My name is Matt Guarino, I am the luckiest man alive, because I get to be married to Ellen!
Growing up, being an entrepreneur was never on my radar. I was always a good student and, like many of us, was fueled by conditions in childhood that I never wanted to experience again.
I was raised by a high school gym teacher and a stay-at-home mom. Compared to many, my childhood was a privileged one. But it also was abundant in scarcity. Money was a topic that was rarely talked about in my household, but when it was, it was always in a negative light. The “rich people” in our town were constantly judged and criticized in my family. I would hear that we paid our bills this month, but only barely. Often there was not enough left over for school trips or summer camps.
I didn’t know it as a kid, but this environment would be the perfect catalyst for my eventual entrepreneurial journey.
My first logical step as a 15-year-old kid was to fire up Google on our family desktop (remember those?) and search “careers that make a lot of money.” I know, teenager logic, right? But all I knew is that I wanted to find a different path than the one I had seen my parents take, and I had no clue where to start. After some reading, I quickly moved past the standard medical careers like surgery and anesthesiology (I knew I did NOT want to work in a hospital), and then dentistry popped up as the first non MD top spot on the list.
Now knowing a bit more about the world, there are DEFINITELY more straightforward career paths to making money, but as a 15-year-old kid, making an average of $150K/year as a dentist seemed like more money than God, and I liked science and had great hand-eye coordination… so the pieces seemed to fit. I had found my answer.
I’ll skim through most of the next 12 or so years, but I will say that I am quite proud of the fact that by some stroke of luck, my 2005 Google search somehow led me down a career path that really did suit me in many ways.
So I graduated dental school in 2016 with almost $500K in student debt to my name (yes, you read that right), and naturally my money motivation was stronger than ever. After a one-year residency and a quick associateship (where I learned that I am a TERRIBLE employee), I bought the perfect dental practice in a northern suburb of New York City and became my own boss.
For most dentists, this is where I would ride out my career into the proverbial sunset.
I was “living the dream,” according to my 15-year-old self’s vision and those of my peers. Thirty years or so of treating patients, working by my own rules, and I could retire with a cool $6 million in the bank. I was set for the life I had always imagined.
Problem was… after some time, I realized that I wanted more out of my career… and working long hours of one-on-one patient interactions was actually really draining to me. Something was missing, and I was left wondering… “Is this really it?”
Here is where I’ll pause the story and give a tidbit of what I learned at this point. At the start of my career, I went in search of what I needed (financial security), without really knowing if it would make me happy. At this moment in my career, however, when I seemingly had it all, I moved towards what made me happy. I have never been afraid of a big change or a pivot. Despite my feelings of uncertainty, I had some great success in my first couple years as a dental practice owner and learned a ton. But as those of you who’ve had the privilege to work with my wife Ellen, I realized that I was clearly operating from my zone of excellence, not my zone of genius… which would never make me happy.
After many nights of discussing this with Ellen, she recommended I join this leadership coaching program she had just finished. I resisted for a long time, not seeing how it would help me figure out where to go next in my career…
Little did I know at the time, it would be the spark to start a whole new entrepreneurial journey.
I experienced an abundance of personal growth in that year-long program, but my biggest takeaway was to prioritize my well-being and go after what I actually want, not just what makes sense or looks good on paper.
So what did I actually want? I realized that I wanted to make not just “great money,” but generational wealth for my family, and that patient care was just not for me, and not the straightest path to get there.
Here’s my tidbit #2: Ellen appeared earlier this year on a dental podcast of a friend and colleague, Paul Etchison, where she shared that the two most important factors when going after a big, scary goal are to create a killer vision and to get support.
As you can probably tell, my vision was far from thought-out, but I had a start. I thought that at least to begin, I could take my success at my dental office and become a consultant in the industry to other driven young dentists like me.
What I did do well, however, was to get support.
