72: The Politics of Dentistry

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All right, welcome, everyone. We're so excited to have you here to DSO Secrets podcast. This is a unique one where we've got Rick Workman of Heartland, Steve Thorne of Pacific Dental, Steve Bilt of Smile Brands, Chris Badgley of the Adso, and Jake Poole, partner in crime, oftentimes of the deo. So thank you all for being here. You know, I titled this one the Politics of Dentistry. And this has been an interesting time because, you know, as I think of myself as kind of typical citizen and how. I grew up thinking about the political process, I really simplified it down to, I vote. Maybe once I get a job, I'll pay a fee to an association, and then everything kind of works out pretty well, or if it doesn't, I sit at home and complain about it. And that's the political process as much as I understood it. Right. And we're really understanding, as we mature that there's a formula here. There's a formula of, yeah, you're going to vote, you're going to actively engage in an association, you're going to more understand the political process, and you're going to engage in that political process. And so I appreciate all of you being on here because it took a global pandemic. But I think our industry is kind of opening up to, wait. There's something going on in the background here, and we need to understand this better. In fairness, there are dentists who are saying, wait, that choice was made or represented for me, and that's not what I wanted. There's hygienists who are saying, wait, this choice and this representation was made for me. That's actually not what I was interested in, but they're not sure where to start. So, again, appreciate you all being on here. And I wanted to start, Rick, with you. You've got some good history here as a clinician, as working with tons of clinicians. I'm curious, when was the turning point for you that made you realize, okay, I'm gonna have to learn and get actively engaged in this political process. Yeah.

Thanks for the opportunity to share for me. I graduated from Dylan School in 1980 and started growing an office or so per year from there. But by the early to mid-90s, kind of a defining point for us, we were all in Illinois, and there was a plan that the state of Illinois offered its employees. It was labeled as a HMO plan, but I didn't even know what an HMO was or managed care. And organized dentistry was very much opposed to that. And I didn't know what it was. So I said, I'll call. And I realized quickly that I might do well if I was always did the opposite. But we were able to negotiate essentially 100% of normal fees for that benefit to our supported doctors. And I didn't know that you could negotiate with insurance companies. What happened? I thought, this is a coup of all time. What happened was that the doctors in our offices were just really attacked all across the board, said all kinds of crazy things. Some of that damage hasn't even been fixed 30 years later. But. But I began to realize that I needed to talk with people that dental boards reported to, to at least get the story. They can like it or not like it, believe it or not, like believe it or not believe it, but at least they ought to hear it because the narrative is being set by people who weren't friendly to us at all. And so it's evolved from that over time. As we went to other states, things tend to be repeated. And so the bottom line is we just became realizing that we were going to either be a punching bag or we had to be in a position to communicate.

And so for you, then it was just opening up. The choice is that primarily. And was it weird that your choices weren't being represented or. I mean, how did you think through that previous to that happening?

Back in that time, I didn't have any belief that all. All of what's occurred with Heartland Dental could have occurred. But I saw a pattern. I'm practicing dentistry, I'm teaching new dentists who are graduating, and they had the same kind of attitudinal things that we all learned in school. And I realized maybe a few years earlier that what they taught me in school, a lot of good stuff, a lot of stuff, wasn't exactly accurate. And so it was repeating itself.

As you think about.

I'm curious. What I wanted to do. Sorry. What I wanted to do and still feel to this day is that students or graduates or at whatever stage of your career, you simply ought to have a right to have a choice of whether you work in a supported practice or a solo practice. We're not anti solo practice. I know anybody on the panel is anti solo practices, but I was in a meeting or something earlier this year where this week where a dentist said from, I don't know if it's the University of Iowa, from 75 to 78, there wasn't a single dentist in this, a single woman dentist, single woman dental student in the entire school. And so I graduate in 1980, and those people are my age today. They're sitting in highly important positions throughout our industry. And I don't, I'm pretty certain I'll say it that way. They don't have all the perspective that they need to dictate to dentists from new to aged how it ought to be and how it will be. I'd vote for the marketplace to get a chance to decide that.

