The Group Dentistry Now Show: The Voice of the DSO Industry – Episode 75

Bill Piskorowski DDS, Health Sciences Clinical Professor, Associate Dean for Community-Based Clinical Education (CBCE) of UCLA School of Dentistry, joins Bill Neumann on the Group Dentistry Now Show. Dr. Piskorowski discusses how he and UCLA School of Dentistry partner with DSOs through their Community-Based Clinical Education program.

On this podcast, discover:
✔️What a dental school’s community-based clinical education program is.
✔️Why a DSO should affiliate with a community-based clinical education program.
✔️What the cost is to a DSO.
✔️What the future of the program looks like.
✔️What DSOs are saying about the clinical education program.

To contact Dr. Piskorowski email him at [email protected]

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 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 everyone back to the Group Dentistry Now Show, I am Bill Neumann. And as always, we really appreciate everybody tuning in. Whether you’re listening to us on Google, on Apple, Spotify or any one of the number of listening apps that we’re on, we appreciate you. If you’re watching us on YouTube or if you just find us on Group Dentistry Now, great to have you here. Without an audience, we wouldn’t have a show. And of course without great guests, we wouldn’t have an audience.

Bill Neumann:

So going to introduce you to our next guest, and if you’re watching this on YouTube, you may have seen this face. He goes to a lot of the DSO meetings, that’s how we first met. Just doing some really innovative things from an educational front, and I’m going to let him tell his story. Because I think it’s really unique, we haven’t had, I don’t think there’s anything like this out there that exists. And Bill certainly will correct me, but I don’t think there is.

Bill Neumann:

But let me do the introduction, and then we into the conversation. And it’ll get confusing, because we have two Bills on today and we both like to talk. But we’ll, we’re going to make this fun. So, we have Dr. Bill Piskorowski. And he is the Health Sciences Clinical Professor, Associate Dean for Community-Based Clinical Education at UCLA School of Dentistry. That’s a mouthful. So, I’ll give you a little bit of his background. But he’s been in the dental space since 1979, started practicing dentistry then up until 2006. Bill, was that in Michigan where you practiced dentistry?

Dr. Bill Piskorowski:

Yes, in a suburb of Michigan. [crosstalk 00:01:58], correct.

Bill Neumann:

He left practicing dentistry in 2006 and took a full-time position at the University of Michigan School of Dentistry as the Director of Outreach and Community Affairs. And then in 2017, he actually accepted a position which is where he is today. He’s an Associate Dean for Community-Based Clinical Education, CBCE for short, at UCLA School of Dentistry.

Bill Neumann:

So I’ll tell you a little bit about the program, and we’ll get into much more detail. The program echoes the vision of the Dean by bringing the dental school to the community. In its humble beginnings, the CBCE Program has treated over 15,000 patients. Delivering over 30,000 procedures, seeing each fourth year dental student. And this is really important, each year, each fourth-year student providing six weeks of service in their fourth year. And of course, Bill, you have plans for expansion for this program.

Bill Neumann:

So all right, I said a lot there. I’m going to stop, and I’m going to let you fill in any of the blanks. Talk a little bit about your background, maybe how you went from practicing dentistry to getting into education, and then I’d love to hear a little bit about this program?

Dr. Bill Piskorowski:

Well, thank you, Bill, for that kind introduction. And what I’ll share with you is that my journey into education was a mistake. I used to be a clinical consultant for The Dental Advisor, a publication out of Ann Arbor, Michigan. And one of my mentors, God rest his soul, Dr. Bill Gregory was the editor of that. And he says, “Bill, I like the way you evaluate our products and I think you ought be a teacher.” I said, “I have no desire to teach. I like to go fly fishing on my day off.” As a favor to him, I experimented with that one day a week and I fell in love with it.

Dr. Bill Piskorowski:

And then the rest is history. That was in 2001 I was a part-timer for a couple years, well, at private practice. I felt that it was my duty to give back, to shorten the learning curves of students. Because as I said to you once before, Bill, when I got out of dental school, I worked for an idiot. And that idiot was me. I had no reason to be the CEO of a company right out of school. Even though I was okay with my clinical practice and my skills, I had a lot to learn as far as business management and leadership. But you know what? That’s a journey in itself. Because of that journey, I felt that I had things to offer for students, to actually guide them in their path going forward.

