1 00:00:05,155 --> 00:00:07,205 - This is the Becker's Healthcare Podcast, created 2 00:00:07,205 --> 00:00:08,365 by the team of Becker's Healthcare, 3 00:00:08,485 --> 00:00:10,245 a multimedia company devoted to the people 4 00:00:10,265 --> 00:00:11,565 who power us healthcare. 5 00:00:11,835 --> 00:00:14,645 Four new 15 minute episodes are released daily containing 6 00:00:14,845 --> 00:00:16,605 industry news analysis and thought leadership. 7 00:00:16,605 --> 00:00:19,485 From powerful healthcare decision makers Support our show 8 00:00:19,625 --> 00:00:22,445 by leaving it a five star rating and review on Apple Podcast 9 00:00:22,665 --> 00:00:23,925 or other platforms you use. 10 00:00:24,075 --> 00:00:25,925 It's a chance to tell us what you like about the show 11 00:00:25,945 --> 00:00:27,165 and act on your feedback. 12 00:00:27,165 --> 00:00:29,125 Thanks for listening. Now here's the episode. 13 00:00:30,715 --> 00:00:32,005 - This is Grace Lynn Keller 14 00:00:32,005 --> 00:00:33,165 with the Becker's Healthcare Podcast, 15 00:00:33,385 --> 00:00:34,725 and we are live at the business 16 00:00:34,725 --> 00:00:38,325 and operations of ASC in the Future of Dentistry Roundtable. 17 00:00:39,105 --> 00:00:42,285 I'm joined right now by Santo Patel, who serves 18 00:00:42,305 --> 00:00:45,285 as the president of Complete Specialty Solutions. 19 00:00:45,835 --> 00:00:47,605 Santosh, thanks so much for joining me, 20 00:00:47,625 --> 00:00:49,325 and I would love to start our conversation 21 00:00:49,635 --> 00:00:51,285 with having you introduce yourself 22 00:00:51,285 --> 00:00:52,645 and telling us a little bit more about your 23 00:00:52,645 --> 00:00:54,005 background. Wonderful 24 00:00:54,005 --> 00:00:55,645 - Grace, thank you so much for having me. 25 00:00:55,785 --> 00:00:57,925 So my name is Santos Patel, president 26 00:00:57,925 --> 00:00:59,925 and Co-founder of Complete Specialty Solutions. 27 00:01:00,425 --> 00:01:03,125 Uh, we are a traveling specialty DSO, 28 00:01:03,125 --> 00:01:06,685 where we bring in specialist and operations teams 29 00:01:06,745 --> 00:01:09,325 and clinical teams into group practices. 30 00:01:09,585 --> 00:01:12,965 So allowing those practices to serve as a multispecialty 31 00:01:13,765 --> 00:01:16,645 organization and really helping those patients 32 00:01:16,985 --> 00:01:19,085 and, uh, the, the services rendered 33 00:01:19,085 --> 00:01:20,165 within that one location. 34 00:01:20,305 --> 00:01:23,285 So the mindset there is refer in, not refer out. 35 00:01:23,985 --> 00:01:25,365 Now, a little bit about my background. 36 00:01:25,385 --> 00:01:27,485 So I actually came from the medical world. 37 00:01:27,545 --> 00:01:29,565 I'm not a clinician. I'm, I'm really just an operator. 38 00:01:29,625 --> 00:01:31,085 So I came from the medical world building 39 00:01:31,145 --> 00:01:32,845 multi-specialty physician groups. 40 00:01:33,425 --> 00:01:36,445 My wife's a general dentist, learn more about the dentistry, 41 00:01:36,905 --> 00:01:39,245 uh, space and the, the, the trend. 42 00:01:39,705 --> 00:01:42,165 And notice that the in-house specialty model 43 00:01:42,265 --> 00:01:43,485 was a bit fragmented. 44 00:01:43,505 --> 00:01:45,805 You know, large DSOs, large groups were able 45 00:01:45,805 --> 00:01:46,965 to figure out that solution. 46 00:01:47,315 --> 00:01:50,125 They had specialty recruiters, they had 47 00:01:50,635 --> 00:01:54,125 operation teams dedicated to the integration of specialty, 48 00:01:54,825 --> 00:01:56,125 but the solo practices 49 00:01:56,505 --> 00:02:00,005 and the emerging groups, they didn't have access to 50 00:02:00,005 --> 00:02:03,245 that information and they didn't have access to being able 51 00:02:03,265 --> 00:02:06,165 to understand the systems when you're only bringing in a 52 00:02:06,165 --> 00:02:07,685 specialist once a month. 53 00:02:07,815 --> 00:02:11,765 Right. So really that's where the idea was born is 54 00:02:11,765 --> 00:02:16,285 how do we integrate a model that's allowing practices 55 00:02:16,385 --> 00:02:18,045 to serve as a multi-specialty, 56 00:02:18,825 --> 00:02:21,725 but in a capacity where it's utilizing their space 57 00:02:22,185 --> 00:02:25,045 and teams, um, but not creating a burden for them. 58 00:02:26,795 --> 00:02:29,235 - Absolutely. Well, thank you for expanding on that. 59 00:02:29,535 --> 00:02:31,835 Um, and my first question for you today is, 60 00:02:31,835 --> 00:02:32,995 what are the biggest issues 61 00:02:32,995 --> 00:02:34,555 that you're currently following in dental? 62 00:02:35,095 --> 00:02:37,235 - Uh, that's a great question. So, you know, I, 63 00:02:37,355 --> 00:02:38,595 I would probably have a different 64 00:02:38,595 --> 00:02:39,835 answer three or four years ago. 65 00:02:40,015 --> 00:02:42,155 Uh, I would say the answer now in the state 66 00:02:42,155 --> 00:02:44,275 that we look at is really ultimately margin 67 00:02:44,755 --> 00:02:45,915 compression, right? 