The Group Dentistry Now Show: The Voice of the DSO Industry – Episode 227

Ranked the #1 DSO Podcast!

Welcome to The Group Dentistry Now Show: The Voice of the DSO Industry!

Building a Future-Ready DSO: The Importance of People, Process, and Technology

Josh Wagner, Co-Founder and Managing Partner of InRevenue Capital and Chief Revenue Officer at PeerLogic shares his insights on:

• Optimizing patient communication
• Overcoming technology & AI overload
• Setting standards & processes

To learn more about Peerlogic visit https://www.peerlogic.com/

To schedule a demo visit https://dso.pub/PeerlogicDemo

You can also connect with Josh Wagner on Linkedin – https://www.linkedin.com/in/joshwagneraz/

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Peerlogic DSO podcast transcript:

Welcome to the Group Dentistry Now Show, the voice of the DSO industry. Join us as we talk with industry leaders about their challenges, successes, and the future of group dentistry. With over 200 episodes and listeners in over 100 countries, we’re proud to be ranked the number one DSO podcast. For the latest DSO news, analysis and events, and to subscribe to our DSO Weekly e-newsletter, visit GroupDentistryNow.com. We hope you enjoyed today’s show.

Bill Neumann: Welcome, everyone, to the Group Dentistry Now show. I am Bill Neumann. And as always, we appreciate you checking in with us. Always have great guests and some great conversations. And I think this conversation is really topical. I think there’s a lot of confusion around technology solutions out there, especially for our audience as you start to scale up. I mean, you’re looking for ways to be more efficient. There’s challenges now with staffing. There’s been challenges with staffing. It’s not just now, but for it seems like pre-COVID. But there are a lot of opportunity solutions out there. And I think we want to try and have a conversation about how you can leverage One of those solutions anyway today. And then also just learn about what’s going on in the different practices when it comes to patient communication. And I know the team at PureLogic has a lot of data points that they can share, which are pretty interesting. So I’ve got Josh Wagner with me here. And Josh is the co-founder and managing partner of InRevenue Capital. So he’s going to talk to you a little bit about that organization. Then he’s also the chief revenue officer at PureLogic. And Josh is also an advisor and an investor at PureLogic. I’m a little concerned here because Josh also has a podcast. So, I’m sure you’re going to get a grade at the end of this and maybe I’ll just ask him to hold off until after we stop recording for the grade. But it’s good to have you on, Josh.

Josh Wagner: Yeah, Bill. Thanks for having me. I’m excited to jump into BSO Dentistry and how we’re seeing some of the trends that are going on in our business.

Bill Neumann: Yeah. Jess, a little bit about your background, because you’ve got deep experience in sales and marketing. And then tell us a little bit about in revenue capital, because that side of things is pretty interesting.

Josh Wagner: Yeah, it’s an interesting firm because the way we started, it’s a very non-traditional venture capital firm. A lot of people think of venture capital as these companies that take these bets on 10 companies, hoping that one of them is a home run and paying back their firm and all those sorts of types of things. Often, the people involved are not operators. They are individuals that come up with finance backgrounds and have experience in big consulting, whatever it may be. So, InRevenue Capital was founded by myself and my partner, Justin Gray. Neither of us have venture backgrounds whatsoever. Both of us are operators. We actually sold a boutique consulting firm in 2021. And during that time, it was about a 10-year run. We worked with over 4,000 different companies, anywhere from high-growth startups to Fortune 5 companies, helping them build out their go-to-market motion. And we had a lot of experience in the sales and marketing technology ecosystem during that time. And when we founded InRevenue Capital, the whole idea was that what’s missing in early stage oftentimes is these companies get these checks and these big investment checks comes in and the expectation is that they grow and they grow really, really fast. Well, oftentimes those founders at that stage aren’t experts in growing, they’re experts in their market. They might be experts in product or engineering or whatever it is that they built, but actually how to take that to market and to grow is not where their expertise lies. So, our whole thesis is that if we can bring in capital, and go-to-market expertise, bring those two things together, then we could accelerate outcomes for founders and for our investors at the same time. And we really look at B2B vertical SaaS solutions and PureLogic is a good example of that. They sell business to business, so they sell software solutions to dental practices or DSOs and it’s verticalized. They currently sell to dental offices or in some cases, veterinary offices. So, it really is in the sweet spot for what we look to invest in and what we call operator immersive capital, which is our operations expertise immersed into the founders that we work with. is very much in play at PureLogic. As you also mentioned, I’m the current Chief Revenue Officer of that organization and really bringing in our go-to-market expertise to help accelerate the growth at PureLogic.

