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Unlocking Growth: The Power of Dental Partnerships
Episode

David Thoni, Chief Growth Officer at Independence Dental Services

Unlocking Growth: The Power of Dental Partnerships

 

For many dental practices, growth comes from engaging with Dental Service Organizations or Partnership Groups. 

In this episode, David Thoni, Chief Growth Officer at Independence Dental Services, shares with Dr. Jonathan Levine and Mariya how his platform seeks to build a profitable patient-centric business model with high-quality results and their relationship with DSOs. DSOs have a bad reputation amongst many dental professionals as, historically, they’ve had a cost-reduction approach to the practices they partner with. Independence takes a different road, where they support their partners’ autonomy and support their practices as long as it keeps patients’ interests in mind. This business model can still raise some eyebrows, yet Independence looks to partner with open-minded professionals who understand successful dentistry can be varied. Independence takes care of office tasks and introduces professionals to new technologies that can facilitate their job when delivering dental care, something that can broaden their coverage with teledentistry and AI tools.

 

Tune in and learn more about the corporate partnerships that can enhance dental practices!

 

Unlocking Growth: The Power of Dental Partnerships

About David Thoni:

David Thoni has held various executive leadership roles in the dental and healthcare industry, most recently serving as President of ClearChoice Dental Implant Center’s east division. Before ClearChoice, David served as head of global sales for Straumangroup’s Neodent Division. He is a growth-oriented management executive with more than 20 years of award-winning achievement driving revenue growth and performance turnarounds within the medical device and dental industries.

 

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Jonathan Levine:
Welcome to Think Oral.

Mariya Filipova:
Where we connect the unconnected between oral and physical health.

Jonathan Levine:
I’m your host, Dr. Jonathan Levine.

Mariya Filipova:
And I’m your host, Mariya Filipova.

Jonathan Levine:
Let’s get at it.

Mariya Filipova:
All right, here we are. Another episode of Think Oral Health. Jon, I’m super excited about our guest today, a very different person, personality, and perspective from our conversation partners so far and a first representation of the DSO perspective on this call. Very excited. I can’t wait to get into the conversation. Tell us who we’re speaking with today.

Jonathan Levine:
Yeah, amazing, amazing. We are super excited to have David Thoni, who is from Independence, a new dental service organization. And I say, and the more I know about what they’re doing, I’m calling them the disruptors of the disruptors. The DSO industry has disrupted the dental industry, organizing the dentists, it’s a fragmented industry. David comes from a fantastic dental background from one of the large implant companies, Straumann, running their divisions. After that, he ran one of the largest implant DSOs in the whole, east side of this country and then partnered up with Lane Theriault to start this Independence. David, welcome to Think Oral Health.

David Thoni:
Thank you for the invite and I’m very happy to be here.

Jonathan Levine:
Oh man, Great to have you here. So, David, I think the number one question I want to ask you is about the pain points of dentistry. You’ve been in the industry for decades, you are a senior executive of the industry, you’ve had a tremendous amount of experience working with dental professionals, different dental companies. What are the pain points that Independence really went after as they develop their business model? What was your thinking there?

David Thoni:
Yeah, it was a very different way of thinking. I never imagined myself being a part of a DSO. We don’t really actually view ourselves as a DSO, that’s more of a dental partnership organization. When I was introduced to Lane Theriault, our CEO, we had many different discussions around the good and the bad that DSOs, their impact on the dental industry. And I personally have a very negative reaction to the things I see in the market around corporate-driven dentistry and its propensity to drive unnecessary or lower-quality dentistry, I just don’t think it’s in the best interest of the patients. A lot of great groups out there, a lot of great DSOs out there and we wanted to create a different model that appealed to what we call the never-DSOs. So every dentist knows a fellow dentist that joined a DSO and was unhappy with the changes that were made. We wanted to create a platform and build a business model that created a harmonious relationship between profit and quality patient-centric, patient-driven dentistry. And I think that’s what we’ve achieved. And the way we achieve that is around what we call an extreme level of autonomy. And there are many groups out there that promise their dental partners autonomy. We go so far as to put it in writing in a contract that we can’t make any changes to the practice without our dentist partners approval. Very different. So we can’t make them use different labs, go to certain CDEs. So it really puts the burden on us to find quality partners to partner with that are positioned to grow. So it’s a very different, somewhat unique. There are a lot of dental partnership groups out there. We just take autonomy to a whole nother level.

