How rising costs are affecting dental accessibility

Increasing costs in dentistry can hurt accessibility as dental practices and DSOs find it difficult to hire more staff, according to Saam Zarrabi, DDS. 

Dr. Zarrabi is the founder and CEO of Fort Worth, Texas-based Rodeo Dental & Orthodontics. The organization supports more than 40 offices in Texas, Arizona and Colorado. 

Dr. Zarrabi recently spoke with Becker's about Rodeo Dental's growth, goals for 2024 and the trends he is following in dentistry. 

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

Question: What are the top priorities for Rodeo Dental & Orthodontics in 2024?

Dr. Saam Zarrabi: For us, it's continuing to focus on structuring for growth and making sure we're giving our team members and providers the ability to have access to care. Access to care is always top of mind. When we're thinking about focusing on multiple service lines from general dentistry to pediatric dentistry, orthodontics, endodontics, oral surgery and even anesthesia, we want to make sure we're providing our teams with all the right tools and team members and training to be able to continue to do that while having the ability to invest in new growth.

Q: What strategies are in place to expand the organization's footprint?

Dr. Zarrabi: We have at least four [offices] we're planning to open this year. We're going to continue to grow in our existing footprints and we're looking at potential regions to expand to, but we really like our continued focus. Texas has been amazing. We have our largest footprint there with one of the largest growing states in the country. At the same time, Colorado continues to grow and expand and Arizona just opened in the second half of last year. We have a couple more planned there, so we're very excited. Then, we're looking to expand across the country and continue to go nationwide.

Q: What are the biggest challenges facing dental practices today?

Dr. Zarrabi: We're facing many of the similar challenges that both DSOs and small practices are facing. Access to care continues to be a big challenge due to the rising costs that we've seen across all areas from labor to expansion, supplies and equipment. Whether you are a traditional provider of commercial pay and PPO or you're servicing underserved markets and Medicaid and Medicare, your fees are set. As those costs increase, the access to care challenges only grow because it's harder to find team members from assistants to hygienists and all of the functions, and maintaining that is something we continually are fighting against.

If you think about the specialty lines and the challenges in servicing those specialty lines in underserved areas, a lot of the markets we're in are not in the larger cities. So we're servicing the Rio Grande Valley, Midland, Odessa and all of these areas where you're having a harder time not just getting general dentists to serve the demand but also the specialty lines. Getting all of these folks in those markets to serve the demand with the growth the state has had is a huge challenge. We're happy to take it on, but it's certainly difficult.

Q: How has Rodeo been dealing with staffing shortages while managing multiple service lines?

Dr. Zarrabi: A great team. I gotta give kudos to the team and the culture, the commitment to our mission and our doctors. We have specialists [and] team members who travel, so we're organizing a lot of logistics to be able to make sure that point of care at the front line is delivered. You have to have everything from the scheduling and credentialing set, the doctor set, to the flight on time. It's a monumental effort that is a total team effort end to end.

Q: Many DSO execs are expecting slower growth amid a challenging economy. Is this something you're paying attention to?

Dr. Zarrabi: Of course. We are a de novo brand at the core. So when we think about a new buildout, the costs have absolutely gone up. The cost of capital has gone up with the interest rates rising. So all of that limits your ability to grow no matter the size. Certainly, if interest rates were lower right now, could we have the ability to grow more locations? Sure. At the same time, we are looking for ways where we can be more efficient in our systems and our doctors, implementing new technology to improve different efficiencies from intake at the front desk to revenue cycle initiatives, to artificial intelligence initiatives. We have made a huge investment in our IT infrastructure and data analytics. All of that is with the goal of removing friction points so we can better serve at the front line and then hopefully lower costs over time.

Q: What other trends are you following in dentistry?

Dr. Zarrabi: I get excited about the development of new technology and software. The AI side of radiology just continues to get better. There are a lot of great folks in this space from Overjet to Pearl and VideaHealth. We use Overjet currently, but they're all great. They all continue to get better. They all make the lives of the doctors better. The practice management softwares continue to get better. The confirmation process and the phone systems continue to get better. Our dental equipment is getting better and better. We use all electronic handpieces at Rodeo, so that's an example of just some of the small nuances in the systems that are making the patients comfortable and the delivery of care better.

On the revenue cycle side, there are some really exciting products coming out around insurance verification and claims processing. To me, where I really appreciate the DSO space is it's brought so much innovation and investment into dentistry that it's so good ultimately for the patients and the teams that are delivering care in the long run. We're at the first stage of it, so when you look at five to 10 years from now, whatever size dental practice you have, life is going to be easier and better. I think that's something everybody should be excited about.

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