A successful, fulfilled, and debt-free life
What can you tell us about your background?
My great-grandparents came to Washington on the Oregon Trail in the 1850s. I was born in Seattle, Washington. After my mother divorced my father when I was 3 years old, we moved to Spokane, Washington, where my mother and my two other brothers lived with her grandmother in an 800-square-foot house. When I was in high school, we moved to Las Vegas, Nevada, when the town was only around 60,000 people. After graduating from Las Vegas High School, I went to Utah State University on a pole-vaulting scholarship. I joined ROTC where I learned to fly fixed-wing aircraft and looked forward to flying helicopters when I graduated in 1966. I studied engineering but was not the greatest student, and by chance, I visited my cousin, Dr. Jomy Zech, who was a dentist just before my senior year. He told me, “If you don’t like engineering, why don’t you become a dentist?” I asked him, “Don’t you have to be smart?” He said, “No, you just have to have endurance.” I changed majors, and it took me 2 years to get accepted to Case Western Reserve dental school. After my sophomore year, I married my wife and my best friend, Nancy, who had just graduated from nursing school. She helped support us over the last 2 years of school, and we had our first child just before I graduated. We have been married and in love for over 46 years and have five children and seven grandchildren.
After graduating, I spent 20 years in the U.S. Army and moved 12 times but totally enjoyed the entire experience. I was trained in endodontics in the Army and spent 15 years as an endodontist and never did fly helicopters in Vietnam. I became a Diplomate of the American Board of Endodontics in 1981. In 1991, I retired from the Army and drove south from Seattle until I ran out of traffic and ended up in Olympia, Washington. There are only two other endodontists in town, and they were booked out 8 weeks. Once I started practicing, the other endodontist told me he was taking 2 weeks off and was sending me all his patients. It is different today; we now have eight endodontists in a town of 100,000, and we book day to day. In reality, this is a great gift because now we are able to see emergency cases that day, providing incredible service and getting easy cases.
Because of my fear of failure, I opened a small practice in an old dental office that had three operatories in 600 square feet. I knew nothing of the business of dentistry or about systems. I worked 5 days a week, 10-hour days seeing 10 to 15 patients a day while only completing three or four treatments. After a year and a half, my accounts receivable over 120 days was a $250,000; I was 9 months behind in my payroll taxes, and I had an overworked team, which led to a lot of unrest. By the way, I was unaware of all these things. Finally, I brought in a practice consultant, who taught me about systems, how to become a leader, and create a vision for my practice as well as teaching me the business of dentistry. During that time, I lost all my team except one and hired new team members that fit into my new vision. We implemented new tracking monitors and an office manager position, and focused on treating only one patient at a time, completing almost all cases in one appointment. I changed my schedule to three 10-hour days and brought in an associate who worked the same. During this time, my net profit doubled even though I was working half as much. From that time on, I never worked more than 125 days a year and each year take off 10 to 12 weeks. In 1997, I founded Endo Mastery, a coaching program to share with other endodontists what I have learned from my initial practice disaster and to help them change their practice model to a stress-free, fun, profitable, and dynamic practice. In 1994, we doubled our office space by moving into a 1,250 square-foot four-operatory office where we are today. My partner, Mike Behnen joined me in 2003, and my son, David, joined me 2 years ago. I now work in the practice 2 days a week, approximately 90 days a year. Over this next year, we will be expanding our practice space by adding another operatory and a large teaching conference room.
Is your practice limited to endodontics?
Our practice is solely limited to endodontic procedures and microsurgery. We believe that all specialists’ practices need a profit center, and that is why we do not do implants, which would compete with the other specialties that do implants.
Why did you decide to focus on endodontics?
While in dental school, I had a great endodontic mentor, Dr. Jefferson Jones, who took a special interest in me and was a master endodontic teacher. This was followed up by another mentor in my Army internship, Dr. Fred Seymour, whom I wrote my first endodontic article with in the JADA.
How long have you been practicing, and what systems do you use?
