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The Group Dentistry Now Show: The Voice Of The DSO Industry – Episode 48

Dave Drzewiecki, CEO of Absolute Dental & David Danielson, Senior Product Manager at Henry Schein One talk dental technology, practice management and much more. Learn how Absolute Dental was able to use technology to easily scale efficiently and seamlessly. The group also discusses patient statement fulfillment, quick bill automatic payments capability and other integration with insurance verification third party. If you want to understand how dental technology can help your dental group or DSO seize opportunities with a combination of standardization and flexibility, this podcast is for you!

Here is a link to the Henry Schein One podcast recording that David Danielson references on the show – Financial Trends in Dentistry Podcast

Our podcast series brings you dental support 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, Africa, Australia, Europe, and Asia. If you like our show, click here to leave a ⭐⭐⭐⭐⭐ 5-star review on iTunes!

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Full Transcript:

Speaker 1:

Welcome to the Group Dentistry Now Show, the voice of the DSO industry. Kim Larson and Bill Neumann talk to industry leaders about their challenges, successes, and the future of group dentistry. Visit groupdentistrynow.com for more DSO analysis, news, and events. Looking for a job or have a job to fill, visit joindso.com. We hope you enjoy today’s show.

Bill Neumann:

Like to welcome everybody to the Group Dentistry Now Show. I’m Bill Neumann, and thanks everybody for watching, listening, and some of the folks actually read the transcripts of this, believe it or not, so thanks for reading. So I’ve got a couple of guests here. We have one that’s new to the Group Dentistry Now Show, one that’s been here before, and they’re both named Dave or David. So it might get a little confusing, but it’s going to be great content, regardless of whether it’s confusing or not. So thanks to Dave Drzewiecki from Absolute Dental. He’s actually new to the show. So first off, welcome. Thanks for being here.

Dave Drzewiecki:

Absolutely. Thanks for having me.

Bill Neumann:

Then this is David Danielson, second time from Henry Schein One. So welcome back, David.

David Danielson:

Thanks, Bill. Glad to be back.

Bill Neumann:

All right. Sounds good. So we got that out of the way. I’m going to give you guys some brief bios, and then we’ll get into some Q&A. So Dave Drzewiecki is the chief encouragement officer, the CEO of Absolute Dental Group. They are the largest branded DSO in the State of Nevada. Dave has served Absolute Dental since 2016. We’re going to talk about his history there, and they are at nearly 30 affiliated practices right now.

Bill Neumann:

Prior to Absolute, Dave was at a large DSO supporting 170 affiliated practices. He was there for nine years. Responsibilities included specialty operations, revenue cycle management, which I know we want to touch on today as well and IT. Dave enjoys leading and building high-performance teams and is an efficiency and patient experience improvement junkie who thinks we can always do better. So we’re going to try and see if we can help everybody do better today.

Bill Neumann:

Then we’ve got David Danielson, 20 years experience in software and technology, has worked for companies like Symantec, Corporation Panasonic, Control4 to improve products and services that drive amazing results. Let’s see what else here, the product manager for Dentrix Enterprise and is also passionate about improving group dental practices, and we’ll talk a little bit about that improvement, their velocity, their growth, and their effectiveness.

Bill Neumann:

Education is a master’s of business administration from Brigham Young University and undergrad studies at Utah Valley University. Okay. Now full for both of you. So again, thanks, guys for being here today. I’m really interested to get into a conversation. Let’s talk about. So why don’t we start real high level, maybe kind of form this theme around people, process, and technology, and we’ll start with that with Absolute Dave. So why don’t we take that away?

Dave Drzewiecki:

Sure. So I’m pretty passionate about this topic. So you may have to shut me up here a little bit, Bill. But for certain, people process and technology is really how the platform, if you are, is built. Just to give you a quick sense of Absolute, 28 practices, about 16 million top line, about 200,000 happy patients are served every single year through the affiliated practices. All dentistry one place is really our model. So in addition to GP and hygiene, which is a normal practice offering, we probably offer oral surgery, ortho, perio, endo, and pediatric dentistry.

Dave Drzewiecki:

So it’s not just your bread and butter dentistry. There’s a lot of other nuances there of being able to offer all those specialties through one single practice. I would say, to kick this off, people and process, that they can be very similar as far as how you think about people and process, because they all interweave so often.

