89: Elevating Dental Hygiene for Excellence in the DSO Space with Sarah Varney & Christine Diehl, Co-Founders/CEO of DSO Hygiene Excellence

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 right out of 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. All right, hello everyone, and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott. And today I'm so excited about my guests because we have been talking a ton on our Facebook site. We have been Facebook messaging each other and now is like our first time live to chat. And we're going to do it right here in a podcast. So we have Sarah Varney and Christine Deal, Co founders and CEOs of DSO Hygiene Excellence. So thank you both for being on the show today. I really appreciate it. Thank you, Amit. Yeah, so I want to hear the background of this. Obviously to come out to take dso, put it with hygiene. I'm like, okay, these are bold entrepreneurs. They clearly have a mission. They're clearly trying to bridge a gap here. And so tell me a little bit about how this got started and became DSO Hygiene Excellence.

So Christine and I were together for about 30 years in the same practice. So we're both there working as full time clinical dental hygienists. Our office was purchased by a DSO four years ago. So it was our first foray into the DSO world and we were a little trepidatious, but, you know, as we got in and got our feet wet, it's fantastic. It's a model that we love. We're very excited and passionate about the DSO model and the opportunities that exist in that moving forward for everything.

Can I ask you, like, what was it that in that transition, I love your vulnerability. Right. Because it's like any kind of change, we're all going to be concerned about what was it that you go, oh, wait, this is going to be better, not worse?

Well, I really think it's the leadership, you know, the leadership in the organization was very open to hear any of our concerns, you know, to explain to us how this is going to go and had an open door policy. And that's kind of where we kind of went off and did a little project and started to do some things, and it was really great because we were very supported in the leadership. Yeah.

Well, good, because the S in DSO is supposed to be supported. So.

And for me, it was maybe losing autonomy. You know, we've been in our practice for a long time. We believe in the services we provide, you know, our commitment to excellence in patient care and always growing, evolving new technologies and being able to maintain that level of excellence that we've always had. So I wasn't sure, you know, coming in, you do hear bad things about DSOs. We have probably 1200 hygienists on our Facebook site right now, and we get a lot of personal texts like, was a dso? And I heard it's bad and isn't it bad?

Yeah. And corporate dentistry.

Yeah. And we do a lot of change management. Just from this perspective of what is the reputation of a dso. I would tell them very honestly that it's amazing and you really can still have all the autonomy you want. You can be a leader in your practice, that your DSO will appreciate you stepping up.

Right.

And wanting to help form what that practice looks like with your doctor and align with the corporate vision. Right. And branding and your business model. All a little different. But that it's an exciting space to be in and very supportive.

I just want to stay on this for just a second because this autonomy thing is a big deal. And, you know, one of the arguments that I've put out there, and I'm curious, your feedback on it, is that autonomy can actually increase dramatically with the right DSO support. Because if I have to figure out and manage, you know, especially for a single doc who's trying to figure out their technology is not working, they're making sure payroll gets done, front desk, somebody quit, they've got to make sure they're doing that. That's a lot going on in the brain while I'm also trying to do clinical work. But if I have someone I trust who's providing that support, my autonomy can actually go up where I can focus on the clinical excellence. I'm curious if your experience was similar and where. I'm right on that. And maybe where I'm wrong.

I think you're absolutely right on that, actually. And that was. It's been very true for us. We've always. We've always kept a lot of metrics in our office. You know, I have Excel sheets going back 15 years, probably. But I think you're right. When you have to handle. How do we handle the Facebook page and the marketing, even for the hygiene Department, how do we increase referrals, how do we marketing patients, how do we market our laser services or Invisalign or how do we do some of those other support center things? We were wearing a lot of hats and now that's off of our table.

Right.

And look what we've done. So we started this really organization for hygienists not having to worry about tracking all those other things that we were wearing the hats for. So you're right.

Did it feel a little bit unnerving? Because sometimes there's that need to be needed too where it's like, yes, I am managing the chaos. Yes, I don't love doing all of it, but you know, there's a little job security and knowing that I'm managing the chaos. So as organization systemization comes in, you guys kind of went to a higher and better use. Was there a transition period in that though where it was a little bit scary?