Yeah, no, that's a really good perspective, I think is. And frankly, a humble one to say, hey, listen, when I graduated, you know, I didn't have the dynamics. I'm curious. Student loan debts were probably not at half a million dollars.

During that time, I paid a total of $5,000 tuition for three years of dental school.

Wow.

1200 first year, 1500 second year, 1800 third year. And we were bitching to high heaven about the inflation and where it's going to end up. But it's still.

Yeah. So it's interesting to have that, as you say, kind of moving into leadership. It's our opportunity or our responsibility, I think, to say, okay, how do we represent everyone? Any other thoughts, Steve? Bill, did you have a thought like when was. When was kind of the point for you where you realized, okay, we're gonna have to get involved in the political process and why do it?

Well, you know, for me, I think I probably had an evolution that maybe isn't dissimilar to a lot of folks out there, which is, I came into this, I think, from an overall political viewpoint, like whatever's right should be self evident. And I think a lot of us want to just sort of sit back and say, well, if it's right what we're doing, it should be self evident, so we shouldn't have to beat our own drum or toot our own horn or whatever the case may be. And then as time went on, a couple things happened. One, I just realized that, you know, what I might know about my profession is not self Evident to other people by definition. I remember when I came into dentistry, you know, I first we started doing a retail concept where you have retail storefronts. And I am certain up until the point I got into it, I had never noticed, not one time had I ever noticed a retail dental office. And then as soon as I got into it, I saw him everywhere. It was like every center I look, I was a dentist here. His dentist here is amazing.

Right.

And so it just was a reminder. Like when you're focused on something, yes, it can become self evident. When you're not, it isn't. And so when you think about the political landscape for a dso, we might think, well, sure, we're just trying to help facilitate another practice setting for people and make it more efficient because dentists spend half their time doing administrative work and they need these services consolidated. And that's just self evident. And then all of a sudden you start taking shots from the outside. And I think, to answer your question very specifically, it's probably about the year 2000 when I literally had to change my company's logo. At the time we were called Bright Now Dental, which is one of our brands. I changed the logo. The official logo had our little mark on it, had our name, and then our official logo had the term Bright Now Dental provides business support services to independent dentists. That was our required logo that we put in place because everyone was shooting around saying we're putting quotas and we're making people treat people. None of which was true. But I realized if you remain silent, that void will get filled and it won't be filled probably in a terribly favorable way for you if someone's on the other side economically from where you are.

All right, Steve Thorne, let's dovetail into this. Remain silent because I think there's two parts to that. One is I think some dentists and others feel like those representing them have remained silent. And then there's also. They've remained silent. What do they need to be doing? So, you know, as you look back over this last eight weeks, that feels like 10 years. You know, where places where you think as an industry or maybe individually, you know, we missed and where do you think that to drive the future people want? We need to start taking action and get involved.

Yeah, it's a really good question. Let me tell Dovetail just a tad off of what Dr. Workman and Steve Bildt said. And we have the battle scars

to,

you know, in on our backs from years of fighting these. Steve and I fought battles in California just To operate business in California. We PDS fought a battle in, in the state of Nevada just so we could be in business, just so we can conduct business. And, And I know Dr. Workman has too. So it's been, it's been a long history there. But what happened in the last eight weeks was really interesting for me to watch. It showed that dentistry and dentists have an identity crisis in the United States. We got pushed aside immediately as nonessential. And you compare that to, I think, the country of Germany. That didn't happen. And what happened was because we were non essential, the industry just was absolutely devastated. I don't know if you saw those latest numbers, but in certain states the average revenue dropped 97%. I think as an industry, it dropped roughly 96% in the month of April. So the entire industry was absolutely devastated because we were, we weren't actively involved in the overall healthcare system. Dentists could have played an incredible role in that. Dentists have been leaders in personal protective equipment as an example, for years since the HIV crisis.

Probably more than they. Probably more than they even realized, right?

More than they realized.

It becomes so routine that when people start saying, hey, you should wear masks, they say, well, what kind? Because we're already doing that. Right? Like so much of it, they were already ahead of because of previous experiences.

