112: What Can DSOs Learn from the Larger Healthcare Industry

Welcome to DSO Secrets. I know what it's like to be an entrepreneur in the dental industry. I've had my ups and downs just like you. There's so much opportunity to be excited about, but so few resources to get answers. From here on DSO Secrets, we get you those answers so you can change the lives you're meant to bless and achieve your personal success.

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. Happy day to you. This is Ken Kaufman and I'm thrilled all of you have joined us for another episode of DSO Secrets. I am Ken Kaufman, your host. Today. I am filling in for the ever illustrious Emmett Scott. I'm excited to introduce today's guest, Mike Yates. Now Mike is new to dental, but definitely not new to healthcare. And we're going to be pulling on much of his learnings and expertise that he's gained over the years. He has an undergrad in accounting from Marshall University, MBA from Christian Brothers University. He's been wearing the CFO or VP of Finance hat since 2000. He's currently the CFO at Spring Dental, which is headquartered in Oklahoma. And most recently he was a panelist at the DEO Spring Elite event. And we had a great time with that. Mike, thanks so much for joining on the show today.

Yeah, Ken, thanks for having me. I'm glad to be here.

Awesome. Well, let's go ahead and jump in. I love to ask this question to all of our guests. What in the world led you into this DSO industry? And what in the world are you still doing here?

Yeah, yeah. So a couple of things led me in. So one which is very topical for today is frustration with kind of traditional healthcare. You know, always kind of responding to payer demands, always trying to do more with less. You know, just always kind of trying to hustle to keep doing what you're doing for your patients while the payers kind of keep trying to attack. In my particular background, oncology claims. So that was the big thing. You know, what's kept me here is just the industry, how fast it's growing, you know, how much opportunity there is to touch a lot of people. You know, in our situation, we are pretty heavy into rural markets and so we really are getting to touch people that aren't necessarily getting the service otherwise. And so that's exciting to be a part of that.

Outstanding. Well, welcome from a selfish Perspective. Super glad to have you here and to be able to rub shoulders with you and others from other areas of health.

Thank you.

Let us get to know just a little bit about spring dental. Give us an idea of like total locations. Fte doctors supported how many states and are you more of an acquisition de novo shop? Maybe you could run us through some of those things.

Yeah, so we are, as of as we sit right now, we're 44 sites. By the end of next week, that number will be 47. So lots going on over here. We're in four states like you mentioned. We're headquartered in Oklahoma. Obviously our biggest single concentration is in Oklahoma focused Tulsa and Oklahoma City. But we're also in Missouri, Arkansas, and then have our most recent real growth has been in Kansas, Wichita and Kansas City area. So when I've been here about 10 months, when I joined, we were at 29 practices. So we've increased our total numbers by more than 50% in less than a year.

Very nice. And are you doing just de novos or some affiliations or a combination? How do you guys approach that?

Yeah, historically it's been really, really heavy on acquisition. And that historically is up even until the last few months, what we have kind of in the pipeline right now, there's as much de novo as acquisition. You know, the thing about the acquisition is, especially with our business model, you truly can go in kind of day one, hit the ground running, you know, whereas the de novo, you know this as well as I do, you know, it's just, it's just a little bit slower process, you know, obviously more capital intensive. We've got some that we're building from the dirt up, and it's just, it's a different. It's a different deal, certainly a different speed. But I do think, you know, moving forward, I think, I think we probably would maybe sway a little bit more towards, you know, at least a 50, 50 mix.

Okay.

Than what we've ever done.

Okay, great. You know, there in the industry, there tends to be this thought process of, hey, you can either be really good at de novos or really good at affiliations. Hard to do both. Sounds like you guys have figured out how to thread the needle between both. Any, any insights there you've gleaned in that process?

Yeah, one of the big things we've done is again, we focused on locations. You know, the de novos that I've been involved in, you know, they're again, in, you know, smaller towns, but they're on kind of the busiest highway where they're in the, you know, the most growing part of that community, you know, just so we get the traffic. We have a big marketing push, especially on the de novos, you know, because we know we're starting with a blank slate, you know, so big marketing push in advance to try and when we open the doors, we want a full schedule from day one. And we've been able to do it pretty well.