Yeah.

Yeah, I'll say. Yes, you do. The control, losing the control. Like we handled our recare, we had it down, we knew the numbers, we were in charge of how recall ran. And then they came in and this

is how we do recall.

And you're like, yeah.

There were different systems. Obviously we had been used to certain systems and then getting used to new systems was a little bit challenging for some of us.

There was business change management. There was really like no different than if I brought in a consultant and they said, hey, you could actually do scheduling this way and it would improve patient flow, et cetera. Yes, you want the improvement, but there's always like a little bit of like, that was my baby. Right?

Yeah.

So every DSO is a little bit different on that, but it sounds like they had some process oriented things that

would say to everybody, trust your decision. You chose a DSO because you were value aligned. Right. So you trusted them, your doctor chose them. Trust that that is a good match that your values have already lined up. So then let the rest of the changes just roll like accept it. It's going to be as good as you were doing it, I promise, if not better. And understand then that to your point, it frees you up then to focus on patient care. And how can you elevate patient care? How can you elevate yourself professionally? And we didn't time to do a lot of personal development or personal development when you're managing all those other hats.

Right.

So.

So actually your ability to focus on the clinical is going up.

Right.

I'm curious and I'm going to hit you up with A hard one here, but did you have any business people coming in and saying, you got to do this much clinical work and if you don't, then, you know, you're out of here type things. Did you see any quotas? Right. All the things you hear, and I'm sure this is what you get the text messaging on, you know, no, we

didn't have any of that.

And honestly, if we did anything, you know, we realized, Christy and I realized pretty quickly into our DSO experience that there's a huge untapped power in the DSO space that we thought it was unharnessed. And for us it was. We realized we had dirty offices and 100 hygienists, and we realized a little bit into it, like, we don't really know them. Like, we wonder what they're doing, you know, what are they saying to patients, what things are they really good at? And so we were lucky within our DSO that we were given the autonomy to collaborate with other hygienists. You know, we honestly said to our CEO, like, can we like form a group, like a peer to peer collaboration group? Because we feel like that's the huge benefit of dso, that you're not a private practice. One person in an office.

You don't have to have all the answers. Yeah.

You have a community where you can share best practices and what are you doing in that space. And if you don't know how to something, if you're doing something great, people can share it. And we didn't know any of the hygienists. Even a dso, you could still be one person in an office by yourself.

So why not take everybody together? Whole community.

Yeah. Brilliant. And now is this what started the beginning of DSO hygiene exports? Yeah.

Yeah.

I think it was the seed, right?

Yeah.

So that was the seed. We did create a Facebook page and so we would have, you know, weekly calls, we would drop different. Christina just ran a lot of content through it on things we wanted to push. Maybe it was Oral Cancer Awareness Month or on laser. So we would draft free CES and we would have a call. People could jump on and chat about what you liked. Or if you're. You're doing something great on this topic, throw an article in, share something.

Right.

So just that collaboration, super powerful. That's a power of a dso. And the hygiene space, that's, I think, is untapped.

Do you think? It's interesting because most people think of business as being very competitive, but what you're describing is very collaborative.

Right.

And do you think that you actually got more collaboration, I guess, by the nature that you now have a way to even collaborate. Right. When you're by yourself, it's just harder to call up the guy across the street and say, hey, hi, Janice. Can we all get together and share best practices? It just. It feels clunky. But you're actually taking kind of that model and you are bringing that to the people across the street. I mean, DSO Hygiene Excellence really is bigger than just any individual dso. Right?

Right.

So I'm a graduate student at Notre Dame. Right now I'm getting my mba, and one of my classes last semester was marketing at the firm. So I had to do a growth strategy project, and I did it on this, you know, peer review collaboration group. But we had to do some laddering and research and surveys. And at the end of that, my professor said to me, you. You understand that you have a great responsibility here. What you developed is amazing. It doesn't exist. And your responsibility to pivot it nationally especially. We're in the midst of COVID Right. So there's a lot of uncertainty and anxiety and what's going on in DSOs. And we're on some of the social media sites with hygienists that are not knowing. And I was like, okay, he's right.