Jonathan Levine:
So for the people out there listening, the dental service organization industry came to being to take these dental practices which are fragmented. In the old days, it was one dentist, one hygienist, one assistant, 70% overhead. The dentist was asked to wear many, many hats. Very difficult to create the type of business model that is highly efficient and highly effective. And so there was a new approach. They were originally called 20-25 years ago, dental practice management companies that evolved to dental service organizations. And as David, you’re saying, is evolving again. Mariya, when we think about this in health care and medicine versus dentistry, the medical professions that have their private dental offices where they have to hire people, they’re outside the hospital systems, the plastic surgeons, the derms that have these private offices have a similarity to these dental offices where the dentist has to be, the executive has to be a leader, has to wear all of these multiple hats. I guess the big question, David, to follow up is where do you think the early dental service organizations went wrong, where they developed this negative reputation, especially with a number of people in the industry? Where did they go wrong right in the beginning, as kind of these early pioneers?

David Thoni:
I’m not sure I would put the blame necessarily on them. And I want to be very careful not to speak negatively about them. I would put it really on the financial people that were putting these on them to achieve the returns and the profits.

Mariya Filipova:
That’s right. When in doubt, always blame the finance people, right? As a recovering banker, I take offense to that. I do appreciate the corporate-driven dentistry that could be a side effect of optimizing for the bottom line and efficiencies. And so I do think that’s the conversation we want to have.

David Thoni:
Quite frankly, it is the easiest thing to do, and there are many dental practices that need a full-service DSO to come in and run them, and in many cases making it a better practice, servicing the community better. That’s just not the clientele that we’re looking to partner with. So I think perhaps maybe they just got carried away, was the focus on cost reduction. Let’s just go beat up all of our vendors and get the best price that we can, let’s optimize the schedules, and they didn’t focus on the culture and the practices. They didn’t really focus on the person they were partnering with. The idea is to make every practice look the same. I’ve heard that mantra from many different DSOs. We’ve got our playbook. We’re going to simplify and make them the same, and we want to partner with unique practices and continue to support their vision and what makes them unique in their market.

Mariya Filipova:
Let’s double click a little bit on that because I love where Jonathan was going with this. I, on one hand, dentists go to dental school and learn about clinical care and taking care of a patient. They don’t learn about running a business. And from that perspective, it makes sense. Let the dentist or the clinical team do what they are trained to do. What they, probably was the driving force for going into that profession to begin with, and then optimize for all the business operational aspect of taking care of a patient to the people and the teams who are best suited to do it. Conceptually, it makes sense. Now what I’m hearing is what we’re seeing in the medical side and the dental side is when the pendulum swings one way or another to the extreme. And if you are owned by a private equity firm, a private equity firm wants to do one thing very, very well, take costs out of the system. Now, it sounds like in your case, David, you’ve got that happy medium where you’re striking a balance between patient-driven dentistry and an operating model that is efficient yet not at the expense of the patient. Could you just describe what patient-driven dentistry means in your case? And specifically, are you talking about a standard of care doing things that maybe other dentists would look as a cost, like preventative care or procedures, or investing in technology and making the experience of the patient more, dare I say, joyful? So what is that patient-driven dentistry, what’s the meaning of it when it comes to your organization?