Dave Drzewiecki:

But I would say, to win the game, you got to know the rules. I think when you start talking about people and with people, you gotta know the rules, and then you got to understand whether it’s operations or RCM, what those metrics or KPIs are to know the rules so you can play within the four walls of the game. Right? I don’t think it’s just the people within your organization. I think it’s also the people that you work with outside your organization.

Dave Drzewiecki:

I think this is why today’s today’s conversation’s a unique conversation because I look at Henry Schein One as really a technology partner. When I think of the folks that we have on our team in Absolute Dental, and I can go through all their names and all their responsibilities and all the great things they have gone, but certainly, on the Henry Schein One side, whether it’s Karina or David or all the way through Jonathan, I mean, I really have felt Absolute really has felt that we have a strong technology partner with Henry Schein.

Bill Neumann:

Well, let’s dig into that a little bit. So when you came over to Absolute in 2016, were you working with Henry Schein then, or were you working with them at the previous DSO? You talk about relationships. Talk a little bit about that, Dave.

Dave Drzewiecki:

Sure. So luckily, I had the opportunity to work with Henry Schein since 2007 at the previous DSO, where we grew that from 67 practices to 170 affiliated practices. So at that time, we were able to leverage dental supply services through Henry Schein. We were coordinating with their IT department on building de novos through the Henry Schein Design Services. We did some work with their lab product and partners. There were a number, and I’m probably forgetting half of them because Henry Schein is such a vast organization with reach that they have. But yeah. We luckily had lots of platform experience with Schein before I happened to move to Nevada.

Bill Neumann:

Excellent. So David, I’ll through this one out to you. As far as in the theme around people, process, and technology, I think we talked about people, talked a little bit about process. Are you seeing this play out, this idea, this concept with other DSOs that you all work with, whether they’re emerging or some of the larger? I mean, is that something that people get?

David Danielson:

I think there are some things that people are really gravitating toward. I mean, everybody knows that they want to have a good software stack. I think that that’s an important part of it. But I think some of the things that, well obviously, Dave Drzewiecki and I, we’ll talk about it a little bit later in the podcast, but how to better leverage a partner to get something that meets your organization’s specific needs. I mean, there’s a lot of great software that comes out of the box, but you’re going to run into roadblocks, and you’re not going to be able to achieve your goals, and I think there’s some real meaningful opportunity to look at, how can you leverage your partner? How can you leverage technology? How can you customize it?

David Danielson:

We talked about people and process. We use a term in the dental industry a lot. We talk about workflows and workflow design, and I think sometimes when I think about those terms, that’s the people executing the process, and I think sometimes we need to really kind of dial that in and make sure that people understand those things all kind of work collaboratively for the greatest level of success.

Bill Neumann:

Excellent. So just as far as some other questions for Absolute Dave. So we’re talking a little bit about process there. Tell me a little bit about how that works in conjunction from practice to practice? What’s the communication like there? When you add a practice, how does that work? I mean, talk a little bit about Henry Schein One and Dentrix Enterprise there. Is that difficult to do? I mean, as you roll up in another practice, what does that look like?

Dave Drzewiecki:

It’s actually really simple to do amazingly enough. Again, 28 practices. I started there when they had about 22. Whether it’s de novo or whether it’s acquisitions. We’re going through one right now with the three-practice acquisition. It actually happens here in three days, the migration itself. We’re ahead of schedule, and we’re going to press a couple buttons and automatically move the data from the curb dental system into the Dentrix Enterprise system.

Dave Drzewiecki:

So we’re not expecting any challenges and all systems are go at this point. I would say though, as you think about process, we talked about people and having rules of engagement and KPIs, processes is not only just about technology, but it’s about the people getting it and understanding that they have the processes in front of them. When I joined in ’16… So fun story, I guess. When I joined in 2016, I saw the closet that had the server which had hosted Dentrix Enterprise, which I had never used before, frankly in the back room, and it was a room that had no air conditioning in Las Vegas, Nevada, which gave me pause as a guy with IT background. That was a huge understanding and opportunity.

Dave Drzewiecki:

Then we got some folks from Schein involved, where we were able to move this. The beautiful thing about enterprise is it’s a scalable from the heart. So we were able to put this into a brand new data center and hard nets service. We have our remote desktop farm in there. That built the platform, if you will, to even get to the process that we’re talking about now. The technology end of it’s one thing. But certainly the process ended it because once people understand what their role is and role clarity around that and understand what they’re responsible for. again, whether it’s in the practice, like you’re asking about or in the back office centralized portion, it really does help.