What profession in the last 30 years has dealt with blood and splatter and aerosols more than dentistry? Maybe a surgery center, but dentists are pros at this stuff and we haven't been. Dentists have not been in the headlines for transmittable diseases in the last three decades. They've been awesome at it. And in fact, we haven't made the headlines in the last eight weeks either. So it just proved there was this identity crisis and leadership void in dentistry that needs to be filled so that dentists, this never happens again to dentists and dentistry. And they can be part of the solution in a big, big way and not just brushed aside. Like we like dentists are no better than cutting hair or doing nails.

Well, you use the term identity crisis, a confidence crisis, like we're sitting on such great services that we bring. And Chris, you had an interesting conversation that we talked about offline where you're interacting and your team's interacting with CDC and OSHA and Surgeon General and others, and you're saying, hey, dentists have a big concern around not being included as medical providers. And they're like, what do you mean? They are medical providers. And so it's interesting and I'd love for you to kind of talk about maybe some of the things that those conversations are leading to, some of the things that Adso is doing for providers. But it's interesting to see that, to Steve Thorne's point, in everyone else's mind, we are part of the medical community. There's almost like we need to step up and just be that and support accordingly. What's your thoughts on that?

Yeah, you raise a really good point. And I want to build on something that Steve Thorn had said, and that is this is that I've only been in this space for a relatively short period of time, and certainly I've been in the advocacy world for a long time now. And if you're not at the table, you're on the table. And I think dentistry has not necessarily been at the table, but it also, again, looking at it from coming in from the outside. And this is where I want to build on something that Steve Thorn had said. There's really a difference in my mind, a difference between the profession of dentistry and the practice of dentistry. And again, I'll define it this way. If you look at some of the organizations that represent what I would define as the profession of dentistry, they're interested and really go after how to improve clinical efficiency, how to make sure that people are trained correctly, all the things that surround the clinical delivery of care. The practice of dentistry, again, as I'm defining it, because I don't know how to define it any other way, is where does dentistry fit in to the overall fabric of healthcare in the United States? And that, I believe, in terms of what's been missing in terms of advocacy again, and Steven talked about this, Thornik talked about this, is that dentistry as an integral healthcare deliverer and a valued part of patient care has been somewhat left behind. And the concentration has been on the profession of dentistry with some of these other groups. So again, I think that one of the things that we looked at holistically as Adso and in our advocacy is how can we advance the practice of dentistry so that it isn't thought of secondarily, it's thought of with all the other groups. Certainly a cardiologist isn't thought of as not a medical doctor, not as a physician, but dentistry. In the discussions that we had with as recently as yesterday with some of the representatives of cdc, they were kind of amazed that we're being perceived that the dental profession is being perceived as separate from being an integral part of the delivery of care overall to health in the United States and patients. But it is. So we keep pushing in our advocacy that we are an integral part. In fact, we're on a forefront because as Steve Thorne has driven in my head, what starts in the mouth is delivered to the rest of the body. And it's the oral systemic health continuum. And we have to really up that game and up that messaging so that we become again incorporated into the fabric of the whole.

Well, and you brought up an interesting situation that I think is really current is dentists saying, oh, wow, look, N95 masks have to be fitted by a medical provider. You're there with your team advocating saying, hey, dentists need to be able to take care of this and be included. And they said, well, they are. And it's this weird, interesting confidence thing of, oh, wait, we are medical providers. We are included in other people's minds. We just have to step into that instead of constantly carving ourselves out of it. As I look at it, the primary healthcare provider, that system has really collapsed for most patients. They're not seeing them consistently. In fact, they're seeing the dentist way more consistently than that provider. Why not step into providing that help and more systemic type health? And so I think that's where we, as an industry and what you all are hitting on here is we have that opportunity to step into it. Can you talk a little bit more to Chris about tactically? I think people are frustrated with what are organizations doing number one for us. So I'd love to kind of put Adso on the spot here and say, all right, Chris, what have you done for me lately? Right? Not just for DSOs, by the way. I want to know what you're doing for providers as well. If you're supposed to be the dental support organization for providers, are you supporting providers? Are you just putting money in the pockets of the business guys? So I'd love. Let's start there and we'll put you on the spot.