Yeah, that's cool. So you felt the mission. You felt the alignment with entrepreneurship and your mission, and then it was kind of the universe saying, move forward because you actually had DSO support that gave you the freedom to do something like this.

Right, Right.

It's nice to bring to everybody nationally what we experienced in our own dso.

Yeah.

Would you say that's the overall mission or what is kind of the vision of DSO Hygiene excellence?

Well, I think the vision we really want to. We really want to elevate the profession of dental hygiene. And we want to do that not only professionally, but personally. So people really have a good foundation and they can be leaders in their offices.

Yeah. It's interesting, Christine, because when you're an individual office and you say, hey, we really want to have excellence, but you have no collaborative capability. How are you defining excellence? Is it off your schooling that happened in the past? Is it off of a CE credit that you have? I mean, to really pressure test excellence, you have to get in the same room with a bunch of great, excellent people. Right. And then you build on each other. Is that kind of the vision that you're doing here? Is it different?

Yeah, and it's a little bit. It's a little bit of a wider net that's cast with that, we really did want to. We do plan to and want to elevate the profession of dental hygiene. I think what dental hygiene looks like in the DSO space is a little bit undefined right now.

Right.

Like I'm hearing about kind of models coming up as offices are going from, you know, emerging offices are growing and scaling two offices to five offices to 10 offices. How are they developing on hygiene? Are they writing protocols for their hygiene departments? You know, it seems to be a little scattered and kind of all over the place. So DSOH excellence is there to standardize that, to say this is what excellence is in the DSO space. And it's truly the elevation of hygiene. We want to take the profession elevated for where our needs are now and for where we see them going to be in the future. And it's really offering a skill set that you didn't get in hygiene school. You know, when you come to hygiene school, you did learn how to do your job as a hygienist. But now in the GSO space, especially since it's a little decentralized for most people and your CEO is not in the building with you, your doctor is obviously a leader in the practice and hopefully has a lot of autonomy. But you do also, as a co producer in the office, can co lead right. With your doctor and again, in line with your corporate vision. But I think to train hygienists with some basic certifications to be able to step up, you know, come to the table with a skill set beyond what they learned at school, that's the true elevation, right? To be able to come in with a certification in leadership, to be able to come in with certification in teamwork and diplomacy, to be able to come in with a certification in dental medical synergy and how that looks now and moving forward, right? To come in with certification in what is business excellence. We've, you know, earmarked like five KPIs that to us speak to is your hygiene. You know, how you're profitable. If you're going to own that space and you want to be recognized as a leader and a business leader within dso, then you need to understand some basic. Right. Like business performance metrics. And then we have six key points or metrics that are clinical excellence. So to come in certified with that skill set, that's the elevation, right?

And that would be our five pillars excellence of our diplomat program.

That's awesome. I love where you're going because I think there's an interesting conversation that's not happening just in dentistry, but Happening globally, which is what is the role of education? It used to be kind of the repository of all things of knowledge. You would go in there, you would extract it, you would get your degree and you'd say, I now know everything that's to be known to some degree. Obviously, with the Internet, with the evolution of information going so quickly and with the demand of customers being so intense and what they want, you know, now we walk out of school, I don't care what degree, what profession, you say, okay, I have a starting point now I gotta get right now. I gotta learn all these other things to keep up with the customer, because I've got freaking Amazon always creating more and more entitlement in all of us, right? And so I've got to start running and saying, okay, how am I going to connect better? How am I going to be better? And by the way, I also have to move with all the clinical technology and learning that's happening as well. Well, am I going to just keep rotating through the school system? No, that doesn't work for any profession. You've got to have some way that you're continuing to grow and learn. Especially when you start getting 5, 10, 15, 20 years out, if you're still relying on what you, you know, got a few CE credits here and there, you're just not going to be able to keep up. Right. And again, this isn't about dentistry. This is about knowledge and learning generally. You guys have really found a mission to say, okay, well, hygienists are also people that have to keep up with learning, too. And how do we create a career path that sounds like a learning path, a knowledge path that isn't like segmented off by, I'm sitting in one practice and that's all I'm, you know, so many hygienists reach out to me and they're like, I've hit my ceiling, like, I need more. And there's just. They've got growth and fulfillment, everything they can, and it's just not available.

