Inside 1 DSO's 'special sauce' for success

Prime Dentistry is focusing on educational training to attract and retain dental staff.

The DSO, which was founded in 2011 by Ali Saad, DMD, and Mohamed Saad, DDS, has eight practices throughout the metro Detroit area. 

Both dentists recently spoke with Becker's about the company's growth and keys to success.

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

Question: What is one of the biggest changes you're seeing in the dental industry today?

Dr. Ali Saad: One of the biggest things I'm noticing that's happening across the industry is you're seeing a lot of these DSOs that were non-dental founded [and] there were non-dental people involved, so they weren't dentists. We're seeing more and more of some of the collapse of that happening [as opposed to] a group like ours where it's owned by two brothers who are dentists and who had a great reputation in the community they were serving. I think the world is kind of waking up to that.

I believe that as a dentist, your main consumer would be your patient. When you get into the dental management side of things, you start to realize that your customer becomes your dentist first and foremost, and alongside that is your manager within that practice. One is your revenue producer and it's the person that you need to see your patients and the other one would be the person that's actually running the business side of things within that. So I think that's an awakening that the industry is kind of seeing from the dental starters, like the guys who are dental people starting an organization versus a private equity firm that [is] just bringing a dentist on board. You're seeing a shift of the customer, which is your dentist and your manager, choosing to work more alongside dental founders who had their hearts into it [and] had their sleeves rolled up because they understand the painstaking work that has to go on within a practice. 

Q: What are your plans for growth this year?

AS: For one, we're bringing on somebody in our finance department. We figured out a way to improve in-store sales, so in-office location productivity within each practice. Part of that is because we now have very strong regional operations in play. So first and foremost is building out our eight locations to improve productivity and profitability ... Alongside that, we're looking at two more locations to close by the end of the year. 

We're also doing something unique. A little special sauce we have is to affiliate with some dental hygiene and dental assisting programs and really provide our time to them by educating them and teaching them the gap between being in a program versus when they graduate. I think besides just pay, it's important for them to understand what workflow is like within private practice. The faculty really loves this because it's helping them to expand on their vision for them as students for what a career will look like within this profession. It's very short-lived right now. Hygienists are graduating, they're getting a job or two, and then maybe they go on to something else. With this approach, we're showing them the love, heart and passion these patients will feel because of their capability, skills, knowledge and expertise. 

Part of this initiative is they're shadowing within our practices. That's helping us to bridge the gap between education and real-life dentistry from an assisting and hygiene standpoint. Dentists do this before they even enter dental school, they shadow, whereas a lot of hygiene and assistants don't do this. So whether it be an assistant, hygienist, whatever it may be, they're going to be rotating and physically spending a certain amount of time at each one of our locations. So the idea is that they get real experience of what private practice is like while they're still in school, but more importantly, instead of just applying for a job and taking it because they're paying X amount and because the facility looks a certain way, they're actually going to choose working at one of our practices because of the culture of what the doctor is, what the environment's like, the clientele, the setup [and] the structure. So you're not just choosing a location based on cost. That's how the industry changed after COVID, like who's giving me 50 cents more an hour? It's so short-lived. Everyone's bouncing around month over month somewhere else because they don't really see the value yet because they're just judging it based on who's giving more money.

We've been working on this for a long time and I really believe that the tools like AI revenue cycle management, all those things are great and there's a need for them, but you need that education foundation. It starts within the school, being involved with them, and then also how do you bring that back into your organization on a monthly, quarterly basis at different levels so that way it's a very well-refined, cultural patient care model.

Q: How are you building a supportive culture at your practices?

AS: For one, the hygienists get an hour to clean teeth. These 30-minute cleanings they were kind of sucked into, I think they realized really quickly, this is not why I went into this profession. So we provide them with an hour for patient care, and that's for an existing patient. Obviously, with a new patient, you get a little bit longer. Each one of our offices is updated with technology and we're just big on education and training. I think that's the biggest thing for us. We do things on a monthly and quarterly basis. That really helps to build a culture because when you keep those smart minds busy with just learning and training, it gives them a sense of passion for what they are doing. Within that, you start to evolve other leaders within your group.

Our locations are all separately branded. There isn't one name associated with each one, and we wanted it to feel like it's your local neighborhood dentist, [like] "I've been going there for X amount of years. I love this place." So when the patients feel good, the staff feels good. When the staff feels good, the patients feel good. I just really believe it just comes down to nuts and bolts and just treating people really well within a practice. That's what goes a long way.

Q: What are some things you look for in a partner practice?

AS: The first thing we look at is the reputation and longevity of what you're buying because that's what you're inheriting. We typically don't do de novos, we acquire locations. So you're buying a reputation of 30, 40, 50 years. We look at Google reviews, we look at online presence [and] we get to understand the community. And then we get more granular — how big is it, how many operatories are there, what's the technology look like, what's the culture look like, staffing and is the doctor staying on? None of our locations take Medicaid as well, so we're more selective on the type of practice we purchase because we just always believe that at a Medicaid-style practice, you have to be very high volume, very high turn and burn in essence, so that's something we avoid and stay away from. We have select parameters that we check off before we even consider buying a practice.

Mohamed Saad: One thing I always look at is, for one, would I work there? And the other thing is, would I raise a family around that area? My customer is my dentist, so I have to be thinking ahead of time. If the dentist you're buying the practice from stays on, great, but if not, is another dentist going to fill those shoes easily and is that something I can put my name on and say, look, I endorse this place, this is a great team, this is a great community, et cetera. I think that goes a long way for people.

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