Bill Neumann:

That’s great. It’s just kind of interesting you talk about the boss being the idiot. And I think that could be a reason why we’ve seen such a growth with DSOs, right? Where dental schools I think unfortunately haven’t done any favors on, from the business side of things for dentists and a lot of or most of the business education that a clinician gets is in undergrad. It could be an accounting course or something very general and maybe a brief week or two weeks at dental school and some, maybe a consultant comes in and helps out. But you don’t really, you still don’t hear much. And I guess, that’s why there’s so many consultants in the industry.

Dr. Bill Piskorowski:

Well, you know what, Bill? It’s a great point, but think this out. A student goes into dentistry, literally not knowing what to do. You have a basic science background, but you’re literally learning a foreign language towards excellence in four years. And you know what? It’s not that you can make a mistake in a sentence, you’re dealing with the lives of patients. So, it’s just to embrace everything you learn to be a clinician is hard enough.

Dr. Bill Piskorowski:

And it’s easier for some. But to balance with both practice management and clinical skills right out of school, that’s a task for a lot of people. And what I’m just trying to do is make our students as proficient as possible and make them aware of all the opportunities after graduation, whether they are traditional or nontraditional. That ergo, that’s why I’m in this space with the dental support organizations.

Bill Neumann:

So I think a lot of the viewers and listeners might be like, “Well, why do you have Dr. Piskorowski on this podcast? What does he have to do with DSOs and group practices?” So let’s talk a little bit about this program, the Community-Based Clinical Education Program, and then how it ties into DSOs. Yeah, so I’ll stop there and let you explain it?

Dr. Bill Piskorowski:

Well, when I was at the University of Michigan in 2006, I started with a program that had three public health clinics and six doctors. When I left, we magnified it to the point of 39 locations with six different healthcare delivery models and 117 doctors. And I have to share with you, those doctors led the way for showing the path for our graduates. And in the public health space, if you will, only 1.7% of all graduates were going into public health dentistry. There was a time, even when I graduated, that if you went into public health, you were considered less than an adequate provider. I have to tell you, I can’t even lick the boots of half those people. That’s how proficient they are in this world, market. So I have high respect with them, and the challenges that compromise patients in that arena show.

Dr. Bill Piskorowski:

And I tell my students, “If you could work in this arena, you could work anywhere.” And as a result, I have to tell you, we went from 1.7% in the year 2006 as a national average to my graduating class in 2017, 22% went to that model. There’s only two reasons that happened. Because they knew that they had great mentorship while they were on rotation, and the second thing was they found that these organizations were now running at a higher level. Because of our involvements with academics, because we provided them insight as to their operations. Through the lens of our students eyes, and we helped them get better. So I can only make these programs better if our students are honest in their assessments, and we assess everything in our program. That’s the importance of AI in today’s market.

Bill Neumann:

Really interesting. So talk a little bit more about this program, because I’d love to know the process and then how it relates to DSOs. So you’ve got, we’ve touched on it a little bit that you have fourth-year students. And really the idea is that they’re doing hands on work, but let’s talk about what that looks like and-

Dr. Bill Piskorowski:

What I consider this-

Bill Neumann:

Why it’s good?

Dr. Bill Piskorowski:

Yeah. So, what I consider here is this experience for our students is a capstone project. We developed a clinical assessment tool with Dr. Vidya Ramaswamy from University of Michigan for clinical competency. And it’s a 13-point assessment tool that our students do a self-assessment before they go, they do a self assessment after the rotation. And then the doctor that is overseeing them does this, the same tool and assesses them. We see if they’re in parallel with one another, and I will share with you that different models lend themselves to a different type of educational experience.

Dr. Bill Piskorowski:

So we now allow our students to go up to two three-week rotations, my goal is to do two four-weeks in the not too distant future. At Michigan, I had three four-weeks and we started with a two-week rotation. All dental schools should be able to do at least one two-week, and then as they positioned their curriculum to accept more rotations in the last year. So, this is a big leap of faith. And I have to tell you for those that are resistant to change, sometimes it becomes a miracle for this to be implemented. But I have to tell you, this is the direction where we’re going.