Yeah, and that was part of it for us, too. We were, we looked at some DSOs in kind of their, I guess, recruitment just sort of, you know, just to be bold and honest. And, you know, I read things about professional development and I'm wondering, what are you offering them? Like, what are you truly offering? It's a great recruitment tool to say, we're going to offer you professional development, but what is that? How are you developing beyond what they learned in school? You know, So I think this is a nice recruitment tool. To say to a hygienist, you know, we're going to hire you and we're going to, we're going to train you to become a DSO Hygiene Excellence diplomat. You're going to become certified in leadership and teamwork. And you know, those are lifelong endeavors. You're no ceiling on that.

Right.

And the medical dental synergy is just taking off now. I think we've only touched the iceberg of where that's going. You'll spend your whole career getting the medical dental synergy down for sure.

Right.

And the business KPIs and the clinical excellence KPIs, I mean, those are things that you'll never hit a ceiling on. And you're right, you'll become initially certified. But obviously this organization is going to continue to enrich all those five pillars with content moving forward.

Well, I'm passionate that the entrepreneurs in the dentistry space need to be supported. And I love what you all are doing. And I think, you know, the other thing I'm passionate about is dentistry's got to be elevated. It feels like we not only need to take our place at the table for healthcare, we need to take our place at the head of the table. I mean, we're seeing the public more than any other healthcare provider. I know primary care has completely collapsed. That's why we have all these ER pop ups going on around. And frankly, as the dentist hygienists, we're the medical providers that are seeing the public more than anyone else. Right. And they tell us ahead of the table and oftentimes we're sitting on the ground eating with the dogs. Yeah.

And they trust us. Right. We have great relationships and they tell

us, they tell us way more, I think, than they tell their doctors. Oh, yeah.

What counsel would you give? I think this is a good point. What counsel would you be giving to hygienists right now that you see them where they're kind of playing below their potential, below their capability? You know, I'm big on. As humans, we should always be moving ourselves to our highest and bestiest. I think within the healthcare field we use terms like playing at the top of your license or providing services at the top of your license. But you guys are talking about something much broader than even clinical excellence. You're also talking about leadership development excellence as well. Right. So as you think about that with hygienists, where do you feel like if you were just kind of generally stereotyped, where do you feel like we go next as hygienists?

Yeah, I Do think it's a creation of choosing to elevate. I really feel like GSA Excellence is an organization, and I would hope that every hygienist who cares about the profession and the patients and elevating our profession wants to become a member of this organization that we band together, that we step up. You know, this is a national call to action. It is saving our profession. It is elevating our profession for our patients, for our practices. I mean, is that commitment kind of just next level? You learned the skills. I mean, really hygiene school, you know, it's great. But you did just learn the skills. You didn't really learn how to take it into your community then. And to be a pillar in your community and a beacon in your community for your community, for your practices, in your business, for your profession. It is just next level.

Well, and I do think too. I do think we definitely have to work more with physicians like cardiologists and endocrinologists and all those things, because there's so many patients who aren't getting dental care that are seeing their cardiologists on a regular basis. And I'm really surprised that cardiologists aren't saying, you need to see your dentist. And I really hope they all are. But I'm not sure that we have that communication with those types of practices where we really should develop those relationships with those doctors.

It's interesting because, you know, I can tell you guys are very entrepreneur, forward thinkers, future thinkers. You've latched on to DSO the same way I have. Less about some kind of, you know, business structure, LLC structure, whatever it might be, and more about dental support organization, this mindset of the future. And that's how I've thought about it, too. I'm standing in the business role, so I always say I'm second fiddle. My job is to help elevate from the bottom up. I can never go faster than what the clinical vision is. But that's how I think of dental support organization. It sounds like as you guys are talking, this isn't about if you're a hygienist in a dso, come join us. It's more of if you're a hygienist who's ready for the future, come join us. If you're a hygienist that's tired of playing at a lower level, come join us. If you feel like everything that you learned in school wasn't everything to be learned, come join us. Am I hearing this correctly?

Yes, yes, exactly right.

Yes.

