101: DSO Defined — Its True Pieces with Host Emmet Scott

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When I was working as an associate rat at a school, I never imagined I could own these many practices with this amount of support. So thank you.

You have helped build my marketing mind

to a whole new level. You have this natural talent, this unique ability.

Hello, everyone, and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott, and today I want to talk about the truth of what a DSO really is. You know, I was on social media and I saw in one of these dental groups, someone asked, hey, guys, I've never heard of this before. What is a dso? And it was interesting, all the different comments, and of course, some of them were pretty uneducated and some were derogatory and so forth, but I thought, how helpful would it be to really break down what a DSO is? I'm working with my son right now learning about engines. We have a 1994 Ford F150 we've completely taken apart. And I'm learning what. What is an engine? Right When I go into the mechanic and I say, hey, I really need to fix my engine, what am I talking about? Well, I'm learning things like crankshafts and camshafts and all the different pistons and the headers and so forth and the manifold piece. Okay. It's really kind of fun now that I'm learning this. I mean, I'm older now, but I love to continue to learn, especially areas that in the past, I'll admit, I just looked inside of an engine and hoped that I knew what was going on. And frankly, for many people, when they look at a dso, they're taking the same approach. So I thought, why not pull it apart into its different pieces? Now, if you've listened to my other podcasts, you know that when I think of a dso, I love the name dental support organization. In fact, it's fascinating to me that someone can take the name support and turn it into something negative. And of course, there's humans involved, so I'm sure somebody screwed it up somewhere. But for the most part, this concept that clinicians should be supported so that they have more autonomy to focus on clinical care, I think is absolutely amazing. And when you break down the organization Part that's what I want to talk about today, like what is truly a dso? And I think you have to start with the individual pieces to really understand what makes up the engine. And so you have to break these pieces down and you have to say what, what are the complexities within a dental practice? And especially if you're trying to do multiple dental practices, that would constitute the need to have an entire dental support organization, this entire engine, and what would be the pieces that you need? So I'm going to start at the top. And the very first part that you need to have a strong DSO is you have to have strong clinical leadership and vision. If you don't have that part of the engine, well, then you've really got a boat with no direction. You're building out something where you say, we're just trying to fill in the blank. So you want something that's really clear.

At the end of the day, the

better DSO is going to be because it's better clinical clarity and vision. So for me, if I think about this from an executive position, the most important executive in any DSO is the clinical director or the chief marketing officer, someone who's saying he Here is the care that we're bringing to patients. Here's the patient avatars that we're focused on. Here's how we want to be different in the marketplace. Here's where we wanna take care of the underserved or solve a problem that's not getting solved, or simply provide access where it's not being provided. And here's how we're going to behave to do that.

Now, since most of you understand the pieces of clinical, I'm not gonna go

too deep into that.

But you understand that there's got to

be all of the processes and systems

to provide great clinical care. And you have to pick out all of the supplies and equipment and design that's going to go along with that. So to me, that's number one in having a dso. Now you move into something like marketing. And marketing is really going to feed the engine. It's going to take that message and it's going to take it out to the world and it's going to tell the patients, hey, we've got a clinical team that can solve these oral healthcare problems for you. And so that marketing team is going to get broken down into its individual parts. You're going to have those who are doing maybe community outreach type events. You're going to have those who are taking care of your branding, your flyers.