Yeah, that's fine. And again, the people on this panel who are the heads of these companies, the DSO supporting practices, Dr. Workman, your folks have ingrained in me that the dentist is the customer, the dentist is the client. So again, at Adso, we look through that lens and say, look at whatever is best for the practitioner in an office is going to be best for our members or DSOs that are supporting the dentist office. So there were some things that were kind of specific in the third stimulus bill relative to small business and what constituted a small business. And it was under 500 employees. And there are some affiliation rules, and we continue to work through some of that in order to make sure that the individual supported dental offices, whether it, whether again it is supported by a DSO or an individual office can apply for things like the Paycheck Protection act, the ppp. So we were involved and in advocating for as many providers, dental offices that could apply for that and get relief as possible. We also, as the Provider Relief Fund was being developed, we wanted to make sure that dental was not forgotten. And quite honestly, again, fortunately we got in at a time when dental could be folded in, but dental in some ways was forgotten and medical was the concentration. Hospitals was part of that concentration. So again, we believe that if we can advocate on behalf of the practitioner, the dental office, whether it's a sole practitioner proprietor, whether it's a small self contained group or whether it's a dental practice supported by a large dso, it's going to benefit. But again, it's, it's the provider, it's the person that's having the practice of dentistry and having the impact with the patients and the contact with the patients and also looking after. How can you protect and mitigate transmission of not only COVID 19, but to the earlier points, HIV, AIDS, hepatitis, all the things that we're talking with CDC and others in terms of updating their guidelines. It affects everybody and somebody's got to have that voice and we hope to provide that.

Well, I've been really thankful for some of the things I've heard come out of Adso. I know the federal relief Fund, HHS is trying to get money to dentists, but no one's in there helping. You guys stepped in to say, all right, here's how you allocate the funds out to dentists. Right? They need that kind of leadership and support. So I'm thankful for that. For those dentists who are doing Medicaid funds, they've got those already allocated and they're like, how do we get this to Medicaid providers? You guys are the only ones in there trying to help get that done. So anyway, I've been very thankful for that. Yeah.

Amit, there's a point Chris was he mentioned quickly, but I think it's super important for people too. And that's that. Yeah, there's getting cash in people's hands to make up for what happened is one thing. And obviously Chris and the Adso are in there fighting like crazy for Dennis. But the bigger thing is what Steve Thorne was referring to, which was the devastation that occurred when we got sent to the sidelines and the amount of advocacy work that Chris is leading to make sure all the way up through the Surgeon General and beyond that dentistry's voice is very clear and that the essential nature of what we do shouldn't get conflated with. Well, originally there was a shortage of N95 masks and PPE, and therefore dental got pushed to the sidelines. That was a false equivalency.

Right.

That was a PPE issue, not a vitality issue. And Chris has been absolutely banging the drum for the entire profession nationally and at the state level to make sure that when this thing does spike back up, it's not going away. Right. When it does spike back up, that dentistry stays on the vital side, not on the side where we got sent to the. To the bench. And that, I think, is the most important thing going on right now.

So, Rick, where do we start? Where do clinicians need to change their mindset? Right. In order? And, Rick, if you could talk to the clinicians in your graduating class, first off, right. If they're the ones helping lead some of this, where does that mindset need to change to get the future that we all want? Like, what would be the principles that people need to start thinking through to get there?

