200: Unlocking the Clear Aligner Economy with PerfectFitOrtho

Almost shocking when you really start doing a deep dive into what we call the clear aligner economy. There's a 31% compound annual growth rate right now in the aligner industry that's forecasted from 24 all the way up to 2030.

Hi, I'm Emmett Scott, and just like you, I've had my ups and downs in the dental industry, but times are changing. The DEO has built a map of how to succeed in one of the most challenging industries to navigate. On this show, we talk to dental industry leaders, solve problems, and get you the answers you need to face these challenging and thrive. Welcome to DEO's Growth Secrets podcast for dental organizations. Now let's get started.

All right, everyone, welcome to DEO Growth Secrets podcast. Here I am with Jay Hogan of Perfect Fit Ortho. We're going to hear today about the clear aligner economy. Excited to hear kind of trends that you're seeing there, Jay. And then also with us, we have Dr. Noah Liu, who, who is a dentist who is actually utilizing this strategy to really a high degree of success. We're going to hear about that, too. So, Jay, do you want to give a little introduction of yourself and Perfect Fit Ortho?

Sure. Thank you. And Dr. Lu, thanks for being on with me as well. Like you alluded to, my name is Jay Hogan. I'm the vice president and co founder of Perfect Fit Ortho. We are a virtual orthodontic solution company. Oftentimes people think sometimes that means we manufacture aligners. That's not necessarily the case at all. Our whole goal is to be a virtual orthodontist for general dental practices. So we started in 2019. My partner and I, Dr. Abramowicz, kind of just like as a pilot, as a beta test to endear ourselves to general dentist and help them do the cases they wanted to do and ensure that they would send everything else to us. About six months to a year after we started that they started, they stopped referring, and we realized that they were using our services internally as opposed to having to send it out. So we decided maybe we should pivot and maybe, maybe we found something. So we launched nationally in March of 2023. We were just in a couple pods in a couple states. Fantastic results so far. Fantastic feedback. Adoption rates are very, very, very high. We're in 17 states. Excuse me, we're in 18 states now, as well as two provinces of Canada and soon to be in Puerto Rico. We're based out of Tampa, Florida. And that's our whole gig.

Beautiful. That's what we call a happy accident. Right. I mean, that's easier. It's easier to execute and provide value for you to the dentist, is easier for your dentist customers. So that's a beautiful. A beautiful pivot there. And then, Dr. Liu, do you want to give a little background? Because you have successfully utilized this strategy, we're going to go deep into how you're doing that. The very much the specific. Excuse me, the numbers and how you're doing that. So. Yeah. You want to give us a little background?

Yeah, absolutely. I'm a general dentist based in Peoria, Illinois. And, you know, we. We run a group practice with multiple locations. The first thing that we actually found out with Jay's team was how easy is it to implement? Because, you know, we have doctors who are just like freshly graduates, you know, out of school. They have no clue about orthodontics. They feel very, very uncomfortable. And one of those challenges was how do we implement ortho clear aligners in the practices? You know, for myself, I'm. I like to learn. I will adapt. I will go ahead and get it done. But for my other doctors, you know, most of them were not willing to do that, and some of them would not even touch these cases. So when Jay came up with this team and with this idea, and we are partnered with ClearCorrect, so that's where we found this infusion. But it was not without challenges. I mean, you know, Jay can attest to that, that we still had a lot of pushbacks, and even then, today we are still trying to integrate, but it's gone a lot better than when we started about a year ago. So that's a little bit about our background. So we are a husband and wife team. We are co owners of Secure Dental, and that's where Jay came in into our organization, and that's where we started with this whole process. So it's been amazing so far.

Yeah, yeah. I mean, with any of these kind of implementations and change management. I love that you said it's going to be a challenge, right? Like, it's going to be hard to kind of change the direction of your associates, the way their behaviors are, but the payoff is big. And so, Dr. Liu, maybe you can talk about, you know, how you were understanding the opportunity in the beginning and what made you decide to approach this? Because I just got off the call with one of our D.O. members at 70 locations in New York, and they don't do anything with the liners. Right. So it's a decision that has to be made and it sounds like you made that positively. So how did you walk through that?