You're going to have all that digital

with the website components, you're going to have your social media and are you going to go do something over on TikTok or Instagram or, or Clubhouse now or any of these other great platforms that are out there to reach out to people, to disrupt them? Right. If you think you can just hang up a shingle and no one else in the world is ever going to market to them. I'm not talking about dental, I'm talking about anyone else. Disneyland, Kroger, your grocery store, whatever it might be, the movie theater, the playground. If you don't think they're going to try to say, hey, spend your time, spend your energy over here. Every app that's popping up, if you don't have a strong marketing team, you're not going to get this amazing clinical message out to them. So for me, marketing is so critical to line up with clinical so that that story can be told and be told in a way that's influencing and compelling. Then you've got your next piece, which might be your operational piece. How are we going to behave to support this clinical vision? What is the front desk going to look like? What is the service, the scripting we're going to have around our services? How is that treatment coordination going to work? Now, on that clinical side, we're going to have all these hygiene components and we're going to have hygienists there too. And so how is operations going to support and serve them and how are those going to interlock together? And as I scale across multiple locations, how is the regional team going to support the practice managers? Each of these are those different parts of the engine. Of course, you can't have an engine without fuel. And so you've got to have the accounting team to track all of the different components of your revenue, your expenses. You've got to have the revenue cycle management components down, you've got to have the billing piece nailed down, especially if you're doing something like government pay, such as Medicaid, because you don't make billing mistakes, you do fraud, waste and abuse. So what is your processes and systems to ensure that you're protecting the clinician as you're doing out this billing? Are you studying up to make sure that those doctor notes are right in line with the insurance contracts requirements? How is all of that working? So you've got that accounting, you've got to make sure those taxes are filed. You need P and L so that the clinical owners and the other operators understand how things are influencing the bottom line. Are they really bringing support to the clinician. Are they really bringing the value that you were hoping to have? Are those P and LS timely or are you getting them once every six months or once a year? Well, it's hard to do a lot of changes when they're that far apart. How is your balance sheet look? Is the ratios right? All that in that accounting and that finance, are they doing performance on any new practices you might be looking at? Maybe the clinical team really wants to add a specialty. What does that performa need to look like as you're trying to figure out compensation? And you might be losing money initially in order to bring that care to patients. What does that look like? You need that finance team to do that? Of course, all of this is tied together through technologies. So how is your technology set up? How are you going to make sure that you have a help desk to make sure that your teams have the whatever tickets might come up, whatever screen might not work, whatever TV system might not work? Who's going to support all of those things? Do you have enough bandwidth coming in if you've centralized anything, how is that centralization working across your technology platform? And are you secure? We're working with PIHI information. So do you have the right security so that you're not sitting there with ransomware and phi information knowing that you got hacked? And now we're into compliance. Right, and I'll hold off on that, but who are we supposed to notify if that happens? So we don't want that to happen. We want it to make things secure. We want them to be fast. We might have technology in the front for the team members to be able to use or the patients to be able to use. Do we have guest wi fi? And what kind of technology experiences are we giving to them? So many things with the networking and centralized services and support centers. And how are we pulling the data from 1, 2, 10, how many ever locations? So it's up in an Amazon cloud or a Google cloud or somewhere where the FP and A, the finance team can pull that information and provide that to your clinical team, to your operators so that we're all aligned with this vision. How is that compliance working? Do you understand the OSHA and the hipaa? Do you have people dedicated to this? This is all in the engine of a DSO that you need to have in order for it to run well. Otherwise you get these putts and all the bad sou that you don't want. You can tell I'm still learning. And then you've got the White smoke coming out because the oil's in the engine and so forth. You've got to make sure that when it comes to compliance, how does your facility look and do people feel safe, especially during these pandemic times? So sterilization processes, et cetera? Of course you have to have hr. We're delivering a business model all through individuals, through people who have emotions. And there's laws and there's requirements and there's pay and compensation scales. And you can't be discriminating. So you can't just be subjectively paying people based on how you feel or how much they whine about something or whatever it might be. And of course, you want to do great culture events. And how are those going to be organized? So you have to have a team around that. The facilities have to be managed and organized. And so these are the parts of a dso. When someone says, what is a dso? I would love for you to say, let me begin, and just hit play on this podcast and let them hear all of the different parts that are necessary in order for clinicians to have a bigger impact. And anyone who says, well, I don't know if that really brings value, doesn't understand the engine. It doesn't understand the individual parts that are necessary to succeed. So often as entrepreneurs, we often become these rugged individuals, these lone wolves. We think we have to do everything. And I think what's beautiful about a DSO is it very much speaks to the fact that if you're going to have a bigger impact, you're going to have to have a bigger team. And so I hope you continue to build a great dso. If you have any questions around what fits in as a dso, or if you see on social media people ask, what is a dso? I hope you will share with them this podcast. I'd love to get feedback. What did I leave out? I wanted to give a nice synopsis, but I'm sure I left some great pieces out that really support clinicians so that they can have that bigger impact. Please join us over on our Facebook site at DSO Secrets, and until next time, keep smiling.

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