Dr. Bill Piskorowski:

So now at Michigan, I had six delivery models. And it did not include DSOs. Now at California, it does include DSOs and I have relationships with six of them, okay? Technically after these conferences, 13 others have reached out to me to learn more about the platform. So the goal is to centralize the processes, okay? Of student experiences, because I want to be seamlessly integrated with our clinics. And if you accept students from another school, why not go to one common platform of assessment? Because I don’t want Dr. A to listen to six different dental schools on how to do something.

Dr. Bill Piskorowski:

And I’m not saying our program is perfect, but we do and have come forward with a lot of modules. A lot of AI to, how do you say, make this a predictable experience and to be seamlessly integrated with the clinics? So going forward is I believe that every dental school should have a capstone program, that they should give our students an experience in traditional and nontraditional opportunities. Because at Michigan and now here, we have given students experiences in Indian Health Service, tribal clinics, federally qualified health center, community centers, local dental centers. Private practices, private practices that have developed a 501(c)(3) for philanthropy and giving back to the community, DSOs that actually work in the payer mechanism for fee-for-service and even Medicaid.

Dr. Bill Piskorowski:

So my heart is really out to those that are in areas that struggle with access to care, number one. Or dental deserts, okay? And for the most part, that’s the type of clinic that I am looking for. And in California, it’s such an easy thing to explore, I have to tell you why. Because just in the SoCal area, I got 20 million people. I mean, I could have the best program in the world and the world won’t know, okay?

Bill Neumann:

Right.

Dr. Bill Piskorowski:

Because we’re just another thing. One of my clinics actually has a 100,000 patients in one square mile of the office.

Bill Neumann:

Wow.

Dr. Bill Piskorowski:

That’s insane.

Bill Neumann:

That is insane.

Dr. Bill Piskorowski:

But if you drive in traffic here, you understand that it’s real, okay? So, over that is I’m just trying to create a centralized process to make dental schools more appreciative of the other workforce model. Because as we know, I believe the last number that I saw from the ADA was 30% of all graduates are going into this space and never experiencing the model other than maybe a lunch-and-learn and a pizza party at the school and having one of the representatives going there. But now I’m offering a protected, working interview, okay?

Dr. Bill Piskorowski:

And quite frankly, many of our students have been hired from this process. Because they saw it, they tried it, they liked it. Or at least they saw potential. Because with COVID, I have to tell you, my number one job as an educator is to give our students the best experience possible. And what is happening is through COVID, their experience at school is maybe 50% of what it used to be, okay?

Bill Neumann:

Right.

Dr. Bill Piskorowski:

So, it’s incumbent upon us to find solutions. And I have to tell you, the DSO space really stepped up in making that happen. And I thank them for that, I have such valued partners in this arena right now.

Bill Neumann:

Well, that’s great. So let … I’m just going to make sure we kind of recap what you said there. So you’ve got students, fourth-year, they have a 13-step self-assessment that they fill out prior to actually working in the field, right? With a DSO. And then they actually do the self-assessment on the way back as well, right? When they come out of that. Talk to me a little bit about those results. It’d be interesting to kind of hear what their, how they felt about themselves before and after?

Dr. Bill Piskorowski:

Yeah. So third, I have to tell you that in every category our students have seen an increase in proficiency, according to their self-assessment. And it’s really, we know we’re hitting the ball right on the hammer. I mean the nail right on the head when the preceptor evaluation is between those two spaces, okay? So this year, we’re finding out that some of our students need more practice at prescription writing and pain management prescription writing. What we do is we go back and we interview our department chair and say, “How are we teaching this? Can we give our students more experience in this area to make them more proficient?”

Dr. Bill Piskorowski:

So, what we’re learning from our external set of eyes comes back to the school and restructuring how we do things. So prior to my involvement here at UCLA, I looked at the clinical profile of our graduating class before the program was implemented. In a very short period of time, we have doubled our students restorative experience and we have tripled their surgical experience, and we increased the root canals by 70%. And I have to tell you, I’m not happy. It’s still not where it needs to be. Because at eight weeks we’re expecting another, in doubling of that proficiency with valued partners.

