The Dental Boardroom

Participants:

• Wes Read, host, PracticeCFO
• Michael Anderson, dental marketing and brand advisor who works with practices on defining and showing value.
• Megan Shelton, dentist and practice operations advisor focused on patient experience and retention systems.

Duration: 41 minutes

A DSO opens down the street with a $49 new patient special, and the instinct is to match it. This episode walks through why price is the most expensive growth lever a practice can pull, and what to use instead: a defined value proposition, visible proof of expertise, and an in-office experience that justifies the fee. The panel closes with whether membership plans are a real alternative or just discounting in disguise.

Key topics

• Discount math and margin erosion
• Online reviews and word of mouth
• Signature details and patient experience
• Membership plans versus PPO participation

Key takeaways

• Discounting cuts your fee but never your costs, so volume has to multiply to break even.
• Low price attracts the patients least likely to stay or accept treatment.
• Patients cannot judge clinical skill, so they judge everything else.
• Membership patients accept more treatment because they already committed to you.

Actions to consider

• Audit the full new patient journey, from the phone call and web form follow up to the bathroom, and fix what contradicts your fees.
• Pick one signature detail you deliver every time without asking, and train the team to build value around it before it happens.
• Start documenting cases on your phone this month, and run your PPO contracts through AI to confirm what your discounting obligations actually are.

Wes Read, host, Practice CFO

Duration: 44 minutes

A solo walkthrough of the year-end tax planning work that must be finished by December 31st, built around the idea that a strong year of planning only counts if the final execution lands. Wes covers what locks in at year end, the internal checklist Practice CFO runs on every client, and why single tax strategies have to be judged inside the full financial picture rather than on their own. The central point: tax friction is the main brake on financial independence, and most of the levers close on December 31st.

Key topics

• Retirement plan design and funding deadlines
• Section 179 and bonus depreciation on equipment
• Pass-through entity tax elections
• Tax brackets, phase-outs, and lost deductions

Key takeaways

• Retirement plan design cannot be changed once the year closes, and elective deferrals must clear payroll by December 31st.
• Financing equipment for a Section 179 deduction can start a debt spiral: deduction now, payments later with nothing to deduct.
• Missing the pass-through entity tax election is the most common and most expensive oversight on a dental return.
• Getting income under a phase-out threshold pays twice: lower tax now, plus deductions you would otherwise forfeit.

Actions to consider

• Schedule a year-end projection meeting with your CPA or CFO advisor in October or November, while options are still open.
• Confirm your W-2, spouse and children payroll, and 401(k) contributions will land on target before the final December payroll run.
• Have an advisor vet any supplier equipment deal for whether you can actually use the deduction before you sign.

Participants:

• Wes Read, host, PracticeCFO
• Megan Shelton, a practice management consultant specializing in dentistry who previously owned and sold her own dental practice
• Michael Anderson, a dental marketing consultant with 13 years in the industry

Duration: 60 minutes

Reimbursement is flat while overhead climbs, and most owners have at least daydreamed about dropping Delta. This session breaks the decision into three levers, price, friction, and yield, and argues that the fee schedule is rarely the real problem. Friction, the cost of collecting the money, is what owners actually control.

Key topics

• UCR fee schedules and percentile benchmarking
• Claim denials, eligibility, and breakdowns
• Per-plan profitability math
• Marketing readiness before going out of network

Key takeaways

• The squeeze is often the cost to collect, not the fee schedule.
• An 80 percent PPO practice can still be highly profitable.
• Not every plan delivers the same patient; case acceptance varies by carrier.
• A practice with no marketing history will struggle to go fee for service.

Actions to consider

• Run a UCR percentile analysis and raise fees toward the 80th to 85th percentile, then resubmit.
• Pull payer distribution and case acceptance by plan to find your worst performer.
• Verify eligibility within two days of every visit and get a full breakdown, not a coverage table.

Participants:

• Wes Read, host, Practice CFO and Practice Orbit
• Jared Bergquist, a licensed business and commercial real estate broker in Nevada who runs his own brokerage selling dental practices and handling dental real estate across Nevada, Utah, and Arizona

Duration: 57 minutes

A broker and a CPA walk through what the practice acquisition market looks like right now: where DSO activity stands, what private buyers are competing for, and why the "perfect" practice is the wrong target. They cover building ownership, rent as a percentage of collections, and how staff stability drives both value and a successful transition.