Well, I'll give my credit. I'll give the whole credit to a buddy of mine, Dr. Atar. He runs, you know, his other aligner business. He's the one who actually got me on the phone and was like, you know, you're leaving a lot of money on the table. So that's number one. Number two is we've noticed that, you know, there's a lot of patients that needs help and they want to be under one roof, right? And we were just sending away all these patients to the orthodontist, and most of them were like, easy cases. When I say easy, I mean like just a quick fix with like 6 to, you know, 12 months of aligner treatment. So those were all going out the door. Number three was we were getting associate dentists who wanted to learn clear aligners, but we did not offer that and we did not have any kind of backup or support. So that's how we got started with my buddy there. You know, he's a great orthodontist down in Dallas. And after that, then we found some issues with the whole efficiency process. So we dropped everything, right? We dropped everything. We were like, you know what? We're not going to do any more liners. This is way too much hassle, too much problems because we did not get the support that we needed. So after a while, we got involved with Neoden Straumann, and that's where the clear, correct guys came in and we got implemented. And Russ Dobson from Strauman, he was like, hey, let me introduce you to Jay. Maybe he can get you guys get back up and, you know, get started. And we were like, I don't know, you know, we. We just went through it. It was not a good experience, but, you know, we were like, what the heck? Let's just give it a try and see if it doesn't work out. Doesn't work out. So we did. And amazingly, Jay just took the whole thing, walked us through, like, you know, held our hand and just walked us through the whole process. His team of orthodontists was excellent to work with. He had a great workflow. Like, everything was done within minutes at the office. And what I really liked about Jay's team was the proficiency and the efficiency and the professionalism that they exhibited with our doctors and our team. And I think that was a huge plus for us because somebody who's actually transitioning from doing nothing to actually going full blown ortho, I think that was huge. And for me, it was more about how do I save time, chairside time for my doctors and patients. Because with regular aligners, I mean, these guys are coming in every two weeks just for follow ups. So my huge thing was, if nothing else, the ROI would have just been for the patients not to show up every two weeks. So I think that was really, really like out of the ball kind of deal.

Yeah, yeah. So it says that you have a fork in the road of whether you're going to do ortho or not. And then if you're going to have it, virtual help and virtual support with that.

So.

So, Jay, anyone listening? And they're trying to assess what the level of opportunity is here. What are some, some numbers or how can a doctor know? Like, yeah, there's actually a lot of opportunity. Because, you know, one thing that we're, that's becoming prevalent in the maturity of the industry is oftentimes before you go out and buy a second and third location, you're much better off. We call it squeezing the juice inside your current location. These patients already have problems. They already have needs. If you can figure out how to serve them, that's a really good use of your time. Right. So what's the level of opportunity, Jay, for an average location or a couple locations?

I mean, it's, it's, it's almost shocking when you really start doing a deep dive into what we call the clear aligner economy. There's a 31% compound annual growth rate right now in the aligner industry. And that's supposed to be, that's forecasted from 24 all the way up to 2030. There's, it's. Right now they're estimating that the aligner industry is going to be worth $33 billion by 2030. And at the same time, if you look at ADA stats, if you look at the American association of orthodontics, on average, 80% of your patient population has some form of malocclusion, and less than 20% of those patients get treated by a general dentist. So it's not really our value proposition, and I think Dr. Liu jumped on this quite quickly, is this doesn't, this doesn't mean you have to spend more marketing dollars. This doesn't mean that you have to go out and get more patients. You just need to present an opportunity for your patients to buy the services that you offer in your practice. If you can capture an additional 20% market share of your existing patient base, that's going to be a, that's Going to be like putting gas on a fire. As it relates to your top line revenue, the average aligner case is around $5,000 in the United States. You add two cases a month to your, to your production, that's going to be a substantial amount of revenue. And you're not asking your staff, you're not asking your team to really do anything they're not doing now. The only difference is now with support from Perfect Fit, you have the opportunity to more quickly diagnose an established treatment length for your patients while they're in the chair. You get the support necessary with an orthodontist delivering the service as it relates to the setup of your case, answering questions, consulting with the general dentist to go through that process. And then like Dr. Lu had mentioned at the end, instead of seeing that patient every two weeks, four weeks or six weeks, you're seeing that patient when it's necessary to move their treatment forward. We have many cases that the doctor may see them at delivery IPR if they need it in the middle, and then debond. Worst case scenario, if a patient is not tracking the way they should be, or if attachments have come off or there's elastic cooperation issues, we can more quickly identify that and communicate with the practices so they're not finding out eight months later that their patient is not tracking. We can make those adjustments in real time and the patient gets the value proposition of they get to see and talk to their doctor. They're an orthodontist every single week, but they're not taking time out of school, they're not taking their kids out of school, excuse me. Or taking time off of work. We meet the patients where they are. Right. The 21st century. I'm sometimes shocked because I live in Tampa that I can order dog food from Amazon and have it delivered in two hours. It's not. The times are changing and you have to meet people, you have to meet patients, you have to meet people where they are. And I think this is a perfect collage of that. And I sometimes joke, tongue in cheek that it's almost as if from a general dental perspective, you're getting free ce. Because the way our system works, every single doctor that we work with has the opportunity on their time, on their schedule to schedule video consults with our team of orthodontist. So if they have questions about a case that they want to present or that they've already started, or if they just need to bounce ideas off each other or they need to coordinate treatment plans, there are oftentimes we Work with actually one of Dr. Lou's good friends, Dr. Shore, who does a lot of implants. And for him, a lot of his aligner cases that he starts with us are because he's trying to establish room or maintain room for implants or permanent restorative dentistry. So you have that collaboration with your orthodontist at all points and times and again, you're capturing the market that already exists in your practice. These patients are going to do treatment just a matter of where. Are you going to send them somewhere else to do it, or are you going to be able to offer that service to them under your own roof?

