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Timothy O'shaughnessy
President, Chief Executive Officer & Director, GRAHAM HOLDINGS CO

Q&A with Tim O'Shaughnessy

🎥 Oct 31, 2024 📺 DDSmatch ⏱ 6m 👁 5 views
Why should a dentist use a broker rather than going it alone, and how does a broker add value to the dental practice sale process ...
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About Timothy O'shaughnessy

Tim O'Shaughnessy, president and CEO of Graham Holdings, has discussed the company's investment approach and portfolio strategy in several recent appearances. At the 2024 Markel Group Reunion, he described Graham Holdings' model as resembling a "publicly created family office" and noted that the company is willing to start businesses that will burn cash for a period, tracking them qualitatively for shareholders. He also commented on the company's use of share repurchases, stating that Graham Holdings bought back about 7% of its stock in the prior year and that buybacks can act as an "accelerant or an amplifier." In a separate interview, O'Shaughnessy said he found Berkshire Hathaway's focus on maintaining a strong cash balance "fascinating" and noted that he "steals" Warren Buffett's concept of a "too hard box" for evaluating potential investments. O'Shaughnessy has also addressed specific business lines and broader economic trends. He mentioned that Graham Holdings owns Hoover Treated Wood Products, which he described as the largest producer of fire-retardant wood in the United States, and Graham Healthcare Group, which provides home health, infusion services, and in-home aesthetician services. He said healthcare represents about 17–18% of U.S. GDP and that the company focuses on niches within that sector. Regarding artificial intelligence, O'Shaughnessy stated that AI should "free up capacity for people to do things that are more valuable or productive" but that the "full form factor" of changes in areas like education is not yet known. He also expressed optimism about housing, saying he expects the housing market to be in a "better spot" a year from the time of his remarks.

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Transcript (2 segments)
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So DDS Match, one of the first things that's most important to us is that we figure out what you want, doctor. We want to go through a process, the trusted transition process, to make sure all your needs are met. I often talk that my role is running the whole team. I am the quarterback, and there are so many aspects to a dental transition. Let me just back up and go over a few of them. One is the legal aspect, the other is CPA, and then the most important part is dental. And that's what we really kind of quarterback. First, we start with the dental side, and let's make that attorney and let's make that CPA fit to what you want dentally. That's not a word, but let's make it fit on the dental side so that as you move forward, it's what your wishes are. The other couple aspects too are banking and certified financial planning. So we kind of run, we get information from our valuation team that goes out to your accountant, that goes out to your certified financial planner. We bring it back, we make sure as the train starts headed down the tracks that it's what you want. So we say at DDS Match, we'd like to talk to you three to five years ahead of time. But currently, I'm working with dentists: one is six years out and the other one is nine years out. It's actually never too soon to contact your DDS Match representative to start the planning process. But some of the things that are important is that conversation we want to have with you: what do you want? What do you want your retirement to look like? What sort of dentist do you want taking over after you? Or are there other options that you want to explore? And the biggest step a dentist should take as part of the transition process is to reach out to the DDS Match representative to have that conversation. There are lots of things they can do with their dental office. We also talk about keeping things up, keep it strong as you're moving forward. You can do a little refreshing, zip up your office a little bit. But for the most part, we want you to make it your transition. We don't want you to do things you don't want to do. We want to follow with what you want to do. So this is my 25th year in dentistry, and so there's lots of trends going on, there always are. One of the challenges that dentists are facing today is staffing shortages. I remember a time where a hygienist used to have to work at a front desk at the front desk rate to get a chance to become a hygienist in that office. So right now, one of the biggest things is staffing issues. But that's not something that blocks transitions at all. Some of the other things that can slow things down are interest rate hikes. We did see some hikes last year, and we've already started to see interest rates come down. The reality is it's not that big of a concern because if there's enough cash flow in your practice, the spike in interest rates won't really hurt you. Where it really affects some people is if at the end of your career you wanted to wind down and you're winding down your practice, those get a little harder to sell because we have to have enough cash flow to pay the mortgage on the practice, and then we also have to have something left over for the new buyer. One of the biggest things when you look at selling to a DSO versus a private buyer is a private buyer, they buy it and normally you're done. Obviously, if you're selling a larger practice, sometimes you might have to work back for that new buyer just to bridge the gap. But the biggest difference between a private buyer and a DSO is a DSO wants you to stay to work maybe three to five years after. So is that something you want to do? And that's why we like to talk to them so far ahead of time, because that might be a good route for some. And then with the private buyer, you're completely done, and some dentists struggle with that. They kind of would like to ride out and maybe work a little bit, or work summers, or maybe work a maternity leave or things like that. So those are the questions, and that really starts with that initial conversation that we want to have: what do you want, doctor?
Yeah, that's a great question. So this is very emotional. A doctor retiring after 40 years, 30 years, 20 years, whatever it is, they are incredibly emotionally invested in that practice. I often tell dentists that this is bigger than any other event in their life outside of their family, bigger than dental school, bigger than college, bigger than even buying your practice, because you are completing a 30- or 40-year run of taking care of multi-generations as they've come through that dental office. So one of the things I do is I always want to make sure my sellers never have to say no to the buyer. And this comes up a lot. In fact, there's one I'm dealing with right now where the buyer, three months prior to closing, and obviously we were working on the paperwork but nothing has been signed, but the buyer wanted to come in and shadow the practice. Well, how are we going to explain that to the staff and patients that there's a random dentist there today? So we had to work with that buyer, we had to wait until we get the paperwork signed. Now in this case, we're going to get it signed about a month in advance, so we're going to allow that buyer to meet the staff ahead of time and do some things. Both parties agreed that this was important in this particular transition. But it's very important to manage both sides' emotions, because remember, this young dental student, $350,000 in debt, they might have a spouse that put them in more debt, maybe they just bought a new home, we all maybe remember that, and then we're asking them to go into a million dollars of debt to have a job. So one of the things that we do is we help create a pathway. We're unique because we only represent sellers, but we do want to help give that pathway to a buyer to be successful, because every dentist I've ever met with or worked with selling their practice wants their practice to be successful after. Again, we have to make sure we're representing the seller, but we want to also help all parties involved, and we want to make sure the wishes are respected by that selling doctor.