Dave Drzewiecki:

We utilized Henry Schein for what we called super-user training at the time, and it was really just a reset, what does the product do? How does it function? Are we using it correctly? I’m sure David will tell you there’s a lot of times that product is designed, and it’s not being used for what it’s for, and that’s a recipe for disaster. But once we got past that, and we understood how the product was supposed to work, because again, it was new to me, once we got past that and understand how the product was supposed to work, we were really able to layer on there.

Dave Drzewiecki:

Other services that Henry Schein One was able to offer, like patient statement fulfillment and other integration with our insurance verification third party and really have that platform, a process that we have expected every single day from practices.

Bill Neumann:

Great. So you mentioned something earlier. So first off, thanks for being on the podcast here. You’re what, three days away from these three practice acquisition or something? So it sounds like you’ve probably got a lot going on? So we appreciate you being on here today. Well, first off, this acquisition, are they using Dentrix Enterprise or no? Are you pulling from another system there? You might’ve mentioned that earlier? Are you pulling-

Dave Drzewiecki:

Yeah. There’ll be using Dentrix Enterprise in three days.

Bill Neumann:

Okay. So with that process, there’s just going to be some training, right? Because you might have some staff over there that have never used that before. So let’s talk a little bit about maybe that training, because that’s really the people and the process right there, right, and the technology.  Maybe we’ll ask David Danielson that question. Talk a little bit about training. What are some best practices that some you onboard these new practices that are not used to the system, the software. How does that all work?

David Danielson:

I think that’s a really good set of questions. With organizations like Absolute, they’ve been such a terrific partner. They’ve partnered so closely with us that we enabled their own internal training departments to do the training in an ongoing way. So when David alluded to this idea of a platform, it’s a technology stack, plus a people stack, plus an enablement training. So we probably reach out and train Dave’s team here and there. But for the most part, they’re pretty self-sustaining. I think it comes back to organizational needs, right? It’s really adapting what type of a training and ongoing priority program they want to have.

David Danielson:

In this particular scenario, our trainers and our teams were very lightly involved. We definitely have some conversion team members that are helping move the data from one system to another. But from an actual training hands on the ground, I mean, Dave’s team’s running the show, and we’re just here in the background ready to support them with whatever needs.

Bill Neumann:

So great. So these are the super users really internally that have already been educated, and they can come in and educate them in a group or the new practices that you’re bringing in. That’s great. Well, good. Let’s talk a little bit about, again, kind of maybe back to when you started things. Talk a little bit about the growth, some of the struggles you may have all had there, challenges. You obviously came in and then you were brought in for a reason. So what’s that all look like?

Dave Drzewiecki:

Sure. So it was not all purple ponies and rainbows, as they say, right. It was definitely a whole new world. Not only did we move from the Midwest, but we moved to the West and really understanding just a different market, for sure. But certainly, whether you grow through a de novos or merger, acquisition type strategy, they have their own sets of challenges and opportunities. I’m sure both of you know this on this podcast, because you talk to other folks about it.

Dave Drzewiecki:

But I firmly believe that the common thread and the common threat, if you will, is really revenue cycle management, because it’s not all about production. If you’re producing, that’s great. But if you’re not collecting, you have a whole nother set of issues. You guys have probably talked with other folks in the industry, and you’ve heard of some of the horror stories that are out there with some of the other groups, whether they’re going from a five to 10 or a 10 to a 20 or maybe even a 50 to 100. Certainly RCM continues to be that challenge.

Dave Drzewiecki:

It was no different at Absolute, frankly. That was the Achilles’ heel from probably 2016 to ’18 and really trying to understand, which is why we had to get with Henry Schein One and try to figure out what the process was, what the technology could do. How do we bolt on some features that we weren’t using, et cetera? But we had to start somewhere, and we did. You couple that with the idea that my belief, that there’s a dearth of leadership in the RCM function within the dental industry, dental continues to be 20 years behind medical when it comes to technology and just ways of thinking with third party payers, et cetera.

Dave Drzewiecki:

So you really have to kind of roll your own to make sure you have a solution that works and finding that one person who has all the answers. They just don’t exist. So we struggled with that on the people side of it, on the process side of it. We finally got it right a couple of years ago when we decided to go with an RCM committee, which was a committee of folks with various capabilities and our collections. We not only implemented some of the new technology and processes from Schein, but we also were able to put into account into place accountable leadership, which really made the rubber hit the road, so to speak.