Yeah, I mean, it's actually a double whammy because the, the liner space is growing and just esthetics, when med spots are blowing up, everyone's, you know, getting really even more into this and virtual delivery of things is getting bigger.

Right.

Like, why go into a brick and mortar? Obviously a lot of value in that. Right. When needed. But if there's anything we can push virtually over the next five years, that's going to happen, especially as technology gets better, as zoom gets better, as videos, Internet get better. So you've got a double whammy there. Two growing things. As a patient, your patients are absolutely going to want to be able to stay at home and do the treatments when they can. So, so Jay, maybe give us a little bit of background on what the virtual consultations are like and just, you know, as you take them out of the office and what's, what's that process and how does that feel for the patient?

Yeah, I mean, our workflow is very simple for group practices, for general dentists, for individual doctors, we allow a doctor, if they have a patient in their chair and they recognize some level of malocclusion or the patient just says that they're interested. All we ask those staff members to do is take photos. So the patient takes, or the, excuse me, the staff member takes photos of their patient. We return a treatment plan as it relates to length within 15 minutes. So we'll say to Dr. Liu, hey Doc, you've got Jake in the chair. He's going to need 15 months of treatment and he's going to need to wear elastics. We give them the software necessary so that they can present a financial treatment plan to the patient which allows them to make short term payments in the practice, pay in full, or use a multitude of third party finance options. If the patient decides, yes, I love it, it's affordable, I want to move forward. We do all that case setup for the doctor. And then once the trays are delivered to the practice and the general dentist delivers them to the patient, the patient's just scanning their teeth from home once a week. And it's not, it's not a, it's not a manufacturer cycle. Right. It's not a forward plan. When they take their scans, they interact with a live person. We can annotate their photos, we can show them where things are fitting well, where there's hygiene issues. And all of that information gets reported in real time to the general dentist as well. Patients absolutely love being able to see their doctor more. But on their schedule, we oftentimes get messages from patients that have nothing to do with orthodontics. It may be questions about their next cleaning appointment or if their insurance was paid. Right. We get all that information and it's all pushed to the patient, to their phone. So it's really, really, really easy for them. And you know, the other thing is, and I hate, I hope I don't get lambasted for saying so, but within our, within our workflow now, general dentists and group practices can say to their patients things that a lot of orthodontists can't even say. Right. They can say to their patient. You're going to be seen every single week, but from home. It's done really well for us. And on the doctor side, you're freeing up chair space. You're not seeing that patient every four weeks, every six weeks, just for a checkup. That is non productive. Yes, this is definitely the healthcare space. Obviously, patient care is first and foremost, but profit is also not a bad word. And if you're seeing a patient Every month for 12 months, your return is going to be minimized much more so than if you're seeing your patient when you need to.

Yes, exactly. So you. Profit is a part of the industry and we really have to kind of just accept that. We say no margin omission. Right. If you don't have the profit, you're, you can't put your engine forward of this, doing such great work in the world with your team and with your patients. So, so, Dr. Liu. Yeah, like walk me through, first of all, the workflow. This seems like an absolute no brainer as far as if you are going to endeavor down the liners. It's hard to say why you wouldn't do something like this. It seems so much easier. But Dr. Liu, how does the workflow, the starting workflow work for you when the patient's in the chair? If the doctors communicating out with Perfect. Ortho. Walk us through that on your end.

