The Group Dentistry Now Show: The Voice Of The DSO Industry – Episode 119

Steve Wright, Director of Enterprise Sales for Solutionreach, joins the podcast to share:

  • The history and evolution of Solutionreach
  • Patient communication at the practice and corporate levels
  • Top organizational challenges facing DSOs in 2023
  • What role does technology and automation play in DSO growth?
  • Much more

To learn more about how Solutionreach can assist your DSO with patient communcation visit – http://bit.ly/3xfrYxE or email Steve Wright at swright@solutionreach.com

If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes http://apple.co/2Nejsfa and a Thumbs Up on YouTube.

Our podcast series brings you dental support organization and emerging dental group practice analysis, conversation, trends, news and events. Listen to leaders in the DSO and emerging dental group space talk about their challenges, successes, and the future of group dentistry. The Group Dentistry Now Show: The Voice of the DSO Industry has listeners across North & South America, Australia, Europe, and Asia. If you like our show, tell a friend or a colleague.

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Full Transcript:

Bill Neumann:

I’d like to welcome everybody back to the Group Dentistry Now Show. I’m Bill Neumann. Thanks as always for listening in or watching us if you happen to be on YouTube or find us on groupdentistrynow.com. We appreciate it.

I always learn a lot on these shows. We’ve had a fascinating guest. Technology is a huge focus, whether it’s on the efficiency side of things, whether it’s being able to measure across the different locations that you have. We hear AI talked a lot about. But we also have technologies when it comes to patient engagement and recall.

We have a technology expert in the DSO space with us today. Happy to introduce everybody who hasn’t already met him, Steve Wright, he is with the Solutionreach and he’s the director of Enterprise Sales. Steve, thanks for being here.

Steve Wright:

Yeah. Good to be here, Bill. Thank you.

Bill Neumann:

Yeah. Good stuff. Talk to me a little bit about your role at Solutionreach. For some of the audience members that may not be familiar with Solutionreach, can you talk a little bit about the organization?

Steve Wright:

Yeah. Absolutely. I’ve been with Solutionreach for just over six years now. I’ve been with them quite a while. As you’ve mentioned, Bill, we are a technology company and we do service several of the top DSOs in the country today. My role with the company has always been on the sales perspective.

I help primarily focusing on strategic markets like DSOs specifically is my focal point. It’s a fast-paced, high volume, especially nowadays the DSO trend is getting extremely popular. We’re putting a lot of resources and time into our DSO segment and enterprise.

Bill Neumann:

Yeah. Certainly is growing. You work with some of the larger groups that are out there as well as maybe some of the emerging groups. You’ve got the smaller platforms as they scale up?

Steve Wright:

Yeah. Exactly. Yeah. We want to make sure we focus on heavily on both. We do service most of the top DSOs in the country today. We provide a range of services for them. But we also really focus on the emerging mid-market level as well. They are the future large DSOs and their models.

In fact, their rate of growth is actually sometimes higher than that of a larger enterprise group. We’ve noticed that. We understand the trend in the market. We do focus a lot of our attention on the 20 location, 50 locations to 100 location groups, which are eventually going to be those matching up with Heartland eventually someday.

Bill Neumann:

Tell us a little bit about Solutionreach, what to do, what types of solutions you have.

Steve Wright:

Yeah. Solutionreach, the big theme of our platform is we believe that text is the best way to reach patients nowadays. Most people have heard of Solutionreach before. We don’t like to say this word, but we’re the grandparents of this industry and specifically this segment here. We’ve been around for 22 years.

We were the first company to send a text reminder to a patient 22 years ago. That was before text was really that popular. We had to do a lot of convincing specifically for dentists that this is the future. Eventually there’s going to be a day where patients prefer text. We need to make it a seamless automated experience for them and for your staff members.

They didn’t believe us for probably 10 years. It probably took a long time for them to finally get to the grasp that text is a great personal … That was probably the most common objection we got for the first 10 years was we liked the personal touch. In our heads we’re like, “Well, what’s more personal than allowing the patient to make their own decision on how they want to be contacted?”

That’s when we really started seeing a change in the market. I think we had a big role to play in converting that technology and advancing it quicker. We saw more tracks on the medical side. It kind of adopted it a little bit quicker. But the dental side kind of required a little bit of pushing.

