Episode Transcript
[00:00:04] Speaker A: Hi, I'm Eric Whedon, a seasoned go to market software executive, team builder and a catalyst for revenue growth. My journey is fueled by a profound passion for ushering in a new era of dental healthcare through cutting edge AI technology.
[00:00:17] Speaker B: Hi, I'm Liz Strickwarda. Since 2008, I've been immersed in the world of dental marketing and business technology. At Truelark, I I focus on explaining how generative AI can help multi practice dental organizations scale while redefining the patient experience. Together, we welcome you to navigating DSO innovation, where we have unfiltered conversations with dental leaders and discuss how they are using tech to win in this booming market.
[00:00:49] Speaker C: On today's episode, we welcome one of our favorite Truelarc partners, Phil Toe. Phil is a co founder of the Smilist DSO, which launched in 2014. The Smilist is one of the leading dental support organizations in the New York area and supports more than 60 locations and more than 1200 employees across New York, New Jersey, Connecticut, Delaware and Pennsylvania. Phil is also an operating partner at Zenith Partners, which focuses exclusively on the healthcare market. Zenith recently secured a whopping 285 million debt facility to fund continued growth. Welcome Phil.
Can you start with telling us about your background?
[00:01:33] Speaker D: Absolutely. Thank you Eric. So my background did not kind of start in dentistry. So early on my career I was a consultant, kind of a healthcare tech startup guy and then also venture capitalist. But then, you know, decided that all of those things didn't quite fit what I was looking to do and then decided to go to business school and take a two year vacation. And so it was a business school that I really kind of saw a lot of opportunity in healthcare, not necessarily dental, but certainly kind of broadly speaking in healthcare. And that was when kind of, I say I fell into dental and I joined Henry Schein kind of after business school. And there Henry Shannon really kind of got to see really kind of the opportunities kind of out there. You know, when you look at so many other industries where there was so much kind of consolidation happening, you know, got to see that, you know, here in particular, kind of in the northeast, kind of in the New York metro area that we're in, that, you know, the, the whole kind of concept of DSO was largely foreign, you know, and so, you know, was at shine for about ten years and then, you know, together, you know, with, with a classmate of mine from business school kind of jumped into it and started the smileyst actually about ten years ago, almost exactly ten years ago.
[00:03:08] Speaker A: 2014, right?
[00:03:09] Speaker D: Yeah, yeah, in 2014 and over time just really started, you know, building the organization, and as you know, so many startups do, made a lot of mistakes along the way and kind of learned, and I'm sure there's still many more in front of us to make.
[00:03:29] Speaker E: So in those ten years now, when we spoke last year for the case study, you did mention how, like other businesses, COVID threw everything aside, all plans aside. But in addition to that, what other big changes have happened to your DSO and then just the broader industry?
[00:03:51] Speaker D: Yeah. So what I would say, you know, you know, at these kind of anniversary points, it's always kind of a time for reflection, right? And so how I would characterize us at the very beginning was really, it was like, again, as kind of startups do, it was a time for experimentation. You know, there are many, many things that we were trying to figure out. You know, what is our business model? Are we going to be kind of affiliation acquisition based or are we going to be kind of de novo based? And, you know, how big should a practice be, you know, how standardized, you know, should we be? What kind of technology and software should we use? All of those things. And, you know, and the most important is the, you know, type of people, you know, that we are kind of interacting with. And so, you know, I would say at the very beginning was just a lot about learning. Learning kind of, hey, learning what's good, what's bad, learning what our, our identity is. Right. You know, who is the smiles? What is the smiles? What does the smiles represent, you know, in the marketplace? Not, not just with kind of our, our employees are kind of our doctors, but also the broader community in terms of potential affiliations, with kind of all the partners that we deal with, whether it's on the technology side or kind of who we buy dental supplies from in labs. And so that kind of really set forth kind of a clear picture for us in terms of what do we want to be when we grow up. And it was there that I'll say kind of two main lessons. One is when we talk about who we want to be, it's about the people.
And, you know, and I'd say some of the early mistakes is sometimes we partner with the wrong people, sometimes we hired the wrong people.