Key topics

• DSO activity and divestitures
• Private practice acquisition
• Buying versus leasing your building
• Staff retention through a transition

Key takeaways

• Waiting for a flawless practice is why many qualified buyers never buy one.
• DSO divestitures over the next five to ten years will create locations, equipment, and patient bases worth pursuing.
• Owning your building controls the one expense you cannot renegotiate later.
• A de novo that fails to launch is very hard to sell, because leasehold improvements and used equipment carry little value.

Actions to consider

• Check rent as a percentage of collections against the seven to ten percent target and know what a long lease escalates to.
• Widen your acquisition criteria to four and five operatory practices and offices with fixable problems.
• If you are buying, negotiate for the seller to stay on twelve to eighteen months to hand off staff and patients.

Participants:

• Wes Read, host, PracticeCFO
• Paul Lipcius, CFO advisor at PracticeCFO, a CPA and Series 65 investment advisor focused on higher net worth clients and capital markets
• Howard Farran, host of Dentaltown, who interviews Wes and Paul in this crossover episode

Duration: 71 minutes

With SpaceX, OpenAI, and Anthropic all heading toward historic public offerings, dentists want to know whether to chase the hype. Wes and Paul explain why euphoric IPO pricing rarely rewards latecomers, how to capture AI's real growth through the less obvious companies underneath it, and why a doctor's own practice, not a moonshot stock, is still their highest returning asset.

Key topics

• AI mega IPOs: SpaceX, OpenAI, Anthropic
• CapEx trickle-down and downstream suppliers
• Concentration risk in the S&P 500
• The practice as the core wealth engine

Key takeaways

• Euphoric IPO valuations already price in years of unproven growth.
• The winner is often the second or third mover, not the first to market.
• Own AI through the picks and shovels suppliers, not just the headline names.
• A well designed portfolio's job is to be boring, disciplined, and consistent.

Actions to consider

• Cap any speculative bet, a single IPO or crypto, at a small insurance sized allocation.
• Pick three or four practice metrics to improve this quarter instead of chasing every new one.
• Pressure test your advisor's fees: ask whether anyone other than you pays them.

A Dental Boardroom data deep-dive, PracticeCFO

A breakdown of the Q2 2026 State of the U.S. Dental Economy Report from the ADA Health Policy Institute, translating national data into what it means for an independent practice. The core tension: dentists feel confident and are busier than ever, yet revenue is flat and margins are squeezed from every side. This episode decodes why, and what owners can do about it.

Key topics

• The confidence versus consumer disconnect
• The fiscal squeeze on practice margins
• Insurance reimbursement as rent control
• AI adoption for the back office

Key takeaways

• Dentists feel recession-proof, but consumer dental spending rose just 1 percent in a year.
• Overhead and wages are climbing far faster than reimbursements, so owners eat the difference.
• Packed schedules and two-week waits mask flat revenue, not real growth.
• AI is being adopted fast for admin and imaging, yet 82 percent refuse it for treatment decisions.

Actions to consider

• Audit your payer mix and renegotiate or drop the worst-reimbursing plans.
• Pilot AI scribing or insurance-verification tools to reclaim staff hours.
• Weigh a DSO's back-office scale against your true overhead before ruling it out.

The PracticeCFO investment committee sits down for its quarterly market update, digging into how AI is reshaping valuations and where the Federal Reserve stands today. The core message for practice owners: AI is genuinely transformative, but most of the hype is already priced in — so valuation discipline and diversification still decide long-term returns.

Hosts & guests: Wes Read (host, PracticeCFO), Brandon Hobson (Chief Investment Officer, PracticeCFO), and Paul Lipcius (PracticeCFO investment committee).

What we cover:

• AI's effect on market valuations
• Government involvement and regulation of AI
• Federal Reserve policy and interest rates
• Portfolio positioning and risk assessment

Key takeaways:

• AI is groundbreaking, but the hype is largely priced in already.
• Every prior CapEx cycle eventually reversed and normalized — this one will too.
• The Fed is holding steady, with a hike now more likely than a near-term cut.
• New Fed leadership is prioritizing inflation, easing fears about Fed independence.
• Strong balance sheets and diversification protect wealth better than chasing momentum.

Actions to consider:

• Reassess your true risk tolerance now, while markets are strong — not after a drop.
• Trim over-concentration in high-flying AI and tech names.
• Rebalance toward a diversified mix: bonds, some cash, healthcare and consumables, and precious metals.

In this episode of The Dental Boardroom Podcast, Wes takes a break from his discussion of The Five Types of Wealth to tackle an important topic for dental practice owners: buying and selling dental practices.

