In today’s show, special guest host Dr. Paul Homoly sits down with Dr. Quinn DuFurrena, executive Director of the Association of Dental Support Organizations. Dr. DuFurrena is a dentist and author of Transforming the Cottage Industry – The Rise of Dental Support Organizations.
Hi, I’m Dr. Paul Homoly on the Attainable Podcast network. With me this morning is Dr. Quinn DuFurrena. And Quinn is currently the executive director of the ADSO. Quinn has been an adventurer and an explorer in dentistry, from being a solo practitioner in a small Nevada town, to now being the executive director of one of the most powerful and prestigious organizations in dentistry. Dr. Quinn welcome to the Attainable Podcast.
Thank you, Paul. It’s great to be here. I think this is going to be an interesting conversation.
So Quinn, give me a sense– you’ve been in the practice of dentistry for many years. Where did you start? How did you get your beginning in industry?
Well, I’ve been in dental offices ever since I was a little kid actually. My grandfather was a dentist, graduated from Loyola Dental School in Chicago back in the mid 1930s. In fact he’s got some interesting stories about the Al Capone years back then. Then as a kid, he had a dental practice and I used to spend a lot of time in the lab. I actually learned to do a lot of fun things, that I thought were fun. Play with plaster and stuff like that, wax. So my mom’s a hygienist too. My uncle’s a dentist. My aunt’s a hygienist. So I’ve got it in my blood in a sense. So I graduated, went to dental school in 1983, University of Pacific School of Dentistry. And then went to the rural area after that as a dentist, and have practicing ever since.
Where did you go? Where was the rural area?
Well, I have a scholarship, and so I grew up in a little town called Winnemucca, Nevada. And my scholarship is to go back to rural Nevada for three years. And it was a fantastic scholarship, paid for a lot of my dental school. So I went back, started my own practice in Battle Mountain, Nevada. And the funny part is, I actually did the improvements on the lease. I built the wall, I put up the x-ray machine, bought used equipment, borrowed $5,000 from my parents, you know, to get it all started. And it’s one of those things where, really, when I opened the door, there was a line out the door. And it was at one of those things that paid back my loan within a few months.
Is your practice still there? Is the building still there?
It is. Actually what I did is I built it up, made every business mistake possible, and then I sold it after my scholarship was up because I wanted to join the Navy. And so that practice has been sold about three or four times, but it’s still there.
It’s still there.
OK, so out of the small practice in Nevada, you went right into the United States Navy? Is that right?
Tell us about that, Quinn.
Well, it was interesting because I had three years of practice and started my own practice, the Navy was very interested in me, because they thought, OK, here’s somebody that actually knows how to build a practice. So they sent me– I put four years in. They send me for one year. I was in Central America and South America, building dental offices, mobile dental offices for the Navy. And then three years I was in Scotland in the Highlands. And it was during the Cold War, so the base was an old RAF Air Force Base. And we actually monitored the Soviet Union and the submarines coming down from the Arctic. It was a blast. I loved it.
Outstanding. And what years were this? ’70? The ’70s?
Yeah. Well, I got out in 1990. So yeah, it was in the ’80s.
In the ’80s.
Graduated in ’83 and then got out of the Navy in 1990.
And from the Navy, where did you go?
Went back to the rural area. I’d seen the world. So it’s like, all right, let’s get back and let’s build another practice and then start practicing dentistry. So I went in again, built my own practice from scratch. This time, instead of used equipment, I bought new equipment, set in my own systems. And then I was there for 20 some years. During that time though, I started liking building dental practices. So I would build satellite practices, bring in an associate, and then sell them that practice.
Yeah. And what type of dentistry did you enjoy doing, Quinn? Was it bread and butter or were you into reconstructed care? Tell us about that?
Well, that’s kind of funny because it’s gold mining country. And my patients had fantastic insurance. Whatever I asked, that’s what they paid. But they really liked the gold restorations that I was doing. So I became famous for on-lays, inlays, and gold crowns because they loved the gold. And you know, it was one of the best restorations there was.
So, you know, it that sense I actually did my own lab work on my inlays and on-lays. But I had to do everything. In the rural area, you have to do everything. I took care of the two-year-olds, even the management problems, all the way up to– my oldest patient was 105 years old.
Outstanding. Outstanding. So 20 years in private practice in rural areas.