Bill Neumann:

David Danielson, let’s talk maybe about some of those technologies that Absolute Dave mentioned specific to RCM.

David Danielson:

Yeah. So there’s a couple of things that when we look at it, part of our onboarding of new clients and sometimes even for existing clients, we go in, we’ll help them with, workflow analysis, where we’ll review kind of their existing RCM situation, and then we can sit back and look at identified gaps and areas where we can plug some of those holes. Some of those holes are people and process. Some of them are technology. Some of the things that Dave alluded to was like our quick bill automatic payments capability, where you’re not licking and sticking stamps for the rest of your life just to get your bills out.

David Danielson:

There’s some automation there. There’s certainly quite a bit of additional capabilities. Many of the customers I work with, they don’t know about some of the tight integration we have with payment processing. There’s other types of integration, particularly around processing claims, some of the additional automation that we’ve added there. There’s additional automation that we partnered with Absolute to create some additional technological options in the software itself so that we can write off small family balances and some bulk editing of things that would really directly apply to efficiencies around revenue cycle management.

David Danielson:

I think some of the times when we look at this umbrella, it’s a really big umbrella, and Dave’s absolutely right. I mean, we’re years behind medical. It seems like when you go to select a new RCM person, they all have medical background, and they’re like, “Why doesn’t this magically happen?” Because it does everywhere else. On our side, as a technology provider, we’re trying to get it there. I mean, we’re pushing on payers. We’re pushing on clearing houses. We want to help people advance that. I think there’s some real opportunities that we’ll see over the next few years for even greater levels of automation in that RCM space. But as it is now, I mean, this is getting it dialed in is absolutely paramount, and leveraging the technology that you can is definitely going to help people get there.

Bill Neumann:

Thanks, David. So Dave Drzewiecki, here’s a question for you. As far as talent goes, David mentioned this or alluded to this, that a lot of the people have a medical background but maybe don’t have the dental background. So I mean, who seems to be best suited for this? Because it’s a question we get a lot when people… We do some recruiting in the space. Revenue cycle management comes up all the time, looking for people that have that experience and can be the change-makers. It’s not easy to find those people.

Dave Drzewiecki:

It’s not. It’s not. In fact, I think that to what David said is when you find someone in the industry that has deep medical experience, and I think oftentimes that person thinks that they can come into the dental industry and just press a couple buttons and replicate what they had successfully built for the last four or five years or maybe more in a medical facility, it just doesn’t happen, and I think it can be very frustrating, because it’s your luck and molasses, right, in some cases.

Dave Drzewiecki:

So that being the case, and I may have bias on this, but I’m of the opinion that a deep dental expert who has actually been in the practice and/or has billed and/or understands the intricacies of dental and the limitations, frankly, with dental, I think that they make more of a better leader, if you will, in the dental RCM field, because they can get to the end result of what we’re looking for versus someone who relies on EDI every day or relies on the payers having sophisticated mature systems in the medical side.

Dave Drzewiecki:

Because whether we know it or not, and maybe 10 years from now, we’ll say it differently, but we’re blazing trails right now just trying to create new processes and get payers and software management companies on board with where we’re trying to go. Even our own mindsets and in the dental practices itself, they’re just not as mature as what the medical industry is.

Bill Neumann:

Interesting. So-

David Danielson:

Bill, I’m going to chime in on that one-

Bill Neumann:

Yeah, please do.

David Danielson:

… because this is where Dave and I have very different sets of experiences, because I’ve seen very successful people come out of medical and adapt to dental, but like he said, it’s like running through molasses. Once they figure it out, they’re like, “Oh, here’s the fringe barriers. Here’s all this issue.” Once they navigate, they can do really well. On the flip side, I’ve seen organizations promote from within, like an office manager who just became a more senior revenue cycle management leader. I’ve seen some of them really take the reins and drive extremely successful revenue cycle management.

David Danielson:

So I don’t know if there’s one area that’s going to be more advantageous than the other. I just know that if I hire somebody, if I’m talking to a practice, and they came in from medical, they’re like, “Here are the six things that aren’t happening that are really hard.” I’m like, “I know, but that’s not my fault necessarily. I’m trying.”