Bill Neumann: Fascinating. That’s interesting. Amazing that you don’t have a VC background and now you’re investing in companies. What was interesting about PureLogic? How did you get involved with them?

Josh Wagner: Well, as simple as it may sound, it’s an Arizona-based company. We’re also an Arizona-based firm. So, we certainly want to support the ecosystem here. Justin and I, interestingly enough, are both Arizona natives and we’ve been a part of that ecosystem and that growth. When LeadMD, our former company, was sold, It was a significant exit in the Arizona ecosystem, albeit a services company and not a SaaS company. It was still something that we could hang our hat on. So just building out the Arizona ecosystem is important to us whatsoever. But most importantly, as an investor, the growth. So when we invested in PureLogic, they had a really nice growth profile. They were on the double, triple trajectory from the year prior. So that was certainly interesting. When you look at investing, so the growth is one thing, but then you have to really deep dive into the problem and the problem they’re solving. So, for us, that’s as important as anything and then how they solve that problem from a product standpoint. It looks like I’m starting to lose light here, so hopefully I can get it back on. The problem that they’re solving for the customers is that patient communications in a lot of ways is broken. And those communications being as simple as someone picking up the phone and answering. You mentioned some data points that lack, you know, we have a few thousand customers in our stable and we’re fortunate enough that we’re collecting a lot of data on how those customers perform. On average, 38% of every call to a dental office is missed. So that’s a problem in itself. So when I understood that as an investor, I was like, okay, great. That is a legitimate problem because that missed call can be attributed directly to revenue for that practice. And for us, then how they solve it was super interesting. The pyramid, as I describe it, is just plain old reliable, Voice over IP service, followed by intelligence on what’s happening with that call, and then agentic AI to drive pure production from those calls was something that we could get behind as an investment group and felt that if we put the right go-to-market horsepower behind it, we could really accelerate the growth of that organization.

Bill Neumann: I didn’t realize there were any natives from Arizona. So, everybody seems to be a transplant. So, that’s good. And I believe Ryan Miller is also a native Arizonan, right?

Josh Wagner: Ryan is a native of Arizona. He actually goes really far back, his family. So, I often joke that if anyone goes as far back as my wife’s family, because they are as deep Arizona natives as you can get, they know each other somehow. And Ryan and I are actually doing a walk around the facility here. last week and tied some things together. My in-laws and his family go pretty far back and know one another through the old days of Arizona. Even stranger, there’s a small suburb of Arizona called Fountain Hills. It used to be an old retirement community, a couple of golf courses, a little lake, fountain. And at one time, the world’s tallest fountain. Justin and I both grew up in that same town. Both of our dads were homebuilders in that town and built up half of what is that community now. So, kind of a small world in the Arizona ecosystem.

Bill Neumann: That’s pretty cool. Very, very cool. Yeah, I heard Ryan’s story about his family in Arizona. So, that’s interesting. So, let’s talk a little bit about Pure logic, and if you’ve got any data points to share, audience loves data, love to find out what’s going on, especially when it comes to patient acquisition, maybe the conversations that patients are having. You talked about, was it 38% of all calls aren’t answered? I think that was the percentage you said, which is incredibly high. That would be the one thing if you could fix anything, right? You’ve got people that are calling, they’re interested and you’re not answering those calls. How many of those patients go elsewhere? I mean, that’s one of the challenges, how many of them maybe call you back again and now there’s a level of frustration. So there, you know, do they, you know, end up not showing up or do they, you know, just eventually get off and go somewhere else because of that one missed call? I mean, I’m sure there’s you know, all sorts of ramifications to missing a call. And there are reasons for it. But there are ways to kind of button that up where you, you know, that that won’t happen. How would you say PureLogic helps to solve fewer missed calls?