It's more about the Excellence part than anything else. It's, you know, the DSO is where the future is going from a support perspective. And so you're leveraging off of that, saying not only should we be getting support from the business side, we should be supporting each other to get to the next level.

It's, again, harnessing that power. Right. Of being in the DSO space.

Yeah. The difference between just general light. Right. And a laser is all about focus. Right, right, right. Yeah.

And you're right. And I think there's hygienists that I think a lot of hygienists are hungry to elevate. We see them going into selling other products, you know, trying to consult. I mean, going to a lot of different spaces. And, you know, I think there's. To create a space clinically where we can again, do true professional development and personal development, where we can keep those hygienists clinical and not have them walking away from clinical. Especially with COVID you know, that was honestly was part of it. We saw people not coming back to clinical hygiene. And I was concerned, like, our patients need us. We have so many patients, you know, that aren't even getting care in the US what is it, 35% of people go to the doc, you know, go to the hygienist or the dentist. So what happens when we rally to 70%? Who's gonna see all those patients? We have hygienists walking out of the clinical care.

Right.

So we give them a space in clinical to elevate. So we keep those excellent hygienists in clinical.

Well, and I'm curious your thoughts on this. I think part of the reason that we saw so many walk away, so many frustrated, is we didn't include them in the conversation. And when I say we, I'm using a very big royal we that I think that the clinician side, the dentist side you know, walk through. Many times I talked to DSOs who were humble about this. Their clinical teams got together, and they didn't include the hygienist. Others nailed it. They included everyone. They included hygienists, RDAs, you know, all the way up and down set. We've got to build a plan. I think when you build a plan together, you understand the plan. Right. And you execute the plan together. And it seems like those who made the biggest mistakes, frankly, oftentimes at the individual practice level, dentists kind of made a unilateral decision. It wasn't as collaborative and said, listen, you didn't let me keep up with, like, where this decision tree is going, I need to opt out. You know, I'm still going through kind of the fear process here, and you didn't bring me along with you. Did you see that? Or was there something else going on?

You know, I think you're exactly right. I kind of have a story. I have two other girlfriends who are hygienists, and one works here in Illinois, and then the other works in California. And throughout that time, one of their doctors, the one in Illinois, he was talking to them weekly. So they had a weekly zoom call. And so he would keep them abreast of what was happening. My other girlfriend in California, nobody called her, nobody talked to her. She's three weeks in, she's like, I haven't heard from anyone. And now us, we were so fortunate because in our DSO, our leader, he called us every single morning at 8 o'. Clock. We had a group call that was Monday through Friday. And he let us know where he was with the PPE and that he was getting everything. We were gonna be safe. And don't worry, he had it under control. I mean, he said and did all the right things.

Ask him questions and test him. Your fears.

Yeah. And he was. He was.

He probably sometimes said, too, holy smokes. I don't know what's going on. I don't have a solution. I'll let you know when I do.

That's important, too, you know, that's important too. To share that like, that. You don't know. And I think, unfortunately, you know, like you said, I think that's why a lot of them walked away. Now, I'm not sure, but I think that's what it is.

It's.

Didn't have a seat at the table. Yeah.

Do you think this is kind of that deeper issue that's been not addressed for a long time? And then the stress of COVID just kind of exacerbated the problem, which is that misalignment. Right. And what you probably saw was those who've had misalignment for a while, who've operated, let's call it, under the old culture, I'm the dentist, everybody else. Right. This pressure just totally exploded, imploded that. And those who said, we're a team, this pressure just galvanized that and moved them forward. That's a lot. What I saw with, you know, deo, Dentist, Entrepreneur, Organization at the ADS level and several others, is this really said, all right, are you a team, or have you not been acting like a team? And it felt like it sent ripple effects throughout the entire industry.

Yeah.

And my hope is that we have DSO leaders bringing hygienists back into the fold clinically and saying, I want you back and we're going to elevate you.

Right.

We're going to invest in you.

Right.

Professionally and personally. We're going to have you become certified as a DSO Hygiene Excellence diplomat. We're going to be co producers in the office, co leaders. You know, you're going to be, I want you to run this hygiene department in alignment with these five pillars and really give them that elevated place back,

you know, would it be fair to say? Because I don't think it's like a DSO leader like myself as much as the clinical director, especially saying that. Right.