I have been a practicing endodontist for over 40 years. I have always been a persistent learner. In those days, we only had Kerr hand files, gutta percha, silver cones, and NaOCl. We are blessed today to have the equipment necessary to provide us with efficient and predictable results. Because of my Army influence, I have always done one-appointment endodontics, which has consistently given me high-quality results with less postoperative problems. In 1993, Dr. John McSpadden introduced me to his new nickel-titanium engine files, which changed all of our lives in endodontics. During that same year, Dr. Schick put one of the first digital radiography units in my office. And we were the first endodontic practice in our area to use microscopes and to have a CBCT scan unit, which is now becoming the standard of care for endodontists.
We have multiple file systems in our office to include those from EndoMagic!™, EdgeEndo® files, and Dentstply Tulsa Dental Specialties products. All nickel-titanium files work well, but the operator must stick to a specific sequence of files that give a predictable result with little or no breakage. Once the operator gets to the apical foramen, it should not take more than 10 to 15 minutes to completely instrument all canals up to at least a size 40 with any of these systems. The real difficulty in the endodontic procedure is to find all of the canals and be able to get to the apical foramen with the size 10 file. This is a blessing for endodontists because this is why general dentists refer. The real secret to this is to use a specific file that can get you down calcified cases quickly. DENTSPLY Tulsa Dental Specialties has the PathFile®, but I have used the EndoMagic! number 15 traditional file from EndoSolutions™ to move down calcified canals.
What training have you taken?
We are always learning in our office. Ever since my residency, I have attended almost every AAE Annual Session. We also have access to the a AAE live Learning Center, which contains presentations from all the AAE past meetings and is an incredible CE resource. In 1979, I took the 1-week hands-on warm gutta-percha course taught by Dr. Herbert Schilder. I took the first courses by Dr. Gary Carr on the microscope and ultrasonics. Recently, my son and I both took the microsurgery course taught by Drs. Syngcuk Kim and Samuel Kratchman as well as the CBCT course by Dr. Martin Levin. Both of these are must-take courses. We have also attended the great hands-on courses by Dr. Steve Buchanan and Dr. Cliff Ruddle. But the greatest educational experiences that I ever had were when I visited another endodontist’s office. While still in the Army, I spent many days in Dr. Steve Cohen’s office in San Francisco. In 1985, I saw Dr. Steve Buchanan present the California dental meeting. He showed some of the most incredible endodontic cases I have ever seen, all done with hand files. I called him, and he invited me to watch him in his office and stay at his home. That night in the hot tub after going through a few bottles of good California wine, I was finally able to understand the concept of passive instrumentation, which has made all the difference in hand and engine filing for me. The time I spent with Dr. John McSpadden’s in his office and his home in Chattanooga, Tennessee, learning the specifics of the new nickel-titanium engine files, was incredible. I highly recommend that young endodontists should find other endodontists that they admire and visit their office or talk with them at the annual meeting.
Who has inspired you?
What is so great about our profession of endodontics is that all our great teachers are so approachable. I remember walking out of the elevator at my first AAE meetings and running into Drs. Al Frank and Dudley Glick. They invited me to sit down and have a drink with them. Besides those I mentioned previously, I would also put in Dr. Gary Carr in the category of those selfless educators, visionaries, and inventors. Without him, we may not have had the microscope or the ultrasonics. Without Drs. John McSpadden or Ben Johnson, we might not have the nickel-titanium engine files. There have been so many great teachers in my life who have taken me under their wings and helped me along my path. I appreciate them all. As endodontists, we are encoded to share with others. It is a great profession.
Kendrick Mercer, the founder of Mercer Financial and the Garden Company, has been my greatest mentor, and I still work with him today. He was the one who helped me become financially free as well as personally free. Now I go to the office because I want to, not because I have to. He also helped me discover and let go of the many painful personal issues I carried from my childhood, which allowed me to soften on my ego and become much more peaceful in my life. And as you get older, you realize that it is not about the money, but as Dickie Fox stated in the movie, “Jerry Maguire,” “It is about personal relationships.” Because we can only live in the moment, you must realize the most important person in your life at that moment is the person you’re with, so why not make it an incredible relationship? We as dentists have the greatest opportunity to connect with and create incredible relationships with our patients, team, and referring doctors. When you are a safe person, at peace with yourself and truly interested in other people, they will share with you at a deeper level, allowing you to make significant differences in your life and theirs.