Drawing from years of experience as a dental CPA and financial advisor involved in hundreds of practice transitions, Wes explores why dental practice sales remain an inefficient marketplace, the critical role brokers play in successful transitions, and the challenges buyers and sellers face throughout the process.

He also shares the vision behind Practice Orbit, a technology platform designed to modernize and streamline dental practice transactions while supporting brokers, buyers, sellers, lenders, attorneys, and advisors.

Key Takeaways

• Dental practice transitions are complex, emotional, and financially significant events.
• A skilled broker can provide tremendous value by finding buyers, coordinating the process, and helping avoid costly mistakes.
• Dentists should carefully evaluate broker experience, incentives, and transparency.
• DSO offers should be analyzed beyond the headline purchase price.
• Technology can improve efficiency, transparency, and communication throughout the transition process.
• The future of dental practice sales may involve a combination of experienced brokers and modern marketplace technology.

Wes Read continues his series on The Five Types of Wealth by Sahil Bloom, diving deep into Chapter 4: The Life Razor. Building on the five categories of wealth Time, Social, Mental, Physical, and Financial Wes explores how a single, carefully crafted sentence can become the most powerful decision-making tool in your life and practice. From the cockpit of Apollo 13 to Netflix’s boardrooms, to a late afternoon assembling a hydraulic bed with his son, this episode delivers a framework that is equal parts philosophical and practical.

What You’ll Learn

• Why your net worth number alone doesn’t define true wealth and what fills the gap
• The philosophical concept of a “razor” and how it applies to your personal life
• The 3 non-negotiable traits of a powerful life razor: controllable, ripple-creating, and identity-defining
• How Marc Randolph (co-founder & first CEO of Netflix) used a five-word rule to protect his marriage through startup chaos
• A step-by-step process to discover and draft your own life razor
• Wes’s personal life razor and the touching story behind it

159: Executive Sessions: AI & The Dental Practice

What does AI actually mean for your dental practice right now? In this executive session, host Wes sits down with Michael Anderson from Wonderist Agency, one of the nation's largest dental marketing firms, and Dr. Megan Shelton of Shelton Solutions to cut through the hype and talk about what's really changing.

They cover the dramatic shift in patient search behavior (ChatGPT now accounts for 20% of all searches and is growing), why the fundamentals of digital marketing still drive AI search results, how AI-informed patients are showing up differently at the front desk, and why the human connection at the center of your practice is more valuable than ever.

Wes also shares a powerful framework from Lawrence Ford's book The Difference Between Knowledge, Intelligence, and Wisdom and explains exactly how Practice CFO is approaching AI adoption, client investment strategy, and the future of financial advisory.

What You'll Learn

• Why 20% of patients are now searching for a dentist via ChatGPT — and what that means for your marketing
• The "unsatisfying but true" answer to ranking in AI search: go back to the basics
• Why AI-generated content is not penalized — but lazy AI content is a dead end
• How the AI-prepped patient is changing chair-side conversations and silently eroding trust
• The knowledge → intelligence → wisdom framework and why wisdom is AI-proof
• Why documenting your SOPs is the mandatory first step before any AI automation
• What Practice CFO is doing with client investment strategy in an AI-dominated market

In this episode, Wes Read continues his deep-dive review of The Five Types of Wealth by Sahil Bloom, a book that profoundly influenced his thinking as a financial planner who has spent his career helping dentists build meaningful lives through their practices.

Wes covers the book’s preface and Chapter 2, unpacking the research on money and happiness, the philosophy behind redefining wealth, and Sahil Bloom’s powerful framework: the five types of wealth that truly define a fulfilled life.

What You’ll Learn in This Episode

• Why money matters but only up to a point. Wes walks through three core findings from the research on money and happiness, including the concept of declining marginal utility.
• The Pyrrhic Victory. The story of King Pyrrhus in 280 BC and what it means to win the battle but lose the war, and how this applies directly to the pursuit of financial success at the expense of everything else.
• Wealth inequality by the numbers. A candid look at Federal Reserve data on how wealth is distributed in America and what it means for dentists trying to cross from labor income to capital ownership.
• The comparison trap. Why “there’s always a bigger boat” and how excessive comparison is one of the greatest enemies of happiness.
• The 90% rule. A striking stat: 90% of all the time you will ever spend with your children happens before they leave home.

