What Got You Here Won’t Get You There in your practice w/Dr. Dave Ternan

In this episode of The Orthopreneurs Podcast, I sit down with Dave Ternan, co-founder and CEO of Orthofy, to look beyond opinions and dig into the actual numbers shaping orthodontics today. With data spanning nearly 1,400 locations and roughly $10 billion in production, we talk about what’s really happening with starts, case fees, patient affordability, adult demand, and the changing demographics of the orthodontic market.The numbers tell an important story. Starts have been largely flat over the longer term, adult demand has softened, and the core 11–16-year-old patient population is shrinking. That doesn’t mean orthodontics is doomed — far from it. But it does mean the old model of simply opening your doors and expecting year-over-year growth may no longer be enough. Dave and I discuss why differentiation, better systems, smarter pricing, and a tightly managed new-patient funnel are becoming essential for practices that want to grow.💬Quotes“This fourth or fifth year in a row of down or flat could be the new norm, folks, if you're an average practice… what got you here won’t get you there.” — Dr. Glenn Krieger“I think the most important thing for a leader is to have the right people in the right seats at the right time.” — Dave Ternan🎯 Key TakeawaysIntro: Why data matters more than opinions right now (00:01)Orthofy’s footprint: 1,400 locations and nearly $10B in production data (05:40)Average case fees are rising — but still trailing inflation (07:27)Why affordability matters more than shortening payment plans (10:09)The historical trend: starts from 2019 through 2026 (13:24)Why 2026 demand has begun to soften (18:22)Adult starts as a signal of consumer confidence (21:17)The shrinking 11–16-year-old patient population (22:28)Why the old orthodontic practice model may no longer be enough (23:24)Differentiate your practice before the market forces you to (24:20)Why every orthodontist needs to understand their sales funnel (27:02)How to reduce leakage from new patient exam to start (28:36)AI’s next phase: moving from isolated tools to intelligent systems (35:16)Using AI to predict patient behavior and personalize at scale (39:18)Why patient affordability is becoming increasingly important (44:37)The leadership lesson: right people, right seats, right time (46:53)🟦 Additional ResourcesIf your practice has been flat or down, don’t beat yourself up. The data shows you’re not alone. But once you know the environment has changed, doing nothing is a choice. Look at your differentiation. Study your new-patient funnel. Make treatment affordable without destroying your economics. Build better systems. Put the right people in the right seats. And start using the technology and data available to you.If you’d like to learn how Orthofy could help your practice improve starts, collections, patient affordability, and revenue-cycle management, visit:🌐 Orthofi.com And have them assess your historical performance and opportunities for growth👉 Airway Meeting: https://web.orthopreneurs.com/arizonasleepandairway2026 👉 For more information about Orthopreneurs, visit: https://orthopreneurs.com/👉 Become an OrthoPreneur and join the free Facebook group:https://www.facebook.com/groups/