That’s the history of Solutionreach and for everyone, just to make sure we understand what we’re talking about here. We started as a reminder platform specifically sending out text confirmations and email confirmations. That has completely migrated over to a complete patient engagement platform. We are obsessed with the patient and its journey with each practice.

We want to automate the experience all the way around the patient journey from the initial finding a provider, managing the online reputation, make yourselves more attractive all the way around the wheel to scheduling the appointment online, booking it, insurance verification, and reminding the patient properly and texting communications before, during and after the appointment.

Recalling the patient, getting them back in the door and maintaining a very healthy schedule, which is of course probably the largest ROI that we provide is our recall functionality, and then all the way around to marketing help and phone automation. Lots of stuff. Really, but just to simply put into place, we are a patient communication platform. Absolutely.

We do work with most EHR and practice management softwares out there today. Benefit of us being in the market for 22 years that we’ve had a lot of experience with working with a lot of different players in the market as far as PMs go and solidifying a great partnership with them for the best experience possible.

Bill Neumann:

Yeah. This is always interesting to understand. When you say patient engagement, it really, it’s not just texts. You mentioned online scheduling. You mentioned reputation management as well. You mentioned insurance verification. Scheduling online is pretty interesting because I don’t think they’re … Do you have any idea stat-wise, we looked across all the practices, what the percentage of practices are that are doing online scheduling right now?

Steve Wright:

Most of them. Yeah. I’d say the numbers very high.

Bill Neumann:

Okay.

Steve Wright:

It’s really common for us to … Most of our clients are using our online scheduling tool. DSOs are unique obviously as far as the level of power and control. They have their own DSO website specifically. Then they also have the individual location website that typically has their own brand if they maintain their own brand.

We’ve created an online scheduling tool that works for both situations. We could have kind of a centralized scheduler on the DSO website for them to find affiliate locations, but also the individual location will have its own ability of scheduling.

Yeah. To answer your question, bill, most people have an online scheduling tool, or if not, it’s a high focal point to made that process.

Bill Neumann:

From a lot of these DSOs want access. They want a platform that they can take a look at all the practice locations. When they’re looking at a dashboard, they can do that. Then maybe at a regional level they can just look possibly the region and that type of thing.

I mean is that something that you see a lot of demand for where you know can slice up the information based on the need and the size of the group?

Steve Wright:

Yeah, absolutely. Every DSO is different. Some don’t even consider themselves as a DSO, but they technically are by the created standards that we’ve created today. But we have to identify that. We have to figure out what responsibilities is corporate or the enterprise team going to have or the business side compared to the individual location.

I love that question. I think this is really interesting to talk about, because with that level of access being so unique, we have to make a platform that’s so customizable that from the enterprise level they could pick and choose what responsibilities do they want to control for the individual practices.

Most DSOs, the question is, “Well, as much as we possibly can, we want to control settings across the entire board.” For example, with automated reminders to go out, the DSOs love the idea of having a best practice cadence that they want to apply to all locations.

We had to create a enterprise tool. We call it Location Hub, which gives that enterprise team the ability of propagating settings to regions, to individual practices or to all locations with a click of a button. That way they could completely handle and control everything from one spot, which is the norm.

It is by probably 9 times out of 10 when our current clients or soon to be clients, it is very much the same. They want as much control, because that’s the perk of joining a DSO. An affiliated doctor for them to come in and join this amazing group, it’s one of those benefits where it says, “Hey, we have you controlled over the ability of automating the patient’s communication.”

It’s a big perk for them as well to have to be alleviate the day-to-day task at the front desk from those little tedious things that are very important, very, very important, I think critical to a healthy practice. But we’ve created a way where corporate could do that from one spot.

Bill Neumann:

You talk to a lot of groups, all different sizes and shapes, some are DSO, some are DPOs, some are dental group practice, whatever they call themselves. Talk about organizational challenges. We’ve had some that … 2022 is an interesting year, coming off 2020, and maybe let’s take a step back.

Love to get your thoughts on COVID and how it affected patient recall and then kind of fast forward to reopening 2021, ’22, some trends that you may have seen and where we are now.

Steve Wright:

Yeah. No. Great question. I love that. Yeah. COVID, I mean we, like everyone else, had to adapt quickly. It was a hard time for us. It’s a hard time for the entire market with those. There was a lot of practices. We had a lot of customers reach out saying that they had to close shop for a few months and it was detrimental.