The Five Types of Wealth are defined:

• Time Wealth: The freedom to choose how, where, with whom, and when you spend your time.
• Social Wealth: The depth and breadth of your meaningful relationships; the #1 predictor of happiness.
• Mental Wealth: Connection to higher-order purpose, lifelong growth, and a healthy relationship with your mind.
• Physical Wealth: Your health, fitness, and vitality; the most entropic form of wealth requiring consistent daily habits.
• Financial Wealth: Assets minus liabilities, but with a twist: your expectations are also a liability.

The seasons of life. How your priorities across these five categories will naturally shift over time, and why balance, not perfection, is the goal.

Most dentists are hitting their financial goals and still feel like something is missing. In this episode, Wes Read (CPA, CFP, and founder of Practice CFO) steps back from the balance sheet to ask a bigger question: what does wealth actually mean? Kicking off a new multi-episode series, Wes introduces the book The 5 Types of Wealth by Sahil Bloom, a framework that redefines wealth across five dimensions and challenges high-earning, time-poor practice owners to intentionally design the lives they keep deferring.

What You’ll Learn

• Why financial success and true wealth are not the same thing
• The five types of wealth: time, social, mental, physical, and financial
• The “arrival fallacy” is why reaching your goals won’t create the satisfaction you’re expecting
• How to break the cycle of marginal thinking and start building your designed life
• The math exercise that changed Sahil Bloom’s life and Wes’s
• Why dentists in particular are vulnerable to being rich on one dimension and bankrupt on the others
• Three questions to take inventory of your own wealth right now
• Three action items to start this week

Key Takeaways

Financial wealth is one of the five.

Time wealth, social wealth, mental wealth, physical wealth, and financial wealth. Most successful dentists score very high on one and are quietly bankrupt in at least one other, often wealthy.

The arrival fallacy will keep moving the finish line.

Reaching a financial milestone does not produce lasting contentment. The assumption that it will be the arrival fallacy. Recognizing it is the first step to escaping it.

A designed life beats a default life every time.

If you don’t intentionally author your life, thousands of others are waiting to do it for you. The opposite of a successful life isn’t a failed life. It’s a default life.

What gets measured gets managed.

The reason most practices run well financially is that everything gets tracked. How much are you tracking the other dimensions of your wealth? The book gives you a scorecard to do exactly that.

Marginal thinking is the enemy of blueprinted life.

Skipping the gym once is harmless. Skipping it 9 out of 10 times compounds. The aggregation of small neglected decisions is what separates the life you designed from the life you actually lived.

The 1% framework works.

The coach of Team Sky didn’t demand a breakthrough; he asked for 1% improvements across every variable. Small, consistent, intentional gains compound into transformation.

One of the most persistent tensions in dental practice ownership is deceptively simple: should you reinvest surplus cash back into the practice, or distribute it to yourself? In this executive roundtable, Wes, Michael, and Megan break down the capital allocation framework every dentist-owner needs, from defining “enough” personally and professionally, to tracking ROI on every dollar invested in people, equipment, and marketing.

Key Topics

• Capital allocation is the most important strategic decision every dental CEO makes
• Why every financial plan starts with a personal budget
• Defining “enough”, lessons from Jack Bogle’s book, and the Shelter Island story
• Why money becomes psychological and “enough” becomes a moving target
• Treating your dental practice like a micro-stock, when the internal ROI beats the S&P 500
• Where the first dollar of surplus should go: people, systems, or equipment?
• The CBCT trap, six-figure equipment sitting unused because training was skipped
• Working capital “sleep insurance”: how much cash to always keep on hand
• Tracking marketing ROI and holding your agency accountable like a CMO
• The annual practice roadmap: aligning personal goals with business investment
• Practical example, how to allocate $200K as a growing dental practice
• Why maxing your 401(k) early outperforms most practice reinvestment past the optimization point

Key Takeaways

• Personal financial planning should drive the conversation before practice investment decisions are made.
• Every practice has a breakeven point, 100% of collections cover overhead until that’s met. The surplus is where strategy begins.
• Your practice is a micro-stock. A dollar invested there can beat the S&P 500 until the practice is fully optimized.
• Invest in people before equipment. Great team members multiply results; equipment amplifies existing leaks.
• Working capital target: 75–100% of one month’s collections sitting in the bank at all times.
• Track ROI on every dollar, marketing, equipment, coaching, or you’re flying blind.
• Start your 401(k) early. A 40% first-year return from tax savings is nearly impossible to beat.
• Attack one bottleneck at a time. Spreading dollars too thin creates friction, not momentum.