So I'll give an example of Dr. Shore. Dr. Shore was one of the guys that used to work with us, and now he has his own practice. And he was the kind of guy, he was the first guy who was very, very reluctant about doing ortho. He told me, Listen, Dr. Lu, I'm not going to touch ortho. I'm not going to do it because I don't understand ortho. So we'll take his case as a worst case example. Right. So the workflow for him began, like, with the assistant seating the patient on the chair, taking photographs. And with that time, they're going to send it to Jay's team. And Jay's team will respond within 10 minutes and let us know that, hey, is this a go or is this a name? And most of the time it's a go.

Is that patient expressing interest ahead of time, or are you just doing every single patient?

No. So we basically we go in there, we just look at the patient, we do a full comprehensive exam. The only thing we're doing with patients is we're just letting them know, hey, did you ever consider aligners? Because I can see a lot of, you know, wear and tear going on in your teeth. They are, like, not aligned properly. Or if we see any kind of sleep apnea disorder. So those are some of those things. We just bring it up to the patient just as if we are just educating them.

So almost every patient, you're. You're actually sending the perfect fit ortho

for a diagnosis only if they show interest after we've expressed what we found. Right, right.

I see.

Okay.

Not every single patient now, because there are a lot of patients, they'll be like, yeah, you know what? It's fine. I'm cool with it. I've been having it like that for years. So I'm. I'm fine. Right. So. So we are talking to, like, you know, those patients that actually does exhibit, you know, a lot of ab fractions going on in the teeth, a lot of grinding, you know, wear and tear on enamel. So those are the guys. We will actually take photographs. And when we tell them, they're like, oh, so what do I do about it, doc? All right, cool. So, you know, this is something which we should explore together, and let's talk about, like, getting them online. And this way we can minimize that wear and tear on your enamel for your future, you know, as time goes by. So those are the guys. We'll take photographs. We'll send it to Jay's team. Jay's team will review it, let us know, hey, you know what this patient we need probably like what, like maybe 12 or 18, you know, months. And then based on that, Jay's team will send us the software where it's going to tell the number of treatment needed, the number of months needed for treatment, and then the payment plan. So the payment plan will have a third party option and then it will also have an in house financing kind of deal. So it's almost, almost always, I would say, if the patient has made up their mind, they'll get financed pretty much.

So who's presenting that part of it then?

Is that going all through the coordinator? Yeah, the treatment plan coordinator or our office managers. So whoever's available at that time, let's say if the coordinator is busy with another patient, then our office manager will jump in and just take the lead.

Do your dentist need to be educated on how to get to a yes for this? I mean, because. So they're not typically used to talking through this. Right. How do you get them to, you know, trained on talking through it?

You know, Jake, the, the basic thing that I just require of them is just diagnose and just do their job by just educating the patient and that's it. You know, I think, I think if they do that good enough, I guess they don't have to sell anything.

Right? Do they need education? I'm just imagining they need some kind of training to feel a little more comfortable talking through that, even for a little bit. So, so there's training involved. And then, Jay, are you providing the training or how do you get Dr. Liu's doctors feeling good about just talking and answering the questions of the patient about this?

That's a Jay's question.

Yes. Surprisingly enough, what we have found is more often than not, doctors, it's my personal opinion that you want to try to keep dentists out of financial discussions as much as humanly possible. But what we have found is when doctors know that they have that support, when they know that they have an orthodontist standing behind them throughout the entire process, we have found it's much easier for general dentists to have general discussions about malocclusion, about crowding, about spacing, because they're already well versed in the positives and negatives to the conditions that these patients have. The real difference is now they have the confidence to know, if this patient decides to move forward, I can provide them the service that they deserve. And to a point, Dr. Lewin, made earlier. The other offering or the other thing that we try to do to be as supportive as possible is in the event that that patient's in the chair and they go through that entire process and they just decide, I need to go home, and I need to talk to my mom, my dad, my brother, my sister, husband, wife. We follow up on behalf of the practice with those patients for 90 days. So we call those patients to answer questions and follow up. We send emails and text messages, and every time we touch those patients, they have the opportunity and the ability to execute their treatment plan from home. You know, on top of. On top of those patients being in the chair, we also allow patients from home they can visit Dr. Liu's secure dental website, click a widget, answer a few questions, and take photos. We will send them a fully executable treatment plan. Those patients can review it, sign, and pay. And they've never stepped foot in Dr. Liu's practice. So it's another way to garner new patients. Now, I will also say this. There are. Every single day we get those photos and that data for patients that want an implant or they want a denture or they need a cleaning, and all of that information we pass directly to those points of contact within the practice. But it's a very easy way to garner additional new patients as well.

