Ep. 79: Delegating Effectively to Enable Practice Growth
Being able to delegate effectively is an essential part of being a business owner or manager. It’s also the key to having good organization, reducing upsets and disagreements, and being able to grow rapidly without creating a bottleneck. So this week, Jeff dives into the topic of delegation—how to do it well and all the ways it can go wrong.
Topics:
:11 – The importance delegating job duties the right way
13:46 – When it’s time to hire & where delegating can go wrong
34:08 – How to delegate effectively
Links:
Team training video courses - https://ddssuccess.com
The MGE Communication & Sales Seminars - https://www.mgeonline.com/abc
MGE Power Program - https://www.mgeonline.com/power-program
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Questions From This Episode
Why does a dental practice need a team at all, if a solo doctor could technically run one alone?
Because building a team means deliberately handing off duties and responsibilities that would otherwise fall entirely on the owner doctor, in exchange for growth, higher profitability, better patient care, less personal stress, and the benefit of working alongside other people.
What are the four real reasons to delegate a task or role?
Growth, since one person, or even one doctor and a single assistant, can't scale a practice alone. Reducing stress and burnout that comes from overloading a single employee. Building long-term staff retention by giving people the full, meaningful parts of their job rather than skimming off the interesting pieces for yourself. And making sure each person's time is actually spent on the work that matches their real value to the practice.
If collections or productivity in an area start slipping, is hiring another person usually the right fix?
Not usually. If the same staff who once handled an area well are now underperforming with no real change in workload or process, adding a third person to what's really a two-person problem rarely solves anything, since it's most likely masking a training, accountability, or fit issue rather than a genuine capacity shortage.
What's the most common reason delegation fails in a dental practice?
Not having a clear organizational structure in the first place, specific jobs with specific functions, responsibilities, and expected outcomes assigned to specific people. Without that, there's no obvious place to hand off a task, so it either gets stuck with the owner or gets handed to whoever happens to be standing at the front desk.
What's the simplest way to test whether a new hire is actually going to work out?
Give them a few simple, low-stakes tasks first, like confirming easy patients or scheduling routine hygiene visits, before handing over anything complex. If someone can't execute a basic task in a reasonable amount of time, that's a strong early signal, and it's kinder to both sides to address it immediately rather than dragging out two more frustrating weeks.
Episode Transcript
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What's the one thing a dental office can't survive without? Or put another way, beyond equipment and supplies, what's the single most basic requirement for any dental practice? The answer is fairly obvious: a dentist. In theory, you could run an office with just a dentist doing all the work, including the administrative side, scheduling, filing insurance, all of it. I've known a few doctors who tried operating that way, it wasn't a great idea, and it wouldn't be very productive. I'd imagine that doctor would be fairly stressed out too, but it would still technically qualify as a dental office.
So what does that tell us about staff, about your team? Essentially, by building a team, you've taken duties, functions, and most importantly, responsibilities that would ultimately belong to you, and delegated them. Because again, if the whole team disappeared, you could theoretically still function as a dental practice with just a doctor. It wouldn't be fun, but it would technically be possible. So why do we build a team at all? For practice growth, higher profitability, better patient care and service, less stress, and the genuine enjoyment of working as part of a group. We know a team is important.
So if that's the case, if a team is supposed to be this genuinely rewarding thing, why are the primary complaints we hear from new clients almost always staff related? Things like, I can't get my staff to do things the way I want them done, or they're unable to execute what I ask, or they don't seem interested, or they don't share my sense of importance, accountability, or urgency, we had a bad month or a bad day and it doesn't seem to register with them the way it registers with me.
If you look closely at these complaints, they all trace back to one common denominator: delegation. That's what I want to talk about in this week's episode, how to delegate effectively so it actually spurs practice growth. My name is Jeff Blumberg, and I'm your host. We're going to do a genuine deep dive on this, we may well break our usual 30 minute mark. We'll look at the four reasons why you delegate, when it's appropriate to delegate, including when to hire someone new, the six biggest problems people run into with delegation, and finally, how to delegate effectively.
Let's start with why you'd delegate in the first place. Number one is growth. You're not going to be able to grow a practice with just yourself, or just you and a single dental assistant, you'll need more staff. You increase overall productivity by replicating parts of yourself across your team. This applies at every level, if it's you and an office manager, and your office manager starts bringing in additional people for reception or scheduling, they're essentially replicating themselves across those specific jobs. The whole reason you're doing this is that you're expecting real growth in revenue as a result.