David Thoni:
Well, it starts with the dentist partner and their mindset of always doing what is right by the patient. For example, they may be looking at a tooth that has a lot of infection and endo might be an option, even though they know that it’s probably going to fail. In a patient centric-model, you explain clearly to the patient, but you say, you know what, I would like you to go see an endodontist to get their opinion, that’s what they do, they may have something else to tell you. Or doing a filling when that will suffice as opposed to doing a crown. The way I approach dentists in the past is to explain to them If you ever go to an auto mechanic and the mechanic tells you, no, you don’t really need to do this, this, and this, I think we should just make these minor adjustments and let’s see how it goes. You’re always going to see that mechanic. You’re always going to go back to that person because the trust and were skeptical. And so I think patient-driven or centric dentistry is about truly always having the patient’s best interests in mind and not trying to beat the crown production because some regional manager from DSO has come in and said, hey, your crown production is off 15%, what are you going to do about it this month? That’s what I mean by corporate-driven dentistry perhaps not being patient-centric. It puts the emphasis on profit.

Jonathan Levine:
Yeah.

Mariya Filipova:
And the implication is that you could still make money while you’re still being patient. And tell us about the business model behind that.

David Thoni:
Well, I had a professor at Harvard Business School that his mantra was make a fair profit fairly, and you will end up doing very, very well in business. That’s the mindset. Take the long view always with the patient, know that you’re treating them and their whole body because this is a profound impact on their health overall and their families and your community at large. So if you always keep that in mind, your reputation as a dentist will take care of itself and you’re going to get referrals from your patients.

Mariya Filipova:
You know, favorite topics. Jonathan is writing a book on this, on the systemic health and treating the whole body. So I can’t wait to hear what he has to say about this.

Jonathan Levine:
I love the conversation. The dental professionals, the medical professionals. The big common thread, I truly believe, is that we’ve gone into the profession because we want to help people. People coming out of great universities, we all had that wonderful opportunity and we have a lot of gratitude for it. And there’s choices we make in our college years of what pathway we’re going to take? When you go into health care, you’re not going to health care unless you’re going onto the business side of health care right away, you’re really going in to help people. And what’s happening today in dentistry, when these organized approach started hitting, there was a very big focus. And David, please comment on this on production, on the numbers, which leads me to one of my favorite conversation, which is the capital partners, that when you start, let’s say a company like you started choosing your capital partners and getting alignment on vision, on your strategy, on your value system is so critical. Talk to us a little bit about how you think about when you first chose your private equity partners or your capital partners. And as you guys have grown, as I understand, you’ve grown so steeply that you’ve actually gone to that next level. So tell us a little bit about what has happened in the last I think it’s a couple of years and where you are today with that thinking.

David Thoni:
Sure. Well, we launched at a very difficult time during the pandemic. It was a crazy time to start a business. And we had planned on launching in May of 2020. And then when the pandemic hit, we actually lost our financing or financial partner. We had to kind of start from scratch there. We were fortunate to meet a group called the Firmament Group, Private Equity Group based out of New York that really bought in to the management team and to the vision and saw the uniqueness of our platform. So we’re very fortunate. Our partnership with them in place, their vision was always to stay in about three years and we grew so rapidly the first year that we started making plans to bring on a larger sponsor, which we’re we’re in the process of finalizing right now a very well respected large group that’s going to provide a tremendous amount of capital for us to achieve our very ambitious goals.

Jonathan Levine:
And the quality of those partners, as you think about that, what did you look for besides just the capital? We know money is fungible, it comes from many sources. But those kind of decisions that you made as you had a number of choices of who you partnered with, what is your standard?

David Thoni:
It was interesting because our pitch was different. There were some confused faces in the room, and these are very, very smart financial people and they all know the business models that are out there. But when you sit down with a group, when you explain to them that you’re only going to focus on quality dentists and you’re going to put in writing, that you can’t make any changes to the practice without their approval, there’s a lot of head-scratching. Quite frankly, a lot of people just couldn’t understand how that would work. So I would say our biggest challenge in a partner was finding someone who grasped that vision, that understood that it’s much more likely that you’re going to grow a successful partner with great fundamentals in the practice than to grab a falling knife and correct things. We were fortunate that we’ve been able to a couple of groups that really bought into the vision and saw its unique place in the market that it’s appealing to those dentists that see the value in efficiencies that you get from joining a larger group, they just don’t want to bust.