And that was a, you know, a big lesson for us. So when we talk about how we're very kind of culture driven, you know, culture comes from the people, right? And as a growing organization, we're going to add more and more people. So that was like a huge lesson for us and kind of finding the right people, it's going to help us kind of deliver kind of exceptional care and service and kind of what's going to set us apart from, yeah, you know, meh, kind of average offices and then the other kind of big learning, I put in the big category of kind of like the infrastructure. You know, we knew we wanted to grow.
We want to grow in measured ways, but, you know, I'll say kind of ambitious kind of group of people. And so we want to grow very quickly as well and making sure that we have the infrastructure in place so that we can grow, I'll say kind of more easily because, you know, every time we, you know, we affiliate with the practice and kind of integrate it with us, it's, it's a challenge. It's managing change. And so making sure that we have the infrastructure in place so that we can grow, we can provide, I'll say, personalized service for the offices. Cause our customers, oftentimes we say, oh, well, the DSO, our customers are the patients, but really our customers are the practices. And so when we bring them into the smiles family, how are we helping them? How do we help them kind of operate better? How do we help them kind of grow, and how do we help them not have this kind of us versus kind of corporate kind of mentality that I've seen kind of my entire career.
So those are, I'd say, kind of like the two big lessons that kind of taught us, like, you know, from the beginning and, you know, where we are today.
[00:07:52] Speaker A: Thanks for saying that, Phil. A couple themes that you touched on, kind of us versus them working with the right people, kind of creating the right culture, I'm really in. You said that, you know, you made a lot of mistakes as a startup, and I don't know what you're talking about. As all kidding aside, you know, one of the things that you guys decided to do was have a unique, unified brand across all locations. The smilestime, engaging with the smiles location. I know as part of the brand, I, you know, it's very consistent in terms of look and feel and how you present yourself, you know, on your websites and things like that. And I'm sure you carry that through patient care. That's not always the case with all dsos out there. We see a lot of dsos where they're, you know, they have, you know, affiliates, partners, acquisitions, things like that, where they're maintaining the brand that is local into the patient. They may or may not even know that they're going to a practice that's affiliated with XYZ DSO. Can you share a little bit about your thought process behind going down the route that you went down and was it even up for debate? Was that even a discussion of how.
[00:09:11] Speaker D: No, absolutely. It was, again, part of that experimentation phase kind of at the beginning. And what I would say is that pretty quickly we kind of came to that conclusion where we wanted to be a branded model because one of the things that we always heard was why they didn't want to be a brand, why somebody didn't want to be a branded model was because of you. The risk that kind of came with it. Oh, well, what happens if brand X or brand location x of brand Y kind of had something bad happen, let's say completely out of their control?
And I would say the way we think about it is, no, we want that kind of that pressure on us. We want to have that elevated standard that says no, let's, instead of planning for us where, you know, we're going to make the mistake, we're going to make the mistake and that's fine, but how do we react to that mistake?
And, you know, it's like, you know, whatever you could be in, you know, food and beverage and, you know, something will happen. But what comes out of kind of the value of the brand and the brand you build is how do you deal with it. And so in a much, I guess, kind of lower, you know, not as critical. It's like, hey, if we get a poor review and it's not like, hey, we don't strive to say, hey, we're going to be perfect. We're going to have five stars, you know, whatever, 10,000. 10,0000 reviews. No, because that's the feedback that we get on how we can do better. And so that very quickly kind of made us want to be a branded model.
And, you know, it doesn't happen right away. You know, again, we talked about when we partner up with practices, you know, we want to have that change management and so, but the reality is that, you know, we, we hold ourselves to a high standard and we want to be, and it's kind of like how, again, how do we react to when things that don't go right as opposed to trying to prevent things from not going right because it's just gonna happen.
Yeah. And then we find that there's a lot of, you know, operational and marketing kind of synergies by having a branded model, you know, because again, we're very geographically concentrated, so where we have a lot of practices, you know, we have people that know us. They're like, oh, yeah, we saw you kind of, you know, you guys are popping up like everywhere kind of when I'm driving around that particular area. So that really helps from recruitment standpoint, helps from a branding standpoint, marketing standpoint. And so there's kind of many positives that come from branded model, but recognize it's not for everyone. And at various points, you know, early on it wasn't for us as well, but we made it work.