Josh Wagner: Well, before I answer that explicitly, I’ll go back and double down on the data point, the 38% of missed calls. In the dental world, 80 plus percent of revenue is still driven through the phone. So let’s not forget that this is not a world where we’re doing a bunch of e-commerce and we’re taking you know, driving traffic through the web and all that kind of stuff, right? Like the phone is the lifeblood of the organization when it comes to booking revenue. And that’s where it gets really, really interesting, right? Because the doctor can pretty simply draw a straight line from, oh, missed call. That’s where the money comes in the door. We need to solve this problem. And then if you look at the data we collect across DSOs, let’s say you have a 20 practice book of business, you’ll see like anything, a bell curve, right? You’ll see some really high performers that are in the maybe high single digits or 10% of missed calls. And then you’ll see some really low performers. I’ve seen some that are missing 50%, 60% of their calls. So as a leader in a DSO, you’re really looking at, well, how can I flatten out that curve and really get people to a baseline that matters? And one of those things is just setting standards, right? You acquire a bunch of practices. Oftentimes you don’t know. what you’re getting in terms of the individual people at the front office. And I’ve heard this a million times as I’ve gotten more and more immersed in the industry is you acquire some front office staff that many times have been there for years, if not decades. And I always hear that, well, this is the way we do it. We do it our way. This is my way. This is our way type of thing. And that may be all well and good if you’re running a single practice, but when you are starting to roll up and set up for scale, one of the first things that needs to be done, regardless of technology and infrastructure, is really just setting good process in place and getting people bought into that process. Answering the phones is no different than any other process. Answering in a very consistent way, a patient-centric way, in a way that drives towards that appointment and getting people in the door. And one of the first problems that PureLogic solved was just that, putting call intelligence into the voiceover IP or the phone system so that they could understand what’s actually happening on those calls. And now we can serve data up both at the micro and the macro level that tells the DSO or the practice owner that this is what’s happening on the phone. And these are the people that are following the standard, not following the standard and this is what we can coach and train and uplevel against. It’s that first layer of defense to tell you, one, how you’re performing, but two, who is saying what explicitly on the phone and how can we course correct and how can we write policies and procedures that are going to make a better experience for the patient on the other end.

Bill Neumann: Let’s talk a little bit about what you see when it comes to that role in the dental front office and how that’s evolved, especially as it comes to having multiple locations.

Josh Wagner: Yeah. One of the things I get asked about the most is just the role and prevalence of AI because I think there are two diametrically opposed forces when it comes to the perception of AI in a dental practice, right? I think the dentist or the leadership at the DSO is thinking, oh, how can I make AI be pure production for me so I don’t have to hire more FTEs? And maybe that’s okay, right? And the other side of that is pretty obvious. The front office staff is thinking, is AI going to take my job and replace me? So, you get a little bit of pushback, right? When an organization comes in and says, hey, these are all the things we’re going to do and we’re going to roll out these technologies. AI is going to be a part of that. And that immediate fear factor of, oh my goodness, am I going to be at risk for losing a job here pretty soon? So, one of the things that we really try to focus on, whether it’s with leadership or with the front office folks, is what I like to call human-in-the-loop AI. I want AI to make the human being the most productive version of themselves possible. I don’t necessarily want to replace them, but I do want to make sure if you use the front office staff as an example, that they can spend their energy and be the best version of themselves when the patient is standing in front of them in the office and not have to worry about what’s happening on the phone. Let us pick up that burden for them and leverage AI in ways that can be really meaningful to the patient who’s trying to get through on the phone. Remember, 80% of the revenue is still driving through the phone. So we want to make sure that we can make that experience, if they’re talking to a patient, or face-to-face, they don’t have to worry about missing a call because the AI is going to pick up that missed call, book that appointment for them, put it on the calendar, send them an alert, and let them know that all they need to do is send a confirmation or get them into their confirmation queue. So, those are some of the things that we’re really seeing is that diametric opposition between what leadership thinks AI should do, what front office staff thinks AI should do, and getting everyone on the same page. This needs to be a win for everybody, not just one side of the house versus the other.

Bill Neumann: Yeah, that’s fascinating. I just saw a study, I think it was inc.com did the study. And it was wrapped around AI. And one of the survey questions had something to do with the feelings that employees had using AI. And one of the stats that stood out to me was that, I’m going to get the percentage maybe not completely accurate, but it was still pretty close, is that, 38% or 39% of all employees try somehow to sabotage using AI, right? So it’s doing something to make sure they don’t have to use it, or they do something to undermine these initiatives when they come into the… So what was striking is you had that, and it was 35%. So let’s say it was 35%. But what was even more striking was you would think it would be older people, but no, the percentage grew higher the younger the person was. Millennials, actually, were more apt to do something to undermine that AI initiative than the older generation. So I think to your point, it’s like you’ve got corporate at once, this is what we should be using AI for. Employees looking at it more to support their, probably, right? Their role versus to eliminate their role. And so, I think that’s a communication issue for sure. Mims, do you kind of hear these things and see that every day in dentistry?