David Danielson:

Then on the other side of it, I think that if you come from dental, you don’t know how great it can be. So there’s that kind of tug and pull. I actually really love the customers that I have because they pull me both directions. They’re like, “Hey, this is great. You added this small feature.” I’m extremely excited. Then there’s the others where it’s like, “Where’s my auto magic button? I want this capability.” So I think that if you look at it from that perspective, I think also in that selection process, Bill, some things to look at, it’s background, propensity to learn, adaptability, because I really think that there’s really great talent out there. They just need to understand when I’m stepping into dental, it’s not medical. I think as long as they know that, they can get from point A to point B pretty well.

Bill Neumann:

Well, yeah. Let’s talk a little bit more about that, David. So why is dental more complex? Why is medical and dental so different when it comes to revenue cycle management? Maybe a touch on why that is?

David Danielson:

There’s a couple of things that really come to mind. I think one of them has to do with payer sophistication. I think it really comes back to not all payers are created equal. I mean, I know for a fact in dental, there are some payers that still take claims on paper and send stuff back in the mail. I mean, there’s no electronic capabilities at all. To say that in the medical world, that would be like, “What?” That’s heresy. Right? So I mean, just starting with just some of the maturity on the payer side.

David Danielson:

I think the other parts are you’re starting to see some trends toward diagnosis based. Payers are getting more interested in diagnostics. So you’re going to see that’s been on the medical side for a long time. It’s starting to creep into the dental area. I think you’re going to see some changes in that area over the next few years. But those are things where… Yeah. I mean, the big ones are just propensity to adapt technology. There’s still some just natural barriers on payouts on dental that are just a little different.

David Danielson:

So without going through exhaustive, nail-biting examples, I think that people just need to understand that… I think from an industry perspective, there’s a lot to say about on the payer side, that it has been more challenging, and I’m sure Dave can attest to that.

Dave Drzewiecki:

Yeah, I’m chuckling because when I joined absolutes, upwards of 70% of the volume of planes was done by paper. I mean, from even a more mature DSO, where we had 95% done electronically, you say to yourself, “Wow, what just happened.” So not only as a medical dental chasm. It’s also call it maturity of large group and medium group and small group mentality, right, because of resources. So it becomes a situation where you need to find that leader who’s going to say, “Wow, it can be done better, and then you need to have that ability to partner with somebody to figure out how to make it better, and then you go and make it better.”

Bill Neumann:

Excellent. So this leads into the next question I have. So we’re touching a little bit on growth when you first started and where you are now. So we have a lot of what I would say is small, medium, and these emerging groups out there. We kind of look at growth opportunities. Just what should these groups be looking for, whether it’s organic growth? If it is organic growth, what have you all done? I mean, you can use… I’m sure COVID gave everybody a bit of a pause, opportunity to be a little bit more strategic. You probably didn’t want the time to be strategic, but you had it.

Bill Neumann:

So I mean, talk a little bit about that. Then even from maybe an acquisition standpoint, I think there’s been some hesitation or again, a pause there. What have you all done to really kind of combat that and grow beyond… I guess we’re still in COVID, right? So-

Dave Drzewiecki:

Yeah. I think it’s both, to answer your question. Organically, there’s always an opportunity to improve the practice and improve that service being offered to the patient, whether it’s the depth or breadth of service, depending on which KPIs or what that leader in that smaller practice looks at to understand. I mean, we look at it as a portfolio of affiliated practices. We don’t dictate expectations. We share results from all practices, with all practices, so that they understand the bigger opportunity, if you will, whether that’s in specialty services, whether that’s in specific lines of businesses, like general dentistry versus an endo, for example, whatever it might be.

Dave Drzewiecki:

So I think that organic piece is definitely one that within the same four walls you already have, are you really optimal and really stepping back and not being proud, but stepping back and saying, if wasn’t responsible for these X number of practices, where could they be operating at? That’s number one. Number two, with acquisitions, I do think COVID has dampened a little bit of the idea of going out and acquiring or affiliating practices. But I think it was Warren buffet who said, “Look, be fearful when others are greedy and greedy when others are fearful.”

Dave Drzewiecki:

I think that you’re going to see some. I think that the industry speculated a little bit that there will be lots of folks transitioning out of practices during COVID. In fact, I think the last statistic I read in later of 2020 was hardly anybody or nobody did, because they all kept going at it again for probably a couple of different reasons. But I think you don’t want to underplay your strategy. But you certainly want to keep an opportunistic mindset on what’s out there so that you can grow.