Dr. Bill Piskorowski:

So once I established this valued baseline, then we go to improve the certain sections. We look at ages and stages, are we giving our students the same pediatrics and geriatrics? Can we make them more comfortable and confident? Because I want a competent clinician when we graduate. And maybe what we’ve seen is that less students are going into postgraduate opportunities because of this experience, that they gained this confidence, okay? And again, I’m just opening their eyes. We’re not directing them to anything. They get to make an intelligent decision based upon this program.

Dr. Bill Piskorowski:

I have to tell you back in 2006, Dr. Marilyn Laski who was the Academic Dean at U of M, “Bill, this information that you have … ,” and she was just a rockstar. She said, “When our external eyes say that we’re graduating a competent clinician, that’s an academic grand slam,” according to the Commission on Dental Accreditation. And that’s very important. So we are very compliant with state regulations, with the Commission on Dental Accreditation. And so, we just want to grow the program. I’m not saying the DSO model is the only model, we want them to experience several models before they graduate.

Bill Neumann:

Right. Right, and then they can feel where they are the most confident. And regardless of whether they go to a DSO or Indian Health or wherever, or private practice, they’ve experienced that model. And I’m sure regardless of the model, they become more proficient. Because you’re doing different things and you have a different … the demographics are typically different, so you’re dealing with all sorts of different people. So must be, really [crosstalk 00:16:09]-

Dr. Bill Piskorowski:

Bill, one of the most critical things that I’ve ever seen is one of my students after a three-week rotation said to me that was, “The worst experience of their lives,” okay? And I said, “Well, I’m sorry that happened, but could you elaborate?” And she gave us this elaboration about what could have been better at the clinic, I took that to heart and I had the discussion with the clinic. Two months later, she did another three-week experience in a similar model, literally five miles away from where she was. She says, “Dr. P, I want to tell you something, this was the best experience of my life.”

Dr. Bill Piskorowski:

And I said to her, “So, even the bad experience was a learning experience?” And she said, “Absolutely.” I said, “So, what was the difference?” She says, leadership of the clinic. That was such a profound statement, okay? What I say to DSO is that any clinic model that wants to engage, choose your teaching doctors wisely. Because the world will know tomorrow, because a lot of our DSOs and our public health clinics have benefited through the recruitment platform. I know that that’s a big struggle for a lot in this space, how much money are spent on recruitment and retention annually?

Bill Neumann:

Right.

Dr. Bill Piskorowski:

And you know what, I’ve given you a free working interview, okay?

Bill Neumann:

Yeah. Right.

Dr. Bill Piskorowski:

I mean not free, but it’s offset.

Bill Neumann:

Yep, yeah.

Dr. Bill Piskorowski:

The costs are offset. And [crosstalk 00:17:21]-

Bill Neumann:

Absolutely. So, that leads into the next question I have. So as far as we talked a little bit about how, what the students feel, right? When they come back from working with a DSO or one of the other models. Talk with to me a little bit about the feedback you’re getting from DSOs?

Dr. Bill Piskorowski:

A lot of DSOs, I have to tell you are very enamored with the program. And they understand that this is a stepping stone, right? So those that really work this out well, I have to tell you when they come forward and they provide an orientation process on day one of expectations, those are the clinics that they’re going to accel. When the student has this orientation with the dentist and says, “These are my strengths and weaknesses,” if they listen, then they make this go and happen. Because you know what? Residency programs, this is nothing exceptional. It’s a residency program, basically with trained doctors. And I have to tell you, one of our DSOs has really hit it. That is, they selected their top mentors in their group as teaching dentists.

Dr. Bill Piskorowski:

So every one of those dentists won some sort of mentorship award within their organization, and those are the ones now being selected. Now, what has happened? We have seen various levels of expertise and clinical expertise. We talk to them on how to be a good teaching dentist, and we have modules on this as well. So what I enforce, I used to do, first, allow our students to treat all the emergency patients. Because they’re really good at triage medical histories and deciphering, and making it simple in a presentation to the dentist. And in those contexts, that patient feels more comfortable. Because quite frankly on exit interviews, we find that the patients actually like being treated by the students, because they’re more compassionate. They haven’t been scathed, okay? By real world, if you will.