Josh Wagner: Oh, I see 100%. And if you flip, go back and put my investor hat back on, really interesting statistics in terms of macro trends of where AI is going. So when you think about SaaS, SaaS for the last two decades, was generally adding efficiency to something, right? Either you were using a spreadsheet and now you’ve got this SaaS product that makes it more efficient than using a spreadsheet. That’s a pretty common use case actually for a lot of SaaS companies, right? Like, oh, the solution that they have in place is a spreadsheet. We replace that spreadsheet and automate it for you and make things more efficient. So during the, we’ll call it the heyday of SaaS of the last 20 years or so, the biggest laggard industries in the adoption of software as a service technology was healthcare and legal. They just, in general, didn’t see a lot of value. They didn’t see the incremental lift in efficiency as enough to invest a ton of money in and go down that route for whatever reason. Now, when you look at AI, you would think that that trend would be somewhat similar. But in fact, it’s the complete inverse. The biggest adopters of AI technology by industry sector are legal and healthcare. And you can point to one reason for that, and it’s what you were just talking about, Bill, is Those industries view AI as pure production replacement. It is actually the reduction in headcount in their business, which either has a pure top-line production or pure bottom-line reduction and an increase in gross margin, either way you look at it, right? So, if you look at legal as an example, do I go higher 15 new associates to help me do contract reviews? Or do I build a large language model for all my best practices and all I have to do is dump a contract in it, review it, spit it back out for me? That’s pure production. And you can see that type of thinking in the dental field going the same way when you get into this idea of, oh, I can’t tell you how many presidents and CEOs of DSOs have asked me, will I be able to replace the front desk someday? Like, I don’t know, man, that’s a little bit of a slippery slope if you ask me. I would like to think that we can optimize that staff and give them a job that they actually want to do more by enabling AI to take the things off of their plate that really aren’t that fun to do anyway and is probably not a best use of their talents. And can you rethink the front desk in a way that says, okay, what if I could actually invest more in that person, have the most awesome, patient, experienced person possible, paying them a little bit more, incentivizing a little bit more, doing the job that they really want to do and offload everything else to AI and have an AI-enabled front office. And maybe you don’t need as much headcount, but you can invest in the headcount where it matters and it’s a better experience for everybody.

Bill Neumann: Let’s talk a little bit about that front office team, the people at the front desk there. I mean, are they, what are some of the operational stressors that you see there? It seems like, you know, a lot of times they do everything. So they’re, you know, calling for insurance, you’ve got, they’re greeting the patient, they’re taking the phone calls or missing the phone calls, but what do you see?