A stint in the Navy, seeing the world. So where are you now, Quinn? What are you doing now?
I kind of have to go with a story just a little bit more, because at one point, I decided to go to law school. So I did the four year plan while I was practicing. And then the ADA made me an offer I couldn’t refuse. They said we will pay you, come spend a year with us. We’re going to send you to Kellogg’s MBA program, which is right next door to Northwestern University. So I was there for a year as the Hildebrand fellow. And I did projects for the ADA.
Well then, I went to Idaho. My parents and family, they had moved there, and so I was the executive director for the Idaho State Dental Association. Then I went onto to the Colorado Dental Association. And then, at the time it was called Dental Group Practice Association. They called me up and said, hey, would you consider creating an association for us and expand it. So that became ADSO, the Association of Dental Support Organization. So I’m the executive director for that. And I’m the executive director for DOHI, Dentists for Oral Health Innovation.
And those dentists are whom?
Those are DSO supported dentists.
You know, they have a different need than a lot of the traditional solo practice dentists.
You talk about the Navy, going to Central America. You talk about going to Scotland and monitoring the submarines. You talk about becoming executive directors. How do these opportunities find you, or do you find them? How does that operate in your life, Quinn?
I think it’s because I’m into adventures. And so I seek ’em out. I wanted to go the rural area when I got out of school. But then it was like, no, I want to see the world. And so I volunteered for everything in the Navy. I mean, I went on a submarine, aircraft carrier, anything I could volunteer for, I did. And I loved it. It was fun.
You’re on a bit of an adventure now as executive director for the ADSO. Talk to us a little bit about that organization.
Well, there’s really two goals. And they’re both really fulfilling. They’re actually fun. One is advocacy. You know, this is a new model. This is something different in dentistry that’s really starting to take off, and it’s really because of the business environment. So there’s the advocacy part. So I go state to state. I educate what DSOs are and what they’re not.
Who are you speaking to?
Dental associations, dental boards, the dental industry as a whole. This is a concept that has come of age, and it’s one that people are very interested in.
How do you help dentists, or how do you help groups of dentists overcome their fear of change? Or do you?
Education– that’s the key. You know, there’s this grieving process of change, and education is part of it. The typical corporate world, the name of that brings up all these negative emotions. Well, once you sit down and realize that we’re all just dentists. We all have a choice on how we want to practice. Some dentists like doing the business side. Some like, you know, contracting with all these different individual entities, with these vendors. They enjoy that. I would say most dentists don’t.
I would agree with that. They don’t enjoy the business aspect and they’re not good at it.
Exactly. We’re not trained to do that. You know, there’s a few that have MBAs and good for them. But for the most part, dentists what to do dentistry. That’s what we are trained at. So you’ve got two extremes. You’ve got one extreme where the dentists say, well, I don’t want to do any business at all. I don’t want to own any assets. And that’s where you see a lot of millennials heading to, and they’re going to affiliate with Aspen and Pacific Dental Services and Heartland and those big DSOs.
Then you’ve got on the other extreme, the traditional solo dentists that says, I want to do everything. I want to do the HR. I want to hire fire. I want to do my own marketing. But you have this big gap in between. And with this changing environment, what I’m seeing is what I call it a hybrid in there. And it’s changing the dental industry. And that’s the dentist that wants the control– may want the assets. Dentists take risks. It’s a risk to try to get into dental school. It’s so competitive.
So that’s the type of personality that goes into it. So you’ve got this big group in the middle here, you know, hundreds of thousands of dentists, or 100,000 maybe, somewhere in there.
And what they want, is they want to own their own assets, but they don’t want to do all the business stuff. They want to concentrate on becoming an excellent dentist. And so that’s where I see the future going, this hybrid.
You know, I see the DSO is sort of a high quality dental laboratory. You know, right before we walked into the studio, Quinn, I gave you that metaphor of the dental laboratory. And you said you liked that comparison. Talk to me a little bit about that.
Well, you know, as a dentist if you trust a certain vendor, say you do this side. Let me do the dentistry. You do this side. Well it’s like having a great lab. You know, you build that trust over time. And it’s very inefficient for a dentist to do the preps impressions and then do their own lab work. And it’s very tough to get away with that anymore. Now I did it, but I had a corner on the market.