I'm going to go to that. I want to go back to Chris for just a second because I think he was either very modest or maybe he can't say it yet, but I would be willing to bet that 90 plus percent of all dentists in America have no idea that there is a line item in the Stimulus three bill that is hopefully getting filled with a few billion dollars worth of relief grants for dentists. I'd be willing to bet 90% have no idea. And you're not gonna have to apply for it. It's just gonna show up in your account sometime, we hope, in the next couple weeks. And I want. I'd love to have one message, would be for all dentists who wonder where that was and where that came from. It came because, in no small measure, because the Adso put together a team, a lobbying team, and costing tens of thousands of dollars a month for the benefit of all dentists across the country, some of which, obviously, are supported by the DSOs and the ADSO. But I think that's an important point

that's critical. Yeah, and it's an interesting one. This is what's getting revealed that behind, you know, under the covers here, there's a lot going on, and we've pointed to some of the negative that can happen, but the positive. And maybe that's a good segue into the positive that can happen when People engage. And I wonder, Chris, in part of that lobbying, are you going to have the checks with your name on it? That would be. It's a good one to bring up though, Rick, is there's real effort being made, that money doesn't magically happen. Somebody has to be there advocating, educating to make those checks come down. So very grateful for Chris and his team's work.

And one thing to add there, Emmett too, that's at the federal level. Chris and team have been advocating at the state level with the carriers also, to some minor degree of success, to get some dollars into the hands of dentists because the carriers have continued to collect their premiums and, and with a 96% reduction in payouts, the carriers are flush with cash. And so I know Chris and team have been actively trying to access some of that to help dentists. And again, that's just not Adso dentists. That's all dentists. In some states those carriers have actually excluded DSO supported dentists, I.e. california. And so we've been actively trying to get some of those things rectified too. But they've done a great job around the country.

Yeah, you bring up. And I'll pivot with you here for a second. It's an interesting time because this PPE thing is very relevant and there's really like three choices these insurance providers have to engage with us and the clinical providers on number one is they could help pay for the safety of the patient and engage with the provider on that. Number two, they could go one step down and say, well, we're not going to engage with you, but we know you think it's important, so go ahead, you can charge the patient for it and make sure that they're safe. And number three, which is sadly happening, is they say not only will we not pay for it, but we are going to try to politically block you from being able to charge the patient and from having the financial means to provide the safety.

And I believe they're not trying to. They are definitively saying we can't.

And Steve, I mean, do you mind sharing? I mean, you're already engaged in this to try to help providers have the ability to do that. Right?

Right.

All providers, the patients. I think most carriers view the patients of our supported practice, our supported practitioners, as their members, generally. That's how they refer to them. Right. Why would they not want to engage in serving their members and then their customers, which are the payers, whether it's a state or whether it's an employer in keeping their members And Their customers, employees, safe. I have no idea why they wouldn't engage in that. Hats off to some states that are doing it and some carriers that are doing it. I want to congratulate them that are. It's very, very much needed and it shows the integrity and character of those organizations.

Yeah. So those that stepped into it quickly, quickly. And the cool thing is when people do that, right, then we can get behind and support them in those actions.

Why does it have to be this all the time, this fight the industry Again, coming back to the identity crisis in the industry, there's no partnerships really with these carriers out there. As Dr. Workman said at the beginning that started out, it's like, why are we working together? We're our supported docs are the ones serving their members and those members are their customers, employees.

Now, Steve, Bill, did you want to add something to that? Was there anything that you had?

Well, you know, I think number one, the moral high ground is we have a contract. Contract has assumptions. You know, every contract that's ever been written has an expectation that it's based on certain assumptions. You cannot tell me that contract anticipated a quadrupling or quintupling of PPE costs. You just can't say it. So it's, it's gamesmanship. I know how the story ends. Someone's, it's going to the customer. We know that it has to. Right. That's what happens in business, our pain. You know, patients that get charged have actually been largely extremely supportive because they see what it's night and day different. They're used to seeing their dentist, you know, wearing a mask and maybe some goggles and all of a sudden they're behind, you know, all this ppe. They get it and they're comfortable with it. So for a carrier to say there's not a fundamental change, that's just a silly place to start. And it's not going to get us

in the room together.

I think that's one piece of it. Over time, sure, we can build it into the pricing structure and everything else, but this has been a 180 degree change event. So let's not play games with it. And by the way, all the docs we support, they're doubling down on their efforts around ppe, not doing the bare minimum. So I mean, dentistry has done a great job of that, but let's not play games where we try to squeeze that out of us. It just doesn't make sense. So that'd be one piece of it. And then I'd say, you know, hats Off. There's some corner cases where payers and providers really are working together, and it gets a better outcome. It just does. That member has a way better experience when the provider relationship's good. Right. And when the member has a better experience, the payer does better. And so if we're working together, the biggest problem in this country is not enough people go to the dentist. So for us to fight over crumbs is stupid.

