New Hyde Park, N.Y.-based Dental365 is focused on expanding its footprint this year while also enhancing the patient and doctor experience.
Robert Kolts, DDS, is senior vice president of clinical affairs at Premier Care Dental Management, the parent company of Dental365. He recently spoke with Becker's about Dental365's growth strategy for 2024 and the challenges facing dentists today.
Editor's note: Responses were lightly edited for clarity and length.
Question: How would you describe Dental365's growth over the last six months?
Dr. Robert Kolts: I would call Dental365's approach aggressive, yet selective. We're now in seven states. We've added 30 to 40 locations over the last six months. We have 133 practices at the moment, but we're actually quite selective over practices that we choose to affiliate with. I'd say we probably pass or say no to four times as many practices we acquire. That might be a conservative estimate. As we grow, we're looking for practices that are going to be a good culture fit, so practices that are focused on patient outcomes, quality of care and that do good dentistry. We audit charts for practices we're going to acquire to make sure the doctors are doing good dentistry there.
Q: What are some factors that make Dental365 turn away from acquiring a practice?
RK: There are a couple of things that as an organization we insist on. We don't call ourselves a low-touch DSO. Some DSOs come in and say, "Hey, come affiliate with us. We won't touch anything. Everything's going to remain the same." We come in and we are very transparent. We say we are going to change some things for your practice and for your patients, and we want to make sure you're on board. For example, we have a unified patient management software, so we're going to change most of the practices' PMS to our unified PMS so there's easy administration of patient charts. We insist on financial transparency, so we make sure we estimate the patient's out-of-pocket costs and we collect the patient's portion at the time of service. [We also] insist all patients receive consent forms that are signed for all procedures that are done.
For some practices, those changes are too dramatic and the doctor who's looking to sell their practice is very hesitant to be on board with those changes. If you're not going to be on board with that, that's okay, but maybe it's not a right culture fit for us. We're [also] looking for providers who are focused on quality of care. So if we can tell everything about them is about production and not so much about the patient outcomes, then those are practices that may not be a good fit for us. So there's a number of criteria we use, but we're very upfront so we make sure practices we do affiliate with really fit our ecosystem and our culture and it's a smooth and seamless transition, both for our support staff and for the doctor and patients.
Q: Dental365 has experienced rapid growth in Pennsylvania recently. Is there anything specific that makes this an attractive state for the DSO?
RK: It's a really diverse state. It has some concentrated urban areas and there are many rural [areas] where there's a lot of need, and it's just filled with hardworking, good people. It's an area where it's not overly saturated with dental support organizations and there's a need for increased access to providers. These practices are busy. It's hard to get appointments. Specialists are booked out for months and it's hard to recruit specialists to some of the areas that really have a need, so we're really trying to help bring more accessibility for dental care to these areas. There are also expanded function dental assistants, which is unique to Pennsylvania and a couple other states where they can assist by placing restorations for the doctors. That helps with the access to care issue and increases the dentists' availability to see patients. So all of those things kind of come together, and it's close to our footprint. We're headquartered on Long Island, so it's not far to support this operationally. It's a logical step for us.
We are looking at probably another 10 additional practices [in Pennsylvania] that we're evaluating specifically. We're looking really to repeat what we've done in other areas, which is to build an ecosystem. As we continue to grow our general dentist footprint, we start building that specialist ecosystem where we can build some specialty centers and have oral surgery, periodontics, endodontics and all those specialists there. That's the next step from an acquisition standpoint. We're also looking at growing our operations footprint as we continue to grow. We're right at the point now where we're beginning to have conversations with payers on trying to improve reimbursements for these practices as our footprint becomes big enough to have those sorts of conversations.
Q: How else does Dental365 intend to expand its footprint this year?
RK: We're in the seven northeastern states, so you're going to see continued expansion within those states. We're really working on that ecosystem. We have seven divisions. We have TMJ, pediatric, orthodontics, oral surgery, endodontics, periodontics and then our general dentistry division. We're looking at growth within each of those individual divisions. I wouldn't be surprised if we saw an eighth state. I don't think it's necessarily on the radar at this moment, but I wouldn't be surprised as we continue to expand if we see additional states added.
Q: What are some core focuses for Dental365 outside of M&A activity?
RK: We're an organization that really believes in perpetual improvement, so we're never satisfied with where we are now. This year, we're really focusing on our doctor university. We employ close to 350 doctors across our organization, so it's bringing clinical and non-clinical education to the doctors. So not just how to prep a crown and how to do better endodontics. Those aspects are part of it, but also how do we build on clinical skills? How do we build our doctors as leaders in these practices? How do we improve their communication skills with patients? So we've got a big focus on our doctor university.
We're also focusing on our hygienists. We're expanding our hygiene executive committee, which is a group of hygienists who work in our practices and help provide mentorship and review charts to provide support to our hygienists. We have a big focus on technology with saliva testing, and we're actually expanding our saliva testing now. The saliva testing we've implemented is primarily for determining a patient's prognosis or susceptibility for periodontal disease, but now the ability has been expanded so we can help our patients receive oral cancer screenings. That's a new initiative we're just beginning to roll out that we're excited for. Over the coming months and years, we're going to continue to see saliva testing explode and what it can test for and the impact it's bringing to our patients. We do all of that at no charge to our patients. This is truly a service just to improve patient outcomes and their experience.
Q: What are some of the challenges facing dentists today?
RK: We still have a big demand and request for mentorship and training. The doctor university is a big piece of that. We also have a doctor mentorship program that we've expanded significantly where we pair up experienced doctors with doctors who would like some mentorship. Sometimes those are younger, new graduate doctors. Sometimes these are more experienced doctors who just recognize that they want to improve their skill set. Also, as we continue to expand, [we're looking at how] we continue to take hold of our culture and make sure we're always focused on quality patient outcomes. So we're starting some culture initiatives and some committees that are focused on that specifically to make sure that as we continue to grow, we still are seeing things at the individual patient level. As you expand, some of your challenges get magnified, so we're trying to make sure we're staying ahead of some of those things.
Q: Are there any trends you're following in the dental industry currently?
RK: We prefer not to follow trends. We like to be cutting edge and maybe create some of the trends. For example, we have artificial intelligence fully rolled out in all of our practices, which I think that's still an area where a lot of other organizations are just kind of dipping their toe in or evaluating. I've mentioned how [saliva testing is] expanding to test not just for periodontal disease but for oral cancer. Our big focus this year is we're trying to improve what we call our frictionless experience, both for our patients and our providers. We're improving our RCM protocols for our patients. We really want the patient to have a concierge-type experience in each of our practices. To that end, we do concierge training for our staff. How do you answer the phone, how do you greet a patient and how do you check out a patient in a way in which you're focused on what the patient's actually experiencing during one of those situations?
We also work on that frictionless experience for our providers. We make sure all of our doctors, if they have a concern, have a clinical support director they can reach out to directly. It's just continuing to build that ecosystem, so how we give and control the whole patient experience, from the general dentist practice, to the referral, to the specialist and then back to the general dentist. A lot of times, patients get lost in that process or it's not a good experience. They liked the treatment they got at the specialist, but maybe they didn't have a great experience at their front desk or things like that. For our areas where we have a higher concentration of practices, we're really trying to help provide that concierge experience for the whole patient's lifecycle. We're continuing to refine and build on that in 2024.