And I set my fees, and can I set them as high as I want it. Good luck finding that type of practice now. So if you’ve got a vendor that you trust, like a great lab, what you do is you rely on them to do your lab work, and I’ll do what I’m good at, and that’s crown preps.
Yeah, you know, and Stratus Dental is sort of a hybrid in terms of the DSO market right now, where Stratus allows dentists to do the dentistry that they enjoy doing the most. And then they take that business responsibility over and provide very high quality of services. Talk to us a little bit more about that hybrid, and where do you think that might lead us?
You know, I’m not sure where it’s going to lead us because I think it’s going to change. I think we’re going to see a lot of change. We’re in the middle, I would say, of really this industry just starting to mature. And I think what we’ll find is that there’s enough different practices out there for every type of dentist. So I think it’s incumbent on the dentist to decide where they want to practice. What do they want? Do they want the traditional? Do they want to affiliate with a large DSO?
And I think what will happen is that many will fall in the middle and decide, OK, I want to either own my assets or not. But I think more and more dentists are going to learn to trust entities that can do everything for them, because it’s like one last thing I have to worry about in the practice. So I see that whole middle ground really growing and maturing and changing, you know. But I don’t think we need to be fearful of the change, as long as we get back to the fact that as dentists we’re responsible for our patients. And let’s give the choice to dentists, how they want to do their business side of their practices.
Yeah. Do you see the DSO being an advantage to performing higher quality dentistry?
Absolutely. And I’ll tell you why, for several reasons. One is that, as dentists we can actually concentrate on doing what we’re trained to do. I don’t have to be sitting there if I’m doing a crown. I don’t have to worry about the fight that’s going on between the assistant and the hygienist again.
So I’m not concentrated on that. I’m concentrated on doing the crown prep. So that’s one thing. The more we do something like that, the better we get. And that’s what it’s all about, quality of dentistry. You know, and that’s best for our patients. But there’s another side to it too. And that is the quality assurance programs, the quality improvement programs that DSOs bring to the industry. I know very few traditional solo practices that have quality assurance programs in their practices, or quality improvement.
And I first became aware of this in the first DSO that I practiced at, the Navy. You know, we had quality improvement, quality assurance programs. So every week we would share with each other good practices, bad practices. And that is something that DSO-supported dentists– they have that. Solo traditional practices do not. So there’s a big advantage to that.
You bet. You know, you and I are about the same age, and we saw implant dentistry come into the marketplace. We saw dental advertising come into the marketplace. We saw cosmetic dentistry come into the marketplace. Do you see any parallels between those changes and the changes that DSOs are bringing in?
I do. You know, when we first started doing implants, when we first started doing cosmetic dentistry, there was a lot of push back.
You know, the old guard was saying, you can’t do cosmetic dentistry. Now get back to doing fillings.
Yeah. Gold foils, exactly. Or amalgams like, hey, you can’t do composites, you need to do amalgam. Well, like everything else, there’s a cycle. And you go through the cycle and you show, hey, look, this works for dentistry. In fact it’s very good for dentistry. And so I think once again, we see this cycle where there’s resistance upfront. And then there’s the fear. But then comes acceptance. And we realize looking back, that hey, this was just another phase we went through as this industry matures and changes.
What would you like to see the DSO industry do better?
I think that through this change, I think one thing we can do better– besides communication, that’s a given. Communication and education. But it’s about bringing awareness to ethics. You know, there’s a big fear out there that as you give up some control of the business side, that in some way that interferes with your ethical decisions. Well, I think we need to address it head on. I think that we need to sit down, we need to work through the ethics.
We need to realize that it’s the dentist that is responsible to the patient. We should never let any entity interfere with our doctor-patient relationship. So I think ethics is a big one. But I also think we’re at a crossroads. We have the ability now to create an environment that’s conducive to good ethics. And I think you put those two together, and our industry and our reputation as an industry skyrockets. And I think that’s what we need. That’s one.
The second thing, metrics. We have got to start measuring our dental quality. We have to start getting away from these procedures, reimbursement by procedures, and we need to get towards utilizing metrics so it improves the quality for our patients.
So more outcome-based compensations?
Exactly. Value for the patient.
Well I think that’s the key to the future of dentistry, at least as far as I can see. Ethics is a big concern. We read about it every day. Let me tell you this. Just last night I got another paper. Senator Grassley is coming out again and talking about the ethics of over treatment in Medicaid. And so I think that is just forefront. We’ve got to address the ethics problem.