We had some very difficult conversations with some of our clients and COVID affected us as well. We had to adapt. I think quickly we try to innovate and create more product technology that focused around the telehealth and teledentistry and just simply the ability of connecting to the practice and text, park and wait capabilities and a better pre-visit instruction cadence where these patients know what to do when they come in.

Automating the check-in process for intake forms and making that more digital so they didn’t have to touch papers and be in the wait room. There’s a lot of things that I think COVID, as horrible as it was and is, it really pushed the market forward to the digital age where we shouldn’t be doing anything with paper anymore. We need to be automating these processes anyway.

It really shot us forward to do that. I think not only that, COVID did … You mentioned … I wanted to make sure I answer this, he brought recall. Never has recall been more important. The ability of identifying who did we lose during this time, who was scheduled and who do we need to reschedule?

It was really hard for these practices to manage and recall. Our numbers increased drastically at that point. Our communication texts go out through group messaging and identifying who’s due and who’s past due and how do we get them back in conveniently. It was a massive help for these practices that were nervous.

They shut their doors down and some of them were closed for two months and they came back and said, “How do we get this back to a healthy schedule again.” Recall’s the way to do it. Of course, we got to get those patients back in.

Now as far as the DSO perspective goes, we’ve never seen an increase quite like the last couple years in DSOs. I mean we have completely noticed a trend where … I mean just simply looking at the numbers, I mean roughly 208,000 registered dentists in the country today and growing.

Roughly 30% of those are affiliated with a DSO or some type of group organization. That’s a big number. It’s a huge number. Compared that to last year or two years ago, that number was 12%, 13%, 14% just a couple years ago. That’s a massive increase of providers joining groups.

The reason for that is COVID impacted them heavily business-related. That risk was not worth the reward. They wanted to go tie themselves to a group who has the ability of managing and holding some of that liability for them, for them to have, do what they do best, which is focus on the patient and providing care.

That’s why we see the growth and we’re heavily at focused on innovating our enterprise solution because 100% that’s the future of dental is groups.

Bill Neumann:

Organizational challenges. We’re in a new year here. Looks like the economy’s kind of … Well, recession, not recession, I don’t know what we call it, but certainly slower than when we first came out of COVID and pre-COVID for sure.

Any thoughts on some of the challenges that you’re seeing for the organizations that you work with in the industry as a whole in 2023? Then how you think technology can really help solve for some of those challenges?

Steve Wright:

Yeah. Love it. Three come to mind. Number one, consolidation is by far the largest problem that these DSOs are running into is with their acquisition and M&A process. They’re acquiring practices who are using such a variety of different solutions. Technology-related, focusing on the practice management software and different patient engagement platform.

They have a different software for online communication and the RCM and they’re text-to-pay and they just have seven, eight different vendors going. The big consensus is, well, let’s simplify this. Data is king. How do we get the proper reports back to us? Let’s get one system does all is the idea is we want to consolidate down to a couple vendors.

There’s a couple benefits for this. Obviously, the one that stands out the most is price. Price is typically going to be a lot less if you consolidate and bundle within one package of … We don’t ask people of course to sacrifice functionality. Of course, that’s most important is a system that works.

But if you could find that working system, if not a better system in one specific platform, that’s a massive win and typically will reduce their cost down quite a bit. It’s easier to manage the account. Price of course is the biggest factor of that consolidation benefit, but also training.

I mean there’s a lot of users. There’s a lot of people that need trained on these specific products and front desk or coordinators or any position that’s going to be using our product or any product like ours, they require some training to make sure they understand how to use our technology.

If you hire a new receptionist and day one you say, “Okay. Here’s seven different logins that we got to teach you how to do each one.” It’s a little overwhelming and there’s a lot of churn going on. There’s a lot of staffing issues going on.

Number one, build consolidation. Absolutely. We’re hearing everyone is just running around with their heads cut off trying to figure out how to consolidate their solutions. It’s not easy. You got a group with 1,000 locations, 500, 200, 300 locations. That is not an overnight thing. That’s a process for you to identify the workflows.

What do we do when we acquire a new practice and how do we convert them conveniently without affecting anything? It’s easier said than done. But absolutely everyone’s running around trying to figure out how to consolidate.