So that's outstanding. Yeah. Appreciate the difference and the impact you're having with those patients in especially those rural locations. That hits, that hits home for me as well. So I want to start to kind of dive in. And I know, you know, you came in and the books were all kept on a cash basis and you, knowing what you know and with the experience you had, knew that, hey, one of the number one tasks here is get this converted to accrual. We don't want to spend a lot of time on this because you know Holly really well and she, she and I are going to do a deep dive here in another week or two that really dives into that, the process of that, of that conversion. But maybe if you could high level walk us through. You brought in a new accounting software. You had to change a bunch of systems and processes, get from cash to accrual. Let us know some of the key decisions there and some learnings you had.

Yeah, so the first decision obviously was the system, the accounting system. We did a pretty deep search, demoed a lot of products, had a few kind of get to the final finish line. So the biggest problem I was finding besides the cash to accrual issue was just the ability to get financials into one platform. Having that many sites, like a lot of DSOs, every site's its own entity, it's its own set of financial statements. And so that was really kind of where I focused is what's going to make me the most efficient to get consolidated reporting that I can use with doctors, regionals, lenders, the executive team, whatever. The second big point for us was staffing because like you said, we were on a cash basis, but we had really no staff at all. The cash basis reports we got were outsourced. And so it was picking the right person or the right people, had one false start that really as much as anything, set us back a couple of months. But people that understand the systems, people that really kind of understand where we want to get. And again, because we've grown really fast, it had been a, we're only about a 7 year old company anyway and a lot of what we had done, had been, I won't say not structured. It was very structured. It was very effective for the systems. It wasn't scalable, I guess is the best way to say it. And so that was really the focus we had to look at was from the minute that patient comes in the door up till the time I'm publishing financial statements. What needs to happen systemically to get me the data. We need to then generate good usable operational data. Right.

And do it in a fair, in a pretty quick process. Right. So what accounting software did you guys end up going with?

We ended up with netsuite.

Great. And any thoughts or learnings from that implementation?

Yeah, the only, the biggest takeaway was, you know, however much time you think you need to make those structural setup decisions, allow yourself about an extra two weeks. Because what we kind of found out is we had to go live date a target date and we let the system drive a little bit more of the decision making than maybe we in hindsight certainly than we should have, we should have forced a little bit of the issue more with NetSuite than we did on a couple of things that you know, they prefer. The system is set up certain ways but it's, it's created a little bit of extra work and you know, at this point we're five months in, we're through it, but it's, it created a few, a little bit of extra work through that five month period.

So yeah, so we had something similar happen when we switched accounting software where there were a couple processes that we didn't realize this until after, but we just didn't vet those processes out well enough and to know that it was going to be completely different. And it slowed us down and team fell behind and it took us about, you know, the better part of four and a half months to recover to where we were back to the regular closing schedule with, you know, financial statement generation and everything.

Yeah, and I guess maybe just one piggyback comment there. The one big thing that I would do totally different is there were some things where we assumed, you know, you assume certain processes just work this way or you assume the system is going to have this and you know, to really just focus on ask that extra question or that extra series of questions. You know, the worst that happens is to say, well yeah, everybody knows that and you know, if that's the case, that's great.

Well it works this way in QuickBooks so why wouldn't it work that way in the next software? And it turns out there's based on the way Certain things get set up, there's different functionalities and different process flow. Awesome. So I want to start to bridge this gap now over, because you've been in dental now for 10 months and that's just enough time to have got kicked in the face, kicked in the teeth. Where is my enterprise level stuff? I'm used to over in oncology or other parts of health care. Love to have us start to unpack this concept of where is healthcare ahead of dental and what are some of the things in dental that we should be thinking about and increasing our mindsets around to run better operations in the future.