[00:12:20] Speaker E: So turning a bit to tech now, in a recent Deo magazine interview, you said AI will continue to be able to do more to raise people to the top of their licenses by giving them more confidence. Making everyone more efficient will free up time to see more patients, enabling greater patient access that many patients otherwise wouldn't have. So is, how is that manifesting itself in your network of practices?
[00:12:49] Speaker D: Yeah, so what I would say is, you know, we now live in an age where, you know, everybody's trying to do more with less. Right. This kind of age of how do we improve productivity and efficiency?
But in the dental industry, it's difficult because there's so many things that are so manual, right. All these like, you know, manual tasks that, that we have. And, and so it makes it difficult. But having said that, it also, like, I'm not sure, you know, I always say it's not like the best, best use of, you know, our team's time to do lots of follow up work. Right? Hey, you need to call the insurance, you know, filling out forms, you're confirming appointments, you know, explaining x rays. And so when we think about kind of AI and technology is like, it can play such a big part in kind of like, that's what technology is good at doing, right? How do we automate or kind of address these very kind of repetitive tasks? And, you know, and then back in the day, it's like the old, like, okay, you know, if, you know, if x, then y, it was very rigid.
But now kind of with AI is that, you know, it can be much more contextual and so now we can apply it. You know, I'll say kind of the, the super low hanging fruit where kind of effects, then y still works, but also kind of raising that, that level of the types of things that it can do. And so our view when we say, okay, can somebody operate at the top of their license is like, how do we take these things away? Kind of, how do we utilize and leverage technology to handle these things so that the teams can have a job that's just much more kind of fulfilling because they can focus on kind of addressing like, real patient concerns. You know, the real patient concern is not for you to, you know, make me wait while you're calling, you know, the insurance company.
But as opposed to, hey, spending the time. Spending the time with me to explain to me that treatment that I might not understand, that I might not think I can afford, you know, and, like, what? Why do I kind of need, need this treatment? Why it's important. So we want it to be where, you know, people feel like every day and kind of every moment kind of patient interaction that they're making a real difference. So it's not like I'm not sure people say, oh, I made a real difference because I stood on hold for 30 minutes while calling the insurance company. You know, so by having a much more kind of like, hey, this is, you know, this is what you're good at. That's why you're in this position. You know, and we have plenty of people. They say, I love interacting with patients, but I hate whatever kind of a lot of the backend, administrative and workflow type activities that they just don't enjoy. And so that's a lot of. We comb through the organization, understand what are the things that can be addressed with technology and really kind of hone in on how to address it. And so then it's not like this feeling that, you know, there's always this fear, oh, well, technology is going to replace me, right? No, it's not. You know, Google maps didn't replace anybody. You know, it made everybody better, you know, and how does it get to their destination and hopefully get to their destination on time? So that's kind of how we think about it.
[00:16:27] Speaker A: Yeah. And I got to imagine, Phil, that line of thinking and kind of presenting the why behind it of, you know, hey, this allows you to do the activities that are higher, better value use of your time that are more enjoyable for you. Right. Which will lead to, you know, satisfaction in your role and hopefully longer retention and time with the company.
And is that. Does that.
Do you use that when rolling out new technology? Because ultimately, you know, the two things are a little bit at odds. Right. You know, here's something that is new, and you're gonna have to change the way that you do things. And usually people have a very high, strong resistance to that, but I think if you're able to get through to them up front, like, hey, no, yeah, maybe short pain and changing the long term benefit and being able to free you up to focus on these. These higher value activities, is that.
[00:17:24] Speaker D: Yeah, I would say, um, you don't even need to focus on the long term activity, right. You know, we've all kind of read about and heard about the labor shortage.
I mean, not just in dentistry, but kind of, you know, across the country in all industries, right? And so what we find, it's a very easy message because it's just everybody's like overstretched.
And so it's not like, oh, well, I only do this activity. And then now you're trying to convince me that this technology is going to do that. One activity that I do, the reality is LA team is doing, you know, 5100 different activities and by saying, hey, we can help get these like five or ten things off your plate. They're like, thank goodness because I have another 50 things to do and I know I need to do it, but I don't ever have the time to get around to it. And so, and so maybe part of it is, you know, the timing, right? The timing, you know, it's been, I'll say, a much easier kind of conversation.