Bill Neumann:

Right.

Dr. Bill Piskorowski:

And then at that level, there’s the communication that goes on and this bond is occurring. And the preceptor along with the chairside assistant that they work with is another set of eyes and ears, says, “You know what? This student is capable of doing more or less,” than originally thought. That’s how you have to build upon it, right? So I look at clinical experiences, I try to of our students of 40-40-20 split. 40% of all their procedures should be preventative or diagnostic in nature, 40% restorative in nature. 20% should be in pain management, whether it’s root canals, exodontia or prescription writing.

Dr. Bill Piskorowski:

Those are the three platforms that I look at from a general practice perspective. Then we look at geriatric, pediatrics, and the general population in the middle. Are we giving them? Because my experience with pediatrics, when I graduated from Loyola was pretty minimal. And ergo, I liked working on kids, but I wasn’t really trained that well in working on kids. Back in my day, right? So, that’s why a lot of practitioners. But now we’re giving that confidence, because we have sites that only work on children, okay? So we look at the profile of a clinic, we tried really to fine tune that and make it better.

Dr. Bill Piskorowski:

In the end, we look at the strengths and weaknesses. But I have to tell you, I would say that the clinical skills of most students in most dental schools has gone down just a notch. They’re going to need a little bit more nurturing going forward. But you can make that work in this arena, because confidence built up. I mean when I left dental school and started my own practice, I literally did my entire graduation requirements in two weeks in private practice. Was I prepared to do that? No, I was thrown into the fire, okay? But I had to do that to survive. So this is what we’re giving, is a nice assessment. And if they’re true to their, how do you say, judgments and of their own self-assessment, this is a great path on what they need to do after graduation.

Bill Neumann:

Oh, that’s great. So, talk about this. If a group practice DSO is listening, and this sounds intriguing, what’s the catch? What’s the cost? What’s the pain point?

Dr. Bill Piskorowski:

Okay. Like anything else, you become an extension of the school. But we do not tell you how to run your practice, by any stretch of imagination. In essence once you sign up with us, we go and review the clinic, we look at the facility. Is it going to be a good, nurturing environment? How many chairs do you have, how many spaces are not utilized? And then I come up with a formula of how many students you should consider in a pilot program, whether it’s one, two. The most we ever had in one of my models was six, and there was a retired dentist that was overseeing those six. So at that age, he wasn’t really, how do you say? Capable of seeing that 20-patient schedule himself, but he could definitely work with six students in the restorative arena and two students in the surgical arena.

Dr. Bill Piskorowski:

So we gave that individual another opportunity to give back, if you will. And to make a living, okay? And they had fun doing it. So, the model is this. I go and see how the clinic participates. Quite frankly in some situations, I’ll stop, I’ll show up at the office. I usually book the first appointment. I watch the employees walk into the office, and I see what the attitudes are. Are they energized, are they less than energized? How am I received at the front desk? These are all things that we look at. I have to tell you, normally within 10 minutes you could find out if we’re heading in the right direction, okay?

Dr. Bill Piskorowski:

Then if that passes that purview, we have a discussion with the doctors and I lay out a formulary of the expectations of the doctors. And if you want to go forward, give me a list of the names of the doctors that you want us to credential. For an adjunct appointment, as a faculty. Because that adjunct faculty appointment gives liability protection while working with the student, just as if you were working with our student in our home base clinic in Westwood, California. So basically, no extra liability insurance is necessarily. We don’t say to give up yours. Because if in the event of a lawsuit, everybody gets sued, okay? What I’m just sharing to you is that UCLA prize themself on this structured process.

Dr. Bill Piskorowski:

Now, it takes two to three months to go through the vetting process. Because we do background checks, everything with the UCLA to make sure that you should be a teaching dentist. Then we also have to tell the State Board of California, and also the Commission on Dental Accreditation, why we selected this clinic. Then we get approval, and it takes a couple months for that to happen. Then we do a three-month pilot program, and usually one rotation is good enough to find out what’s going on. But in three months, we can look normally do about 12 rotations or 12 different students at three weeks each, okay?