But I think it’ll be addressed in over treatment. It’ll be addressed by the fact that we move away from procedure-based. That way there’s no incentive for dentists to over-treat. Because we understand– you know, I’m not justifying it, but we understand when there is such low reimbursement for Medicaid, and it’s based on procedures, that there is an incentive to over-treat, and certain individuals will do that. Once you take that incentive away, it changes the game.
So number one is ethics. Number two is the metrics. To be able to do that, to be able to change from procedure-based reimbursements, we have to measure. We have to take the population at risk, evaluate them, and say, we’re going to get them to a place of help. We’re going to get them to better outcomes and value.
And then the third thing is utilizing the metrics for innovation. And I see Stratus as in that area of innovation. It’s a new innovative model that can help dentistry. We didn’t even have this discussion only 10, 20 years ago. And now all of a sudden we’ve got these discussions. So I think the ethics metrics and innovation, that’s going to drive the future of dentistry.
You know, you’ll written an excellent book called, Transforming the Cottage Industry: the Rise of the Dental Support Organizations. I read it three times. I think it’s outstanding. Tell the listeners a bit about this book and why they should read it.
Well I start off explaining how we got where we’re at right now. You know, we’ve got an environment that’s rapidly changing. Things like dental expenditures are expected to remain flat for a long time. The high debt that students are coming out with. You know, the fact that 50% of the dentists now are females. They’re going to want to practice differently. There was one dental school, their graduating class, 60% of the class was female.
Yeah, we had one in our class.
Yeah, yeah. Exactly. And so you can. And it’s changing. And the fact the millennials are changing. You know, there’s a recent study– 88% of them, they don’t want to work in a traditional isolated practice. They want collaboration. You put on top of that, this change in consumerism, that they’re demanding quality, they’re demanding convenience, and accessibility. You know, they are demanding things. And technology’s changing. They’re empowering consumers.
So that’s the changing environment. And then, in the book, I start looking at how did DSOs adapt to this changing environment? Well, they started creating economies of scale, standardized efficiencies. Very similar– I talk in the book about how Henry Ford did it with the Model T. I wasn’t alive back then, close. But I’ll bet you, you had a lot of resistance when he started saying, hey, we’re going to do this on an assembly line. You know, there was a lot of car manufacturers that said, oh you can’t do that. But what he did, he drove down the price of a car, so that the average individual in the United States could buy one. And that is what DSO supported dentistry is doing. It’s driving down the cost, so more people can access that care.
A study the ADA did– 40% of the individuals that didn’t go to the dentist, the reason was, they said they couldn’t afford it. Well, you know, we have the responsibility as professions to change that. We live in a very rich country. We should be able to provide dentistry for those that need it.
And so, if a reader wanted to get this book, how would they go about it?
There you go. And later on in this, we’ll give you Quinn’s contact information. Talk to us about the Dentists for Oral Health Innovation.
That’s an exciting group, a very smart group of dentists. They are the DSO-supported dentists. That was their choice, and that’s what they like to do. And so they’re all about improving the quality of the industry by utilizing metrics. Because they’re affiliated with DSOs, the DSOs have the ability to aggregate a lot of metrics, a lot of data on dentistry, the procedures. We can look at what works and what doesn’t.
And it’s like the first time in history we’ve actually been able to aggregate the data from provider space. You know, we’ve been able to do it from payer space. You’ve got insurance companies, they can get all this data. And they don’t share it, but now we can get it from providers. So we can find out and improve the quality of dentistry. Well they’re leading that charge. And so it’s exciting for those dentists.
Quinn, you mentioned that the ADA did a study on 40% of Americans not being able to afford dental care. And that it’s the professions responsibility to help solve that. I get that, I really do. I practiced in a rural area. I understand what people who have significant dental problems in their life– it destroys their life.
But, you know, there are dentists who want to practice a more elevated level of dentistry– implants, cosmetic, reconstructive dentistry. Talk to me a little bit about, how does the dentist who wants to pursue a more comprehensive, a more of a complete care practice– in the DSO environment, how does that work together?