Yeah, I think oncology specifically, just because it is such a regulated field, because it is so competitive from an economics standpoint and I don't necessarily mean competitive provider to provider, it's almost competitive provider versus payer. It's always a game of we want you to do more with less. This service is great, so we need to pay you less for that. We're going to cut reimbursement next year. The thing that I think helps in oncology is there's a lot of benchmarking. There's, you know, in oncology basically everything in the world is based off of some multiple of the Medicare published rates. So you have universally you have a benchmark, you have a baseline and you know, you can negotiate with payers based off that you can negotiate with providers. I've not found anything like that in, in dental. You know, like I said, we're in four states. We have Medicaid, you know, we deal with Medicaid in all four of those states. We deal with payers in all four of those states. And you know, it's, it's. I think you've said it before, you know, once, once you see one dso, you've seen one dso. It's kind of what I'm finding with the payers. You know, Blue Cross in Arkansas is very different than Blue Cross in Missouri is very different than Kansas. And there's. Because there's no common point of reference, that's one of the big things. I do think the other big difference between what you would consider traditional healthcare versus dental is the data and just the ability to compile that data, to manipulate that data, to go out to multiple sources and get literally reams of data that you can compare against, you know, by product line, by region, by cancer type. You know, that's. I think those are the two big things that I think certainly

I've seen

a change in, I think the third, slightly smaller thing. And one of the big things that was really important in oncology, again, just because of the raw dollars involved in chemo and the equipment, et cetera, is the cost accounting. You know, the cost accounting in oncology is huge. I mean, you need to know what every procedure costs, you know, what margins you have, exactly where you can pull or push.

In oncology, your medical supplies run like about what percent between medications and supplies? It's a much higher percentage than dental is. Right?

It is a much higher percentage. I mean, for instance, you know, there are certain oncology drugs, you know, they're going to account for, you know, 60, 65% of your total reimbursement. Wow. You know, so it's, you know, whereas you look at a dental supply, I mean, you know, you're, you're in the single digit range, you know, and that may be high depending on your practice type.

Right, right.

And so that's the one thing that I think is really different is just compiling some of that really detailed cost accounting. That doesn't seem to be as much of a focus.

Yeah, because the margins are just so high. In dental, there hasn't been that need or that focus on it. What about on the labor side, particularly with the physicians in the oncology setting? On the dental side, there aren't a lot of time studies around. How long does it take a dentist to provide specific procedures? Were you guys more focused on that in oncology and understanding how to leverage that doctor's time? And was there comp generally fixed or what? Did it have variable components to it?

Yeah, no. So that's a great question. Very, very focused on productivity. Time studies where I most recently was, it was a full hospital. So we had traditional chemotherapy, we had radiology, we had radiation, but we also had surgery suites. And surgery is probably the best example. And you get maybe a new surgeon, relatively young, out of fellowship, versus an experienced doc that has got a thousand of these cases versus the hundred that this physician had to do in residency. You know, you may have a procedure that Dr. A is five hours, Dr. B is two and a half hours. Quality isn't change at all. It's just comfort level and speed and efficiency. But when you look around that room and you think you have an anesthesiologist, you have a room full of surgical nurses, you have the, the pharmacists that are stand on standby, the scrub techs, I mean, that, that clock is ticking. I mean, and every minute is literally thousands of dollars. And you get paid the same, you know, on a surgery, you don't get paid anymore for that five hour surgery than you do for the two and a half. You get paid based on the code. And I think so that's really important that you want to know how long it takes if you get down to a more comparable, you know, the other piece in an oncology clinic is the physician's clinic itself. He's going in, he's seeing the patient, you know, talking about the disease, talking about the treatment, those things. You know, the doctors in oncology get paid on work RVUs, relative value units and you know, so they are very much incentivized to be efficient in that room. And I've dealt with doctors that literally they managed their day in seven minute increments. That was what they were comfortable with and they could keep a high patient satisfaction. But then I've also seen, and it's the same example with the surgery doctors that they didn't think twice about spending 45 minutes in a room with a patient. You know, but again, you're not getting paid any more for that 45 minute visit than you are for the seven minute visit. So it's funny you mentioned that though because this weekend I was actually talking with one of our physicians or one of our dentists here about kind of that same thing. You know, we're in our structure, we do have a lot of younger dentists. You know, we've very much a mentor mentee role is kind of the way we structure and you know, just looking at, I hate to use it these terms, we're talking about people, but kind of looking at the throughput of a seasoned experienced mentor dentist versus that new doc, that's maybe a year, two years out of school again, it's night day and the financials show it.