Josh Wagner: Yeah, the one that stands out to me a lot and I actually saw a lot in my days working in the marketing and sales tech ecosystem is technology bloat and technology overload. The dental field in general over the last five to 10 years has been flooded with technology. So, in my old industry, there was a thing called the Martech landscape map. And when I started 20 years ago, this Martech landscape may have had like you know, two dozen technologies on it. And if you look at it today, that landscape has something like 5,000 to 6,000 marketing technologies on this landscape, right? This guy puts together this thing every year. The dental field is in that uptrend right now where you’re starting to see a point solution for every little thing pop up that just creates more and more complexity, more and more tools, more and more technology that gets thrown on the desk and on the plate of the front office person that now has to be an expert in all these different technologies, all these different tools. They might have 15 different tabs and windows and browsers open on their computer that’s sitting in front of them. And then that makes talking to the person who’s standing in front of them or Answering the phone, which seemed like the simplest things you could possibly do and the thing that you want them to be doing, comes this Herculean task because they’ve got all this stuff that’s overwhelming them and it’s making their life more and more frazzled. So again, going back to what are some of those things that technology can do and AI can do to reduce that burden off of that person, consolidate down into the things that really matter. Going into that trend, and I talked about it in the marketing and sales tech ecosystem, what tends to happen, and I see Dental going through this right now, is you’ll get a big player and let’s call it in this world, the practice management system. It’s kind of that hub. It’s that system of record, right? That’s where everybody lives. That’s the big thing. And the ecosystem I came from before, it was CRM. So, Salesforce.com is the most well-known in that ecosystem. So, you’ve got this practice management system, and it does a lot of great things. It’s missing this thing. It’s missing that little thing. It’s missing this thing. It’s missing that thing. And then what happens is you get spinoffs. to create a widget to solve that problem. The spinoff has a spinoff. The spinoff has a spinoff. There’s a little spinoff company and widget for every single little thing. And that’s how the tech landscape starts to get really, really bloated. And then what you see come after is this consolidation cycle in the form of M&A. The practice management system, the partners, this and that, they need to consolidate because people were getting overwhelmed and they need to consolidate what’s happening in the front office. And that’s the biggest push I’m hearing right now is How do we consolidate? How do we have less windows, less tabs, less places for my people to go so that they can be more efficient as possible? And that’s something not to… you know, stand on the pure logic soapbox too much on your show here. But one of the things that we’re really trying to do is focus on how do we enable the practice, the front office and the DSO with a 360 degree view of the patient and the patient experience and consolidate that tech stack down to a core place where they can go look that encompasses their phone, encompasses their AI infrastructure that they’re leveraging, encompasses their call intelligence, encompasses all their patient communications in one place that it’s easy for them to find, view, see what’s happening in the patient lifecycle so they can provide the best patient experience possible and actually get in front of that person or get them on the phone.

Bill Neumann: Yeah, that really resonates with a lot of the conversations. You hear a lot of talk about interoperability right now in the space, single sign-on, a lot of things that maybe are a little bit more advanced in hospital systems and medicine, but not in dentistry. You’ve got a lot of different solutions, and to your point, there are probably tenfold more than there were even four or five years ago. And so, I mean, at some point, especially when it just comes to the front office, how much of that, which is supposed to make you more efficient, is now slowing you down or affecting the patient experience. And the patient expectations, I think, have changed a lot too. Used to be, you didn’t have, when you’d go to your dentist, go into the dentist that was run by a solo practitioner at the old Shag Carpet, and they were great dentists, but you didn’t really think about anything else but getting your teeth clean there. But the younger generations today expect an experience. So it’s a little bit different. What are you kind of seeing when it comes to patient expectations and what they expect at the dental practice and from the front office?

Josh Wagner: Yeah, so I’ll throw something super interesting at you because One of the things that’s popped up really, really recently is the idea of voice AI. And that means, can an AI answer the phone for my practice? And this goes back to what we talked about a little bit ago, which was, can I replace my front office staff? Do they never have to answer the phone again? And now, think about your expectations as someone calling in. So, what the data is showing us, and I think if you just listen to your gut, you would probably think the same thing. If I make a phone call and someone picks up the phone to my dental office, my expectation is that I talk to a person. If AI answers the phone as good as it could be, and some of them sound really, really good, you know it’s AI. Oftentimes, you get disenfranchised really, really quickly. And what we’re seeing, we ran some test data, what we’re seeing is that 5% engagement when an AI picks up the phone is your first line of defense. People are going to talk to somebody, zero, office manager, speak to someone, immediately, the engagement level is super, super low. So, you talk about expectations. Still to this day, the most basic expectation is that if I call the practice and the phone gets picked up, I expect to talk to someone. Now, you make a really subtle tweak on that. You ring the practice, nobody picks up the phone and it clicks over to voicemail. There’s a really interesting mindset shift in that because people have been talking to voicemail for decades now, whether it be leaving a message on a tape machine or in the cloud or talking to AI even. The perception of going to voicemail now is, alright, my call has already been missed. I’m going to have to leave a message here and someone may or may not get back to me. If you engage with someone on the voicemail, the engagement rate skyrockets with AI, where AI can pick up in a couple of different ways. It can pick up with, hey, my staff is really busy talking with patients right now. You have a couple of options. You can talk to me and I can try to help you and book your appointment. I can send you a text or you can leave a message with me and I’ll notify the staff. And all of a sudden, engagement rates shoot through the roof. And we’ve seen with even text message on a missed call that went to voicemail, 65% engagement by people just because their expectation is, oh, this has already gone to voicemail anyway, this is probably going to be better. And people really, really like to engage via text, especially I’ve noticed that mothers I can tell you from experience, my wife, she wants everything in text because then there’s a record of it. There’s a log of it. If something goes wrong, she could put it in someone’s face and say, hey, look, I have the text and this is what happened. And you actually see that, right? Our AI agent engages via text oftentimes and people not only book an appointment off the missed call from a text message, they go back and revisit that text thread for the next appointment. Now, you’re bypassing the front office altogether. A new appointment is being booked by texting a person that doesn’t even exist. The person on the other end may not even know that they’re texting an AI agent and now you’re starting to get production through a channel that is not costing you any human capital. So some interesting nuances when it comes to people’s expectations and how you leverage AI that we’ve seen through the data and running a bunch of different tests.