Right.

We should be elevating the level of service.

Yeah.

So let's elevate the level of service. Let's make us proud that the. I think it's one of the greatest opportunities the profession ever had. If you think about it being coming out of the barber chair and, you know, maybe fighting to be like medicine, mainstream, which we've all been fighting for, all of a sudden, you put on all this gear, you keep people safe through a crisis. The opportunity to elevate this profession is upon us. It's the greatest opportunity we've ever had. But payers and providers should be working together, which, by the way, if the public takes dentistry more seriously and cares

more about it, I think that is

the nexus of success for the payer also. So doing that together, I think it's an incredible opportunity. But as Steve Thor said, it's been set up in an advertising adversarial way. But I think we need to break that mold. There's an opportunity to do it.

Yeah. Excellent. All right, so we got to move forward now. So, Rick, take us to the future. Like, I'm a dentist listening to this. I agree with you all. You know, maybe not everything, but there's a lot I agree with. And now I want to step in and help support this. In fact, mostly want to support Chris because he's the one sending me some money. But how do I. How do I do it? And what should I be doing? What should I be thinking?

I think, you know, if you were a dentist of a certain age like me, and you had a. You had a child who is a dentist or in any profession, I think you would be trying to educate your child to pay attention to the marketplace, pay attention to where you think your career is likely to go. And dentistry is going to go places, really not necessarily because of anybody on this podcast. The people on this podcast are probably spending a lot of their time trying to figure out where it is going to go and if it's going to go there, maybe how they think it might be best to end up there. But to deny and continue to deny and be in the Neanderthal, and continue to try to resist where the marketplace is going because half the people are women. People move around the country more today with professional careers, 5, 3, 4, $500,000 worth of student debt, dental practices costing a million dollars to open, technology being extremely expensive, payer relationships being differentiating. In other words, you don't have to be a genius to figure out that it's not going to be, you know, Marcus Welby, M.D. from the 60s. And so just, just let it, you know, I invite you to be smart and come along and pay attention, but just let the marketplace be aware. The marketplace is going to decide. And your physician brothers and sisters, they're working in integrated healthcare groups. There's all. In other words, you just know that's where it's going.

Yeah. And it's really driven. Again, when you say marketplace, it's driven by the customer. Right. We just can't get away from the ultimate boss here. And Steve Biltz hinted at a number, which is that 65% that ADA says, hey, these are the individuals not going to the dentist regularly. You know, I always ask myself if I was a cell phone carrier and I knew that 65% of the marketplace didn't have a cell phone. Right. The thing I'd go is, hey, team, where are we screwing up here? Now they're an industry that actually 125% of the market has them. You know, people have multiple.

I think I'd want to quickly add, you know, if we look at the dentist as the customer, we want to put them in a position to be most optimized to attract those patients who haven't been seen to provide the services that they need. That the, as the, as, you know, clinical things change and emerge in technology to allow them to have the tools and skills needed to, to provide the services to their patients. I think that, I think you'll be successful if you do that on your own or as a part of a large group.

Right. Can I touch on something?

Yeah, please.

Stephen Thornton, what Dr. Workman said, because I'm right there with him. If we look at the data, rough. These are rough numbers. In the next 10 years, dental schools in the United States, as long as we don't see a precipitous fallout because of the COVID crisis. But dental schools and then international students, there will be 70,000, roughly 70,000 new dentists coming into the profession in the coming decade. 70,000 young kids that are kind of, I can now say, half my age coming into this profession. How are we going to set the profession up so they succeed. Help those because they're the future of the profession. Dentistry has, in my, my opinion.

And at least solve. And at least solve for their realities.

At least solve for their realities and help. But help. I mean there's a, there's a financial realities, right? There are those, there's the clinical realities for sure. And I think we would all agree on this webcast that dentistry has gotten so much more complex to operate a practice from when I started in this 30 years ago. So help them with the complexities of the simplification.