It's fascinating how that works. Right? And the interesting thing is, and I've this is what I love about healthcare in general is everything we're talking about here, efficiencies and throughputs and all these things, ultimately it ends up creating the best outcomes for the patients. Right, because the providers able to have more impact with more patients as they figure out how to deliver great care but in tighter and tighter time ranges and you know, always being compliant and never putting anyone or anything at risk and you know, all of those sorts of things. But there's some interesting lessons to be learned that dental just hasn't been pushed on yet that in oncology because those margins are getting squozed in. So just, just from the medical and other supplies, medicine and other supplies, it's just really interesting to Think about at some point, how are we going to help dental get to a place where time per procedure and those sorts of things become more and more relevant.

Yeah, yeah. And like I said, I mean, you know, I think, you know, I think the standard in DSOs are, you know, the physicians are paid some percentage of collections. You know, something. Something along those lines. You know, again, I was having a conversation this weekend. That model has really gone away entirely in oncology. It's. Well, for a couple of reasons. One is because, you know, most physicians are paid as a multiple of rvu, which, you know, the entire intent is to really measure what are they investing in their day, you know, be it chemotherapy, clinic visits, radiology treatment, or whatever.

Or long lunch breaks.

Yeah, exactly, exactly. You know, the other thing that is. Is different is kind of to what we talked about before. You know, your claim versus collection in dentistry is going to be really high, you know, exceptionally high. Based on where I've come from, you know, it's not unusual in oncology, you might have a collection rate of 60% of what your bill charge was.

Wow.

And so again, it's a little bit of that change of philosophy. But what is forced oncologists to do, though, is kind of what you said earlier, they have to make sure every minute of their day counts. And is it medically necessary? Is it all of those gatekeepers that are going to determine do they get paid or not. Whereas the dentist, that's been the big change for me, is just understanding the philosophy.

Interesting. Look, Mike, I can't tell you this is really fascinating stuff to jump into and understand, even if it's just the vertical of oncology, how at some point, like some of these principles are going to start to come over because it's a dentistry. Because at some point margins will start to thin out. It's a process of consolidation. It's just a process of the ultimate evolution of the industry. And it's fascinating to think about how we're so fixated on how doctor compensation works right now and ultimately it could end up headed down the road that you saw oncology ultimately have to go to. So I'm interested if you think is that anytime soon or. We've still got a lot of room and a long ways before things like that start to happen to dentistry.

You know, I think that the best thing about dentistry and, you know, so I came from an industry that was on the news almost daily. Cost of drugs, you know, was always debated. You know, is it reasonable? Is it ethical? You know, you know, you get A new, a new chemotherapy that comes out and it may literally be 50, 60, $70,000 per dose. And you know, so I think the benefit in dentistry, the numbers are so much smaller. I think that in dentistry we kind of get to stay off the radar a little bit. Yeah, but I do think, to your point, I think it's coming. I mean, I think just the economics of healthcare in general are going to drive it that way soon. I think the one thing that helps dentistry is if you look at most dental policies, there's relatively small caps on coverage and then it shifts to a patient responsibility issue. On health insurance, you know, there are no caps anymore, really, you know, on what can be covered, there's no lifetime max anymore. And you know, some of those things that really kind of protected the payers a little bit years ago, you know, so it's, it's not unusual for a cancer patient to be a million, 2 million, $3 million outlay for an insurance carrier. So obviously, I mean, they're, they're motivated to really control those costs, you know, and we can talk about the ethical piece of that conversation another day. But sure, but you know, it's, it's. I think that's the one thing that will keep it slower coming to dentistry is just, it's. The numbers just aren't as big.