What is the most satisfying aspect of your practice?
Our office is a fun place, where we have an incredible team, no drama, and great doctors who provide the patients with a loving, caring experience that is unsurpassed. It is a stress-free environment where we see patients on time and complete them on time. We have great systems that make the office and schedule run smoothly, and we rarely go home tired. I must admit that we do have those few days and patients that are “special,” but these become the opportunities that allow us to truly excel. Stress in the practice is a function of poor scheduling, the doctors’ ego and perfectionism, and their inability to learn how to be at peace with themselves and circumstances. I’m fortunate to have Melissa Garrett, our office manager, who takes care of all the administration of the office, allowing me to treat patients 99% of the time. The following is our vision statement, which describes our office culture.
Vision: “We are in a continual process of creating a magical story for our practice that is fun and highly successful and brings each of us personal and professional fulfillment, aliveness, happiness, and freedom. Through people, ideas, and the use of systems, we have a positive, nurturing, and caring environment for both our patients and each team member. It is a place of mutual respect, laughter, clear communication, and teamwork in an atmosphere that is fun, energized, and efficient. We provide a patient experience that is so incredible that they hesitate to leave our office for fear of entering into a harsher world. Our office has a reputation of being so gentle, safe, and caring that we draw the best patients from all of the best doctors in our area. We enjoy every day to the fullest but live in each moment. Our office flows effortlessly and is filled with pride, a sense of ease, and a calmness that allows us to provide excellence in endodontic treatment that is unsurpassed.”
Professionally, what are you most proud of?
That I am able to develop and teach simplified systems that help endodontists and their teams move to higher levels of success, excellence, financial freedom, and peace. Whether it is teaching at the AAE, endodontic residency programs, my Endo mastery courses, or my website debt-reduction seminar at Endomastery.com, or Doctorace.com, I know these systems change lives.
What do you think is unique about your practice?
All practices need something to differentiate themselves such as one-appointment endodontics, using nitrous oxide, seeing the patient that day and completing the treatment that day, providing an incredible WOW experience for the patient, caring and loving doctors and team members, plus much more. Compared to other endodontic practices that I have seen, we are unique in a few ways that we take care of our team and the amount of doctor time-off. Dr. Joe Camp many years ago taught me never to work more than 2 days in a row. In our office, each doctor only works 3 days a week with a day in between. Our goal is to never work more than 130 days per year. With all that time off, we have more time for family, are much more refreshed, love our practice more, are more profitable, and provide a higher level of care.
I am proud that I am able to develop and teach simplified systems that help endodontists and their teams move to higher levels of success, excellence, financial freedom, and peace.
Another way our practice is unique is that we do not have a retirement plan but a debt-reduction plan. Money that used to be given to team members for retirement is now given to them to put toward debt reduction, which actually provides over 100% return on their money while providing them with 3 times as much money at retirement. I have a meeting each year with the entire team and their spouses to show them how they all could be completely debt-free, including their house, within 5 to 10 years. Since I began this program 5 years ago, I have three people completely out of debt, and everyone else is just paying off their house and will be debt-free within 7 years. The real gift I give them is changing them from spenders to savers. I developed a free website, Doctorace.com, to show other offices what I teach my office team. I find I have a much happier team when money is not an issue in the family. I have also encouraged members of our team to attend 3- to 4-day personal growth seminars where they address personal issues that hold them back from having peace in their life. The office pays for all the seminars and for the time they are there. When they come back home, they find that their relationships are much stronger, or they have the ability and courage to make changes.
What has been your biggest challenge?
My biggest challenge has been to get the word out to all doctors that they can have their practice just the way they want it. And the second challenge is to help them understand that true personal freedom begins with becoming debt-free. The problem is that our culture teaches that you have to work hard for a living, and you will always be in debt, which is not true. They can go to my Endo mastery website under resources for a free presentation on exactly how this is done.
What would you have become if you have not become a dentist?
A career Army officer and pilot in the combat engineer corps.
What is the future of endodontics and dentistry?