Well the nice thing is that there’s all sorts of different types of DSOs. So as a dentist, you get to pick what you like. Some are very geared around technology. Some do big, large cases with implants. Some are very geared towards the Medicaid population and children, and taking care of that population. I think it’s very nice at this time in history where you get to actually choose what type of dentistry you want. And don’t forget that we have this all baby boomer population that needs all of this restorative dentistry.
And if we look at the payer base, the greatest percentage is fee for service dentistry. That’s still huge out there. A lot of times we start concentrating on the different ends, you know. The Medicaid population, how to make that work. And there are specific DSOs that make that work. And it’s a whole different business model. Then at the other end, you’ve got dentists that want to concentrate on cosmetic dentistry, you know, and add implants to that. And there’s a big demand for that. Then in the middle, you’ve got everything in between. And the nice thing is, is as a dentist, choose where you want to go. What are you interested in?
Is there a menu out there? Is there a clearinghouse? Can a dentist call a phone number or look at a directory to find ideas that caters to a specific type of dentistry? How would one go about that?
Boy, that’s a great question. I don’t know the best way, but I think of what, if you’re a senior in dental school, you better start looking. Or a younger dentist, you know, find out more about yourself. What really turns me on as a dentist, and then pursue that. In a sense getting back to, I like adventures in dentistry. And I think dentists need to decide, hey, what do I want to do? And then pursue that. I know dentists that are fantastic in cosmetic dentistry. I know other dentists that absolutely love treating children, and 60% of their practice is Medicaid-based dentistry. And I think, just find your niche. That’s what I’d recommend.
You know, we talked last week about this. And you made a comment I thought was really, really smart. It was, for dentists who might be investigating the DSO environment, to actually talk to other dentists who belong to those DSOs. Talk to us about that.
Yeah, that’s I forgot about that. Absolutely. You know, the best way, if you know somebody that is affiliated with Pacific Dental Services, call them up. Go visit their office. I’ve spent many days in different DSO-affiliated practices, looking at the different practice models. And, you know, a lot of them, I go, I’d love to practice here. In fact, most of them I would. But it’s find the dentists that are in those practices and spend some time with them. Find out what they like, what they don’t like. And I think that’s the best way, boots on the ground.
Boots on the ground. You know, the American Dental Association, from what I read, seems to be taking a neutral stance on this. Talk to us a little about the ADA and the DSO relationships.
Well, actually we’ve been working together. The ADA is a conundrum, it that’s a real word. What’s happening is, as these younger dentists are affiliating with DSOs, they really look at the value of joining the ADA, and they don’t see it. They don’t see the value there. So the ADA is losing relevance. It’s losing membership. But as a long-time ADA member, I think it’s important that as dentists we belong to the ADA. I think it’s good for the industry which is good for our patients.
So the ADA and ADSO have been working together to create value, so members will join the ADA. But we want something too. We don’t want to be fighting in the states against organized dentistry that doesn’t want to see this changed. And so we’ve been working collaboratively with the ADA. And it’s a slow process, and I understand. The ADA’s a big battleship, hard to turn it. But we’re making progress.
And so I think in the future what we’ll see is that a lot better collaborative effort between ADSO and ADA. I think we’ll see more members joining ADA. But I also think as the acceptance of this new business model, the more acceptance, the less resistance, and I think eventually we’ll look back and say, yeah, you know, ADA’s taking care of me as a dentist. And it doesn’t matter what mode of practice I’m in.
And so give me a sense, what form does this resistance take on the state levels? What are you hearing and what are you seeing? What is actually happening on the state level that inhibits DSO growth?
Well, a lot of times it actually could be the state boards creating some type of regulation to try to restrict the growth. And a lot of it comes down to, you know, a very anti-competitive behavior. The FTC has weighed in. The Supreme Court has weighed in on that with state boards and being market participants. You know, when there are market participants and controlling the market, it has created an issue. So the Supreme Court came out with their ruling just recently. FTC has been involved.
That in the state of North Carolina.
And it’s in Texas too.
So, you know, I think the consumers that are really backing all this– you know, you got to ask yourself, what’s better for consumers? And so we see resistance in the states from that. I think it’s improving. I think we all agree that no entity should interfere with the doctor-patient relationship, with clinical decisions. It’s just more of working through the issues with that.
What about the Academy of General Dentistry or the American Academy Cosmetic Dentistry? What about the other associations? How do they see, and how do they relate to the ADSO and the DSOs?