Bill Neumann:

Excellent. David Danielson, what are you seeing with… You got probably a 30,000-foot view. So what are you seeing, or what are you hearing that you can tell us about?

David Danielson:

Yeah. We actually covered this topic pretty in-depth in a podcast on the show that I host, which is kind of funny because I’m backwards today. So on the Dental Deep Dive, we had a conversation with one of our guests talking about financial trends, and he talked about the fact that acquisition world is hot and heavy right now in dental. So there were definitely a few drop-offs, not as many as I think people anticipated. There were some early retirements. I mean, I don’t think anybody’s going to disagree with that. But I think from an activity level, I think people are still seeing lots of opportunity in dental.

David Danielson:

I think that we’re still seeing a lot of… One of the things I would say based on conversations that I had with large groups, everybody was really smart. I’m going to tell you, when things shut down, nobody stopped working. I’ll tell you that. I saw realignments on technology portfolios. I saw standardization of workflows. I saw a lot of things that people were like, “We never had time to do this, and we actually have an opportunity to start really refining some things.” I got a bunch of requests for custom reports because there wasn’t quite as many reports as we wanted in enterprise as people are asking for.

David Danielson:

So it’s just really fine-tuning the machine, I think really happened over the last several months. I think we’re going to see some really good upticks coming in 2021. I think that people are optimistic about the industry. I think there’s some pent-up demand for some procedures that need to be done, and I think we’re all really savvy to go capture that. So at the 30,000-foot level I think people, they should definitely check out the previous podcast, because we went into detail on that. But I think there were some real opportunities, and I think some of the leaders that I work with really capitalized on it.

Bill Neumann:

Great. We’ll drop a link to that podcast in the show notes so people can check that out as well, David. I’ve got a couple more questions. Just a couple more here. I wanted to make sure we touched on… We talk about centralization is a big thing, especially I talk to you, David, about, what does that mean? I’m kind of curious both what you’ve seen out there. So you’ve got Dave Drzewiecki, and as you’re looking at practices that you might acquire, this happened to be a three-location group, are they all on the same system there? I mean, what are you seeing from a software perspective? Are groups centralizing now?

Bill Neumann:

I mean, I hear some, they’re 100%, others that are kind of each one’s doing their own thing. How does that really work if everybody’s kind of doing their own thing? What I mean by that is not clinically doing the wrong thing, but as far as getting information if everybody’s on different practice management software. How does that work? How do you ever have a good feel for what the group’s doing, and how does that really affect the value of the group as well? So I’ll let Absolute Dave.

Dave Drzewiecki:

Sure. Well, I think there’s probably two schools of thoughts on this. The second school of thought has probably emerged recently with technology. The first school of thought, which I’m probably more in line with is because of, again, being an IT purist, you standardize. Standardization creates scale, platform, stability, reliability, all the things that you know work well within what we’re trying to do in this industry that’s consolidating. I think that’s one of the reasons that we’ve been able to do what we’ve needed to do on a grander scale, and we’ll be able to grow very quickly.

Dave Drzewiecki:

I think the other mindset on this is that you don’t have to have the same standard practice management system in practices, and that you can piece it together with other technology that will allow you to have a view over one pane of glass, so to speak and operate it separately. Operating separately versus having a technology stack, those are two different animals, and I think that comes down to an appetite of risk, because frankly, I don’t want to wake up six, seven, 10 years from now having four or five, six systems that I have to maintain and care and feed and figure out how to make sure that they all function together.

Dave Drzewiecki:

Because frankly, when you have different systems, you also have different processes. When you have different processes and the practices, you have different outcomes. So that being the case, I’m more on the fence and more on the first standardization, and I do believe that that is where the strongest competitors eventually will be on one system. Practices we just acquired, to answer your question and affiliated with, they all happen to be in the same system, all three of them. So that’s part of the reason why this conversion is not as much of a heavy lift as what it could have been.

Bill Neumann:

There you go. So that was probably a consideration for you and probably the valuation, and that’s great.

Dave Drzewiecki:

Yeah. It’s almost as much work to integrate one practice as it would be three around the same system and same culture, et cetera.

Bill Neumann:

Yeah. Great point. David Danielson, what are your thoughts on that? What are you seeing out there as far as some of the groups that you’re working with? I mean, are they all trying to get to that point of standardization now, or are they still kind of all doing their own practice?