Now, to be honest, I am never the type to go out of my way to ask for support. At this time in my life especially, I was a total lone wolf. And when I started to take on some vision work of what it is I wanted to do next, Ellen encouraged me to share my story and reach out to others I knew in the industry who were doing this type of work. It was super uncomfortable for me at the time, so much so that I asked Ellen to help me write the emails and posts because I didn’t even know where to start.
Somehow, it actually worked. I ended up joining my favorite dental podcast as the third partner. They had no existing consulting business at the time, but they did have a loyal listener base and some loose ideas on how to expand to other services. Three years later, this little podcast turned into a multi-7-figure consulting company, marketing company, and soon-to-be legal firm for dentists.
Things were going great… and then 2020 rolls around. Governor Cuomo shutters my dental office for 3 months. With my ample time and newfound life at home, I do another check-in. Building this consultancy on the side and being a full-time dentist just REALLY isn’t working for me. Although that time was very challenging from a business sense, I very much enjoyed spending so much time at home. What if I could do this for a career?
Major pivot #3: launching a Dental Service Organization (think chain of dental offices). During this time at home, I did some forecasting. My dental practice was doing well, but it was killing my happiness. Our consulting business was on a great trajectory, but there was a ceiling down the road to the level of growth we could reach. I knew I didn’t want to treat patients anymore, but I also had no plans to leave the dental industry, since I was starting to know it so well.
So I took the leap in September of 2020 to cut down days at the dental office from four to one and a half. I had no idea how I would replicate the income I was giving up, or frankly what I would do with my newfound time. But my gut was telling me I needed some space to figure it out, so I listened.
I am not a big Universe guy, but there have been times in my life where it’s hard to ignore. My subconscious was asking the Universe for a path to generational wealth. Four months later, the Universe would deliver.
One of my partners and one other key member at my podcast-turned-consulting company went to a seminar on DSOs. Dental patient services are by far the largest scale sector in the dental industry. I, like many dentists, always hated these corporations. In fact, our podcast was built as a bastion for private practice dental ownership – we help people like me who run a solo practitioner office grow to their greatest potential and avoid corporate sellout.
My two colleagues were initially angered at what they heard at the seminar. The dental industry is consolidating, they learned, and it is doing so rapidly. 20% consolidation at the time, but it was trending to get to over 50% within a decade.
‘We have got to stop this,’ they thought.
After the seminar concluded, we realized there is no stopping it. It’s happening, it is just a matter of how quickly.
Our next thought: we can do this so much better. Instead of the mega-corp finance bros taking over our industry, what if the people who care the most about the dentists themselves were to build a corporation?
We could change the industry.
Tidbit #4: I am an anti-people-pleaser. I do not do things for appearances or to appease others (and I thank the Universe daily for the balance Ellen and I bring each other in this way). But you see, there was a big segment of our podcast audience who was angered that our company decided to start our own DSO. I did not care. My gut was screaming that this was it. This was my path to create an industry-changing business, life-changing financial landscape for my family, and it lit a fire in me unlike any I’ve experienced in my career.
It took my five partners and I fifteen months to finally launch the DSO. Getting it legally set up brought countless challenges and frustration. Our partnership almost blew up several times under the pressure of it all.
We officially launched in 2022 with eight dental practices alongside our consulting company. By the start of 2023, we have now opened up ten additional practices and have reached multi-8-figure revenue in our first year. Patients’ lives are changing all over the country, dentists’ careers are booming as part owners of their practices, and the industry is seeing a new model of leadership by dentists for dentists.
Will I succeed in my vision of creating generational wealth and industry change with this DSO? Who fucking knows, honestly.
But what I do know is that I am so fueled by my desires, vision, and purpose that I will climb absolutely any mountain to get there.
So just as Ellen said, with a clear vision and my dream team of support to get there — including and especially my amazing wife, Ellen — I have lived the reality that “anything is possible.” We help each other live with more courage and honesty.
I guess the moral of the story is twofold: allow yourself to follow your happiness and gut towards a vision that ignites you, and get Ellen in your corner… because the sky is truly the limit.