Yeah, the simplification.

So when we start putting it in terms of what's happening now in the future and, and then I think about the people that are in general making the decisions right now in so many organizations. I don't know if they felt the pain that we felt and that our supported docs felt. I haven't had a paycheck in months and I think some of the other people on here haven't had paychecks in months either. And our senior team hasn't had paycheck in months. Our docs incomes have been dramatically reduced. We've had to furlough. Our numbers are public out there because we're such a large size. They're public. And I'm not so sure the dental boards and the associations and the various people that are kind of mandating what we can and can't do or feeling the same level of pain that the dental industry providing services, providing the dental services, whether it's us supporting dentists or dentists doing the work or the vendors and the supply chains and the manufacturers, they haven't felt that pain. And that's concerning to me.

There's that misalignment and that's what I'm hearing is we've got to get in the mindsets to create alignment. So on a tactical level, Steve built and Chris like, okay, I want to take action. I get the mindset that needs to happen here. Like what do I do? What do I do locally? What can I do from an association perspective? Like, how should I get involved?

So I'll let Chris talk about how we're going to try to make sure we're getting the tent more open than it has been on the Adso side. Because I think that's really important. And I do think all of us, and this might be contrary to popular belief, all of us do want the tent to be as big and open as possible.

I don't think we're.

There's any question about that among the Adso Group. So I'll let Chris talk about that in a second. You know, I think, you know, sort of the biggest bane of our existence in a lot of ways, is social media.

Right.

And there's so much noise and chaos and everything else. I also think you can flip that and say it's a huge opportunity. There's 200,000 dentists in this country.

Right.

There's 500,000 people in the dental profession, lost their jobs just last month. There's a tremendous platform to have a voice that's loud about how vital we are in the stories. And so one thing that Steve Thorne and I were pushing really hard on from mid March when this started, until now is just posting about the people we've kept out of the er. And it's hundreds of thousands of people that have been kept out of the ER and raising the professional raise it. And as people are going back to work, I think there's a huge opportunity. I have doctors telling me they saw more periodontal abscesses in a day than they saw in a year. When they came back, I have dentists saying they did more root canals in two days than they did in two months previously. So what's happened while we've been on the sidelines is terrible, and we need to have the entire profession use the voice that they have, which the social media platforms are unbelievable, to get that word out, get those stories out and make them personal stories, because they make a huge difference to people. Not, you know, hey, I saw this. But seriously, here's a story that happened, and this person was in pain, and this person couldn't get care, and this person was miserable. You know, and I think those stories, you give us that narrative, we can take that and run with it as a profession and then open the tent up on the Adso side. Chris, I'll let you take that one. But I think that's the opportunity we have.

Yeah. If I'm a new doc. In fact, one of the questions that came in was, I'm a new doc, I want to engage. I agree with what you're saying. Maybe I'm a member of DEO as well. Right. So I'm trying to be entrepreneurial. I'm trying to support more dentists, reach more patients. How do I engage and have a better voice in some of this locally or globally?

Yeah. If you look at how I've approached political campaigns in the past, and this is really all about political campaign, and I'll use a provider relief fund as an example in a moment. But really it's our duty and responsibility as your advocate and as your association to representing your views to, number one, educate. So what we do is we take the information in terms of what's going on and how it might impact your ability to practice in the way that you want to as a clinician or operate as a DSO member. The next thing we have to do is motivate you. So, okay, so you're educated now, but you're sitting there going, okay, so I'm interested. But, you know, what do I do? We have to motivate you to get out of your chair and say, I'm ready to pick up the pitchfork or the torch and go to my elected officials to have an impact. So we educate, we motivate, and then at some point in time, the trigger's pulled and you're activated. And what we do as your advocates and to prep you for that is to give you the talking points, give you the information, give you the contact, educate again, you on how to act and behave in front of elected officials. Because, look, they really want to help constituents, which goes to Steve Bilt's point. They want to hear your story. They want to hear how COVID 19 has affected your living, that you've got 3% of the revenue you had this time last year, and you had to furlough all your staff. And now some of that staff is going to Amazon and they're paying. Amazon's paying them more than you can pay them to work the front desk. So you'll never get them back. So even when you come back online, you've got to hire somebody new. You've got to train them. That's going to take time to. So all these things, the stories are what's important, and it's constituent stories. Do we have the ability as lobbyists to have an impact? Yes, but nothing's more impactful than a constituent calling a legislator, going into their office, or talking to their staff and saying, this is how it affects me.

