort Dental partner. Rick's goals and plans for San Antonio will mirror the goals that I have in Albuquerque.

I felt great after the meeting with Tim yesterday. I couldn't be more excited for this opportunity to be a part of building something from the ground up. I recognize that there will be many speed bumps and hurdles along the way. But I feel confident that the team of people working with me on this will be able to guide me through those without too much trouble. I know that there will be a heavy initial investment in both time and money. I can't say I am looking forward to being $700,000 in the hole with my school and practice loans (without even buying a house!). But I am also confident that this will shake out well financially. As far as the time issue goes, everyone on this team realizes that there has to be a balance between work and family. None of us wants to wake up in 20 years with a huge bank account and no memories of our kids. So, that has all been laid out on the table. It was great to have Sara up there with me because she got to hear all of this firsthand. So, she has a clear idea of what we're getting into.

I will post again when I get the demo analysis.

My Options

So, the options on the table for me looked something like this:

1. Stay in Wisconsin and work with a Dr. by the name of Tim Quirt. Tim and I connected through an online forum called dentaltown.com. He is a 2005 grad of Marquette and has successfully started a few practices in Northern Wisconsin. He's got a nose for business. I met him around the end of my 1st year of dental school and he provided me with a ton of practice management materials and a lot of advice. We have emailed a lot in the last few years and he has given me a lot of feedback on my goals, whether it was endo school, Comfort Dental etc. Ironically he went through almost the exact same thought process as I did when he was in dental school: scratch start, endo school, Comfort Dental and then back to scratch start.

2. Move to San Antonio, Texas where Tim is helping another dentist open up a new practice.

3. Go to Albuquerque as planned and start up my own.

I had previously had a discussion with Tim about helping me scratch start a practice in New Mexico using his practice setup, design and management systems. He didn't really show any interest though and instead he encouraged me to stay here in Wisconsin and work with him. I had to let him know that staying in Wisconsin was completely and totally off the table. It's freezing cold here, its far away from "home" for us and if we went up North, where he is, we would be 3-4 hours from the nearest temple. NO WAY, I couldn't even come up with an amount that I could make that would make it worth it.

So, as I started having second thoughts on Comfort Dental last Thursday, I went ahead and emailed Tim to ask for advice. He told me that he thought I could do better without Comfort Dental. And I guess I was starting to believe it by this time too. He only helped solidify that feeling inside me.

Again, he tried to convince me to stay here to work with him. He also told me I could probably go to San Antonio where he was starting up a new practice. Unfortunately neither of those really sounded great. San Antonio definitely sounds better than Wisconsin, but Sara helped me rule Texas out as well. So, finally I get an email from him on Sunday sometime that said something to the effect of, "Hey Tim, if you want there is a chance I can bring you on board and we can get something started for you in New Mexico with my help."

There was still that question of autonomy though. If Tim helps me set up the practice, and we use his advisors, his systems etc, then to some extent we will be playing by his rules. So, isn't that kind of why I decided to leave Comfort in the first place?

I talked to Tim about this and he explained things in a way that allayed my concern. I won't go into the details now, because, quite frankly, I don't have all the details right now. Suffice it to say, I felt satisfied that I could do things my own way while using his systems. I will be starting up a practice and I will be running it. Tim (and his "team") will be providing a great deal of support, which will ultimately put me way ahead of the game in terms of the learning curve for starting a practice. So, in a sense, it's the best of both worlds. I get to start my own practice and accept all the risk that goes with that. But, I have a group of people helping me out along the way. Of course there is some financial incentive for them to see me succeed, so I will in turn be paying for their support and those services. But, it will be significantly less than I would have been paying to Comfort Dental for the right/privilege to be one of their franchisee's.

Sara and I thought, meditated, debated, prayed and fasted and came to the firm conclusion that this would be a great way to go. As I am writing this, I am setting my blog to become private because this is truly going to be more like a journal and less like a blog. I got a strong feeling while fasting that Heavenly Father wants us to take whichever of these paths we want to, whichever we will be happier with. I also got a strong feeling that by going in a different direction than Comfort Dental, I will have more of an ability to serve in church callings, including going on a mission.

By Sunday evening Sara and I decided we were going to go full speed ahead with Tim and set up our own office in New Mexico. We let Tim know on Sunday night and by Monday morning the proverbial ball was officially rolling.