David Danielson:

I pretty much see it exactly as Dave did. I mean, there really are those two camps of thought. You can be divided and then tackle it operationally, or you can be centralized. I know from what I’ve seen, customers that centralize. There’s a bunch of benefits that come from centralizing to a single platform. So there’s things that we see pretty regularly. There’s definitely more consistency in measurement. Your KPIs tend to work out. They tell a better story. It takes less resources to run operationally. There’s just a lot of less people, because you just don’t need as much expertise in a whole bunch of different areas.

David Danielson:

Then as far as like from a traditional DSO perspective, I see the ones that centralize from a technology standpoint, they tend to be able to offer more services to the affiliated practices. So whether it’s direct ownership or an affiliation or have her there, whatever their organization strategy is, I find pretty regularly that they can be more flexible and offer more for less as they centralize. So I see it head that way a lot from a technological standpoint. But I’ve met with some very sophisticated leaders that are in distributed type of strategy, and most of the time I’m having conversations with them about, “Well, what would this look like if we started centralizing?”

David Danielson:

So the conversation definitely leans that way. But you can be successful in a lot of ways. Obviously, I’m a biased on this. I recommend people centralize their platform, for obvious reasons. But I think that I’ve seen people be successful, and those people are starting to see the opportunity of really bringing things together. I know from an M&A perspective, the ones that have centralized, they tend to get a little bit of a bump because they’re stepping into an operationally more efficient environment, generally speaking. So I mean, I don’t know if you’re seeing anything different than those things, David, but that’s what I’m hearing.

Dave Drzewiecki:

Yeah. I generally agree with what you’re saying. Just think about if you’re operating the non-clinical back office between, let’s say a dense market, for example, no different than Las Vegas. If they’re running the same practice management system, we interchange front desk and dental assistants all the time. If they had different systems, practice management systems, which were different processes and different, different, different, that would not be as available and capable. So again, your risk goes higher.

Bill Neumann:

Great. Okay. Two questions here, and then we’ll end the show. So one is a very general, open-ended. But this one’s a little bit more focused. So I know, Dave, you talked a little bit about… We’ve talked about standardization, but you also are looking for flexibility. So as you grow and your model changes or becomes more defined, some of the added customization that you’ve done and then also maybe some third-party plugins that might not be Henry Schein, but that you feel that you need to use. So what have you all done there that might be a little bit unique?

Dave Drzewiecki:

Yeah. It’s a very long list, frankly. So we not only, and we touched on this David and I earlier, but I’ll give you a quick rundown here, which will give, I think, people an idea of what they can do, frankly, with enterprise, which is really to exploit the technology and deliver a better patient experience and increase efficiencies. These are all things that anybody with enterprise can do. We not only turned on the patient statement process. We literally had, as David joked, we had people licking stamps between calls and the call center sending out statements in 2016. So that was a huge bump.

Dave Drzewiecki:

We did take advantage of the COVID situation. We upgraded to the latest version of enterprise because practices were closed. Why wouldn’t we do it? The least amount of resistance there. We have scripts in place with Henry Schein that allow us to pull information out of Dentrix or read script, if you will, and use that for a third-party insurance verification partner that we have that we’ve done business with forever.

Dave Drzewiecki:

Then with Henry Schein support, we also put back into Dentrix some limited information which allows us to have a loosely coupled system, which works out really well. We have worked with Henry Schein on automating the cash posting system. That was just here recently in the last, call it seven months. We increased throughput by 2X. So we have half as many people doing cash posting, and frankly the quality rate has improved dramatically. We have the idea that you can integrate with the integrated credit card systems, the electronic drug prescription and as well as EHR, things that we haven’t even tackled yet that are on our list of items to tackle.

Dave Drzewiecki:

Again, lots of other little improvements that we’ve done, whether it’s a PST here or a PST there. We now manage in Zap accounts at a whole thousands of accounts at a time as opposed to onesie-twosie. Right? So it’s just been a fantastic improvement of just processes in remote automation the last three, four, or five years.

Bill Neumann:

Excellent. All right. Last question for both of you. So pretty open-ended. What do you think the future of the industry looks like? I see the industry, the DSOs, I think we’ve still seen consolidation, right. Even during COVID, there was consolidation. I know we saw consolidation at the top in particular, which was kind of interesting where you had some large groups gobble up some other large groups, which I know have been predicted for a while, but we hadn’t transpired until COVID. But yeah. What do you think. I’m going to let David Danielson handle this one first, and then you get the last word on this, Dave Drzewiecki.