In this episode, host Wes Read uses an AI-generated summary of the American Dental Association Health Policy Institute's Q1 2026 State of the US Dental Economy report to unpack what's really happening inside your local dental clinic and why it's a surprisingly accurate lens for the entire American economy.

Your local dentist is fighting an invisible war: global supply chain disruptions, international tariffs, a crippling labor shortage, and flatlined insurance reimbursements all while keeping smiles healthy. This episode digs into the data, the contradictions, and the survival blueprint emerging from the Q1 2026 ADA report.

Key Takeaways

• 68% of dentists are confident in their own practice, but only 32% trust the national economy. They're operating in a microclimate: recession-resistant but not inflation-resistant.
• 33% of practices report not being busy enough, even though total dental spending is up 4% YoY and 11% since pre-pandemic. Slow growth gets absorbed by existing capacity, leaving empty chairs.
• Supply costs rose 6% in one year, while insurance reimbursement stayed completely flat. The "fiscal squeeze" eliminates any ability to pass costs on to patients.
• Nearly 40% of practices lack adequate hygienist staffing. Over 90% of those hiring called it "very or extremely challenging." One practice got one application in 9 months from a tattoo artist.
• Dental assistants are a different problem: a large applicant pool, but candidates are shallow, and ghost interviews and ignore callbacks. Some practices pay 17% recruiter fees just to poach from competitors.
• Fully staffed clinics aren't paying wildly higher wages; they're offering health insurance and paid leave. In a revenue-capped market, comprehensive benefits are the competitive moat.
• Tech investment accelerated well beyond plans: 16.9% intended software upgrades in Q4 2025; 24.4% had already invested by Q1 2026. Automation is becoming an economic necessity.

Most dentists are brilliant clinicians, but somewhere between $1M and $3M in collections, growth stalls. Not because of skill, not because of ambition, but because every decision still runs through the doctor. In this Executive Session, Wes sits down with practice management consultant Megan Shelton (Shelton Solutions) and marketing strategist Michael Anderson (Wondrous) to break down what it actually takes to build a leadership team that lets you scale, whether you’re going from one practice to three, or from $1.5M to $3M under one roof.

What You’ll Learn

• Why dentists keep hitting the same ceiling and what’s actually causing it
• What a fractional COO, CFO, and CMO look like in a dental practice context
• The four most dangerous clarity gaps inside a dental office
• How to identify and build your “Janine,” the internal operator who frees the doctor
• The financial fingerprint of undefined leadership (and exactly where it bleeds on your P&L)
• Why DIY isn’t always bad and when it becomes the bottleneck
• The difference between training people to execute and training them to think
• How job descriptions, SOPs, and KPIs connect and why most practices get all three wrong

Key Takeaways

You can only scale what is clear.

Role clarity, expectation clarity, decision clarity, and culture clarity; without these four, everything keeps surfacing to the doctor.

The fractional model works.

A fractional COO, CFO, or CMO gives a $1–5M practice access to executive-level thinking without the $250–500K salary. The doctor still has to engage but they’re no longer doing the day-to-day administration.

The financial fingerprint of poor leadership:

• Payroll creeping past 28% of collections (GP target: 26–28%)
• Supplies & labs drifting toward 8–9% (target: 5–6%)
• Doctor distributions quietly shrinking even as W2 stays the same

Build your “Janine” your internal operator.

It doesn’t require an MBA. It requires someone bought into your vision, is hungry to grow, and is willing to hold the line. Promote from within, give them authority in front of the team, and back them publicly.

SOPs before AI.

You can’t build agentic workflows on top of chaos. Your SOPs are the blueprint. Claude can put them into a pretty format, but garbage in is garbage out.

Less is more financially.

Retain earnings in the business. That retained capital is what funds the hire that buys back your highest-value hours. A doctor doing $400–600/hr chairside should not be doing $25/hr administrative work.

Stop being the hero.

If you want everyone to bring decisions to you, keep being the person who has all the answers. If you want scale, train your team to think and celebrate when they do.

The final episode of the cost segregation series. Wes covers the grouping election, the one tax election that determines whether building losses can offset practice income or get suspended indefinitely. Includes the self-rental asymmetry, how to execute the election, five pros, six cons, and when to make it.