Jonathan Levine:
Mariya, think about this from the context of medicine and hospitals and what hospitals are facing with the multitude of issues that they’re dealing with because of scale and how that balancing act of quality of care and also profitability and bottom line interface with each other. And this happens in each dental practice, but now we’re putting practices together under a corporate umbrella and the challenges of just that, it’s a very similar challenge. In your past as an executive and …, you know.

Mariya Filipova:
We see that, we.

Jonathan Levine:
Yeah, please weigh in.

Mariya Filipova:
We’re seeing that live now with frankly, United Healthcare Optum’s Group buying out, right, different practices in clinics and providers and optimizing on making them more digital and providing decision support tools. They’ve gone into beyond the operation model to advancing care delivery by providing some of those analytics tools, AI-driven tools. And so the model is not 1 to 1, there’s certain differences. When we think about where health care has gone in optimizing providers. I think dental is probably just a couple years behind because we’re just starting to look at analytics as part of decision support tools for the dentist. Most of the focus has been on operations, finances, let’s just get this busy work out of the way so the dentist could do what they do. I’m curious to hear both of your thoughts here. Jonathan, it’s no secret that your practice you are a friend of technology, but it’s also I would say you’re not a typical dentist. Most dentists rely on the art of dentistry, where it’s much more driven by the dentist. And so what do you think, David, as well? Like, are you looking to expand that support for your clinics to include some more decision support tools and AI beyond operations?

David Thoni:
Absolutely. That’s a key focus at our partner meetings, and that’s where the conversation with the insurance providers is going to start and come closer together with the dentistry is around AI and the preventive tools that are out there. When you look at the technologies that are coming down the road, it’s going to be much more focused on identifying caries and periodontal disease before it causes damage, it’s much easier to treat. That’s a big win for both sides, all the way around the patient and the providers. So it’s just a fascinating time to be in dentistry, it really is. We’re also very fortunate to be a part of this way, but you talked about pain points earlier. I think the biggest pain point is how we deliver all of these new technologies to a very rapidly changing dentistry demographic. You’ve got 37% of the dentists are 55 years or older, and we’ve got to find ways. I’m older than 55, and I can tell you technology is not as easy to grasp. How do we implement these new technologies and integrate them into the practices that benefit the patients is, I think, going to be key going forward.

Jonathan Levine:
I was thinking about technology before you asked the question, Mariya. That’s why we’re doing this together, and you know, the technology.

Mariya Filipova:
You think about it, I say it, that’s how it works and vice versa.

Jonathan Levine:
Yeah, but let’s think about it. In health care in general, it takes 17 years, by the studies, to adopt new technologies. And here we are in dentistry, it is a very exciting time, as David has said, and one of the great opportunities for these organized approach to dental practices, what Independence is doing is the ability to figure out that integration and on the educational side and how to layer in new technology, whether it’s going to the hygiene room, whether it’s digital workflow. So, David, as you have been at this now a couple of years with the dental practices, the integration of these technologies, can you give us an example of what has worked so far in enhancing and improving the individual partner practices and what kind of response you’re getting?

David Thoni:
It’s very interesting. A lot of dentists join our platform because they want complete autonomy, but we are very fortunate. We’ve got very, very collaborative partners, great clinicians, really nice practices, and they’re very open to looking at new technologies. So again, from our perspective, when we come in, we don’t say we want you to do this and it’s to be a very collaborative approach. We have to convince our partner that this is going to be good for their practice. And we may sit down and we quantify the numbers for them as well too, to say, Doctor, have you considered doing sleep apnea …? I’m a very big proponent of sleep medicine and how it’s really.

Mariya Filipova:
Ah, you’re amongst friends here, my friend.

David Thoni:
Is not only because it.

Mariya Filipova:
It is a big opportunity. Yes.

