1 DSO's journey to becoming 1 of the fastest growing companies in the US: Q&A

Florham Park, N.J.-based Select Dental Management has overcome several challenges on its way to becoming one of the fastest growing companies in the U.S., but they've placed the DSO at a place for continued success, according to two execs. 

CEO Elliot Zibel and Chief Clinical Officer Jonathan Mason, DMD, co-founded Select Dental Management in 2018 and have grown the practice to include more than 30 locations in its network. The company was also recently included on Inc. 5000's list of the fastest growing companies.

Mr. Zibel and Dr. Mason recently spoke with Becker's about the dental group's growth, goals for the rest of 2022 and what advice they would give to other DSOs.

Editor's note: Responses were lightly edited for clarity and length. 

Question: How would you describe Select Dental Management's growth over these past few years?

Elliot Zibel: It comes back to the principles that we started with and leveraging John's experiences to create a unique value proposition, the idea being that we want to provide similar levels of independence associated with a private practice in addition to strategic resources that really are very difficult to access if you're not part of a larger group with more capital and a larger network of providers … What we've done is really started to self-select more ambitious entrepreneurial dentists, not just dentists that say, "I want to retire next year and that's it." Growth is one of our core values. 

When we started the company, we realized there wasn't a lot of growth in the industry on a post-affiliation basis, meaning that people were gobbling up all these practices, but they weren't really able to drive growth post-partnership. The reason came down to doctor retention. So when we started Select, we were really focused on what we needed to do for the dentist. And interestingly enough, we were missing the mark, because a dentist is important, but they're only one part of the equation. As we evolved as a company, we started realizing dentists need a strong support system, and if there's any weakness in that system, there's going to be weakness in the care. Our goal is to make sure we're supporting all of the people and equipping them with the tools and resources they need to provide care to the patient. As we pivoted that philosophy, we started developing better systems and processes around what makes a great practice, but doing so in a way where we're giving them 80 percent of the blueprint, but they can customize it around their own practice in order to keep that identity. The combination has really driven not only best-in-class dentist retention but also really strong employee and patient retention.

Dr. Jonathon Mason: When we started Select, I wanted to make sure that we were able to partner with practices and dentists that have the same mindset of just treating patients right and having success follow from there. Elliot asked me when we started, what would I like a company to do. Basically, I want to come to work and do what my dental degree taught me to do, which is treat patients, and I want somebody else to handle everything else. We want to take all the business and we talked to a lot of dentists, even younger dentists. They want to get out of the running of their business. They want to do their dentistry, but they want a company that can take their practice to the next level. That partnership model has been run really true. 

Q: What are some of the challenges Select Dental Management has had to overcome in its growth?

EZ: The biggest challenge we've had is putting the right people in the right seats on the leadership team and scaling the leadership team as the business has grown. Having the right leadership team in place is critical and making sure that everyone defines success the same way. That's been a huge ongoing challenge, but honestly at the moment where we sit, we have a great leadership team. We are all very much aligned, and it's amazing how much momentum  you can get when that occurs, but it's a challenge to get there. 

JM: I think [COVID-19] was our biggest challenge, and our biggest success was we took those two months of the shutdown and stepped back, and that was the beginning of really revamping our clinical team. We aligned our values, we just got really together as a leadership team on what we wanted to do, set goals for the future [and] how we're going to do it. Coming out of that was probably our greatest success in order to ramp up our acquisition. That was really where a lot of our growth came because we set that for two months and prepared ourselves [on] how we wanted to grow into the future, what kind of doctors we wanted to partner with, what practices we wanted to partner with. And that was the beginning to setting the foundation for being able to grow and acquire and also grow the practices we had already partnered with.

Q: What goals does Select Dental Management have for the rest of 2022?

EZ: We've got some specific things we are implementing, but our mission is to make our team members, practices and patients healthier and happier. So everything we do is going to be focused on how we drive that. We're implementing our first hygiene excellence program, which is going to help share with our clinicians some newer best practices and also some incremental analytics around how we can measure quality of care, which everyone's really excited about. [Dr. Mason is] rolling out some incremental information on clinical philosophy of care and different best practices in conjunction with our clinical leadership team, which [he's] really focused on building out. 

The other thing we're really focused on is what's the best way to improve the health of our patients. We don't have enough hygiene capacity at the moment to service our existing patient base. So one of the initiatives we're focused on is just bringing awareness to every practice to say, if you're booked out on hygiene for four months and you can't get existing patients into your practice, we have to work collaboratively to solve that problem. We are really pushing to make sure we have enough hygiene capacity for our existing patient base and that they're coming in for regular care, because that's the best way we can improve their health and the health of our practices.

The other thing I would say, conceptually, is how do you make decisions without information? It's impossible … We're really focusing on leveraging our data warehouse, and we think that's a huge competitive advantage, because now we can see and communicate things. We're really excited about [leveraging] this new access to information. And not only just from the [property management systems], but we can then incorporate that with employee engagement scores, net promoter scores, Google Analytics, so it's really opening up a whole world of opportunity to really dig down and better understand the business and communicate that.

Q: What advice would you give to other DSOs?

EZ: It is a challenging time for dentistry and for most businesses today. Those companies that embrace the challenges and improve are going to be the winners, and those that have gone out and aggregated a bunch of assets but really have no infrastructure to support them are going to struggle, because what do you do when labor costs are up and you're a PPO-based business that has no pricing power. How do you drive the business? Every macro issue creates opportunities that ultimately make your company stronger. So my advice is to use this time to really crystallize what you're focused on [and] how you are unique … [There's two ways] to offset cost inflation. You could fire people, which isn't fun and we need people to run our businesses, and the other way is to grow the practices.

So we're sitting here and saying, "Awesome, we're going to grow our practices to be able to leverage and offset that labor cost inflation." There's a lot of opportunity and we're excited about making sure we're focusing on those few things that can really move the needle for our team members, patients and practices. It's going to get harder. Capital availability is definitely changing, but I think this creates a lot of opportunity for people to get better and improve.

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