The second thing is really that’s important in this industry to kind of … a massive issue that people are running into is reporting. I mentioned it briefly. But how do we get data in one spot? How are we pulling these reports and data’s king. I think a lot of these groups, we’re hearing them switch to a very data-driven approach and for the ability of just managing metrics and they want all metrics in one spot, like a Power BI or some type of BI solution for them to consolidate this data and really understand how they’re doing specifically.

That’s increasing quite a bit is that ability to pull and report. Then the other one that comes to mind as far as issues within the industry is integration. Integration, the ability to connect and really figure out who works with what and what capabilities. A really popular term nowadays in our world in this, I don’t know if this resonates to too many people or you hear Bill.

But write backs or the ability of writing back data into their PM, because we do have to work with existing solutions for our system to operate specifically the practice management software EHR system. We have to integrate properly. We have to pull that data. We have to pull it quickly and easily and we have to write things back. We have to automate that intake form experience.

Integration is extremely a high priority right now for us, for competitors in this industry, but also for the DSOs trying to figure out how do we get a better integration with some of our solutions out there.

Bill Neumann:

Thank you. That was great info. You mentioned training, which I think is one of these areas that is not always focused on when DSOs are looking at products and services. But with the turnover, the churn where you have maybe new, some front desk people, somebody that may have worked at another practice before, somebody that maybe has no dental experience that now is coming in and has to learn these different solutions.

Steve Wright:

Sure.

Bill Neumann:

Can you talk to us a little bit about the training because I look at that as important as the product itself.

Steve Wright:

Right. Yeah. I mean it’s a great tool. But at the end of the day it’s a tool that people use. We have to make sure they’re using it properly and they understand how to use it to make their jobs easier, because at the end of the day, that’s what it’s all about. We want a solution that the front desk can really shine and they can, day one, be impactful to the practice in identifying the health of the schedule, because that’s their job.

I mean they need to make sure that patients are checked in properly, that they’re confirmed and they have everything that they need to do to jump into that appointment. Yeah. Training, the way we do it and the way we try to help as much as we can is when you’re talking to a large DSO group, there’s a lot of users that need to be trained.

We have very precise rollout plans for implementation and making sure everyone’s trained properly. The problem with that, and what makes this so complicated in the DSO world is every group is so different with their different users and regions and they also have to identify which products do we want the front desk using, to which products do we want corporate to control?

We’ve learned over the past that this is … You’re right. I mean it’s such a big deal, Bill, that when we get close to partnering with a new client with a DSO specifically, it’s probably the biggest topic. It’s like, “Okay. This is all great. How are we going to roll this out? How are we going to get training for 1,000, 2,000 users sometimes?”

We got to be creative with content. I think we’re the ones responsible for the training. We want to say, “Hey, don’t worry about that. We have the processes in place. We have the welcome packets we could send out. We have the content that will make this easier for them.”

I love how you brought that question up because you’re right. I mean it’s probably one of the biggest objections we do get in this sales world is how do we roll out training? It just seems so overwhelming and we have years of experience where we’ve identified a universal strategy to combat it and give them the content they need and don’t expect them to go create it themselves.

That’s not fair. That’s not good. We’re the experts and then we need a create a training project plan and created custom for that specific DSO based on their organizational structure.

Bill Neumann:

You talked a lot about the consolidation and so as DSOs scale up. You’ve got this continued growth. Talk a little bit about the role of technology and automation. But I’d also love to hear your thoughts on, as they’re scaling up and they’re acquiring practices, they may have solutions already in place.

What’s the process like to try and get everybody on the same page and use similar systems because that’s how you benefit when everybody’s using similar systems and can learn from each other. What are you seeing as these DSOs grow? I mean you talk about leveraging technology, but do you see them doing that and what does that process look like with Solutionreach?

You’ve got a customer. They’re acquiring 30 practices in 2023. How do you make sure that each one of those practices is set up so when they come aboard that there’s a path for them to get acclimated then and switch over to Solutionreach if they’re not already using it?

Steve Wright:

Yeah. Good point. I mean most of the time. I mean we do identify if there’s a 30 office or 30 location acquisition. Most of the time a few locations or sometimes even half are using Solutionreach. The whole organization’s using Solutionreach. Depending on the situation, that migration’s extremely important and each DSO is different.