David Thoni:
But it’s a big thing to drive a connection for the medical community between cardiologists and sleep specialists, just as a starting point there, I’m a big proponent of it. But we had a lot of practices that don’t know how to integrate that into their practice, especially when many times it involves medical billing, etcetera. So it’s being able to sit down with them, quantify for them what the financial impact can be on the practice, what impact it’s going to have on their schedule and how you manage that in a busy general dentist practice and then providing a turnkey solution that would help them with medical billing or whatever it is we need to do to make it successful. So we have to present a business case to our partners. And if they say no, we close the book and say, okay, well maybe we’ll revisit that in the future. Clear Liners is another example where we may come in and say, this is the business opportunity. We’ve been very fortunate to have a great deal of uptake with our partners on our initiatives, and now they often come to us with, … say, I’m not excited with working with revenue cycle management or marketing, and we have many third-party partners, which is also unique as far as DSOs go. We don’t charge any DSO management fees, so it’s very, very different, so it’s a true joint venture. So when we do something together, whether it’s investing in new technology or building out more rooms for expansion or hiring a marketing company, it just goes directly on the P&L. So if we’re at 80-20% ownership in the practice, we’re effectively paying for 80% of the technologies that we invest in. So we spend a great deal of time looking for great partners to work with, great technologies that we believe in because we’re actually having to put out directly our money behind it as well too. We’re not capturing it in DSO management fees, so it’s a very different approach, hope that answered your question, Jonathan.

Jonathan Levine:
The uptake.

Mariya Filipova:
…. Aligning incentives, that is a very putting your money where your mouth is and aligning incentives. Brilliant.

Jonathan Levine:
Bingo. Yeah, go ahead, Mariya.

Mariya Filipova:
Those are listeners out there. David, For those entrepreneurs and startups who believe that they have an innovative solution that might be connecting the dots between medical and dental teams, what’s the best way for them to get in touch with you and get a test if they might be a good vendor partner for you guys?

David Thoni:
We have a fantastic vice president of support and performance for our director of Performance, as Carrey Lasher, is her name. She can be reached at Carey, C A R E Y @IndependenceDSO.com, and she and her team are responsible for collaborating. And we’ve got several pilots going on with our partners on new and different technologies to see what’s working. We don’t ever pretend to know best, we want our partners to try it out and for them to explain to the rest of our platform the impact that, in our practice.

Mariya Filipova:
Thank you for sharing that.

Jonathan Levine:
So let me switch gears a little bit for a second, David. As an industry senior executive for decades. And now you’re driving change in this new industry with Independence, where do you see this DSO industry going? Let’s just do a 5 to 10 year casting out. I think it was a couple of years ago it sounded like 12 to 14% of the industry was these dental service organizations. Now I think we’re over 20-21% of total revenue. Where is it going? Is it going to hit a ceiling or is it going to keep going?

David Thoni:
I think it keeps going. I was in Europe for a while and markets over there are, just 4 or 5 years ago. Spain, for example, already had more than 50% of the offices were a part of a corporate. So I think it will continue to drive. And again, what’s driving that, those demographics I spoke to earlier, you’ve got just very changing demographics. Dentists are over 55% of the over 55 years old comprise a large part of the market, they need a transition plan. And a lot of associates that are coming out of school, many of them are women that only work part-time and raise a family, are not interested in ownership. And so these guys need a path forward. They need a way to take the equity out of their practice. And so there’s fewer buyers for them. And some of them just can’t get their head around joining a DSO. I have a friend out in Arizona, asked him what his transition strategy was and he said a pine box, that’s how much he hates books. So we want to create a platform where people that are very skeptical, that just don’t want a boss, they want a partner that can help them grow, but also take equity off the table now and provide long-term planning for them. That’s the niche that we want to fill in this market. And fortunately it’s not a niche. There’s a lot of dentists out there that fit this mold.

Jonathan Levine:
And David, comment about the young dentists, young dentists coming out of dental school, $375 to $400,000 of debt after a number of years of dental school. How can your company have an impact also on the young dentists and the whole DSO industry in general? Answering that need as the dentists are retiring and maybe going from five days to four days or down to two days, the opportunity for new young associates to join these offices that are at a higher level because of this organized approach from the corporate team.