Well, a lot of them are wondering how we can work together. And so we’re reaching out. We’re starting communications collaborations with them. I think, in some of the cases, we’ve gone a long way. The AAO, we’re working with them. And they understand that a lot of our members are their members. And so I think we’re just starting that process. But once again, I think we’ll look back and say, well, of course, we all work together. We’re dentists.
We’re all dentists.
You and I will be doing some interesting work going forward with the DOHI. Talk to us a little bit about that. What’s your goal there?
Well, the goal there is to really be the leaders in quality metrics, and really to improve the quality of dentistry by utilizing the metrics. But there’s also another goal there, and that is to really– that’s right, you’re going to come and do some training for us. It’s actually to help dentists that are DSO-supported really stand up and be vocal.
You know, a lot of times they’ll go to a meeting and they kind of sit in a corner because they’re ostracized because they choose to work with DSOs. And we want to change that. We want to have dentists that are DSO-supported. We want them as leaders. And so we appreciate you coming and helping us, actually go through some leadership training, so that a lot of DSOs can say hey, you know, I’m in leadership and this is my choice of how I want to practice dentistry. And you’re helping us with that. We appreciate it.
Quinn, you said something very interesting earlier about this space in the middle, about having a hybrid DSO, where the dentist owns the assets. The dentist owns everything about their practices and uses the DSO in an advisory capacity to help manage and direct the business side of it. Talk to us a little bit about this hybrid model that you see.
Well, actually it’s interesting that you bring that up because we’ve actually created a whole new category in ADSO. For a long time, we had just the full membership. And to join, you had to do over $30 million in annual revenue per year, and then you’re a full member. Well, they’re such a demand in the lower $10 to $30 million groups. And what they are is they’re dentists that are getting together. They’re groups. And they’re going, OK, we want to learn from the other individuals what’s working and what’s not working. So it’s a very interesting group, because what they are is dentists bounding together to create some efficiencies, to create some standardized efficiencies, and economies of scale.
Beyond the buyer’s group, you’re talking about?
Oh yeah. Yeah, yeah. This is different. Because then there’s a process that goes on, is that at some point you’ve got to look and say, OK, to create more efficiencies, how do we do that? So at one point, instead of having the marketing in each individual office, they decentralize it to a certain area, and that’s about the point where they become DSOs. So it’s not just, somebody wakes up and the next day and goes, hey, I’m going to create a DSO. It’s really a process. So what we’re actually doing now is reaching down and helping those dentists in the smaller groups decide, do they want to become a DSO?
Do they want to stay a large group, and affiliate with companies like Stratus that help them? Or do they want to actually become a decentralized DSO, where they create management agreements with other dentists and start providing their business services more. Once again, there’s this huge opportunity out there. I mean, it’s like the dawn of opportunity in dentistry to choose what you want to do. And dentists are becoming smarter and smarter about that. And so there’s this whole area there of deciding, I want in this, I want to do this, all the way up to full DSO support.
Right. So a dentist may elect to be comfortable with owning the assets and doing that, and they can more or less dial in the amount of management control they’re looking for. Is that right?
Exactly. You know, depending on the type of risk as a dentist. How much risk do I want? Do I want no risk on assets? Then I’ll affiliate with some bigger DSOs. Do I want to own the assets but affiliate with somebody that’s just going to do the business side? That’s great. Then do that. Or am I the other extreme? Like me, at one point, anyway, before I learned.
I’m going to do my own lab work. I’m going to contract with a marketing company and an accountant and on and on. And I’m just going to waste a lot of time contracting with all the business entities.
So it’s just a lot of different choices for dentists. And I think, once again, you’ve got to decide, where do you want to be on that continuum?
Yeah. And also, a big part of it is, what is your unique ability as a provider? You know, what do you really do well? You know, I look at you Quinn, and you do so many things well– law school, dental school, executive director. You have a lot of capability and a lot of bandwidth. You’ve got some unique ability related to your ability and your willingness to be an explorer, to be an adventurer in dentistry. And other dentists have unique abilities too. It might be related to implants or cosmetics. So in many ways, choosing a management system is also a question of, what is the dentist’s unique ability. Talk to us a little bit about that.
I think you hit it right on the head there. I think, first of all, you’ve got to understand yourself. What is it that you like and want to do? And that is, I think, you’re unique ability. And so if, once again, if you want to really just do dentistry, and you don’t want to deal with any business or own any assets, you’ve got that option now. A lot of us are in the middle.