Bill Neumann: Any specific areas you see where there’s like workflow or communication breakdown, where do you see that often occurring and are there any ways to leverage solutions, whether it’s PureLogic or other technology solutions to really help?

Josh Wagner: Yeah. And it’s a good point because when I talked about the ecosystem a little bit growing and growing and becoming more fragmented, that’s where even if you’re not consolidating solutions into a single pane of glass type of view, finding partners who integrate really well is a critical piece of your workflow. Because what happens is when you have the breakdown of data, Data doesn’t get pushed into a practice management system. Well, then now, okay, great. Your AI booked me an appointment, but where did it go? Now, I got to go to another system, pull that data out of it, and then plug it into the practice management system. So, that’s just one piece of advice. Whether you’re looking at PureLogic or anybody else, it doesn’t really matter. Understand what the ecosystem is that you’re working with and how the potential solutions integrate into that ecosystem. Going back to my investor hat, one of the things that we fundamentally believe in at InRevenue Capital is investing in companies that have a really strong partner ecosystem. And there’s a couple of reasons for that. One, I believe it’s the fastest fuel to go-to-market efficiency than inbound, outbound, any of those other things. Partner ecosystems are the best fuel for go-to-market efficiency and go-to-market growth. Now, if you do those partnerships really, really well, what can happen is you can almost pre-engineer M&A transactions for your business, right? And that’s part of our philosophy at InRevenue Capital is looking at that partner ecosystem as, okay, can we sell into this ecosystem? And then does it set us up for potential M&A transactions in the future? Now, if you think about that, in terms of how does it impact you as a DSO, when you’re talking to a technology provider or anyone to bring into your portfolio, how do they integrate into your ecosystem? What practice management system are you using? What AI solutions are you using on the clinical side? Is there any sort of front of the house, back of the house synergies that can be gained there when it comes to But what’s the term called in dentistry? Sorry, I’m forgetting. Case acceptance. That’s it. When it comes to case acceptance, are those solutions that they’re using in the back of the house, are they talking to the front of the house at all? Can we run campaigns off of what’s happening in the back of the house? These are all different things that may seem little, but how the ecosystem partners together, integrates with each other, and goes to market in a really strategic way is going to really produce the winners, in my opinion, as this market continues to grow and consolidate. Even if it’s not through M&A, there’s going to be interesting partnership and integration opportunities.

Bill Neumann: You made a really interesting point a little while back, and I think it’s probably something that we need to have you make again because my thoughts, this is kind of how I see things right now. You talked a lot about, and we talked a lot about all the technology solutions out there, too many of them in most cases. A lot of them don’t communicate with each other, right? So you’ve got a lot of different technologies and people moving around and overwhelmed by them at the front desk. So you’ve got Still most of the calls coming in or most of the bookings and was it 80% of the bookings? Yeah.

Josh Wagner: Revenues coming through the phone. Yeah.

Bill Neumann: Okay. So, we’ve got mostly everything going through the phone. And then we also talked a little bit about… So, I see practices that are trying to tie in technology solutions to help answer the phones, either answer the phone if they’re not available, or to even maybe schedule online. You see solutions like that where they’re scheduling online. But we also see a lot, kind of to your point, is they’re just answering the call via AI. It’s Even if somebody might be available, that’s going to be the first line of defense is going to be, hey, we don’t want you at all touching the phone. We want AI answering the call. What you’re saying is that if that happens, in a lot of cases, people are going I need to talk to somebody or hang up completely, right? So you’ve got that. So we’re not in a situation yet where the patients, and we might not ever be there, where patients are just going to, hey, yep, I expect AI. I’m happy to talk to AI. They want to talk to a person. So can I go through that again? You’ve seen, all right, best case scenario is person answers the phone. Real person answers the phone. If not, you offer options. Can you go through some of those options again?