Yeah, that makes a lot of sense. The potential claim in dentistry is a lot, lot smaller in terms of insurance exposure. Right. Yeah, that's a great point. That's a great takeaway from this. Let me go down this other vein as you think about. Because there are some parts of healthcare and the consolidation that's happened there well ahead of dental that have created a lot of efficiencies on that part of the world that aren't in dentistry yet. If you could wave the magic wand and bring one or two or three of those things over to dental with you, what would they be? And do you think at some point we'll ever get those types of efficiencies in dental?

I think. Answer your second question first. I think ultimately, yeah, I think we will just because again, I think the economics, sooner or later the economics will mandate it. I think some of the things that maybe traditional health care is a little bit more advanced on is some of that regionality, you know, some of what we talked about, you know, like for instance, I'll just go back to the payer responsibility in oncology. You know, a lot of those payers, you know, it may be Blue Cross of Oklahoma or Blue Cross of Tennessee or whatever, but they do a really good job of, of partnering, you know, working together, try to coordinate care maybe across state lines or some of those things to where it's become a little bit of a regional, regional operation. I don't see that so much in dentistry. Like I said, you know, talking to the same brand name payer in all four of our states, it's four totally different conversations. The other thing that I think in healthcare, and I'm trying to leverage a little bit of this with us now, is vendor relationships. You know, again, I've been in a couple of settings where, you know, national or regional presence and, you know, even though it may be different entities, it may be different tax ID numbers, we'd really done a good job of leveraging our relationships with our vendors, managing buying power, you know, managing market control, those kinds of things that I'm not seeing the dentistry vendors as willing to jump on that. Like in the case of us, we're 44 sites that, with some of our vendors are treated like 44 sites rather than one group or affiliation. And I know again, from where I was, that's a material difference in that pricing a lot of times.

Yeah, that's a great point. I want to jump back to something you said earlier when you were talking about benchmarking how. And that's one of the weaknesses or gaps in terms of health care and the way that it's benchmarked aggressively as opposed to dentistry. Now, you and I are part of the Dental Finance Forum. And in fact, when you and I first met last year, we started to talk about the idea of possibly getting a forum set up for the finance leaders of DSOs to come together, put our heads together and try to help each other solve some of these complex problems that we're facing in this consolidated industry of dentistry. And in that process, you've brought up several times this concept of benchmarking. And we even have talked about that perhaps the Dental Finance Forum could take a little bit of a leadership role in dentistry, because it makes sense that finance leaders in these organizations, they'd be probably the right ones to pull those numbers together and create the right outcome with that. Walk me through. Now that you've been in dentistry for 10 months, as you think about what would be some of the most critical things to benchmark, what comes to mind for you there, and you can feel free to jump back to your oncology days and what sorts of things were you looking at and what would be the comparable metric be in dentistry?

Yeah, I think some of the real focuses would be on the productivity, you know, the economics and you know, as I've spent time with you and you know, some of the other, other guys and ladies I've had the opportunity to meet in dentistry, the financial statements themselves are pretty straightforward. You know, you mentioned, you know, dental supplies are this, and salaries are somewhere around here. You know, so we can, we can put that together and we all can compare pretty pretty well. The one thing that I see even within my own organization is the productivity. And the expectation around productivity is very different from site 1 to site 44. So I think that that's one place to really focus on what does an ideal office look like, you know, and again, not, not that they're even comparable so much, but you know, again, looking at an oncology clinic versus a dental clinic.

So some of those metrics, I'll throw these out. You could look at production per day per provider. You could look at number of patient visits per operatory. That's looking at, you know, some utilization. And how quickly are you in essence turning over the chairs, which for those that aren't familiar with that terminology, it's the same in restaurants. Restaurants care a lot about how quickly they can turn a table over because if they could get four groups to sit at that table for dinner versus three groups, it makes a big difference in overall revenue. And with all the fixed cost of obviously running a restaurant, and we have a fair amount of fixed costs in running dental practice, it can create more revenue. So those are some that come to mind initially. Are there any others you've thought about or anything that we could glean out of, out of oncology that might help us think more deeply about that?