Dr. Bill Piskorowski:

We find, and we go back and we talk about the financials. We talk about the productivity, we talk about the experience for the student. We talk about, is it rewarding for the site? Is it a plus, is it an energizer for the location? So we go over all these data sets, if you will, and then we talk about the contract value. So the minimum contract, that I will be straight up with you is based upon the state and the payer mechanism. A standardized contract is $200 a day for a pre-doc student and more, twice as much for a resident. And we even allow faculty to go. And again, depending on the model and the payer mix, we then negotiate this.

Dr. Bill Piskorowski:

And then we review the financial data after that period of time, to see if we’re hitting on target. So if a site takes more than one student, I do negotiate the fee down. Because transportation, our program handles all program costs. Meaning we do the cars, the rentals, the hotels, the flights when necessary. And all this, all the student has to do is show up, okay? And we extrapolate that. If it’s above and beyond costs, the sites or the other clinics usually help with the airfares and hotels. But if it’s local, that $200 per DM usually is enough to suffice everything that we need to do.

Dr. Bill Piskorowski:

Because one of the greatest expenses I have, as the director of the program, is our IT component. Which is not cheap, okay? And we need this information to make the program better. Because my team of Dr. Lisa Nguyen, Dr. Steve Lee and Kyle Tupaz, we review this data every three weeks. And I said, we try to put ourselves out of business after each rotation. Because if we don’t look at this and improve upon what we’re doing, that somebody else will. And I have to tell you, sometimes it’s a struggle at the beginning. But once we go into the flow, most people do do like the process.

Bill Neumann:

Okay. So a couple other things here, as I kind of think this through. What about … and I might have brought this up earlier on in the conversation. But beyond California and beyond UCLA, are there any other university, any dental schools doing anything like this in the country?

Dr. Bill Piskorowski:

Oh, absolutely. I started this I at University of Michigan, okay? With the model. Because most programs rely on grants to fund the process. And when I came on board at Michigan, I lost a grant within three months for some technicalities that I had nothing to do with. And then the Dean even said to me, he goes, “Well, we might have to cancel the program. We can’t afford to be sending our students, and I’m not going to charge our students.” Because some schools do, and I think that’s criminal. When you’re looking at an average graduating student getting out of school at $300,000, that’s insane, okay?

Dr. Bill Piskorowski:

Because going back to what I said before, the return on investment. Depending on the payer mix, is at least break even to 8.9%. It’s somewhere in that spot, depending whether you’re a public health clinic or a fee-for-service, but you definitely do not lose money at this. So it’s kind of if you’re breaking even or making money, you’ve got a recruitment tool, okay? We’re evaluating your clinic from the eyes of a student, “I don’t know if you say no to me that I personally want to work with you.” Because this is a win-win-win for everybody, because you’re enhancing our students education and we’re increasing access to care for vulnerable populations sustainably and accountably. That’s my mission statement.

Dr. Bill Piskorowski:

And it hasn’t vacillated since 2006. So, I have to tell you that we have proven value in most segments. But at the end of the day, most of our students are seeing anywhere from six to nine patients a day, which more than amply pays for the cost of the program, depending on the payer mix. At dental school, they’re seeing two patients a day. So, the environment is so much better. I have to tell you that we allow some of our students to get credit for their services and outreach. And in some cases, they can do as much as one quarter of their entire requirement during CBCE rotations.

Bill Neumann:

Wow.

Dr. Bill Piskorowski:

So, the students like it as well.

Bill Neumann:

Yeah. Yeah, for sure. Talk a little bit about, you mentioned the working interview, which is great. Do you have any numbers on fourth-year students that have worked in a DSO setting, that end up going to work for that DSO afterwards?

Dr. Bill Piskorowski:

Yeah. So there was one DSO that we worked with after the first seven rotations, seven different students, two were hired.

Bill Neumann:

Okay.