Key Topics Covered

1. The Self-Rental Asymmetry

• Rental income from a building you operate in a non-passive (taxable)
• Rental losses from that same building are passive (trapped)
• Result: a $300,000 year-one cost segregation loss cannot reduce your W2 or K-1; it is suspended until the building has future taxable profit

2. What the Grouping Election Does

• IRC Section 1.469-4(f): elect to treat the building LLC and practice S corp as one economic unit
• Losses in the building LLC that become non-passive can now offset W2 and K-1 income directly
• Example: $400,000 building loss reduces $1M of practice income to $600,000, saving $150,000–$200,000 in taxes in year one

3. Qualification and Timing

• Qualifies when: same ownership percentage in building and practice, dentist is the only tenant, same location
• Must be elected on the original tax return for the first year of building ownership; it cannot be made retroactively
• CPA must attach a disclosure statement identifying the grouped activities alongside Form 8582

4. Five Pros of the Grouping Election

• Loss utilization: building losses offset W2 and K-1 in the year they are generated
• Cost segregation amplification: first-year bonus depreciation becomes immediately usable instead of frozen
• Fixes the asymmetry: losses become non-passive, matching the non-passive character of building income
• Simpler participation: one shared material participation test for both activities
• Predictable: no annual suspended loss ledger to manage

5. Six Cons of the Grouping Election

• One-way door: binding in all future years; can only be undone by a material change in facts (e.g., selling the practice)
• Partial sale complexity: selling the building without the practice creates complicated suspended loss treatment
• Forfeits passive shelter: building losses can no longer offset passive income from outside rental properties
• DSO or partner disruption: any equity sale that misaligns building and practice ownership breaks the grouping
• 1031 exchange complications: a grouped building is harder to roll into a like-kind exchange
• Semi-retirement trap: when practice income drops, the non-passive characterization no longer helps and can hurt

6. Best-Case Scenario

• Dentist buys practice without building, grows income into the top brackets over 5+ years, then buys the building
• Commissions cost seg study in year one of building ownership, makes the grouping election, and offsets peak practice income
• Worst case: buying practice and building simultaneously at low income — better to wait for a higher-income year

7. When to Make and When to Skip the Election

Make it when:

• Buying the building with a long-term operating plan
• High practice income and a cost seg study ready to deploy
• No near-term plans to sell, partner, or transition ownership

Skip or defer when:

• Income is low, preserve deductions for a higher-bracket year
• You own other passive real estate and need building losses to stay passive
• A DSO transaction or partnership is within the next few years

In this episode of the Dental Boardroom Podcast, host Wes Read, CPA and financial advisor at Practice CFO, delves into the advanced mechanics of cost segregation and how dentists can use it strategically to optimize long-term tax outcomes. He explains the key differences between bonus depreciation and Section 179, explores how state tax rules can impact overall savings, and shares what to look for when selecting a qualified cost segregation firm.

Wes also highlights how cost segregation can play a role in building purchase negotiations and why aligning tax strategies with a broader financial plan is critical for sustainable growth.

What You’ll Learn

• How cost segregation works and why it’s more than just a tax-saving tactic
• Why front-loading deductions can create long-term tax problems if not planned properly
• How multi-year tax planning helps optimize savings and avoid future tax spikes
• The impact of rising income on tax brackets and the loss of valuable deductions
• How to align tax strategies with actual cash flow to avoid financial mismatches
• Why state tax rules can significantly change the outcome of your tax strategy
• How cost segregation can influence building purchase decisions and negotiations
• Why taking a holistic, long-term approach is essential for maximizing financial outcomes

Key Takeaways

• Bonus depreciation allows you to create losses and offset other income, while Section 179 only reduces income to zero and requires election.
• Cost segregation can accelerate 30–40% of a building’s value into shorter depreciation schedules, increasing early tax deductions.
• Front-loading deductions without a plan can result in significantly higher taxes in later years.
• Multi-year tax planning helps smooth income, maintain lower tax brackets, and preserve valuable deductions.
• Large early deductions may reduce future eligibility for benefits like QBI and child tax credits.
• Financing equipment while taking full Section 179 deductions can create a mismatch between tax savings and future cash outflows.
• State tax laws may not follow federal bonus depreciation rules, reducing total expected savings.
• Choosing the right cost segregation firm is critical look for engineering-based studies, detailed reports, and audit support.
• Avoid firms that use contingency pricing or promise aggressive results without proper analysis.
• Conducting a cost segregation study during the purchase process can improve negotiations and reveal true after-tax costs.
• Allocating more value to shorter-life assets increases depreciation opportunities, while land provides no depreciation benefit.
• The party who pays for tenant improvements receives the tax benefit, making structuring decisions important.
• Tax strategies should always be aligned with a broader financial plan to avoid unintended long-term consequences.

