In a DSO, who’s in charge – Corporate, or the dentist? Gen4 Dental Partners says: How about both?
Gen4, an innovative two-year-old Dental Service Organization based in Tempe, AZ, says the tug-of-war many practice owners fear when they consider merging with a DSO is based on a false premise. Dr. Mitch Ellingson, Gen4 Chief Clinical Officer, said Gen4 believes in a different paradigm: The Collaborative Doctors model.
“The main reason doctors come to Gen4 is: They realize they're still going to have a voice. Our direction is aligned with where they want to go,” Ellingson said. Senior clinicians collaborate to set best practices, and “the operations team is going to deliver results that are aligned with what the doctors collectively think are best for each practice, best for the group, and best for Gen4 overall.”
Many practice owners fear merging with a DSO will push them down from the executive to the administrative level.
At Gen4, Operations, and Clinical are co-equal and collaborate where they overlap.
The Collaborative Doctors model challenges both sides, Ellingson said.
- To the dentist, the organization says, ‘Hey, doctor, I need you to be more operationally focused and learn from the operations team what that actually means. Be humble, park the ego and learn from them.
- And to Operations, the dentist says, ‘Learn what clinical excellence really is so that you can embody what it means to be clinically excellent.
Where those two meet “is a clinical operations team that is truly a team. It's not doctors or Operations. It's a team of doctors and Operations,” said Ellingson, who has seen both sides as a practicing dentist for 13 years and EVP of Spear Practice Solutions for five.
Practice owners are responding. Founded in April 2021, by the end of 2022 Gen4 had added 73 partner doctors with 80 locations in 12 states, including elite clinicians such as Dr. Bill Dorfman, a globally recognized Hollywood cosmetic dentist. And growth is projected to be “explosive” in 2023.
Ellingson said that when a practice owner joins, Gen4 promises they will keep their clinical autonomy. That’s critical because Gen4 only partners with practice owners who have what he called “the leadership backbone.” Each is a premier clinician accustomed to autonomy over how to best treat each patient. But that doesn’t mean – can’t mean – each can have autonomy over how to run their shop. With 80 (and growing) locations, that would mean shops run 80 different ways.
“So let me define what autonomy means in Gen4,” Ellingson said. “Typically, you're worried someone's going to tell you what you can and can’t do. But when we talk about autonomy, actually, it's the opposite – the reality is, we're going to ask you to lead more. We’re going to amplify your voice. Your ideas are going to influence everyone. And theirs are going to influence you. That’s the exact opposite of going it alone.”
And that leads to challenging, exciting growth. You get to learn how to lead a different way – the Gen4 way.
“For a lot of docs, they've been on their own for such a long time that they almost forgot how exciting it is to be with peers who are challenging each other to think bigger, to take the next step, to evolve the idea,” he said.
“Maybe you used to assume you were always right. And now you're amongst a group who make you realize, hey, how many times maybe you weren't right? And you start to go, ‘Wow, man, I've been thinking about this backwards.’ “
As new ideas take hold, there’s a trickle-down effect, he said. Team members benefit. Patients benefit. And the dentist benefits because their ideas, refined by fire, are amplified on a much bigger platform impacting many more teams and patients.
When a dental practice joins Gen4, the first step is to forge a growth plan:
- The dentist is paired with a senior clinician to develop a personal growth plan
- The clinic’s hygienists are enlisted to support the vision
- Support staff is trained in Gen4’s robust set of back-office automation tools
- Patient satisfaction metrics are set up to measure the success of the plan
The result: clinicians who are 25% more productive and yet see 20% fewer patients. Sounds counterintuitive, but that’s Gen4.
“We know we must change it all in order to keep things the same,” Ellingson said. “We must change the way we think, the way we collaborate, and the way we do dentistry, if we want to keep dentistry the way it is today” – with dentists, not administrators, in control.
Ellingson speaks from personal experience. After earning a B.S. and D.D.S. from the University of Minnesota, he performed dentistry for 13 years while owning and operating multiple practices in Phoenix, AZ. Then Ellingson founded and led Spear Practice Solutions, the division of Spear Dental Education that consults with a wide variety of dentists. That’s where he learned how hard – and how valuable – collaboration really is.
“I've personally experienced it. I've been through the transition of going from a private-practice dentist to working inside a group, and it is really hard. It's way harder than anybody anticipates, going from being king of your own island to being a leader in a group.
“But it's also really powerful once you get there,” he said.
Not everyone is willing or able to accept the challenge, he admitted.
“That's why the selection process is so important. We tell them we're not a DSO. We're not playing by their rules. We are here to change dentistry. And if you don't embody that and believe that inside of your soul, you should not join Gen4. Because we aren't saying it just to attract people. We're saying it because that's who we are.”
Why? “Because we are all lovers of our profession. Dentistry is the last great profession that is run by the people who do it – the dentists.” Gen4 is amassing a group of premier clinicians who seek to empower all dentists to do dentistry on their terms – not let it be dictated by administrators (as has happened in medicine, say, or pharmacy.) “Our people have a real passion for our profession; they want to protect it and elevate it.”
Ellingson predicted Gen4 will galvanize a change in direction for dentistry. “We're basically calling every DSO to the mat. We’re saying, ‘If you want to compete in the consolidation space, you're going to need to get your dentist involved with organized dentistry again. Because otherwise, every dentist who is really into dentistry will never go your way again. They're going to want to come our way.”
Ellingson smiled. “At Gen4, we believe a measure of our success is when people copy what we do.”