Number two is reducing stress and overwork. If you have one person effectively doing the equivalent of three full-time jobs, they will eventually burn out, and then you're left with nobody doing those three jobs, which is a much bigger problem. Nobody wants to operate chronically overloaded, it's not a rewarding way to work.
Number three, proper delegation actually builds a stable, long-term team you retain. Here's what I mean: with every employee you bring on, the goal should be building toward a genuinely competent core of people you intend to keep for the long haul, moving them up within the organization as they grow. It doesn't always work out that way, but that's the intention with everyone. Here's why this matters: say you have a lead assistant who's been with you for ten years, alongside three additional dental assistants. If you lose one of those other assistants, it's a much softer blow, because that lead assistant can get a new hire fully onboarded and functioning independently without the whole department falling apart in the process. I'm a big fan of having people responsible for specific zones of the organization who are genuinely competent in that zone, because it makes future expansion considerably easier. If you need to add two more assistants down the road, that same lead assistant helps absorb most of that transition. The same logic applies across other areas of the practice.
Here's a common way this breaks down. Say you have a treatment coordinator, someone who sits down with patients during or after a consult, works out the financial arrangements, and closes the case. And say your office manager used to be the treatment coordinator before you hired someone into that role dedicated, and the office manager has delegated most of those functions, but keeps the biggest cases for themselves, since those are the exciting ones, I just collected $40,000, I just collected $10,000. So anything under $10,000 goes to the treatment coordinator, and anything over goes to the office manager. If the treatment coordinator were genuinely struggling with the larger cases, that would make sense, and fixing that would be the office manager's job. But if the treatment coordinator can reliably close cases up to $10,000, there's really no reason to assume they can't handle cases above that threshold too, if we're being honest about it. Sometimes the real reason is simply that the office manager enjoys closing the big case.
So you end up with the treatment coordinator doing all the groundwork with the patient, and then the office manager swoops in right at the closing moment and takes the exciting part of the job away. Instead of the treatment coordinator walking out of the room saying, we just closed that $40,000 case, it's the office manager who gets to say it. That might feel good for the office manager in the moment, though as I'll get into, it's actually not a great use of an executive's time, but for the treatment coordinator, it's a real letdown. They're left handling all the mundane parts of the job, calling patients to reactivate outstanding treatment and so on, while someone else gets to do the genuinely rewarding part. That's not a recipe for long-term retention. You'll actually hurt retention if you strip people of the real substance of their job, the decisions, the responsibilities, the visible sense that there's growth and a future in the role.
It can get worse than that too. I've seen situations where a receptionist stands around while the office manager answers the phone instead, even though the receptionist knows perfectly well how to do it. I'm not talking about someone who genuinely doesn't know how, I mean someone who's been hired and is being paid, but isn't actually doing the job. You might think that sounds like an easy, cushy setup for that employee, get paid without doing much, but it's actually the opposite. Deep down, that person knows they should be doing more, and they're simply not being allowed or expected to. You will lose people if you underutilize them this way.
The fourth reason delegation matters has to do with how an organization is structured. Every individual on your team has a certain financial value to the practice, the same way we think about a doctor's production per hour. Every employee has that same kind of value, and naturally you'd expect it to be considerably higher than what you're paying them, since you have overhead to cover. But not everyone carries the same value, and what determines that value comes down to three things: what they actually do, their experience doing it, and their competence at doing it. Apply that to a doctor, say an associate with seven years of experience who's genuinely skilled, capable of a wide range of procedures, and does them efficiently without cutting corners, that combination makes them potentially worth a great deal to the business. You can apply that same formula to every other role.