Some people have their acquisition process when they have a newly acquired practice. We noticed it’s a very slow burn. Most have a one-year conversion. They’re scared to make drastic changes. I mean DSOs that’s extremely important to offer that partner approach. We’re not here just to completely to create a corporate environment and you’re going to feel it day one.

It’s a slow burn to slowly identify. We’re not saying Solutionreach should be day one discussed. We identify. There’s obviously a lot of way more important things that this team needs to get. These success teams need to go in and identify how’s the practice doing, where are its needs? What does it need to move forward?

Then at the same time, they also have their migration of software and technology and they have their practice management software. Of course most importantly, they got to get converted over to. We’ve noticed it’s about a year. It’s about a year for most, six months to a year is the idea is typically for these new acquisitions is to convert them over that 6 to 12-month timeline.

Solutionreach will fit in the process at whatever they decide is the most important timing to do so, but definitely based on need. Absolutely.

Bill Neumann:

Just overall, what trends are you seeing with some of the groups that you work with? Are you seeing anything different with the smaller groups versus the larger groups? Just trends in general. They don’t even have to be technology. I mean you’re working with hundreds of different types of groups and then I think it’ll be interesting for the audience from your outside perspective what you’re seeing.

Steve Wright:

Yeah. I think the game is footprint. It’s established locations and it’s partner quick and identify what is your growth model. Is it de novo? Is it full acquisition? We’re noticing a massive trend and kind of like what I was saying earlier, it’s these 15 to 20 locations, we’re seeing the highest rate of growth.

I think once you hit a certain number, you’re like, “This is scalable.” Once they get past the point where all locations have been privately and in 100% ownership, they hit a point where there are 20, 30, 40 locations and they want to expand as quick as possible. That’s what we’re noticing is there’s a massive change in the emerging section of DSOs and their growth rates are extremely high for sure.

Not to say that the largest groups are not acquiring the same. I mean they’re based on their size. They’re growing extremely quickly, too. But it is a game of footprint. We’re definitely noticing the word location is the most commonly used with DSOs and them identifying their size and not just employment or estimated revenue. It’s footprint. It’s location, physical locations is the growth model.

Bill Neumann:

Are you seeing more of a de novo approach and just in general acquisition hybrid or does it really depend on the group?

Steve Wright:

Yeah. Depends on the group. In each group, they really like the idea of the partner approach. Definitely I think a hybrid, if not more so focused on acquisition is more common. I don’t see too many de novo, honestly, setups, but it does happen. I mean absolutely. I think if they want to maintain their brand logo, then de novos are a great way to do it.

But some groups we talk to have the ability to … They have a team set up where they could go purchase and acquire a practice that’s struggling and help revamp it and get it back on its feet. That’s a lot of work, but a great return. Vice-versa, there’s some groups that only partner with successful practices. It’s a very little training. It’s a very little effort initially, but high capital, initially.

I wish I had a better answer there, Bill. It’s super random. I can’t even … Yeah. It’s all over the place.

Bill Neumann:

Yeah. It is a tough one. Yeah. People ask a lot about, like you mentioned, DSO, some don’t call themselves DSOs. A three location group is a lot different than Aspen or Heartland. Even Aspen’s different than Heartland, the larger platforms.

If I was a group practice or a DSO that was looking to have a conversation with Solutionreach, either I’m using another patient engagement platform, how easy is it to make a change? Because again, you’ve got the training, we talked a little bit about that. But that sometimes there’s this hesitation to change because there is this, change can cause issues at the practice level and with employees that are so hard to come by nowadays.

Steve Wright:

Yeah. It’s a good question really. It does come up a lot. I think with each practice or each group that we talk to specifically, we have to figure out. There’s a lot of work. I mean absolutely. There’s a lot of work on their end that they need to do. We can’t do everything for them. We try our best to alleviate as much the stress as possible of switching a system.

But it’s definitely not a plug and play. Everyone has different technology. Their tech stacks are different, their servers, where their data’s hosted there, there’s a lot of in between that we have to identify. These practices and groups, really they have to identify the workload required.

But we don’t find that as such a big, I guess, turnoff to switching. I think they’re in a position as a DSO, well-oiled functioning DSO who’s focused on growth. It’s really unanimous. They all want the best solution possible. If that means changing up things from the business perspective, from the executives, from the exec team, they love the idea of reducing price at all cost.