Dr. Bill Piskorowski:

Okay? And I will share with you that the others were seriously contemplating it, but they chose to go to postgraduate opportunities like specialties’ programs, okay? But this is in their eyes, that so, the seed has already been planted, right? But that same DSO, I will share with you that since 2009 … and this is not my numbers, this is right from them. That they hired 69 of our graduates since 2009, but 30 of those 69 happened since the development of the program. What’s ironic about that, only 10 rotated through that location, okay? But it was word of mouth from their colleagues saying that, “You know what? This ain’t a bad option,” because a lot of students are selecting options with DSOs and other clinics.

Dr. Bill Piskorowski:

And they wind up leaving after six months because it wasn’t what they, okay? So right now this working interview, I have to tell you it’s a win-win for our students in opening their eyes, as well as for the sites. And that when I look at some of these DSOs, anywhere from five clinics to 1,000, that’s a manpower issue, okay? I will tell you that we have become part of an HR system. If they want us to be, okay? Meaning we tell them about their workforce, they can tell us about our workforce. It’s a win-win.

Bill Neumann:

Yeah. And with the issues that everybody seems to have with recruitment and retention right now, I mean I think any help in the HR department is needed. So talk a little bit about the future of the program and what do you see as far as working with more DSOs, across more states with more universities, with more dental schools? I’d love to kind of hear your thoughts on the expansion of the program or just even from a UCLA perspective?

Dr. Bill Piskorowski:

With the other 13 that are now interested and reaching out, I have to share with you that obviously we don’t have the manpower at one school to do that. But it leads into why I came to California to begin with, because there’s six dental schools here, okay? With another one starting up. And I have to share with you that I really would love to see a day where our dental students work with other dental students from other schools. Because if someone’s doing it better, I want to know why, okay?

Bill Neumann:

Great point.

Dr. Bill Piskorowski:

So this is a way of us competing, and healthy competition is good in this arena. Because I know personally, I mean viewing on international programs and stuff. Where students from other schools, they kind of pump their chest up and say, “Well, we know this and we know this.” And you know what? It’s so gratifying to see that these experiences are translating into real world environments, right? So going on, when the dean says, “Bill, you’ve got this aquarium where we don’t have a formidable program,” what now I’ll share with you is that there are a lot of schools that have programs. But again I’ll say it’s, they’re not cost offset. They charge their students sometimes, or they get some other funding.

Dr. Bill Piskorowski:

I want to share with you is that we evaluate just about everything. All our systems are in order. I’m not saying we’re perfect by any stretch of imagination, and that’s why I want to really conglomerate with other schools. So, we have 16 dental schools that we have actually shared this model with. Right now, there are three that have embraced the majority of the platform, and another three that are using parts of the template. And now I will share with you, as we get more DSOs on, we would like to centralize this process. That I had mentioned the first part, UCLA would be very interested in creating what I call an academic dental support organization, that structures the relationship on this platform between other dental schools and different practice models.

Bill Neumann:

Yeah. That’s pretty interesting, exciting, exciting times. Before we wind this down, Bill, is there anything that you want to mention? Did we forget anything?

Dr. Bill Piskorowski:

Yeah, I would say there’s some tangibles and intangibles. And where do I see this going? I’ve met with several DSOs, and several in particular are embracing primary medical care or urgent care.

Bill Neumann:

Right.

Dr. Bill Piskorowski:

And I really believe that that’s going to be a winner-winner, chicken dinner if you will, okay? And I will share with you that my goal is not to just limit this to the dental students, but we are now reaching out to our nurse practitioners school to send a cohort of medical providers. Dental being at the top, because we developed this into these arenas to help our patients understand their own health and to improve their quality of life. So down the road, I do want to see this. Because the model not only works in dentistry, it works for nursing, it works for veterinary medicine. It works for a whole bunch of other cadres of health professionals, social workers to name a few.

Dr. Bill Piskorowski:

I know I’m leaving a lot of people out, but I will tell you that we are positioning ourselves with champions. And the other intangibles are what … if you prove the pilot program is working, some universities are allowing co-branding, okay? So I’m saying, is that probably wouldn’t hurt for some DSOs to have an affiliation with UCLA School of Dentistry on their wall, okay?

Bill Neumann:

Right.