David Thoni:
Great question. The DSO industry, some of the larger ones, won’t name any names, but you have a kind of a revolving door sometime with associates coming in. They come in, they work for a year or two trying to pay off debt, and then they move on. And the patient experience is they’re usually finishing treatment with someone that didn’t start it. And some of these young dentists are doing it out of necessity. And I think what our platform provides is a pathway to work in a quality practice where they can get hands-on mentoring from a great dentist and can be exposed to the technology that’s driving the industry and how to use that. And by the way, a lot of them are coming out of school and are going to be a great resource for their dentist, for digital technology and digital workflows. So it’s very symbiotic, especially now we’re going to see more and more augmented reality teaching in universities. They’re going to come out much, much better trained with very little business training or experience at all. And Mariya, I know the perception is that dentists aren’t very good business people. I can tell you our partners, we’ve got great business people. I know that’s a broad brush to paint with, but it’s true. They don’t training in dental school. But there are a lot of great dentists out there that are great in both the back office and with the patient. So those are the folks we’re looking for.

Mariya Filipova:
Yeah. Appreciate that and thanks for calling out that myth because we do love calling out, …, purposely throwing out statements and see what gets picked up and dispersed. So appreciate that. And I can tell you, I mean, again, every single dentist that I’ve met in my experience so far on the innovation side, dentists are entrepreneurs, so they are quick learners, they go up that learning curve very quickly and figure it out. And so building a practice is very personal for somebody to say, I’m just going to be part of a DSO and have somebody else tell me what to do. It’s a very hard thing to do.

Jonathan Levine:
And Mariya, right, like what Edison says, necessity is the mother of invention. So.

Mariya Filipova:
That’s right.

Jonathan Levine:
You get thrown into it, you’re either going to sink or swim. From a business standpoint, the question is how well you’re going to do. And we know in business, we can all comment on this, it’s all about leadership and it’s all about culture and building your team to be able to provide a service at a high level and also to do well and to do good by people, don’t you think, David?

David Thoni:
Absolutely. The work is one that’s very interesting to discuss right now because it’s become so commonplace for the last 4 or 5 years for leaders to talk about culture. Everyone’s read the books, they’re espousing the same thing and the same values, exercises, it’s become a great talking point, but you have to have the awareness to look beyond the words and actually look at what’s going on with culture because everyone can talk about it, but not everyone absolutely implements. And we look for practices where there’s a great leadership and great culture and you can see that through turnover, you can see that through Google reviews, et cetera. But it doesn’t take long to figure out who is talking about a patient-centric practice and who actually runs one.

Jonathan Levine:
Thank you for that, David. Let’s go back to technology, and Mariya, I know she loves this area, too. In dentistry, we’re getting a huge impact. You were talking a little bit about the digital workflow. For everybody out there listening too, the concept of a digital workflow, in dentistry, it’s the opportunity to scan the mouth instead of taking those impressions, as you’ve seen in those funny TV shows and stuff goes all over the place and it gags you. We now use an intraoral scanner. It’s like a video camera in your mouth to take all of these images that gets pieced together. We scan, then on software on the computer we design, and then we can manufacture. You can manufacture anything from aligners to night guards to restorations. So as you think about new technology, what are you most excited about to bring to these dental practices that are already at a very good level and then trying to take them up to the next level in this collaboration and partnership of your company and these new dental practices, what’s getting you excited these days?

David Thoni:
There are so much to be excited about, but you also have to realize you can’t implement too much technology at once and you have to meet the clinician where they’re at today. You mentioned earlier the slow adoption of technology and industry. I think that’s going to change for a few reasons. Intraoral scanners have been around for quite a while now. There’s a long way to go with getting intraoral scanners, it’s a great opportunity for more and more of that. And it’s really going to be driven from two poles, it’s going to come from industry key opinion leaders like yourself and industry leaders at Henry Schein and other places that are educating the market on these technologies. It’s going to be driven by some DSOs that are realizing the efficiencies that they gain with these technologies, but most importantly is going to be driven at the patient-level. Patients are getting more and more educated theirselves, researching online. I can remember years ago when I was in medical, doctors were complaining about patients walking in with information they’d downloaded on WebMD and wanted to argue with them or debate them on the treatment. That’s happening in dentistry now as well, too. And what’s happening is it’s forcing dentists to embrace technology that patients are expecting. If someone’s still doing impressions and their friend tells them, go over to my guy, and they didn’t do that in my mouth, he uses a camera, they’re going to grow more. I think dentistry is learning more of that, it’s really coming from the market as well as the industry leaders like yourself.