I believe the future of dentistry and especially endodontics is very positive, but we must be aware of the threats to our profession. Over the past few years, the business of dentistry and endodontics has changed and will continue to change. It has become more insurance-driven, allowing the insurance companies to take advantage of fearful dentists and keep fees low. In my state of Washington, the largest insurance provider WDS, reduced its fees by 15% (reducing net profit by 30% to 50%), and we have not had a rate increase in 7 years. Corporate dental offices grow at 5% a year and are filled with young dentists who are burdened by school debt with high-interest rates preventing them from opening their own practices. To slow this progression, we need to be very active in organized dentistry and politics. Every year, our office sponsors a practice management consultant to put on the day course for our referring dentists to help them become more efficient, profitable, and debt-free, so they go to work because they want to, not because they have to, and to become less reliant on insurance. The more successful our referring doctors become, the more successful we become. I also work closely and donate with those in our state legislators who support dentistry and who will protect us from the overreach of these insurance companies.
What are your top tips for maintaining a successful practice?
We all can have the practice of our dreams, and this always begins with a great vision. The vision sets the culture of the practice. The foundation of a great practice is providing incredible customer care and compassion for the patient while providing excellence in endodontics. To support you on your path, you must have a team you love to work with and that are totally committed to your vision. There is no room in the practice for those who stir the pot or cause drama. Because I believe the doctor needs to be at the chair 98% of the time, our office is run by Melissa Garrett, an exceptional office manager who has been with me for over 15 years and has the tools and monitors to manage the practice. She is responsible for all hiring and firing as well as meeting our goals each month. I only do that which is required by law and have empowered my team to do everything else. Our doctors meet with the office manager and marketing coordinator 2 hours at the beginning of each month to review the practice and marketing monitors. We also have a 2- to 3-hour monthly team meeting.
Top 10 favorites
- My beautiful wife, Nancy
- My incredible children
- Melissa, my superstar office manager
- My incredible team who are totally committed to our vision
- My referring doctors and their patients
- My mentors and coaches
- Learning to be at peace by letting go of ego
- Nickel-titanium engine files
- Digital radiography and my Kodak 9000 3D Cone Beam CT scanner
- The Pacific Northwest
You need to provide the highest quality endodontic treatment result possible. It is sad that this is less appreciated by the referring doctor as compared to seeing the patient that day. To ensure that your best doctors keep referring, you have to provide high-quality results while exceeding the patient’s expectations at every opportunity. I have had hundreds of endodontists and their teams that are in my coaching program visit me in my practice, and I have the opportunity to show them what is possible. This is very exciting, and I always seem to do better when people are watching.
You must have a strong marketing program to include a dedicated marketing coordinator and monitors that track your effectiveness. You must commit at least 1% to 3% of your collections to marketing efforts. The most important marketing tool we have is to see the referring doctors’ patients that day and complete them that day, so we always leave space on the schedule each day for those emergency/treatment patients.
Never say anything negative about other dentists or their work. It is our responsibility to point out to our patients things we see on the X-ray, but I never criticize any dentist or the work. Criticism negatively affects the patient’s perception of all dentistry and dentists without serving a purpose. I may just tell the patient that sometimes the filling material loses its seal, or that many of these canals are calcified and difficult to get down. This philosophy has done much to strengthen our relationship with our referring doctors. Although few have taken me up on my offer, I have invited all dentists in our community to visit our office and help them with their endodontic technique.
Have a philosophy of giving. We work very closely with the Union Gospel Mission in Olympia and provide free endodontic care for those street people in need. We also provide free or discounted care for those whom our referring doctors request that we do. We also provide free endodontic care for all referring doctors and their teams. I am a big supporter of the AAE Foundation and am a platinum donor. This becomes a lot easier when you are debt-free.
The secret to a successful practice is to incorporate great systems into the culture of your practice. Examples of systems that you need to create may range from the scripts that you use to answer the phones, to working with insurance companies in obtaining payments, to the way we bring patients through the office and care for them, to the systematic way we do our clinical treatment, to our marketing efforts plus many other systems. The AAE Live Learning Center is an excellent source for this practice management education. I would highly recommend that you get a coach and work with that person for a year. Even though I have coached hundreds of endodontists for over the past 18 years, I have had multiple coaches come into my office to work with our team and me to include some of my own Endo mastery coaches. If you are not growing every year, you are declining and need someone to observe, challenge, and excite yourself and your team to move to higher levels of productivity and excellence.