In Part 3 of the Cost Segregation series, Wes Read shifts from theory to execution. He walks through the five concrete implementation steps every dentist must follow to set up the strategy correctly, runs a detailed numerical example showing exactly how the money flows between the dental S-Corp and the real estate LLC, covers how to determine the right rent amount without triggering IRS scrutiny, and closes with three options dentists should consider when it comes time to retire and decide what to do with the building.

Key Topics Covered

1. The 5 Implementation Steps

Wes lays out the exact sequence for setting up cost segregation correctly:

• Step 1: Form the LLC first. The LLC must be the purchaser on the deed. Do not buy the building personally and transfer it later.
• Step 2: Close on the building. The LLC takes out its own mortgage, personally guaranteed by the dentist. This is standard and should not be a deterrent.
• Step 3: Commission the cost segregation study. Hire a qualified engineering firm (not your general CPA) to do a room-by-room breakdown of all tangible assets into their correct depreciation buckets (5, 7, and 15-year categories vs. the standard 39-year).
• Step 4: Execute a formal, arms-length lease agreement between the Dental S-Corp and the Real Estate LLC. Get a market rent analysis from a licensed commercial real estate broker to document the rate and protect yourself in the event of an audit.
• Step 5: Keep clean books. Maintain completely separate bank accounts for the LLC and the S-Corp. A clean Chinese wall between entities is non-negotiable.

2. How the Numbers Flow (Real Example)

Using a dentist collecting $1.2M per year:

• Dental S-Corp: $1.2M collections, less $600K clinical expenses, less $170K rent paid to the LLC = $430K net K-1 to the dentist.
• Real Estate LLC: $170K rent collected, less $80K mortgage interest = $90K taxable income before depreciation.
• After $200K in cost segregation depreciation, the LLC runs a loss of $110K. The $170K of rent is completely sheltered, with zero taxes owed.
• If the dentist's spouse qualifies as a real estate professional (750+ hours/year), the $110K loss can be applied directly against the $430K of dental income an additional six-figure deduction.

3. Setting the Right Rent Amount

The IRS requires rent to be at fair market value. Inflating rent to absorb 100% of cost segregation depreciation is a red flag and can result in full disallowance of the deduction plus penalties. Wes advises:

• Hire a licensed commercial real estate broker to provide a market rent analysis in writing.
• Consider getting two brokers' opinions and taking the higher of the two.
• Have a real estate attorney memorialize the agreed rate in a formal lease agreement.
• Optimize within the range 'toe the line, don't cross it.'

4. Options When You Retire

When it's time to hang up the drill, dentists who own their building have three paths:

• Option 1: Keep the building and collect passive rental income from the successor dentist or a new tenant. Reliable income, but requires ongoing management.
• Option 2: Sell the building, pay capital gains tax, and invest the proceeds in dividend-paying stocks or other passive assets. Cleanest exit for those who don't want to manage real estate in retirement.
• Option 3: Execute a 1031 exchange into a larger property, deferring all capital gains taxes. If carried through death, heirs receive a step-up in basis, and the gain disappears entirely one of the most powerful wealth-transfer strategies available.

In Part 2 of this series, Wes Read builds on the cost segregation foundation from Part 1 to cover the critical structural decisions every building-owning dentist must get right. He opens with a firm warning against holding your building inside your S-Corporation, walks through the correct two-entity structure, and then dives into passive activity rules — including the often-asked question about qualifying a spouse as a real estate professional.

Key Topics Covered

1. Critical Warning: Never Hold Your Building in Your S-Corp

Wes outlines four major reasons why placing your building inside your dental S-Corporation is one of the most costly mistakes a dentist can make:

• Extraction is a tax nightmare. Pulling real estate out later triggers a taxable distribution at fair market value, potentially creating a $200K-$250K tax bill
• Liability exposure: the building is exposed to malpractice claims and employment disputes inside the operating entity
• Financing complications, lenders underwrite commercial real estate separately; mixing it with operating assets creates problems for refinancing and equity lines
• State licensing compliance in many states, non-dentists cannot own a dental professional corporation; a separate LLC keeps ownership clean

2. The Right Structure: Two-Entity Strategy

The correct setup involves three layers:

• You (the dentist) file a personal 1040 tax return
• Dental S-Corporation owns the practice, generates clinical revenue, and pays rent to the building LLC
• Real Estate LLC (disregarded, single-member) owns the building, collects rent, deducts mortgage interest and building expenses, and applies cost segregation depreciation

The dental S-Corp pays rent to the real estate LLC. This reduces K-1 taxable income from the dental practice. The rental income in the LLC is then offset by expenses, including mortgage interest, maintenance, and most importantly, cost segregation depreciation.