Mariya Filipova:
Could we take that same question and apply it to, again, the practices that are within your partnership are high-performing, collaborative, integrating, medical and dental services, how does that model and technology could help us reach patients who are underserved, who are living in areas that might be dental deserts, who frankly are living paycheck to paycheck, and they show up to the dentist with a very acute issue. So for them, maybe that long-term view might be a luxury. So how do you think about your model of operating and technology enabling to reach some of those patients?

David Thoni:
Great question. Well, as I’m sure you’re aware, there’s about 60 million Americans that are living in rural areas with very little active dentistry. And many of them they’re unaware that dentistry can be affordable. I think Teledentistry is really going to create an opportunity for them to get more educated on the opportunities that are out there. There’s going to be more, I think services, especially if they’re preventive from the insurance providers. But I think it’s an area that we need to focus more on because the corporate-driven dentistry has not focused as much on that area because there’s not as much profit for them in there. But we’re also seeing, after the pandemic, some of the rural areas growing a little bit more. People have less desire to live in a highly populated area. We just don’t know. But no, you’re absolutely right. Now on our platform, it may not be at this point in our development that we’re going to go into smaller markets, but we certainly recognize the need and think teledentistry is a great start. I think AI is a great start for using these algorithms to identify problems, automatically as opposed to having to go in to see it. This could be a connection with their health clinic or provider. So I think that’s the way dentistry is going. It may not necessarily be where we go initially.

Jonathan Levine:
Mariya, just to give a quick thought on that, we have a foundation, the GLO Good Foundation, as you know, and we go to the Bahamas in partnership with Lenny Kravitz, Let Love Rule, and we bring in down about 100 professionals. And what our goal is, is not to go to so many other places, but to bring dentists to see what we’re doing and to educate them and to create a playbook where they can now go to their areas, their communities, and help them out, and we’re in partnership with Henry Schein. And this is something that organized dental groups like Independence could get involved with. And a lot of it is the leadership training of these dentists, the dental professionals, which they’re basically mini CEOs of their practices, but now they have a fantastic support team like David and his team as they come under this umbrella. So this could be a very nice, positive, reinforcing loop to bring access to care to people who don’t have access to care in different communities. And it comes right back down to building awareness and educating people in the capabilities they need to be able to build this, and it could be an exciting future for that.

David Thoni:
Yeah, I agree. And we all need to recognize how just incredibly fortunate and blessed that we are and what you’re doing and what many groups are out there doing is giving back to the community that is underserved I think is fantastic. Kudos to you.

Jonathan Levine:
It really comes back. Mariya, rght, you met some of my team. It comes back to your people because they get so inspired by doing it. When you come back to your practice, the culture of that practice, the excitement of what we do is amplified. That’s right.

Mariya Filipova:
That’s exactly right, I guess what I want to make sure is that, since David, we started challenging assumptions and dispersing myths, I want to challenge the assumption that taking care of those communities who are underserved, who lack access, is not a good business. And it needs to happen on the side as giving back. And I do believe that technology could help us be able to deliver quality care at a lower cost in a model that is profitable and sustainable. That’s really where I challenge everybody out there who is working on a new technology or disrupting the business of dentistry or care delivery. That’s truly where you would be able to show if your product works for those communities, it would work anywhere because if you could solve that. So love everything that’s going on in the GLO Good side. Love the model, David, you are proving with. Independence. And I do think that in the next couple of years we will see scaled models that work in those communities too.