What advice would you give a budding endodontist?
The greatest challenge that faces the budding endodontist is the staggering debt that they carry. They need to have a systematic approach of eliminating all school debt within 5 years. This means they have to learn to be much more efficient in the way they do endodontics. If they are not planning to open their own practice initially, I recommend they find an associate position in an office where the endodontist routinely completes 6 to 8 cases a day with exceptional clinical results. Learn from these doctors. Live like a student until your school debt is paid off. Refinance your high-interest school loans down to 3% to 4%. If you plan to open your own practice, then you must learn the business of dentistry and get a mentor or coach to help you set up strong systems to make your practice fun and profitable. This is an exciting time for you to enjoy the process.
What are your hobbies, and what do you do in your spare time?
When I was younger, I loved to snow ski, fish, scuba dive, and take photographs. I do these things today but at a little lower intensity. I spent 6 years in Germany with the U.S. Army, and my family and I traveled and camped throughout Europe. For the past 23 years, I’ve only been in the office around 125 days a year, which has allowed me a lot free time. There’s been many family trips, but I’ve always loved to do one-on-one adventures with each one of my children. These adventures may be a week’s horse riding and camping trip with my 12-year-old daughter into the High Sierras or fly fishing in Idaho with my son, David, or flying to Papua New Guinea and spending 2 weeks on a dive boat with my daughter, Catherine. Now it is more traveling with my wife, Nancy, spending time with my grandchildren, and large family vacations.
Partners in Northwest Endodontic Specialists
Michael J. Behnen, DDS, graduated cum laude from Xavier University in Cincinnati, Ohio, with a Bachelor of Science degree. He received a doctoral degree from Indiana University School of Dentistry, Indianapolis, Indiana, in 1992. He was selected for a U.S. Army Endodontics Residency, Fort Gordon, Georgia, in conjunction with the Medical College of Georgia, graduating in June 2000. For 3 years, Dr. Behnen was the endodontic mentor for the Army’s Advanced General Dentistry residency program at Fort Lewis, Washington. He presented at the International Association of Dental Research Annual Meeting and is published in the Journal of Endodontics.
Dr. Behnen served in the U.S. Army Dental Corps for 11 years. He had multiple assignments, including endodontic mentor and clinic chief. As a member of the active-readiness Army, he was deployed as a dental officer to Somalia, Haiti; Guantanamo Bay, Cuba; Camp Hovey, Korea; as well as to Kuwait for Operation Iraqi Freedom. He is a Member of American Dental Association, Washington State Dental Association, Thurston Mason County Dental Society (Past President), American Association of Endodontists, and Washington State Association of Endodontists. Dr. Behnen lives in Olympia, Washington, with his wife, Katherine. He enjoys fishing, snow skiing, bicycling, and weight training.
David C. Goerig, DDS, MS, was raised in Olympia, Washington. He attended Olympia High School and Western Washington University before being accepted to the University of Pacific Dental School, where he earned his Doctor of Dental Surgery Degree and Bachelors in Applied Science Degree in 2009. After 2 years in practice, Dr. Goerig completed his Master of Science in Endodontics Degree at the University of Minnesota in 2013.
During his academic career, Dr. Goerig served as president of his dental school class, chaired several committees, and volunteered for many outreach programs, including a dental mission to Peru. He continues this tradition of service by volunteering with the Union Gospel Mission in Olympia and being active in organized dentistry. He is a member of the American Dental Association, Washington State Dental Association, and the Thurston-Mason Counties Dental Society. He is a specialist member of the American Association of Endodontists and the Washington State Association of Endodontists. As a father of three boys, Dr. Goerig is proud to once again plant his roots back in the Olympia community and raise his family in the great Pacific Northwest. He enjoys camping, fishing, skiing, and introducing his boys to all of the fun activities the Pacific Northwest has to offer.