Well, some of the, some of the other things, you know, one of the things you mentioned that I've made a personal really focus is my productivity per operatory, you know, and looking at ROI on, do we need to add operatories, those kinds of things. The other thing that obviously I think we do some data gathering is conversion rates. And again, I hate to talk in terms of widgets, but I mean, at the end of the day, I mean, we're selling a service and how often are we able to convert this need or this desire to a delivered service? And then how do we improve, you know, every, you're going to, you're going to have a plot of, you know, in our case, you know, 70 physicians on a plot. How do you get that lowest quartile up to mid range or that higher quartile? What's the secret sauce there? Some of those things like I said aren't necessarily directly on the income statement, but efficiency, turnover, some of those kinds of things. Which does lead to one other thing that I've seen a lot of that I don't think is unusual in dentistry. Really high turnover rates and especially the DA roles. And you know, what does that mean as far as lost investment and training and you know, just, just search and, and again, how does that impact physician productivity?

Yeah, that, as you said that that was the first thing that came to my mind is in interacting obviously with so many dentists over the years, but especially in our organization now. It's interesting how they can have a day where they do production of say $10,000 that day and feel like it was easy and then the next day do say $3,000 of production and it feel like they just, it was just the most tiring, exhausting day. And generally speaking, my experience in talking with the, with the clinicians is it has everything to do with that dental assistant and how well they know and understand dentistry and how well they know that doctor that they're supporting. And not just the, but the entire back office dental assistant team that's there supporting and helping the doctor. And it goes from sterile all the way, an X ray all the way to very complicated treatments. And so I think that's a, it's a great call out on a great point that there are some of these other metrics that, that can drive that productivity, but ultimately it's the productivity that looks at it. And one other point, as you were talking about conversion, I don't think it's wrong at all to talk about conversion because as a dso, our job is to support these doctors. If the doctor is diagnosing that a patient needs something where they have, you know, full autonomy and everything in terms of determining what does that patient need as a dso, how can we support them in helping that patient feel comfortable to receive that treatment? Like what systems and processes can we build? Are there training programs that dental assistants and financial coordinators and treatment coordinators can, can engage in to help them help those patients receive the treatment that that licensed clinician has diagnosed. So it's a, again, in dentistry, it's all symbiotic because ultimately what the doctors say is best for the patient ends up actually being best for the business as well. And that just, that's how it all ends up happening. And it's anyways, it's a great industry. It's one of the reasons why I am still here and hang out and do all this. Any other insights around Metrics or some of these efficiency and capacity metrics.

I think those are the big keys. And like I said, I think probably one that's, and I mentioned, the one that's underutilized is that turnover rate and just how impactful that is. And quite honestly, I would even take that up to physician turnover rate.

No doubt.

Speak from personal experience. If I go to my dentist office and three appointments in a row, I see three different providers, I'm probably not going back for a fourth. You know, I want somebody that knows me and I can trust them. So just some of those things, like I said, that are more soft metrics but absolutely drive that bottom line.

Yeah, they make all the difference when it comes to how successful financially the dental practice can be. Okay, great. Well, we're starting to run out of time here, Mike, so I'm going to jump into our lightning round and this is seven questions. Everybody who comes on the show, I subject them to. And it's just a fun little way to get to know you a little bit better. And if there's anything we need to dive in and investigate further, we will here. So first question, what are you currently working on?

A couple of things. So one is a couple of product line business models. Just some changes we can make doing a couple of new focuses for us. What does it look like on that investment? And then the second piece is just some of our partner allocation reporting. We just like a lot of places out there, we have partner docs and, you know, there's some of those costs that need to get allocated and it's not necessarily a clean allocation. So working on some of that and getting it as automated as possible.

Very nice. Great. Favorite sports team?

The West Virginia Mountaineers.

All right, there you go. What's the connection?

I just grew up West Virginia, spent, you know, basically Every Saturday for 15 years in Morgantown at football games. And it's just. It's just an amazing place.

That's great. Your favorite hobby?