3. Disregarded LLC Explained

A disregarded LLC provides state-level liability protection but does not exist as a separate entity for federal tax purposes. It files directly on Schedule E, Page 1 of your personal 1040, the lowest-cost, simplest filing structure.

If married, spouses can often be treated as a single member (check your state). If a non-spouse partner is involved, the LLC must file as a partnership — a separate tax return.

4. Passive Activity Rules

Rental income and losses in your building LLC are classified as passive. Key points:

• Passive losses can offset passive income (rent collected) dollar-for-dollar — potentially making rental income tax-free in early years
• Passive losses generally cannot offset W-2 or K-1 income from your dental practice
• Exception: if your AGI is under $100,000, up to $25,000 of passive losses can offset active income
• For owner-operated buildings (you are both tenant and landlord), limitations are stricter

5. The Real Estate Professional Exception

If you or your spouse qualifies as a real estate professional (750+ hours per year, more than any other professional activity), all passive losses from the building LLC can offset any income, including dental W-2 and K-1. This can create a $400K-$500K year-one deduction that nets against dental income.

For most practicing dentists, this is not achievable. However, for dentists with a stay-at-home or non-working spouse, having the spouse obtain a real estate license, manage properties, and log 750+ hours is a legitimate and powerful strategy. This must be well-documented and is audit-sensitive.

In this episode, Wes Read walks dentists through one of the most powerful and underutilized tax strategies available to building-owning dental professionals: cost segregation. With a focus on education and practical application, Wes explains how the two-entity structure (dental S-Corp + real estate LLC), combined with a formal cost segregation study, can generate massive upfront tax deductions that accelerate wealth building. He covers the fundamentals of depreciation, the mechanics of cost segregation, real-world examples, and what to watch out for.

Key Topics Covered

Practice CFO Background & the Wealth Advisor Model

Wes explains how Practice CFO was built as a fiduciary-based firm integrating CPA services with financial planning specifically designed for practice-owning dentists to accelerate personal financial independence.

The Three-Pocket Framework

Every practice-owning dentist operates across three financial entities: the dental practice (S-Corp), the building LLC (real estate), and personal finances. Understanding cash flow across all three is the foundation of advanced tax planning.

What Is Cost Segregation?

A formal engineering + accounting study that reclassifies building components from the standard 39-year depreciation schedule into shorter 5-, 7-, or 15-year asset classes — dramatically accelerating tax deductions.

Depreciation 101

Wes explains straight-line vs. accelerated depreciation, asset classes (5-year, 7-year, 15-year, 39-year), MACRS depreciation schedules, and how bonus depreciation allows dentists to take massive deductions in year one.

Real-World Example: $2M Building

Using a $2 million dental office as a case study: ~30% ($600K) is reclassified, enabling a potential $200–400K deduction in year one when paired with bonus depreciation — at zero additional cash outlay.

Pros of Cost Segregation

Front-loaded paper losses, offsetting rental income, building real wealth via appreciating assets, lookback studies for existing buildings, and estate planning advantages through gifting LLC interests.

Cons & Cautions

Depreciation recapture (25% federal tax on sale), passive activity rules limiting loss deductions against active income, and the requirement to use a qualified cost segregation firm ($5–15K study fee).

Key Takeaways

• Cost segregation is a legal, IRS-recognized tax strategy, not a loophole. It's tax avoidance (legal), not tax evasion.
• Two entities are required: a dental S-Corp (practice) and a separate real estate LLC (building). Never mix them.
• Typically, ~30% of a building's value can be reclassified into 5–15 year asset classes, dramatically accelerating depreciation.
• On a $2M building, cost segregation + bonus depreciation can generate $200–400K in year-one tax deductions with no additional cash outlay.
• The deduction reduces the taxable rental income flowing from the dental S-Corp to the building LLC, lowering your personal tax bill.
• Depreciation recapture applies when you sell: the IRS taxes recovered depreciation at 25% federally. Plan your exit strategy early.
• Passive activity rules prevent most dentists from using building LLC losses to offset active dental income; instead, losses carry forward.
• A qualified cost segregation firm is essential. Studies cost $5–15K but can generate 10–20x ROI in tax savings.
• Lookback studies may allow dentists who have owned their building for years to capture missed depreciation; consult your CPA carefully.
• Estate planning benefits: you can gradually give LLC interest to heirs over time using the annual gift exclusion, reducing estate tax exposure.