So again, Chris, if I could speak to that one for a second. I don't think people realize that if a legislator gets a call from 10 individuals, how impactful that is. You know, we see petitions, you know, with a thousand people on it and so forth, but the reality is, if dentists get together and they say, listen, this is concerning to me, and they make those phone calls, they can move the needle. So I think that's a really great place for people to start to take action. And I think they need to check out Adso. Right? So come to the ADSO website adso.org the adso.org the adso dot org and Rick, you made a comment in the chat that I think is excellent, too, which is, you know, assess your roi. Like, where are you spending your money and what kind of return are you getting? Where do you need to get actively involved? What network do you need to be in? And, Jake, thank you for being on the sidelines, speaking of the sidelines here and letting them kind of present. But, you know, one of the things that we've noticed is those who have a network have succeeded more than those who have been on their own. And that doesn't mean you have to be part of a dso. You could be part of deo, you could be part of Adso or some other network, but we're just better together. Our mindset's better. We're not left to the winds of social media. You know, we can actually take strategy together. So, you know, Jake, anything you would add to that as far as, like, what you've seen with your members and their success around what these guys have said?

Yeah, actually, you know, we have members in Adso, and one of them made the comment two weeks ago that, you know, what you all have provided in the past month has paid for the membership over the past two years. I know you all are, you know, giving access and really communicating what you're doing a lot, and you're also getting on and sharing with each other. I mean, Emmett, you passed along to me a lot of things you all talk about, so I just think these groups are huge right now. And I think exactly what you were saying, Steve. This has been education and kind of how these decisions are made politically. And the education is they're made without a lot of information sometimes, and there's a huge opportunity just to speak up. We've had D.O. members that have just started texting their senators. They're surprisingly accessible to make these moves. So, yeah, it's just been very good. And again, thanks to the Adso for stepping up, because the number one thing we heard is who's leading this charge? Who's helping us send us out there? And it's really been you guys.

Yeah, thank you, Jake. And we're going to actually have a few of these guys are going to be speaking at deo. So, Jake, I'll give you a second to make that plug that's coming up here. So if you like this mindset of taking control of the future, having choices now, what do I do with that? DEO is a great place to start adso excellent place. So you have a summit coming up. We've now got hundreds of people coming to it, but still a few tickets. So you want to talk about that?

Yeah.

No.

And again, the DO and Adso have always been good allies and we like to provide a megaphone, a microphone to what you all are working on. And so everyone here has been pretty much on our stage and helped out the emerging groups, anyone aspiring to build a DSO or currently building DSO. So thank you so much. And Dr. Workman, we're going to talk to you and hear how your group is really interacting in the current crisis and how you guys are ramping up now. So, again, thank you all. And yeah, we're just going to continue to do what we do and get the word out to all these leaders in the industry are doing awesome.

So that's June 4th and 5th. Go get your tickets to that and it'll be excellent. So any final words? I really appreciate all of the feedback and comment. Love to have you all back. Chris, go get that money for all our providers.

I do have one request for everybody. If you want to get involved, you call your senator, U.S. senator. You call your U.S. representative and tell them to release the HHS Provider Relief Fund money to dentists today. Because we've been working on this for well over a month. We were told earlier today by some of our lobbying team that the money should be out to dentists by the end of this month. But as I told our executive committee earlier today, that's another two weeks. You guys need the money today. So call your senator, call your US Representative, text them whatever, and say that that they need to release those funds now.

That is an awesome way to end this. Thank you all so much. I really appreciate it. Thanks for everyone listening in. And until next time, keep smiling.

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