Well, I mean, you keeping up with that relationship just virtually is so valuable. It's almost like the oral health economy, clear aligner economy kind of leads to the overall relationship. So, Dr. Lee, that's. That's got to be super beneficial to be followed.

Yeah. I just want to add a little bit more to that, you know, with the Education Department. I was just thinking about is a partnership that we also have with ClearCorrect and Strawman's team. So when Jay's team and their team, they get together, we have those monthly zooms for our doctors, and that's when we do case discussions.

There you go.

Right.

And.

And just. I just didn't want to ignore the. The whole, you know, educational gamut there.

So.

So basically, Dr. Luciana from ClearCorrect, she is really, really helpful. So we have her on a WhatsApp as well, on top of what Jay's orthodontists have. So, I mean, we have, like, a double whammy going on. So with our doctors, if they ever have any issues, they can sit down for, you know, clear aligner with coffee with Dr. Luciana, or they can just contact Jay's team. I mean, you know, that's all super supported. So It's a no brainer.

Yeah, super supported. And then let's talk about the virtual consultations after the first one. Kind of ongoing. You know, those are happening virtually. It sounds like you're filling in notes. Jay, your team is. Dr. Liu, your doctors are able to follow this. Anything else about the workflow that it's important to know throughout the treatment cycle?

Well, with my team, I'm. I'll be honest, I'll be. I'm a little bit oblivious because, you know, once when the patient's gone, I mean, I don't know what's happening. Okay. Honestly, the only time I see them back is when that's the idea.

Right. I mean, that's a great. You need support.

Yeah. Oh, absolutely. I think that's a great service because I'm not seeing the patient. The only time I'm seeing them back or my team is seeing them back is, you know, they go like, hey, this patient needs. This tray needs a little IPR here. It's not tracking well. Maybe you want to add a little bit changes to, you know, the treatment modality or, or maybe even, you know, something you just come in and just for a follow up or. The last time, I think the last time we saw like a few patients, I think I remember was they're just coming back for the retainers and that was it. So, I mean, it was pretty seamless the whole process.

So, Jay, what's happening? I know you described it a little bit, but what's happening underneath the hood there as this is going on that you've taken off of their plate so much that they're able to focus on the day to day office operations?

Yeah, we see the patients weekly. So every single week these patients scan. They get prompted at a time that's convenient to them. They get to choose the time that works and. And if they don't, you know, on occasion, patients will forget or get behind and we will reach out to them and let them know how important it is they stay compliant. But we're able to see everything, Right. We take. We get scans of them with their aligners in and out. There are often times where we will see patients that are missing attachments on second molars and the patient doesn't even realize it.

Right.

Patients sometimes are oblivious to what they had or what they no longer have. So it allows us to more quickly identify those things. Reach out to the doctor and say, hey, doc, your patient has an attachment that came off. Please bring them in as soon as you can and get that put back on. All of that information is available to the general dentist in real time as well. So it's just an opportunity for again, the patient to be able to see a doctor seven times more than they normally would, but they come into the practice seven times less. That's really the workflow for us. And that all happens every single day, right? Every single day. And you'll be surprised. Some patients take their scans at 5pm, other patients take their scans at 2am it's, it's really interesting what, what works for patients. But we're, you know, our team of orthodontists are reviewing them, seeing them, and sending out that information on a daily basis.

So what's the. Just kind of curious the other end of it, Jay, like, what's this orthodontist team set up? Are they like a command center in like a NASA setup with like a multiple screens? You know, like, how does this. Are they at home and kind of, you know.

Yeah.