Dr. Bill Piskorowski:

And we do have an example of that in Southern California, with one of our public health clinics. And that person really deserved that award. Because not only is he taking our pre-doc students, he’s taking our oral surgery, pediatric and our endodontic residents, and open to mind for innovative programs in digital dentistry. So I mean, we are really trying to position ourselves to really create and be that person that goes into the community. I’m just trying to live the mission of our Dean. Because when he told me, “I’m bringing the dental school to the community,” I’ve never heard those words from another dental school, okay? That’s what captured my interest in coming here.

Dr. Bill Piskorowski:

So I will share with you, is that those doctors also have a tagline to go and communicate with our experts at the school. If something arises in their practices, if there’s something they want to learn, if a practice profile says that these doctors that are watching our students need more surgical experience, then we’ll go and train them, okay? Or provide a program, or in fact encourage our faculty to go work their day a week to help offset some of the shortcomings of those practices. So, everything’s on the table. That’s what I really love about the Dean and his administration and leadership, is that he is considering all opportunities.

Dr. Bill Piskorowski:

And that’s kind of like you, Bill, with your corporation. And that is, you explore everything. Because at the end, we’re trying to assist people to become better, at whatever they do. That’s basically what I want to do is shorten a learning curve of our graduates, to become better clinicians and confident in what they’re doing.

Bill Neumann:

Well, I certainly appreciate that, Bill. And I think it’s a really valid point that you make and something that probably can’t stress enough, is it sounds like UCLA School of Dentistry operates a bit differently than maybe some of the other dental schools out there. And especially the perception I think that DSOs and maybe the industry has, sometimes they’re maybe stuck in old ways. It sounds like you’re very progressive doing things that are pretty much outside the realm of what we would think of in, as a traditional dental school doing.

Dr. Bill Piskorowski:

Yeah, I’m just trying to give diverse portfolio experiences, okay? There are some dental schools that actually own their own public health clinics. So that’s one model, that their students are engaged in. I think we need to allow them to explore all opportunities.

Bill Neumann:

Yep, and that’s what you’re doing. Bill, can you just shout out your email address? If anybody who’s listening or watching this wants to get-

Dr. Bill Piskorowski:

Okay.

Bill Neumann:

And we’ll put it in the show notes, but in case they’re just listening.

Dr. Bill Piskorowski:

Okay. So it’s my first initial, B as in boy. And my last name, Piskorowski, [email protected]

Bill Neumann:

And we’ll make sure that we have that in the show notes, just in case you can’t spell that. We’ll give you a pass on that.

Dr. Bill Piskorowski:

And again, if you just go to the UCLA website, just look up administrators, you’ll see. It’s easy to find as well. But again, I really look forward to speaking to others, because entering into the DSO space has really enlightened me in many different ways. And the vendors that I’ve met, I have to truly tell you, these are things that dental school should be looking at as well. The AI components that I see, if you look at this, Bill, a dental school is a vertical DSO. We see 600 patients a day. I have to tell you, our systems are not necessarily perfect, okay? We would benefit by even attending these segments as well.

Bill Neumann:

Yeah. And you attend quite a few of them. So I mean more than likely if you’re at one of these upcoming … especially in 2022 and now that we’re at the end of the year, there’s a bunch coming up. And I know I’ve … in fact where I met Bill several times as, at these DSO conferences. So, we’ll hopefully see you there. But in the meantime, don’t be afraid to reach out to him. Like I said, we’ll put his email address in the show notes.

Bill Neumann:

And I’d like to, again, thank everybody for listening in or watching us on YouTube. And again, it’s been a great year for us here at Group Dentistry Now. We appreciate the relationships and having great, meaningful conversations like the one we’re having here today with Dr. Bill Piskorowski. Again his, he is the Associate Dean of Community-Based Clinical Education. CBCE, that’s what we’re talking about today and how a DSO can leverage that. Thanks, Bill. Any final words?

Dr. Bill Piskorowski:

I just really am enjoying the ride. I know the DSO space is here, and I just want our students to get the best experience possible. And I can’t thank you enough for allowing me this opportunity.

Bill Neumann:

Yeah, and thank you. So until next time, I am Bill Neumann, and this is the Group Dentistry Now Show. Thanks.

 

 

 

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