And I think the reality is also, again, a function of the roles within a dental office. Very few people only do one thing in an office, particularly kind of in the front desk, you know, area. And so as a result, it's been, you know, we found, and part of it is culture, right? The culture has been people accept, hey, how can I do things kind of better? And if you're introducing these tools and becomes like a great kind of recruiting tool as well, it's like, wow, you know, you do this, you know, you mean, I don't have to, you know, you have technology that will get the insurance verification, you know, and I don't have to spend all day or part of my day doing it. Fantastic, you know, and so it's been welcome with open arms until there's a mistake and then, you know, we hear about it.
[00:19:36] Speaker E: So not, I guess none of the employees at your practices want to be on the phone all day with insurance companies.
[00:19:43] Speaker D: Certainly not.
[00:19:46] Speaker E: So what emerging tech are you most excited about? Not just in dentistry, but, you know, in the broader healthcare, say in your, you know, Zenith Partners portfolio?
[00:19:58] Speaker D: Yeah, I mean, it's in the title of the show, you know, AI, I think. AI, it's just scratching the surface. I think there's so much that it can do because it's not as rigid as it used to. Right now. It's like, you know, again, it's the eye portion of it, there's the intelligence where it's not, you know, hey, I have to define like 1000 rules because the reality we, we live in a world. There's lots of gray and, and it's not so easy for us to document kind of every, you know, rule if then statement to capture everything. And so being able to leverage technology to be able to do some of these things, and it, it's incredible. I mean, we're using, I mean, even with Truelark, right. We're interacting with patients in a very kind of conversational way, integrating it with our practice management system so that it can actually do things. It's not just answering questions, but it can actually do things like schedule appointments for you. We have bots that go out to insurance companies and gets all the information so that when you come through the door, we know exactly what's covered, what's not covered, and there's transparency. You know, just like when you jump into an Uber, you want to know how much it's going to cost. You know, we need the information to be able to tell you, okay, this dental visit is going to cost this much.
Unfortunately, you know, the industry is not always kind of adopting technology at the same pace, but we're finding ways around that using AI as well. We're using AI to, to call insurance companies. I mean, I am blown away. They must have some metric that they're not allowed to hang up the phone, but they, we have basically AI chatting with insurance agents to kind of get information because otherwise they don't, you know, kind of offer that information kind of readily that we can get, you know, in other methods. So it's a bit of our kind of last line of defense. And, you know, and we're also using AI to, you know, read x rays. And that's helping to facilitate conversations with patients where it's like, look, you know, most people don't know how to read x rays. If I put up an x ray and say, oh, well, you have a cavity or, you know, you need a root canal, people would say they'll nod their heads, but most do not know what you're talking about. But with the advent of, you know, AI, it's able to highlight and show, you know, you can take them, you know, the colors on and off, and it just really helps facilitate that conversation with patients and, you know, really kind of builds trust as well. It's like, well, the computer said it, so it must be true, right?
And so, so I think we're looking, you know, all of these things that I've mentioned, they're very, they're still, like, in my mind, kind of very, like, point solutions.
So you know, the AI is addressing one particular issue, but I think over time, as it, you know, as it gets more and more advanced, it's going to be able to do more things and then be able to connect different things and, you know, throughout a dental office and even more broadly kind of healthcare.
[00:23:27] Speaker A: So not all practices are tech forward as much as, you know, how you describe the, the smilist, when evaluating a practice that may join the smilist, how much does their openness to innovation, their openness to using technology come into that decision point of whether they're a fit or not to be part of your DSO?
[00:23:53] Speaker D: It doesn't, honestly, we're not projecting our philosophy and values onto them. So like I mentioned earlier, most important is the people.
And, you know, we find the right people with the right cultural fit. And I'll say perhaps the thing that we are looking for is, are they open minded? Just as I say, look where the smiles is. And what we are today is not what we were ten years ago.