The nice thing is it's a virtual world, right? So they're all, you know, our doctors are spread out. We have doctors, we have orthodontists here in Florida, where we're located. We have orthodontist in the Chicago area. We have orthodontist in Nevada as well. So we're all over the place. And the orthodontists like it a lot because they have the ability to do what they're trained to do, but not necessarily have to be hopping chair to chair, you know, hour to hour and clocking in and out, so to speak. So it really is a, a win, win, win. And you know, a lot of our doctors, probably, I don't want to speak for Dr. Liu, but all of our orthodontists, one of the things they enjoy most is teaching and guiding and helping and to allow general dentists to take part in the clear aligner economy to be able to see more of their patients. Because, you know, there is kind of an old adage that every time you refer your patient out of your practice or something else, there's a chance they may not come back. So having the ability to help doctors do what they want to do and continue their level of education, we have many doctors who, when they start, they are afraid to do anything past 10 months. And then within a year or two, they're doing 24 month cases or phase one, phase two cases, because they know that they have that support system in place that can help guide them through it. And a lot of it is the setup, getting the proper setup, getting the proper instructions to the Lab manufacturer Choice, whether it's ClearCorrect or SureSmile or Invisalign or any of the other aligner companies that we work with, it's all about the correct setup and the correct instruction. And then, obviously, once that happens, then it's kind of. I should coin the phrase. I. I like to sometimes call it crock pot, Orthodontics. You just set it and forget it.

Yeah, it's. You know, we always joke kind of orthodontist that's. They've done a good job choosing that profession. I mean, it's such a cool one, right? Like, you get. That's a massive impact on the smile. You get all the credit, right, for the smile makeover and the changes. And then also, you can do it now. It's virtually, which is pretty cool. And also that when you do it virtually, it's more efficient. Right? It's just. You can probably treat more patients at once with that. And there's a dry as all this. So many benefits that kind of come out of this. So, Dr. Liu, I want to talk. Just quickly, any challenge you had going through it, you know, if somebody's considering this, going down this road, and then finally, you know, where you're at today, what the results have been, how many cases you guys are doing, and also with that in mind, knowing that you're just on the beginning of this path, right. You're getting better right here. So. So, yeah. Any challenges for somebody considering this?

The biggest challenge would be to get everybody on board. That's. That's the biggest one. We still have team members that are still not very efficient and still not very comfortable doing this. And that's the honest truth, right? Anytime we have a staff turnover or if we have, like, a new person, a new personnel coming in, we have to go through the whole training again. So that. That would be one of the challenges. Are we where we want to be? No. We still have a long way to go. But are we better than what we were last year? Absolutely.

Yeah. This is the thing with these changes, right. I think you just hit on two really important points. It's. It's one thing to just think that something is the best way to go, right? As a. Especially as a leader, we go to a conference, we're like, oh, we need to do this thing. You have a lot of humans at your office, and so first you have to get them emotionally on board with this.

Right?

And if you don't have Jay to do this with the training, the support, just knowing you have support, there is massive. Knowing that you're asking people to do something different than they've always done. Right. And so you can take it, you know, take it a little slower. Lots of education, lots of buy in, but that's how you approach an opportunity that's new to people. Right. So that's, that's going to happen. And I think, you know, you guys probably have come across this and that's something you're also able to help out with.

Oh yeah, yeah. We, our training is we, we are where we need to be when we need to be there. You know, when we onboarded Dr. Liu's team and all of his locations, we actually did it on site. So we did, we put all of his offices in pods and we hit basically three offices a day over a four day span so that we could, you know, meet the doctors, meet the staff, put names with faces, answer questions, walk through them. Now every single support member, every single staff member on any within any group practice has the ability to reach us in real time via email, text, phone call. Actually, as we, as we're recording right now, I look down on my phone and an office manager from one of Dr. Lou's offices had just called me. So we want to be available when they're, when they need us. Right. And we have offices all the way to California. So we, we operate and we're full, go 8am to 8pm every, you know, every day but Sunday.

I mean, Jay, if you need to answer that call right now, feel free.

We can. Dr. Luna, I shot her a test. I think we're good. Nice.

Yeah. So you have a little bit of the installing something new and then also there's just the learning curve. You know, we. Another great example is a recent event inside the deo. We had a case study of saving RCM costs and somebody was installing some, some technology to do that. And again you make the decision like, oh, we need to find some automation. Well, when you look at the graph, it takes three years to actually realize that savings once you decide to install or something new. And so it's not something that comes out of the gate. And all of a sudden, you know, it really takes a dedicated effort. But if you do the dedicated effort and you're committed to it, it's massive payoffs. And then once you get it kind of the plate spinning, we say, right, once you get that plate spinning, it stays right. You got that system going. So Dr. Lu, can you give us any insight into, into where you're at doing a lot of cases? Are you doing about A quarter of what you think you're going to do. Like, what's the magnitude here so far? And what do you hope it to be?