David Danielson:

Oh, boy. That’s a loaded gun right there. You’re asking the technologist who’s trying to predict the future, what the future looks like.

Bill Neumann:

First of all.

David Danielson:

Yeah. So I see a couple of things. I think we’re going to continue to see, and I alluded to this earlier in the call. I think we’re going to see more push from the insurance companies to do more diagnostic work on the provider. I think we’re going to see some changes in more becoming more outcome focused. But the DSO leaders I talk to are already outcome focused. They don’t want to redo a crown. They don’t want to redo anything. So in a way, it’s almost self-serving. But I think that we’re going to see more and more some of those types of directions improving.

David Danielson:

I think we’re going to see a bigger push towards clinical effectiveness. I think the demands on the clinical capabilities of the technology, you’re going to continue to advance. I think we’re going to start seeing some of those new types of technology creep their way in both on the clinical side and revenue cycle management. So I think you’re going to start seeing advancements in those categories.

David Danielson:

As far as operationally, I think people are going to continue to bring more training in-house. I think you’re going to see more education to the staff. I think you’re seeing a bigger push on culture inside of practices. I know the ones that are leaner and meaner are also the ones investing in their people more. So you’re starting to see this. We hear the tale the big gobble up the small, but what I’ve heard more recently is the faster gobbling up the slow. So you’re starting to see a big push towards that, who can respond quickly, who can integrate more quickly, who can add more capabilities? So flexibility in those areas are going to become more and more important. That’s kind of my 30,000-foot prediction there.

Bill Neumann:

Great takeaway, fast gobbling up the slow. I love it. Go ahead, Dave, Drzewiecki. [crosstalk 00:41:58]-

Dave Drzewiecki:

I love that, the fast gobbling up the small. So true. So true. Well, let’s be candid. COVID has changed the way we all do business. We can all work remotely now. So we’re already hiring team members in different states. Kind of think of it as we were doing nearshoring or offshoring before. But certainly, the talent pool is now going to change. I think because of that, you’re going to see improvements in also efficiencies, but also patient experience. So I think David’s right. Industry consolidation we know is going to continue to happen, for sure.

Dave Drzewiecki:

So outside of that, I won’t talk technology or industry. I’ll talk more about the patient experience. Because to me, technology is a means to an end to the patient experience. If we think of robotic process automation that’s happening and all the ability for us to become more lean and mean, and I have no doubt that Henry Schein One will be a staunch partner of this, of trying to really figure out, how do we get RPA involved in these everyday processes? We already do cash post and insurance verification accounts, small balance write-off. All these things that we know take time from a person and a human to do something, we know we can start automating that much more efficiently and frankly, more effectively.

Dave Drzewiecki:

I think because of that, we’ll be able to offer a much more improved technology and patient experience to patients. What I mean by that is we probably have the same opinion of Amazon. It’s changed the world. I can click a button at 10 o’clock at night in my own bed, and I can have something delivered to my home the next day, and it’s just there. If I don’t like it, I press another button, and they refund my account, and in some cases, they ask me to keep the item.

Dave Drzewiecki:

Dental patients, in my opinion, have the same expectation for dentistry. They’re becoming more capable of understanding what technology options are out there. They want to do teledentistry visits, right? They want to be able to schedule their appointment without talking to anybody directly into Dentrix, which is what we’ve done too, by the way. That’s one thing I did miss. We turned on online scheduling, not requests for scheduled, not request for appointments, actual scheduling in Dentrix Enterprise for the patient. They press a button. That is what they’re looking for, and we will continue to go down that path of, how do we improve the experience for the patient, because that’s why we’re here.

Bill Neumann:

Excellent. Those are great final thoughts there. Thanks to both of you. Thanks, everybody for listening and/or watching the Group Dentistry Now Show. Like to thank David Danielson from Henry Schein One on his second appearance. Like I said in the show notes, he has his own podcast at Henry Schein One. So we’ll make sure we send a link to that. Dave Drzewiecki from Absolute Dental, thanks. First time. Maybe we can get you back again.

Dave Drzewiecki:

Yes. It was a pleasure. Thanks for having me.

Bill Neumann:

Yeah. Thanks, gentlemen. Until the next time, I’m Bill Neumann with the Group Dentistry Now Show.

 

 

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