Josh Wagner: Yeah. So, one of the things, my whole goal and our goal as Velocity as an organization is you want to meet the patient where they are. So, we’ve run through a couple of different things. One is purely call goes to voicemail. As soon as that call goes to voicemail, it triggers a text message to that patient that says, hey, I’m really sorry we missed you. This is Amy. We call our AI agent Amy. This is Amy from PureLogic Dental. Sorry, Mr. Call, how can I help you? And they can immediately get into a text-based dialogue while they are while they’re talking to that agent to schedule an appointment, to ask basic questions, to cancel, to reschedule, whatever it may be. And the interesting thing about that, so we’ve seen engagement rates as high as 65% on call goes to voicemail and it triggers a text message from the AI agent. And one of my theories in terms of why that engagement rate is so high is because The person, the patient on the other end doesn’t know that it’s an AI agent. They’re getting text messages and responding like it’s a human being. Some of the text responses that I’ve seen tracking these is they actually have empathy. They’re making jokes. They are saying, oh, you have a cracked tooth. I’m really sorry to hear that really sucks. Let me check the emergency schedule to see what’s going on. These agents and these models get really, really good. So it seems like you’re talking with a human being. So they never have that level of interference. that feels like it’s AI. So that’s one thing. And actually where we’ve seen the highest engagement rates with our AI agent is through just missed call, goes to voicemail, immediately triggers a text from the AI agent, and they have a conversation from there. The next best has been Missed call, a lot of practices do the, okay, if the phone rings three times, then it rolls over to maybe a call center, maybe an outsource. And in some cases, we’ve tested it with an AI agent. And the AI agent then basically acts as an IVR line of defense. But instead of being on the front end, it’s when the call’s been missed. So, the call has been missed. It says, hey, all of my awesome front office staff are talking with patients right now. I can help you. Either you can talk to me and we can have a conversation here and figure it out. I can shoot you a text message or you can chat with me online or you can leave me a voicemail and I’ll let the staff know. And we’ve seen pretty good engagement there, right? You give people options and probably in the 40% to 50% engagement range where they do something, meaning they say, okay, well, let’s talk or let’s go into text message or let me leave a voicemail type of thing. So, you get some level of engagement, but at that point, they know they’re talking to a robot, right? And that’s why I think the engagement goes down a little bit. So, those are the two things where we’ve seen the most active engagement, giving people the option or just going miss call straight to text. Where we’ve seen the least engagement is first thing, pick up the phone. Hey, this is Amy at PureLogic General Studios. How can I help you today? That’s like 5%. It just goes to like, talk to somebody, front office, front office, right? So, really giving people those options and ways to think about it, I think, and trying to meet them where they are is the best path to go down.

Bill Neumann: So let’s talk a little bit about, as we start to wrap this up here, from your perspective, what does a future-ready DSO look like? And what do you think, again, a lot of options out there when it comes to technology, a lot of ways to build a practice and be successful, but what should the priorities be today?

Josh Wagner: So I have a consulting background, so everything for me is always people, process, technology, and there’s a reason for that. No amount of technology in the world is going to automate or optimize a bad process. You got to really build the house and build the foundation in order to successfully deploy anything. And I think the first thing that really needs to be looked at when you come in and you start buying practices and rolling things up is set a standard because that standard will then help you optimize the people and optimize the technology. So, I really think it’s best to start with process. What is your way going to be? And that’s where I’ve seen the most success because Branding a process, while it can sound really unsexy, is actually a building block and a foundation for culture. And culture can drive a whole lot of things, right? And if you build a really scalable foundation for this is how we answer the phone, these are the best practices for booking an appointment, this is how we handle cancellations, this is how we handle reschedules. If everything is documented, there’s a standard set, then you can train and enable people around those things and build your culture of accountability and performance-based. And then you can layer in technology to support all of those things for training, coaching, enablement, scale, automation, and pure productivity through AI in a lot of different cases. So, that trifecta of people, process, and technology is really, really important. I think starting with process is the key. And then when you get really good at it, You can have your roadmap, but then stamp in, okay, this is my process. This is how I train my people. And this is the tech stack that enables it. And you can just rinse and repeat from there because you know you’re going to get in the outcomes that you’re going to get every single time.