We want that kind of evolution, that evolutionary thinking from our partners. And so when we work with them, look, they may have some amazing, amazing ideas and how, or, you know, ways of doing things that we didn't think about. We're always listening and, and then we think, okay, you know, how do we adapt this to kind of all our locations?
Because that's a great idea and vice versa, you know, we want them to be open minded, to try things so that things, you know, with this kind of idea, like, hey, we want, we want, we want to improve, we want to grow. And so we find that when people are open minded, that they are kind of very growth oriented, whether it could be kind of clinically, professionally, kind of personally. And that again, it's not measured in a spreadsheet, but that kind of, that mentality kind of permeates through the office. And so it's not like one person that has that, that thinking. It's like everybody in the practice has that thinking and, and it's hard to measure for sure. You know, and that's one of the things that we try and hone our skills on is kind of how do we be very good judges of character? How do we be very observant in terms of, you know, what are the little clues and the body language, you know, in an office? Those are the things that we're really looking for, not necessarily like, oh, well, you know, you still seem to be, whatever, using an old version of this or maybe worse, like paper scheduling, those things we find we can overcome, you know, as long as people are open minded.
[00:26:09] Speaker E: So do you have a specific example of something that one of your practices brought this idea that you were able to, you know, spread to other practices?
[00:26:19] Speaker D: I would say most of our kind of technology ideas, you know, has kind of permeated many.
Always such a nice surprise when we kind of meet a practice, and then they're like, oh, no, we're already using whatever, this kind of piece of software, or we're using technology to address this kind of need, because immediately we're like, oh, you know, they can test it. Yeah, they get it. And, you know, whether you use brand a or brand b, it usually is less, less of an issue. And so you'd be surprised, um, some of the super basic things, um, that I'll say kind of has helped the practice, help save time, save money, run more efficiently. Uh, one, procurement, you know, it's very common, uh, for a dental practice. You know, I buy from, whatever, ten different suppliers, and they go to ten different websites, and, you know, and it's not uncommon to meet, you know, perhaps an assistant or a dentist that says, oh, yeah, I'm really good at, like, finding deals.
And it's like, no, no, there's like, things like kayak and Expedia out there. They'll just kind of aggregate everything and make it simple for you, you know? Yeah, let's do that. You know, even, you know, with truelark, I mean, it's. Look, every practice, you know, has some level of unanswered kind of phone calls. And when we talk about the ability to address the unanswered phone calls immediately and also be able to kind of take action, and it's like. And their immediate kind of reaction is like, oh, it's one of those, like, they think of it as, like, you know, those phone kind of directories. Like, okay, press one, press two. And we're like, no, no. And then we'll show them, like, hey, here's like, the different types of conversations, conversations that I had, and there was no, like, human interaction. And they're like, wow, you know, like, we cannot believe that this is, you know, that this exists out there. Because, again, we're.
We are, I'll say, kind of healthcare operators, right? We're not like, technologists. Dentists don't have time to kind of comb the market, you know, whatever, comb the web and figure out what are the new companies and new technologies out there.
They're focused on patient care. They're focused on maybe new clinical technology.
And so when they see these types of solutions, out there, oftentimes the reaction is like, wow, I didn't know this existed or, oh, I heard about this company, but I don't know what they do.
So perhaps that's a criticism of the marketing of various dental software companies.
But yeah, I think in terms of just kind of introducing all, you know, all the different types of technologies ultimately, you know, as Eric mentioned earlier, it's to make your life simpler and that's the value, you know, we want to bring to a practice. It's not like, oh, you know, you're now part of the smiling and you know, and that's it. You do everything yourself and, and, you know, literally like nothing changed. We say, no, no, there will be change. We hope it's positive change, but changes change and we're going to help you kind of navigate through it.
[00:30:02] Speaker A: Yeah, kind of on that. Helping people navigate through change and just, you know, not, you know, we talked about people. You've talked a lot about people and in the culture, what would you say? I mean, there's a lot of people that I talk to that are working in, you know, at the front desk of a practice and they're looking at kind of their career and ways to evolve and maybe even successfully transition into being part of the DSO management team, you know, any advice, you know, to those out there that might be in that position that are looking to grow their careers and, you know, be part of a DSO management? And how different is that from going from practice to, you know, the operator behind the scenes?