Take an office manager who's juggling three jobs at once, treatment coordinator, schedule coordinator, financial coordinator, on top of actually being the office manager, and is completely overwhelmed. If you ranked those different functions by value, answering phones or scheduling patients is going to command a much lower hourly value than what you're paying your office manager. Since they're stretched across all of these roles, they're not able to fully do the actual job of managing. Assuming your practice is growing rather than contracting, it often makes sense to break off the easiest piece to hand to someone else. When I say easiest, I don't mean it reflects poorly on whoever takes it on, I mean it takes less time to bring someone new up to speed as a schedule coordinator than as a treatment coordinator, since a treatment coordinator also has to genuinely learn how to sell, and not everyone walks in with a natural inclination for that. Someone might be excellent with numbers and precise administrative work but not particularly comfortable discussing finances directly with a patient, that person is probably a better fit as a financial coordinator handling insurance than as a treatment coordinator asking someone to commit to $15,000 in treatment. So the office manager might break off the schedule coordinator function first, freeing up time to focus on the office manager and treatment coordinator responsibilities specifically.
The same principle applies to a dentist personally. If you're doing something your assistant is legally permitted to do, and can do effectively, say making temporaries, and you're still doing it yourself simply because you like doing it, that's not a great use of your time from a business standpoint, since your value per hour doing something else is far higher. Building an organization and delegating effectively means letting go of things you don't actually need to be holding onto.
Now let's look at when you'd actually delegate, or even when you'd hire someone new. Say you have two people handling finance and insurance, verification, treatment plan entry, benefit estimates, collecting copays, and so on, in a fairly sizable practice. Collections start to slip, specifically in the area these two people are responsible for. You ask them about it, and they say they've just gotten too busy and need a third person. But picture the actual situation: the same two people have been in that role the whole time, through periods of growth and stability, and now, with nothing structurally different about how insurance is being collected, collections are simply declining even as production goes up. If that's genuinely the case, I would not hire a third person. If I'm adding anyone, it's more likely to replace one of the two already there.
This is essentially what a government tends to do when something isn't working, add another person rather than address why the existing setup isn't functioning. You don't have unlimited funds, so you can't operate that way. Look honestly at what's happening with the two people you already have before assuming the answer is more headcount.
So when I'm actually considering delegating or hiring someone new, the first question is whether this person is needed to support genuine expansion. Take an office manager who's completely overwhelmed. Usually the office manager offloads reception, scheduling, and insurance duties first, and holds onto the treatment coordinator function the longest, since it requires more skill and they're the one closing cases alongside the doctor. Once that office manager is spending half their day or more functioning as the treatment coordinator, that's usually a sign it's time to bring in a dedicated treatment coordinator, since neither the office manager role nor the treatment coordinator role is getting the attention it needs. Beyond sitting in on case presentations, a treatment coordinator is also supposed to be doing outreach to bring inactive patients back into the practice, which simply isn't happening if the office manager is splitting time this way.
Finding that treatment coordinator might mean promoting from within, a dental assistant with a natural aptitude for this kind of work is often easier to bring up to speed than someone external who needs to be trained on your office from scratch, or it might mean your receptionist is a good fit, or it might mean hiring externally. The same logic applies to other roles. Take a busy practice with four hygienists, two and a half doctors, and a couple of visiting specialists. If hygiene starts to flag simply because it's too much to reasonably expect one schedule coordinator to manage, especially with a few thousand inactive patients also needing outreach, that's when you might bring in a dedicated hygiene coordinator to work alongside the schedule coordinator and report to them, ensuring that area keeps growing.
So the underlying question, whether hiring or simply delegating, is fairly simple: am I doing something that actually belongs to another role I already have staffed? If nobody's in that role yet, and the workload genuinely justifies it, that's when you hire. If I'm the office manager calling hygiene patients myself, or handling every case over $10,000 while my treatment coordinator handles everything under it, that work belongs with the treatment coordinator, and I should delegate it there.
What makes any of this actually workable is having a genuine division of labor in the practice, real organizational structure with people responsible for specific areas. Every part of what happens in a practice, administratively and clinically, from a dental assistant restocking supplies to a receptionist verifying insurance, sits within a specific zone of control. Each of those zones has specific duties, specific responsibilities, and critically, a specific purpose and an expected outcome.
Think about why you'd hire a treatment coordinator in the first place. Say that role is defined as being responsible for practice income, closing cases and getting patients onto the schedule. The expected outcome is obvious: more income, more patients moving through treatment. If you hire one and neither of those things improves, something is wrong. Same logic for a schedule coordinator, you have that role to keep the schedule filled effectively, efficiently, and productively, with patients showing up on time for the appointments they're supposed to have. Without specifically assigned areas of responsibility, delegation becomes genuinely difficult, because you end up handing people tasks that have nothing to do with their actual role. Asking a financial coordinator to mail new patient postcards, for instance, makes no sense, that's not their statistic to own.