Bill Neumann: And I think you hit the nail right on the head, people process and technology is, it’s another, here’s another stat that I saw recently, a survey from, it was Gartner, and this was Fortune 150, I think it was that they had surveyed. And this was early 2025 that 42% of all AI initiatives were either paused or had failed completely. Yep. These are not small companies. These are large organizations that had, we think, had thought things out pretty well. So I think when you talk about the process side of things, sometimes that’s where it falls short. You know, they want to invest in technology, it makes sense, and it’s either not implemented well, you have the wrong people, the wrong process, there is no training or education, all the above. So there’s a lot that goes into it. And as we kind of wrap things up here, I know PureLogic has invested a lot of time and money and people when it comes to the onboarding and education process, because you can have the best solution in the world. And if your team isn’t really, they don’t buy into it, they’re not included, they don’t understand how to use it, it’s going to fail. And I think that’s why we see a lot of these technology users, you know, they’re overwhelmed. It needs to be easy. You need to have a process in place ahead of time to make things successful.

Josh Wagner: Yeah. You know, there’s one thing I really encourage the team to hang their hat on and it’s time to value. And that requires everybody working together and every functional team in the business in order to deliver time to value for the customer. It starts at the very front end with sales and how they do discovery, how they understand the problems that the practice is having, how do we design solutions for those problems and then how do we then hand that over to our onboarding team to say, listen, we could do a lot of things for this practice, but this is the most acute pain that they have right now. We need to get this up and running right away as a part of this onboarding process so that we can deliver them value front and center. And oftentimes, you can monetize that value with our solution. Can we deliver $500,000, $1,500 of value within the first two weeks of being onboarded with our solution out of practice. And then, okay, we get through onboarding. We’ve set that benchmark that says, great, this is what we’re trying to accomplish. We did it. We got onboarded. We hand it over into customer success and say, listen, this is really what they care about. But there were these other things that we talked about in the sales process as well. Let’s make sure we don’t forget them and continue to drive value throughout that engagement and that lifecycle with that customer. So, time to value is a really important metric for me across the organization because it doesn’t just touch one functional part of our business, it touches everybody. And it’s really a patient-centric, customer-centric message that we want to deliver value to that customer as fast as we possibly can.

Bill Neumann: Josh, if people want to learn more about how to really figure out the best way to engage with patients efficiently and effectively, you gave some great tips already, but if they want to get a demo, find out more about PureLogic, what’s the best way for them to do that?

Josh Wagner: Yeah, purelogic.com, you can get anything you want there. A big shout out to Jacqueline Friedman, our head of marketing, who is a content machine. So a lot of the stats and data points and things that I referenced on this podcast are coming from stuff that she’s helped me either source or co-write or write for me. So that’s certainly helpful. I want to send you to purelogic.com blog. There’s tons of information. You can also book a demo directly there. If you ever have any questions for me directly, I’m on LinkedIn and I’m pretty active. So, you can find a lot of content, maybe not always PureLogic specific, but you can see I wrote a book called The Go-To-Market Cheat Code, which that cheat code, hint, hint, is partnerships, as I talked about a little bit in the show. I do have a podcast currently called Cheat Code and Friends. You can also find that at nrevenue.com, the podcast, the book, and all those different types of things, if you’re interested in that as well.

Bill Neumann: Excellent. We’ll drop links to all those in the show notes so you can get a demo, find out more at PureLogic. We’ve got a bunch of great articles that Jacqueline was involved in writing that are on our website as well. So there’s a lot of information out there and I think it’s Again, a lot of solutions, a lot of technology, probably too much technology. So you want to make sure that you’re choosing the right solutions and it’s enhancing the patient experience instead of actually being detrimental, which I think is really something that I’ve learned today on this podcast. You’ve got to do it a certain way and the way people want to interact. still is via the phone. And I think it’s going to be like that for quite a while. And if you can’t answer it, then there are other solutions. And there’s really, I appreciate that. Totally different than what my thinking was. So thank you, Josh. Great, great having you. And thank you, everybody, really, for watching and listening today. And until next time, this is the Group Dentistry Now Show.

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