Hiring.

Sure.

Yeah. It's that cdo, it's that clinical, it's the associates even at the practice level saying, hey, we're co producers together. I loved your term around that. Yeah.

Because you are right. And with that comes some responsibility and definite value add.

For sure.

And I think if you, if you, if you give your hygienist ownership of their department and give them guidance on how to do that, they'll take it and they'll go. I mean, that's what Sarah and I have done in our department. And we enjoy it, but we also feel that we know our roles and responsibilities. And I think sometimes, again, I think too, it's about mindset, unfortunately. I think sometimes people are, you know, hygienists come in and it's a clock out, clock in mentality mindset. And that's what we want to change. We want to change that mindset to, you know, be the free thinker that you are and be kind of that, that leadership.

Yeah. Your highest and best use. Right. Your highest and best level and capability and talents. All right, so if people want to be involved, if they're hearing this and they're like finally, finally this organization, where do they want to start first?

They can contact us at DSO hygienexcellence.com we have a sign up area on there and they can just sign up and ask us questions and we'll get right back to them.

Awesome. And you guys have a Facebook site as well, right?

Yes.

How do they join that?

It's a DSO Hygiene Excellence Facebook page. Yeah, you just Google it on. Search it on Facebook. Yeah, we're excited, you know, to speak to your last point. We did launch a survey nationally a few weeks ago, about a month ago, out to all the DSO leaders and hygienists and we got back quite A few, yes.

We got, I think over 150 responses. And we did find that 58% of the DSO leaders said they didn't have consistency through their hygiene departments, which was really important to them. So we have learned a lot from taking the surveys. And 75% of DSO leaders said they would benefit from a system based hygiene program. So we are listening to the needs.

That was kind of the clock in, clock out thing because I feel like a lot of hygienists, they maybe lack the direction of, understand what they were accountable for. Like what are you accountable for? Your, your DSO leader or your clinical director has some metrics that they are looking at, right. Holding you to, but maybe you're not aware of what those are or how to move them. I think that survey said, well, actually, 42% of DSO owners said that their hygiene departments were not accountable, like lacked accountability. But what have you put in front of them? You know, nothing should be about numbers and hitting numbers, but some of the business KPIs in our program and clinical excellence KPIs does give, you know, the DSL leaders that accountability, but also the hygienists some direction of what they're looking at. Well, how do we want the hygiene department to look like moving forward and

how do we do the best patient care? I mean, if you're, if you're not at that level where you want to be, how do you get there? I mean, I mean, I think, I think unfortunately a lot of times people think numbers are punitive and they're just numbers. It's growth experience and we want people

to grow and supported. The last part of that survey was the hygienists were interesting hygienists. So they don't feel a sense of community within their dso, which kind of makes sense when there's not one.

Right, Right. Well, here's what I love, and this is how you can tell you have leadership and that you want to be a leader is I would say for every DSO leader out there, we need to step up and we need to include hygienists more in the conversation. For every clinical director, we need to step up and we need to be better leaders and include hygienists in the conversation. And what you guys are saying is, yeah, and for every hygienist, we need to step up and improve our capabilities and get included in the conversation. Right. And not be a clock in, clock out. I think if everybody kind of lists where they stand, right. We take everything to the next level, which is Excellent. The one thing we all know we can control is ourselves, right? So if we improve our part of the circle of influence, that then we can expand it from there. All right. Is there anything else that we should know about DSO Hygiene for Excellence? Otherwise, you guys said you had some questions for me. I don't know what they are yet. You wanted to ask me some hard questions and I'm totally up for it.

Well, we kind of were curious on how you saw the alignment between dentists and hygienists.