But this is exactly the setup in a lot of practices: three people at the front desk, all doing a bit of everything, with nobody holding a specific title beyond front desk, literally named after the furniture they sit behind. When everyone is nominally responsible for scheduling, collections, and everything else, nobody is actually responsible for any of it. A big hole opens up in the schedule, and you walk up front with no clear idea who to even ask about it. Without proper organizational structure, you won't know where to delegate a given task, because no one has a specific job with specific functions, responsibilities, and expected outcomes attached to it.
I've also seen, especially in the tight labor market of the last few years, practices settle for an employee who doesn't actually do the core function they were hired for. You hire a scheduler who doesn't enjoy calling patients on the phone, so as the office manager you just keep doing that part yourself, while they handle everything else. That's largely pointless. If you hire someone for a specific job, the expectation is that they actually do that job, with clear expectations set from the start. A proper division of labor is what makes delegation possible in the first place, otherwise you simply won't know where a given task belongs.
Which brings us to the six biggest problems with delegation. Problem number one is exactly what I just described: no clearly outlined organizational structure, no staff responsible for specific aspects of the practice, all the way down to your newest hire. Every employee should know the functions and duties of their job, the purpose behind why that job exists, and the expected outcome they're responsible for producing. Say you bring on a new hire specifically as a reactivation assistant, responsible for working through three or four thousand inactive charts. You'd explain why that role exists, patients need to keep coming back regularly for both their oral health and their broader systemic health, and that their responsibility is bringing that inactive count down as close to zero as realistically possible, with that number as the expected outcome you'll use to measure their performance. Every person in the practice needs that same clarity: functions, duties, responsibilities, purpose, and expected outcome, all clearly communicated. Once that's in place, delegation becomes straightforward, if an inactive patient calls in, I know exactly who that goes to.
Problem number two is having nobody appropriate to delegate to, either no one in the role at all, or someone in the role who isn't a good fit. If you have someone handling part of the schedule but you don't trust them to handle more of it competently, that tells you something important right there, either you need to address that as the executive, or you need someone else you're genuinely comfortable delegating to.
Problem number three, often the real reason behind problem two, is improper training. You brought someone in to manage the schedule, but you haven't actually trained them well enough to do the job. And yes, I understand you don't have unlimited time to train, nobody does, that's not a unique problem, though some people manage to solve it and others don't. But if you never invest that training time, you'll never actually offload that responsibility. Take that office manager and treatment coordinator example again, if the treatment coordinator can only handle smaller cases and the office manager is stuck handling every larger one, that's fine as a temporary bridge while you're getting someone up to speed, but it becomes a real problem if it never progresses beyond that. Training the bigger cases takes real time, sitting in the room together, apprenticing them, letting them absorb how you close a larger case, possibly formal sales training too, which is exactly what our Communication and Sales Seminars are built for, I'll put a link on the episode webpage. Say you invest twenty hours over a couple of months personally training this person, if they're genuinely capable and productive, that twenty hours will save you hundreds, if not thousands of hours down the road, freeing you up for other parts of your own job. You have to let go of the idea that there's no time for this, because without investing that time, you'll never build a genuinely competent team. It might mean scheduling a bit lighter for a month or two while that training happens, but it pays off as a real investment.
Problem number four is failing to clearly explain what's actually being delegated. You tell someone you need Task X done, but the explanation is vague, they come back with something that isn't quite what you wanted, and you get frustrated. Before assuming it's a personnel problem, ask honestly whether Task X was actually explained well in the first place. When I'm handing off something specific, especially something new to that person, I explain exactly what I want, sometimes I'll even put it in writing so there's no ambiguity. If you haven't explained something clearly and you're not getting what you asked for, that's usually your answer. If you have explained it clearly, the person genuinely understood it, and it still goes wrong repeatedly, that's a different problem, likely a fit issue rather than a communication one.
Problem number five is the belief that nobody can do it as well as you can, which, to be fair, is often actually true, at least at first. If you've been an excellent office manager and you bring on someone new, they're probably not going to match your level immediately, and possibly not even in the long run, since that's part of why you were the one in that role. The solution is getting them to an acceptable level of productivity, sometimes it genuinely takes two people to replace what one exceptional person was doing, and as long as that's financially workable, that's simply the reality. But if this mindset tips into either micromanaging someone to the point of being overbearing, or simply doing the work yourself instead, you end up right back at the problem described earlier, quietly stripping away the meaningful parts of someone's job until it's no longer a rewarding position, and they eventually leave.