Since Monday I have been in contact with Delta Dental of New Mexico, looking at their reimbursement schedule. I have contacted a professional demographer to help locate the ideal site to set up a practice. Today I sat down with a dental practice loan officer at US Bank and began the process for getting the 300-400K that we will need to get the office up and going. I have a few other people I am trying to get a hold of to get the process moving as well.

Tomorrow we will drive up to Wausau to meet Tim at his office for a face to face visit and go over some of the details of this operation. I am excited to have Sara there with me for a few reasons. 1. She is better looking than I am 2. She is a better listener than I am, so she will probably pick up on some things that I miss 3. She is more discerning than I am, so she will most likely give me some incredible insight after our visit with Tim.

As soon as the demographer gets the Community Report to me, Tim and I will be going down to New Mexico to evaluate some sites and look at potential space to lease. From there we will need to negotiate a lease and then get an estimate for the buildout. Around that time I will let the bank know exactly what I expect the office to cost and we will secure a loan (hopefully for the entire amount requested, or I might have to get a supplemental loan from somewhere else).

I will update the blog after my meeting with Tim tomorrow.

The End and the Beginning

*Disclaimer: this is a long post meant mostly as a journal entry for myself. Please feel free to read it, I just don't know how interesting it will be to anyone else

Last October I traveled to Albuquerque with my friend and classmate, Chris. On that trip we spent some time with one of the managing partners (Bruce) of a dental franchise called Comfort Dental. The trip went well by all measures. Chris and I talked, analyzed and over-analyzed the professional option of "buying" a Comfort Dental franchise together. We got back to Wisconsin and within a few weeks we both mailed off cashier's checks to secure our spots as franchisee's with Comfort Dental of New Mexico. That decision was essentially the culmination of 3 years of researching and planning my dental career. I am not trying to toot my own horn here, but I honestly don't know anyone who put in as much time and effort as Chris and I did into researching the "best" professional pathways in dentistry. I went from wanting to scratch-start a practice, to thinking of buying an old dying practice and re-vamping it. I spent about a year and a half of dental school convinced I wanted to become and endodontist. I did research, signed up for extra programs, ran for class president etc... all in an effort to boost my resume for a post graduate program. Finally, when the allure of endo faded, and I got back in to the mindset of general dentistry, I started re-weighing those options I had previously considered. Part of that decision making process was based on where in the country we wanted to live. So, we narrowed it down to Calif, Washington, Oregon, Nevada, Arizona, possibly Colorado and maybe New Mexico.

Our decision would be based primarily on a few factors:

1. We want to be "out west" to be close to family

2. We don't want to be freezing (or wet) for a significant part of the year

3. We want a temple nearby

Uncle Pat and Aunt Wendy moved to New Mexico two summers ago and have had great things to say about it. I also found out around March of 2009 that Comfort Dental had spread from Colorado down to New Mexico and was looking to grow. So, we investigated New Mexico, found that it fit our 3 basic criteria. Sara and I went down in April 2009 and took the grand tour of Albuquerque. After that trip I initiated contact with Comfort Dental and got the ball rolling to meet with them in the Fall.

So, that is where I was at as of October 2009. I was fully committed to Comfort Dental of New Mexico. I had put in a cash deposit. Bruce was emailing us with updates on how the other partners were doing. He was actively looking at real estate to set up our future office. I had mentally and emotionally settled in to the idea of becoming a Comfort Dental partner.

Several months go by, over the course of which, I have some second thoughts regarding my desire to go ahead with Comfort Dental. A small part of me felt like I could do better. I don't just mean better financially (the CD partners do very well) but I mean that I could do something more personally satisfying than simply signing up for a franchise and settling in to play by their rules. Those thoughts came and went. I finally got over them and went ahead with the plan as outlined. Then Spring Break happened.

For our Spring Break, Sara, Lily and I traveled to Utah to see Ashleigh, Kyle and Cami (who drove out from Calif). It was a great trip and we spent most of the time trying to sell Ash and Kyle on the idea of moving to New Mexico after they finish school. We explained to them the job I had lined up and how great it would be etc. My classmate, Pako, also took a trip out West. He is considering starting up his own practice after he completes a 1 year residency. It just so happens that Albuquerque was on his list of places to look at for his startup. So, I hooked him up with Bruce so he could take a look at the Comfort Dental offices and learn about their arrangement.