So first of all, it needs to happen, right? It needs to happen, like, absolutely. There needs to be bigger conversations. And as I've talked to clinicians and hygienists, it's been one of these things where the hygienists at times get ambitious, but they're not empathetic to the business overwhelm that the clinician is feeling. And the clinicians not taking the time to say, can I walk you through what my P and L is? Why I'm concerned about it, let's be honest. Oftentimes as team members, as employees, we take the revenue we're seeing, we subtract off of our cost and a little bit more, and we say the rest of it must be coming home or must be going. So, man, they're just rolling it. I think taking the time to understand some of the financial pressures and components really drives a lot of the alignment. From what I've heard from clinicians, they're so nervous that the hygienist is going to learn what's going on. Just want to take more and more and more, both financially and maybe control wise. And the hygienist is like, I just want to help and support. Why is there so much trauma and fear? I think you have to sit down and be really honest about those conversations. What's your intention? What are you trying to do? Because I think a lot of times the reason a hygienist turns into a clock in, clock out is because we took somebody who was very independent and instead of bringing them up to be interdependent, we made them like codependent because we kept pushing them down, pushing them down. So I think that there's a conversation to be had here, sitting across the table and say, I want you to be your best self. I want to be my best self. How do we get there? I also think there has to be abundance mindset, right? As clinicians, as business owners, we have to be thinking, you brought up the 35%. I'm really big on the fact that we only have 35% of people coming to the dentist and if we could get to 70%, we doubled the entire industry. Why in the world are we worried about who's doing what, et cetera? Right. If they're doing a great job clinically, let's let them do it and let's move upstream. Right. Clinicians need to be either opening new practices, figuring new patients that they want to serve, et cetera. If the hygienist can take care of it, let them. If you want somebody to be responsible, give them responsibility. So I think there's been a scarcity mindset for too long. Right. There's been this diminishing mindset too of like, I've got to sit on the ground, I can't come up and do anything. Great. I think the vision you guys have set is let dentistry move to another level within healthcare. Let's grow the amount of care and the amount of service that we're bringing. And there's room for everyone, plus some. We're going to be, you know, we're going to have patient need coming out of our ears and we're going to need everybody to be helping. But this mindset that there's the pie, that's only this big and if you come and help me and do this clinical care, oh, then you're taking away from me. I think that that's old mindset that we have to move past. So I think those are a couple things. Include them in the business model. I can tell you with our DSO and our support, we have open book financials every two months. We have a town hall. Not just our hygienists, not just our dentists and associates. Everybody in the company knows exactly what's going on. We're all working from the same account, trying to have the same impact. And we're not taking those dollars. And this is true for every dso. I know they're not taking those dollars home, they're taking those dollars, reinvesting them in more locations, more patient access. We have states where 90% of the counties have below average dentist to population ratios. There's no way that that state is getting the patient care that they need. So that's the kind of investment we need in this space. And anyway, that's probably bigger than the question you asked, but very excited about it. And I think we just have to think bigger and we get the alignment.

Yeah. And I think I would like to see us align, obviously clinically and professionally and even organizationally, you know, on a national organizational level, just to be honest, I feel like there's been too much not getting along.

Right.

And I'd love to have dentists and hygienists under the same umbrella in a national organization, moving, collaborating.

Right.

And working together, moving profession forward.

Yeah. I think hygienist, as an outsider who's come into this space is standing in this magical place, and you guys kind of mentioned this at the beginning, where they have a clinical understanding and empathy that they know what excellence needs to look like. They also know what the patient understanding is. And the layman turns, and that bridge is magical. Right. And the clinician, the dentists have gone a little bit more upstream to get into the surgical procedures, et cetera, which is super helpful because those have to get done. But sometimes as we get focused on that, our capability in connecting with the patient and being a little bit more layman, we're going to lose that. Right. We're the specialists as a dentist, as you're moving upstream. And so hygienists are this brilliant bridge to not just the patient, but also to the staff to be able to align with the patient and the customer. Listen, if you're a dentist and you have no patience, to me it's like, what do you need to be a leader? You have to have followers. What do you need to be a dentist? You have to have patience. Otherwise, instead of being a leader, you're a loner and you're a loser. I think as a dentist, if you don't have patience, if you don't have that connection, then you're a highly trained individual that doesn't have anyone to work on. Right. So I think hygienists play this really important role and I love what you all are doing. All right, thank you all so much. I really appreciate you being on the show. I love your involvement. If you want to talk to them more obviously, go to their Facebook page, but you can also come over onto DSO Secrets Facebook page. And until next time, keep smiling.

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