Problem number six is specific to office managers. Say you've built out a full organizational structure over the years, starting as the only two people in the practice, and now you have a receptionist, a scheduler, a PR director bringing in new patients, a new patient coordinator, a hygiene coordinator, an insurance coordinator, and one or two treatment coordinators, a genuinely busy, well-staffed office. If you're still holding onto some treatment coordinating yourself simply because you're unsure what you'd do without it, the answer is straightforward: you'd be functioning as an executive, supervising, making executive decisions, which carries enormous financial value to the organization in its own right. Your job as office manager is building a profitable, efficient organization delivering great service, not personally remaining the treatment coordinator forever. No doctor who's built a genuinely profitable, well-run organization like that wants to lose the person who built it. You don't need to manufacture busywork or hire unnecessary people to justify staying on, running and enjoying what you've built is exactly the point.
Now let's look at how to actually delegate effectively. First, you need that specific organizational structure, people in specific roles with specific functions and responsibilities, so you know exactly where a given task belongs, anything related to scheduling goes to the schedule coordinator, and so on. Obviously if you're a smaller practice doing $30,000 a month with just yourself as office manager, one or two assistants, and a hygienist, that doesn't mean you go hire a stack of new people right away, only once you're genuinely expanding and starting to feel overwhelmed does that structure need to grow.
Second, you need genuinely workable people in those roles, and you need to train and apprentice them properly. That means having real training materials, office policies, a manual, clear job descriptions. On our online platform, DDS Success, we offer positional training covering the core elements of most dental office roles, from scheduling to treatment coordination to reception to financial coordination, which helps enormously even if it's not built specifically around your own office's particular systems, you'll still need to walk a new hire through your specific software and procedures.
How do you know early on whether someone's actually going to work out, before sinking twenty or thirty hours into training only to find out they're not a fit? Start them on something simple. A brand new job can already feel overwhelming, think back to your own first day somewhere new, you didn't even know where the nearest place to grab lunch was. So give a new hire something manageable at first, calling a handful of easy, low-stakes patients to confirm appointments, or scheduling routine hygiene visits, not your most difficult patients. This tells you whether they can follow basic instructions and execute a simple task. If you give someone ten easy confirmation calls and it takes them three hours with nothing actually confirmed, that's a serious warning sign, and it's worth addressing well before three hours pass, I'm exaggerating for effect, but you get the idea. There's a reasonable expectation for how long a basic task should take. If someone can't get through something simple, like learning a short phone greeting, something that should take about ten minutes to nail down, and an hour in they're still fumbling it, that person likely isn't going to work out. If someone can't handle something simple, there's little reason to expect they'll handle something more complex, and there's no benefit in dragging that out for another frustrating two weeks. It might feel harsh to part ways that quickly, but it's honestly the kinder outcome for everyone, that person already senses it isn't working and is likely already looking elsewhere, and prolonging it just adds frustration on both sides.
Assuming someone clears that basic bar, you can start giving them more complex responsibilities as you train them further into the role. One place I consistently see executives fall short is in how thoroughly they explain a new or unfamiliar task. If I'm asking someone to do something they haven't done before, I'll explain exactly what I want done, and just as importantly, why I want it done. If you're training a receptionist and tell them to smile while answering the phone, that instruction means a lot more once you explain that they're the very first point of contact a new patient has with the practice, and a poor first impression can cost the practice that patient entirely, which runs directly counter to the whole reason the practice exists, helping people and building genuine goodwill. Once they understand the why, show them exactly how, and also make clear what matters most within that task and what doesn't.