Running. Love to run.

And do you do races ever? Like marathons or 5K?

I do, I do. I've got young kids now, so not as often as I used to, but I used to run marathons and halfs, even a couple of 50Ks.

Oh, wow. Through mountains or just on roads?

Mountains, yeah.

Much.

Much prefer mountains.

Okay. Yeah. It's a little cooler, huh?

Yeah.

Air is a little thinner too. So there's a trade off there.

Yeah, for sure.

Awesome. Favorite app on your phone, Believe it

or not, it's audible.

All right.

Yeah, I know I should have something Better than that. But it's just, you know, it just, it's relaxing. Get you where you need to be.

So is there. This is a bonus question here, but anything you've listened to recently that was compelling or you think our listeners might be interested in?

Well, so I'm a history buff, so most everything I listen to is history. And there's actually a book that I'm listening to on Stonewall Jackson that just, you know, I mean, there's a little bit of military history in there, there's a little bit of religion in there. There's, there's a lot of leadership in there. And not to get too far off, but he was very much kind of an odd duck in the real world. But you get him in the military and in a war setting, arguably one of the greatest generals certainly of the Civil War.

That's incredible. All right, last question. Favorite spreadsheet function.

Again, pretty boring guy. It's sumifs again. Coming from the world where you've got so many locations you're trying to get them in, that sumif is pretty invaluable.

It solves a lot of problems very quickly. No question. I couldn't agree more. All right, as we're wrapping up here, anything come to mind? Any partying advice for emerging groups? Say they've got one or three or five locations and they're, they're just trying to figure out how to keep growing and keep some momentum going. Any advice for them?

Yeah, I guess two pieces. One. And it's a little self serving, but let finance sit at the table. I know it's really easy to let operations just churn and burn, but let finance sit at that table. So you understand roi, you understand that productivity, you understand where this lever can move that, you know, rock. The other thing is, especially for a really small group kind of really trying to move up is take the time to create the systems because what's functional and, and totally doable at five facilities is no longer functional and do it or doable at 20 or 30 or 50. So set the systems up early when you take that extra few days and set up your handbooks and get everything in place.

Outstanding. It's great, great advice. So as we are wrapping up now, some great learnings here. Putting on that lens of healthcare and seeing some differences in that industry, especially the oncology industry that you know so well, Mike, and comparing it over to dentistry, some really, really great learnings. The need for benchmarking and, and the need and the knowledge that ultimately this is going to become about Provider productivity. And it seems to me like it really justifies even more for the DSOs that are focused on helping providers be as productive as possible and creating tools and automations and things that help them so that they can focus as much of their time on being right there with the patient and doing the things that they've diagnosed that the patient need. There's going to be a lot of opportunity, opportunities, it seems like to me, in the next five to 10 years in the industry. And those who figure out how to help their providers be as productive as possible are going to be, you know, some of the clear winners.

Yeah.

So really appreciate your perspective on that. Mike, any advice as to if somebody wants to get a hold of you or talk to you, they're doing a NetSuite implementation or they want to learn more about anything else you've talked about. What's the best way for them to reach you?

Yeah, they can email me@meatespringdental.com and they can call cell phone 918-606-1051. That is one thing, especially being new to the industry, I love to talk to new people. I actually talked to was a Reference for a NetSuite prospect a couple of weeks ago and she and I have stayed in touch. And, you know, it's just fun to watch people succeed and if you can help in that in any way, it is just that much more exciting.

It is outstanding. Appreciate that servant mindset and that servant heart. It is a great, great way to do business, I think. Well, we can't thank you enough, Mike, for participating in today's podcast. Also, many, many thanks to all of you who joined in and who are listening. This is a wrap on how healthcare is going to influence dentistry so that we can ultimately find some of these efficiencies we're talking about and help our providers do more and be more for patients. Any last words, Mike?

Nope, Just thanks for having me. I appreciate it. Always enjoy watching, watching these sessions. So it's exciting to be part of one.

Awesome. All right, Mike. And again, thanks everybody for joining. Happy Day Foreign.

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