Pako went on his trip, visited Bruce, as well as some other offices I am familiar with and came back to Wisconsin safe and sound. I caught up with him at school after Spring Break to ask him how how trip was and he made a comment that went something like this, "Well, you can spend 350K to buy into Comfort Dental, where you get a crummy looking office and you play by their rules. Or, for about the same amount, you can start your own office, make it look nice, and do whatever you want with it. I just don't see the upside."

Everything Pako said is indeed factually correct. Comfort Dental places little emphasis on designing and building offices to look beautiful. and they most definitely set up the rules on how you practice dentistry; including where you are, how often you are open, what procedures you can and can't do, etc...

I already knew all of this, but as I said earlier, I had gotten over it. What do you need a beautiful office for when you are making as much money as those guys in crummy offices? Why do you want to add more procedures when you can make so much with just a few simple ones? Why do you care about when your office is open if you are only there about 32 hours a week anyway?

I had asked myself all of these questions before, and hesitated to ask myself the one question that is clearly more important, "Is this what you want to do for the rest of your career?" Or, the same question, phrased differently, "Can you do better?"

That conversation with Pako happened last Thursday morning at about 10:30 AM. By late afternoon on that same day I started seriously exploring what other options I had.

The Rebuttal

Some people scoff when we say we are moving to New Mexico. "Ha, that's just a brown desert waste land," they say.

California Fog

I think the fog along the coast of California is great. So, you can imagine how thrilled I was to get to go outside to this:

It made me really nostalgic for Los Osos. I can remember times in Los Osos where I would walk out the front door and not be able to see the neighbors house across the street. One of my jobs while I lived there was delivering pizza/smiles for Domino's Pizza. I would have to creep really slow down the streets because it was so foggy. I would even have to get out of the car to walk up to the house just to be able to see the address. There was a car that I saw several times driving around Los Osos that had a personalized license plate that said "FOG OSOS".

Back in the saddle, so to speak

Soooooooo, about 5 months and 9 days ago Sara gave birth to our beautiful little girl, Lily. Well, since that time I have been meaning to write down the feelings I had during that event. So, here goes:

It wasn't at all what I expected. Sara went into labor at home, and basically stayed in labor, having contractions and staying comfortable, while I went to school to treat some patients. I got home, made some dinner and then we just kind of hung out waiting for the contractions to get close enough/strong enough to merit a trip to the hospital. Sara was really quite calm during the whole thing and around 11:30 she decided we better go. There was no frantic bag packing or speeding through red lights. Just a serene car ride through the heart of Milwaukee's ghetto at midnight on a weekday. We parked in the parking lot, walked in and announced that we were ready to have our baby.

So we got set up in our delivery room and proceeded to watch comedies. The last one we had on before Lily came was the highly inappropriate "Blazing Saddles". We were glad we didn't have any racially/ethnically sensitive nurses helping us out. We took some naps in between movies and Sara finally started pushing around 11:00 AM. It didn't take long. There was no screaming. There were no bodily fluids flying around the the delivery room. No explosions, no gurgles or squishy sounds. Up until the very last moment, it was just me, Sara and our sweet motherly nurse. Finally our OBGYN, Dr. Eiche, and the OB resident came in and "caught Lily". She was so squished up when she came out. Her face was so swollen that her eyes looked "Asian".... yikes.

We spent the next two days, hanging out with Lily at the hospital, teaching her to eat and getting lots of help from the nurses.

Honestly, the entire event was so calm and peaceful. It was amazing to first see Lily's head and then her whole body. To think that she started as a sperm and an egg is just mind numbing.

The last 5 months have been much better than I thought they would be. Her 1st 6 weeks of life weren't all that fun, she cried and cried and cried non-stop. She woke up at all hours of the night. But since that time she has started sleeping through the night, playing with toys, laughing, smiling and just being very pleasant.

Before Lily was born I was expecting life to become sort of boring, or less fun. The fact is that it has gotten better. I still make time to play intramural soccer, ride my bike and go for runs outside. Sara still has time to go for runs, get her haircut, go to movies etc. We are fortunate to have such a sweet little baby, she really does let us get away with a lot. We are more pressed for time than we were before, obviously. But it has helped me to manage my time better, and I am actually getting more done in any given day than I did before. Are there days when I wake up feeling like a new, sleep-deprived parent? Yes. Are there times when it would be really convenient to not have a screaming baby at 4:30 AM? Yes. This is going to sound extra cliche-y, but I honestly wouldn't trade the whole experience for anything in the world. I get so excited every day to come home to my girls (and Dirk I guess).

The funny thing is that I am totally ready to start trying to have another one!!!!