Really that’s what we’re running into is these groups are willing to switch and convert to a system that they thought was working fine for them. But I think what makes us so unique in this, and this is why I think these groups are willing to switch over, is simply the fact that we offer a wide variety of tools that’s very, very tailored to them.

We want to consider ourselves the one-stop shop, the complete patient engagement platform. The value shows really quickly and it makes sense for them to take the time required for them to, one, investigate the differences between what they’re using today, if they’re using something, they might not be.

Then two, what is this going to look like once it’s active and how do we get it active and how long is that going to take? There’s a lot of moving parts. But they’re willing to do it. This market, the trend is absolutely what is the best product for us and is the value there with price and we focus.

We have the same mentality. I think that’s what set us apart as a DSO. We want the partner first approach. I think a lot of our products and innovation has come from our clients, 100%. I mean 100% they are the experts in the industry. We’ve been in the industry for a long time. The product works for the industry, of course.

But as for learning what’s happening in two years, what’s the next best thing in a year? Where are we going to be in five years with texting and in the dental space and DSOs, these groups are super, super helpful with … I think we’ve been really fortunate to have great clients that are very large and all ranging from a single location to thousands.

I think it’s given us a great knowledge base of where do you need us? Is there anything you could think of where we could automate better? They’ve really introduced a lot of cool tools to us that we’ve put top of our priority list to make happen, because if it applies to them, it applies to everyone. Yeah.

Bill Neumann:

Well, to start to wind down this podcast, I do have a couple of questions. You mentioned tools and a lot of times you’re driven by your customers, some of the needs of your customers, developing tools. Tell me a couple of the tools that the features that Solutionreach has that these DSOs are excited about in 2023.

Are there areas that you see, “Hey, there’s a lot of activity. They’re really interested in working with our online scheduling or text.” Just give me a couple of thoughts around the tools that are exciting for the DSOs in 2023.

Steve Wright:

Yeah. Definitely RCM, revenue cycle management, anything RCM. I mean, we are getting blown up every day RCM related. I mean there’s a lot of money out there that they need to collect on. I think by far that’s been the most heavily requested product from DSOs for us is what can you do to help us with collections? We have tools and we’ve always had text to pay for years.

But they want to take it a step further. They want a complete automated experience built into their billing solution where we could identify exactly who has it a payment due and how does our system automatically send the most convenient text message or email to engage with that person and make it a seamless collection for it. Collections has been a big conversation.

The other one, I mentioned this a little bit earlier too, Bill, was the reporting. I’d say between those two with some of our larger clients. I mean they’re absolutely picking our brains on how do we automate RCM and how do we automate our reporting API and how are we getting this into our environment?

We’re all hands on deck. We have a lot of these solutions built today. A lot of them are still in development, but it’s absolutely an industry trend is how can we help with collections and the reporting side of things.

Bill Neumann:

Great. Yeah. That’s great. RCM, that was like the 2022 acronym for in the industry was RCM. I think it’s going to continue into 2023. Steve, thanks. This has been great. If anybody wants to get in touch with you to find out more about Solutionreach has any questions at all, how do they get in touch with you?

Steve Wright:

Yeah. We have support@solutionreach.com, sales@solutionreach.com. I’m happy to share my email directly. I’m always open to talking to anybody. If anyone has any questions, if anyone has questions about our product or some of these future products that we’re developing, we’re open. My direct email is swright, with the W, @solutionreach.com.

Yeah. We’re happy to have conversations with anyone who wants to and we love talking DSOs. We love DSOs. We love the idea of being a partner approach where we could help you grow and hit your goals of scalability and providing a great service for your providers.

Bill Neumann:

Excellent. Yeah. Great conversation today. Thanks Steve. Again, just so everybody heard that one more time. You can either reach out to sales@solutionreach.com or if you want to reach out directly to Steve, it’s swright, W-R-I-G-H-T, @solutionreach.com. We’ll drop those emails addresses in the show notes.

But thanks again Steve for taking time today to talk to everybody on the Group Dentistry Now Show. I am Bill Neumann. Thanks everybody for listening and watching. Once again, I think we’re up to episode 115, 120, somewhere around there. Thanks for being part of the show, Steve.

 

 

 

 

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