I'm not sure, Jay. I mean, you got the numbers? Honestly, I. I do, yeah. I have not followed up for the last, I think this whole. This, this quarter since we started. So.

Yeah, that's a case. That's a testament to how much Jay is helping you guys out. Right. It's like.

Right, right.

It's.

It's like totally kept us like, you know, trou kind of ortho.

Yeah. So Jenny, example.

Yeah, Jake, I should have, I should have probably been better prepared because I only know through the first quarter as

it relates to just a General idea. Yeah.

2024, they did roughly 50 aligner cases and through the first. And they passed 50 through the first quarter of 2025.

Right. And so, and so, Dr. Liu, that's literally with the same patient that you already paid marketing dollars to get into the door. It's a great use of your associates time if they can kind of, you know, you're treating patients that are. Already have this need.

Right.

So you already have the getting into their mouth. You're already kind of doing a. Just starting that relationship with them and then it's that initial. That's initial effort and then boom, it goes off into the virtual world.

Absolutely. You know, I almost, I almost think like this is the best of both worlds. Like, you know, like, like they have a brick and mortar that they come to and then they have virtual. Right. Unlike unlike, you know, in the past where they had like the direct to consumer kind of deal. So this one, they had this feeling of, hey, we still have an orthodontist, we still have a physical location, we still have a doctor, and this can still be home. So I think that's the best world.

I mean, I think that's where everything is maybe moving. Right. With even working from an office. Right. You're gonna have some days at home, some days in the office for admin and things like that, shopping. Right. You want Amazon, but also you want to be able to go to the store when you buy a mattress, test it out. It really is where everything's going to. I mean, so 50 cases, you said the average case is 5K, right? Is that, is that what you're saying?

Yep, yep.

That's 250k. So in one quarter, I mean, over a year, that's, that's a million in, in production, in. In revenue. And that's just, that's just kind of Just getting started, really.

We're just getting warmed up, Jake. Yeah.

And Jake, the one thing I want to tell you is that I think, you know, should not go unsaid is from our, from our workflow perspective, Dr. Liu's team, the practices, they are not charged anything from us unless their doctor accepts the case. So they could go through that 15 minute virtual chairside consult. We could do all the setup work with their aligner of choice. We could do the consult, orthodontist to general dentist to walk through and explain the case more fully. And then for whatever reason, if the doctor says, I just don't want to move forward with the case, I'm going to refer it. They pay nothing. So it is literally risk free. We don't ask any of our clients to invest any money in us. We don't ask them to buy any equipment. They, they literally pay when they play.

Yeah, yeah. It makes, it makes tons of sense. Dr. Lee, how many doctors do you have kind of, that are, that are on this system? And also, and kind of.

No, we got about 16.

16 doctors. Beautiful. Yeah. And so there's, I mean, you do the numbers as far as how many patients on average want this type, type of thing, and as you get better at getting your doctors speaking about it, talking about it, that number is only going to go up. You know, it's a long, it's really a long term commitment.

Right. And even then, Jake, it's not like everyone's doing this in our, in our organization, so they must get warmed up. Right?

Well, what happens?

No, that's, that's very true. There's, there's definitely practices that are, that are, that sometimes I, you know, I'm like, this is, this is insane how much, how much you're doing. And there's other offices that I think to myself, maybe I should call them. Maybe we should have a chat. Right? So, yes, adoption is definitely important, but once they get it, you know, it's like the one, you know, they used to say in car sales. I think back the feel of the wheel will seal the deal. So, you know, once they get a couple under their belt and they realize how simple it is, it's, it's gangbusters.

Well, and once they realize the benefit of having multiple doctors, right, Once they see the one doctor who is really taken to it and starts to fly and excel, then, then that's really all you need because then the other documents are like, interesting. You don't even need to, you know, push it at all. They'll, they'll kind of naturally adopt. So amazing. Well, I love it. We are at the very beginning, I think, of a huge wave of this. This is one of those, like, like a lot of things, you know, like online booking and, you know, it just makes absolute sense. There's almost, I can't think of many reasons why this won't just absolutely explode. All the trends are up. Technology trends are up. Patient preference trends are up. So, anyway, I think you guys are at the very cusp of this, and this is. This is going to be big. So thanks so much, Jay, for starting this business and making it easier for everyone. Dr. Liu, thanks for taking the dive and diving in and actually sharing your story here.

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