That’s like being in the Navy right there.
There it is, exactly. And I love the Navy.
I do too.
Yeah. Or, you know, a lot of dentists now, they’re OK with owning the assets. And then it’s a whole different discussion. So you own the assets and you’re hiring out with one entity to take care of the business side. And then you may go, OK, well I want to join some other groups in here. So maybe you’ve got five dentists that own the assets, but they’re hiring out with one entity. And so that’s another hybrid option.
It almost seems like there’s a business model available here as a DSO broker– one who can look at the various market opportunities and then consult with the dentist as to what would fit better for them. What do you think about that?
That’s a great idea, actually yeah.
Let’s do it.
Yeah, OK, there we go. That’s the next book.
Yeah. So what do you know about Stratus, and where do you see it fitting in?
I think Stratus is going to be one of those companies that is going to grow very rapidly. Once it’s out there that dentists realize that it’s like, hey, I’m the kind of person that I want to own my own asset. OK. But by golly, I just want to do the dentistry. I need some business help. And the environment we’re in now, most dentists are saying that. I need help in the business side. And so I see Stratus as growing rapidly. It’s in big demand right now.
Right. And you know, one thing about Stratus, it’s certainly about allowing dentists to own the assets. It’s certainly about allowing dentists to manage the doctor-patient relationships well. But also, Stratus is a community of dentists. It connects its clients through the internet and through meetings. Tell us what you know about that.
Well, we get back to that idea that studies show, a lot of dentists now, especially young ones, they don’t want to be isolated. They want that collaborative environment. And I think technology is helping them, but they’ll never go back to being that isolated dentist out there without communicating to the outside world. It’s a lonely place. And so that collaborative environment is very desirable right now. And I think it’s necessary.
And the fact that you can share– once again, you can share what’s working and what’s not working, and not feel so isolated. You know, there’s been a lot of talk, over many, many years, of dentists being isolated and the psychological issues that that causes. And so I think they’re on the right track. This collaboration is so important now. And the millennials are demanding it.
You and I had that experience too, and the way we solved it is through the study clubs.
We joined study clubs to where we’d have our little isolated experiences in the day to day practice of dentistry. But then we’d go to our study club meeting where it was the same faces and the same buddies, and we’d tell stories. And there was an attempt at collegiality. There was an attempt at sharing. But there was always a distance that I felt, especially for study clubs that were in the same region. You really wouldn’t share best business practices. There was always that wall there. And with a Stratus-like organization, none of that really exists. It’s sort of like a study club on steroids, that helps with the business aspects.
Yeah. And you don’t have to worry about the competition. You’ve got dentists talking from Florida to California to Oregon. And they’re not worried about competition. They’re not going to take the patients from you. Dentistry is a local business, you know. You’re only going to get the patients around you. So I think it’s great. It’s also one of things of the future. I think the more that we can work on collaboration, the more we can be transparent, the more we could work on quality. I think it only improves our industry. And that improves patient care.
So wave the magic wand for me. If you could have your way, what would the DSO environment look like? Let’s say we are sitting here five years from now, and we are having this conversation. Describe to me what the DSO environment is five years from now, according to Quinn?
It’s going to be a combination because there’s no one individual that has all the answers. I think you’re going to see dentists that are in full DSO support, where they don’t own assets. They do their dentistry. They’re very good dentists. They’re totally accountable for their care. I think you’re going to see still, at the other end of the spectrum, I think you’re going to see the dentists that thinks– or maybe they can. They can do it all. But I think the majority is going to be in the middle. And I think you’re going to see lots of hybrids there. But once again, it’s the dentist that it is accountable. They just get to choose from a whole menu of how they want their business services delivered.
Well, Quinn, I really enjoyed your comments today. I always appreciate a visionary in dentistry. You’re not only a visionary but you’re also an explorer. And one thing that I’ve really enjoyed about our relationship, is as an explorer, you’ve left us a map. Transforming the Cottage Industry, it’s your book and I thank you for giving it to the profession, Quinn. It’s an absolute marvelous job you’ve done.
Well, thanks, Paul. And once again, I appreciate all help that you’ve done for dentists, for oral health innovation, and for ADSO. The fact that you’re out there spreading the word, we appreciate it.