That last part matters more than it sounds. Think of a scenario where a patient is standing at the front desk waiting, the phone is ringing, and the receptionist is filing a paper chart instead of handling either one. It's obvious what's actually most important there, the patient in front of you, then the phone, then filing whenever there's a spare moment, yet the receptionist is focused on the least important task of the three. So whenever you delegate something, make clear what actually matters most within it. If you're having someone confirm the schedule, you might say, I want everyone confirmed, but these two patients specifically haven't responded yet, and they're in this morning's primary production block, essentially the bulk of the doctor's day. I need you to make real contact with them specifically, because if we can't reach them by a certain time, we'll need to look at filling that time another way. That doesn't mean everyone else is unimportant, but it tells the person exactly where the day's production is actually anchored, so instead of coming back at five o'clock having confirmed hygiene and afternoon denture cases while the two critical morning patients went unreached, they know exactly what had to be prioritized.
A couple of final notes of caution here. Be careful not to over-explain to someone who's clearly already grasped something, that can come across as condescending. But the far more common failure is under-explaining, and remember that anything genuinely new can feel overwhelming, and most people don't want to be the reason something goes wrong, they want to feel confident before they act. Yes, this takes real time, maybe thirty or forty-five minutes the first time you walk someone through a new recurring task, but once they've genuinely got it, you rarely have to explain it again beyond the occasional correction, and that upfront investment saves an enormous amount of time down the road.
Once you've handed off the full treatment coordinator role, or any role, to someone, how do you actually oversee it without hovering over every single thing they do, which just becomes its own hassle and takes away the enjoyment of the job? The first tool is statistics. Say you have someone answering new patient calls. Tracking new patient calls against actual conversions tells you immediately whether there's a problem. If you're averaging 50 to 60 conversions out of 100 monthly calls and that suddenly drops to 40, that's worth investigating, maybe you start reviewing new patient call recordings, which is worth doing periodically regardless, though obviously not every single call forever. Statistics function as your monitor, telling you when it's actually time to step in, rather than requiring constant hands-on supervision. The same applies to a schedule that suddenly has large unexplained openings, or a treatment coordinator whose closes have dropped.
When something like that shows up statistically, don't just take the first explanation at face value. Most people you hire are genuinely capable and want to perform well, only a small percentage simply aren't able to, but people also tend to justify underperformance when it happens. If a treatment coordinator's closes drop and you ask what's going on, they might say the finance company stopped approving anyone, or patients are hesitant right now, don't accept that at face value, dig into it yourself. Maybe there's a specific selling skill that needs correcting, maybe a difficult patient experience knocked their confidence around asking for payment, you won't know until you look. The same applies to a schedule coordinator with sudden large openings, if a patient says they were never actually confirmed and never got a text or call, that's a more serious problem than a simple skills gap, it means you're being told something that isn't true. Statistics work like the gauges on your car's dashboard, they tell you when something needs your attention so you're not just guessing.
Beyond statistics, you also need direct communication and periodic observation, and you have to build real time into your schedule for both, not just for initial training, but for ongoing oversight. At the same time, be careful not to over-delegate to the point of zero oversight. If you hand off all bill paying and financial management and never look at the accounts again, you'll likely run into real financial trouble fairly quickly. Some level of ongoing oversight, whether through statistics, direct observation, or regular conversation, is what actually allows delegation to work long term and lets your team genuinely grow into their roles.
Here's the best part of getting this right: once someone like a treatment coordinator or schedule coordinator starts genuinely succeeding, they build real momentum from those wins. I've mentioned this before, a client doing $80,000 a month who says they'd like to be doing $120,000, and once they actually hit $120,000, they often find it easier than expected and start aiming for $150,000, something that would have sounded impossible to them back at $80,000. The exact same principle applies to your team. Give them a win by handing off responsibility gradually, in pieces they can genuinely succeed at, and monitor their progress once they have it. A treatment coordinator who successfully closes a bigger case gains real confidence to close the next one.
That ran considerably longer than I originally planned, but I hope it was genuinely useful. I'll put links to our online platform, DDS Success, and our Communication and Sales Seminars in the episode description, especially worth checking out if you're looking to raise case acceptance or train your team more effectively. If you want to go deeper into becoming a stronger executive, building real organizational structure, and managing by statistics, I'd also recommend looking into the MGE Power Program, I'll link that as well. It's a genuinely intensive program, 78 days of training for a doctor and office manager together, and it isn't for everyone, but it produces a real executive at the other end, with results that are hard to match, an average sustained increase of 232 percent five years out. That's my obligatory mention of it.
I hope this episode helped. If you have questions or want to learn more about us, you can find us online at mgeonline.com or call us at (800) 640-1140. Have a great week, and we'll see you at the next episode.