[00:30:48] Speaker D: Yeah, yeah. So, so, yeah, I think part of it, again, it's kind of having that open minded mentality because it is a change and we've kind of lived through, you know, much of this, like you said, as kind of more of a front desk kind of operator. You're so used to kind of getting your information with your eyes, with your ears, right? You know, hey, you hear what people are saying, you see what people are doing, but it changes when you start. And this is a bit of, you know, our kind of, kind of journey, right, as growing as an organization is that you start to, you need to start thinking about how to scale.
So if I am, you know, let's say if I were to manage and oversee five offices, I can go there Monday through Friday, I can still use my eyes and ears. What if I told you, okay, you have 20 offices, then how are you going to split up your day then you have to start thinking about things differently.
It could be, hey, I know what's going on through reports and analytics.
It could be, you know, technology and automation. Hey, I know that this is happening. I trust that it's happening because, you know, the system is doing what it is, you know, supposed to do. You know, the bank is going to tell you how much money you have is, you know, you need to have that trust in like, the system and the, and the processes, right? And then, you know, they need to learn how to use kind of the information that they have to be able to ask the right questions because again, when you are now kind of scaling, you don't have enough resources, you don't have enough time. And so those are the things that you need to be able to do better so that I can now, hey, Eric, I'm not in your office, but I know that this is going on. Hey, fantastic on these things. But hey, what's going on over here? It could be a person. It could be, you know, I don't know, it could be like collections. It could be, you know, maybe some clinical concerns that you have and all of this you're able to do through, you know, at a basic level some sort of like remote kind of technology. And then if it's more advanced, maybe some software that will really kind of help you hone in and do at scale. So even when we talk about some of the AI technology as it relates to on the clinical side, what we're looking at, it is, okay, you know, we do regular kind of chart audits, but I can only sample them. I might, you know, catch something, I might not. But through technology could scan through every single chart, every single patient for some period of time and then hone in on it. I mean, the same thing. You know, I say one person kind of always gets upset at me.
Like when we did the procurement system, we really kind of honed it in a way that really highlights kind of exceptions. Right? And so she alone is kind of overseeing about like 25,000 invoices annually.
She can only do that because she's only in reality looking at hundreds, not tens of thousands, but those are the exceptions and everything else kind of falls. And so that, in my mind, is that mental leap that many people need to kind of jump over when they go from working in an individual kind of dental practice to something kind of, you know, broader where they're overseeing, you know, much more. And then related to that is, again, even on the softer side of things.
Hey, I'm very good at developing relationships and the culture within the office. Now you have to think about how do I kind of have that culture and those relationships when I'm not in the office, maybe I only make it into the office once a month. What happens?
And so they have to think of creative ways, and that's where the open mindedness kind of comes in, because they realize and very quickly need to adapt. What worked for them yesterday doesn't work for them today.
[00:35:22] Speaker A: Thanks for sharing that insight.
[00:35:24] Speaker E: Yeah. Well, you said that you came prepared with some things you wanted to talk about.
Did we miss anything that you'd like to share?
[00:35:38] Speaker D: No. I think you guys covered a lot of the areas and part of that growth journey. Right. That we have. And that's kind of true for, I think everybody is that it is a journey.
And every time we've kind of set milestones for ourselves, and the good news is we've met them, maybe not always in the timeframes that we've set, sometimes earlier, sometimes later.
But it is a journey. And I think when people enjoy the journey because of, you know, the people that they work with and just kind of having fun, it's like a magical experience.
I've just had so much fun in terms of, you know, building the smiles, kind of going through our growing pains. And we grow because of the, you know, the uncomfortable kind of, you know, times that we've had as well. So it's not necessarily just the positive. And so as others are thinking about growth, as they think about adopting kind of technology or kind of change, it's all part of the journey. And each time you do it, I want to say, you get better and better at it. Never perfect, but better and better.
And when you do it, people that you love, then it's quite a magical thing.
[00:37:05] Speaker E: Well, we really appreciate you sharing your sage with us today, and we'll hopefully see you do continue to do great things.
[00:37:17] Speaker D: Absolutely. Thank you.
Have you back. Bye.