Jonathan Levine:
One of the things we haven’t talked about and Mariya, you make such a great point. David, please comment on this, that, when your dentist partnered with an organized approach, you are freeing up time for them, the time that it takes to manage a practice, Mariya, on average, is a day to a day and a half in every week by the dentist, business owner. And if they partner up with an organized approach with business executives that are helping, giving them their independence, but really supporting them in areas that do free them up, they now have time for these other things which could be in the direction of doing well and doing good. David, are you seeing that, that are the dentists coming back to you and saying to you, I now have this support team and I have this extra time and now I’m able to do something that I’ve always wanted to do. Is this something that you might be hearing?

David Thoni:
100% Being a dentist can be a solo practice. It can be a very lonely time, everything is on you. So us taking all of the back office off of their shoulders, all the accounting, bookkeeping, the payables, the benefits management, managing, recruiting for associates and staff is the biggest headache right now for everyone. So them having a partner to take that pressure off of them or you’re in December and you’re thinking about how you’re going to meet payroll because of the way it’s going with the schedule. Those are things that are not a stress anymore on a dentist, we take that off. And I think having more time makes them better dentists because they focus on, above their staff. They can focus on now having a little bit more time to implement technology in their office. So we hear that from all of our partners.

Jonathan Levine:
Yeah, amazing. Yeah, It’s so exciting to hear these new trends in the dental profession where the profession is going and the ability to embrace technology not only with technology that we think about from a breakthrough, whether it’s AI or the new digital revolution, but business model innovation, bringing new innovation to how we think about delivery of care and doing it more efficiently and effectively. That is a great vision and very exciting to hear all the things that you’re doing over at Independence. What do you think, Mariya?

Mariya Filipova:
I think that we’ve given our listeners a lot to think about and I would love and again, thank you, David, for sharing your thoughts and congratulations on the success. We will be looking to you and be celebrating your growth and the milestones ahead of you. So very excited to continue to follow your success and we will absolutely continue to ask those questions that we raised here because we need more success stories like you in dentistry and more conversations like this.

David Thoni:
Thank you so much for having me. And Jonathan, I’m going to ask for an autographed copy of your book when it comes out.

Mariya Filipova:
That’s right. I think that’s it, for anybody who wants to be on the show, if you get to be a guest on the show, I think you might get a thank you gift from Jonathan. And I don’t know. I’m just.

Jonathan Levine:
Always.

Mariya Filipova:
Got ideas here. That’s right.

Jonathan Levine:
Always a little bit of swag. It’d be my honor and my pleasure. David, thank you so much for being on the show. Mariya, like always great to be on with you.

Mariya Filipova:
Great to have that time together. Thanks, everyone. Thank you.

Jonathan Levine:
Thanks for listening to the Think Oral podcast.

Mariya Filipova:
For the show notes and resources from today’s podcast.

Jonathan Levine:
Visit us at www.OutcomesRocket.Health/ThinkOral.

Mariya Filipova:
Or start a conversation with us on social media.

Jonathan Levine:
Until then, keep smiling.

Mariya Filipova:
And connecting care.

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Things You’ll Learn:

  • Independence doesn’t make any changes to a dentist’s practice without their approval, and they go so far as to put it down in a written contract to ensure it.
  • If one makes a profit fairly, one will do well in business.
  • Dentistry has just recently started to use analytics as a decision-support tool.
  • 37% of dentists are 55 years or older.
  • Independence does not charge any DSO management fees.
  • More than 20% of dental practices are part of some corporate partnership.
  • In some countries, like Spain, dental practices being part of corporate partnerships can rise to more than 50%.
  • Young dentists coming out of school can be significant in helping the adoption of new digital technologies and workflows.
  • About 60 million Americans live in rural areas with small access to dentistry. Historically, corporate-driven dentistry has not focused on them as they are not seen as profitable, so it’s an area that can be improved.

Resources:

  • Connect with and follow David Thoni on LinkedIn.
  • Follow Independence Dental Services on LinkedIn.
  • Explore the Independence Dental Services Website.
  • Reach out to Independence’s Vice President of Support and Performance, Carey Lasher, at Carey@IndependenceDSO.com.