68 00:02:45,935 --> 00:02:47,635 So margin compression is 69 00:02:48,305 --> 00:02:51,475 tied into multi different layers from the fact 70 00:02:51,475 --> 00:02:53,435 that staffing costs have increased 71 00:02:53,455 --> 00:02:55,715 by 30% over the last two years. 72 00:02:56,295 --> 00:02:57,715 Uh, the cost of supplies 73 00:02:57,735 --> 00:02:59,605 and goods have gone up at least 10 74 00:02:59,605 --> 00:03:01,725 to 15% in several scenarios, 75 00:03:02,835 --> 00:03:04,615 but the reimbursement rates, uh, 76 00:03:04,615 --> 00:03:07,175 from payers have remained a relatively flat. 77 00:03:07,315 --> 00:03:10,375 So we've not seen a, a shift in payment reform, 78 00:03:10,755 --> 00:03:13,015 but we've seen an increase in overall costs. 79 00:03:13,075 --> 00:03:16,575 And so even the cost of building a, uh, 80 00:03:17,135 --> 00:03:19,135 location has increased substantially. 81 00:03:19,675 --> 00:03:21,255 Um, and then just the cost 82 00:03:21,275 --> 00:03:24,175 of money has increased substantially for interest rates. 83 00:03:25,035 --> 00:03:29,095 So, calculating all that in, you really think about 84 00:03:29,095 --> 00:03:31,455 where practices may have had a, 85 00:03:31,695 --> 00:03:36,575 a 2020 5% EBITDA margin in the past are now hovering 86 00:03:36,575 --> 00:03:40,735 around a 14 to 16% EBITDA margins simply 87 00:03:40,735 --> 00:03:44,015 because of those areas and, and, uh, cost constraints 88 00:03:46,555 --> 00:03:47,555 - A hundred percent. 89 00:03:47,555 --> 00:03:50,995 And my next question kind of has a two, two parts to it. 90 00:03:51,135 --> 00:03:53,435 So first, what are you most excited about 91 00:03:53,455 --> 00:03:54,515 in the dental space? 92 00:03:54,655 --> 00:03:56,915 And then second, what in the dental space 93 00:03:56,915 --> 00:03:58,155 makes you the most nervous? 94 00:03:59,175 --> 00:04:01,195 - So what, what am I most excited about actually? 95 00:04:01,195 --> 00:04:02,595 So, you know, coming from the medical world 96 00:04:02,595 --> 00:04:05,435 where the medical world is heavily consolidating at, 97 00:04:05,455 --> 00:04:07,835 at a pace that is now similar to 98 00:04:07,835 --> 00:04:09,355 what is happening in dentistry now, 99 00:04:09,445 --> 00:04:12,035 we're still probably about 10, 15 years back, um, in, 100 00:04:12,055 --> 00:04:15,235 in terms of the, the consolidation speed. 101 00:04:15,935 --> 00:04:18,675 But the, the excitement is that it's happening 102 00:04:18,815 --> 00:04:21,155 and there's some benefits with economies of scale. 103 00:04:21,155 --> 00:04:22,795 There's some benefits of organizations. 104 00:04:23,255 --> 00:04:25,595 Um, there's, there's the benefit of the fact that, you know, 105 00:04:25,735 --> 00:04:29,475 for example, Becker's is creating a, an avenue now 106 00:04:29,475 --> 00:04:31,635 for dental leaders to come in and talk. 107 00:04:32,335 --> 00:04:36,755 Um, so it's creating that, that highlight of, uh, education 108 00:04:36,855 --> 00:04:39,035 and, and really operational excellence. 109 00:04:39,255 --> 00:04:40,835 So I think that's what excites me is 110 00:04:40,835 --> 00:04:42,395 that there's more like-mindedness. 111 00:04:42,395 --> 00:04:44,675 There's more understanding of the industry 112 00:04:44,675 --> 00:04:45,915 and the opportunity of the industry. 113 00:04:45,915 --> 00:04:48,675 What makes me nervous is almost a similar kind 114 00:04:48,675 --> 00:04:50,515 of response is the consolidation, right? 115 00:04:50,615 --> 00:04:53,435 And so sometimes when you're consolidating too fast, 116 00:04:54,055 --> 00:04:55,475 you can make errors and you can make, 117 00:04:55,575 --> 00:04:56,755 uh, you know, missteps. 118 00:04:56,815 --> 00:05:00,075 And what that ultimately does is that that loses credibility 119 00:05:00,585 --> 00:05:02,875 back to the provider aspect, right? 120 00:05:02,895 --> 00:05:06,155 So doctors and dentists, if they start to hear stories 121 00:05:06,295 --> 00:05:08,835 of consolidation efforts that have failed, 122 00:05:09,385 --> 00:05:10,395 then they pull back. 123 00:05:10,855 --> 00:05:13,515 And by pulling back, either they're not 124 00:05:14,115 --> 00:05:16,355 invested into growing an organization, 125 00:05:16,545 --> 00:05:19,675 they're now jumping from organization to organization. 126 00:05:19,675 --> 00:05:22,955 So you have the lack of stability and lack of consistency. 127 00:05:22,975 --> 00:05:26,175 So I, I think that's what makes me nervous is, you know, 128 00:05:26,175 --> 00:05:27,775 being able to, to build 129 00:05:27,795 --> 00:05:31,775 and consolidate appropriately, have great use cases, um, 130 00:05:31,955 --> 00:05:35,815 and then really focus on the retention of, of the providers. 131 00:05:36,095 --> 00:05:38,455 'cause that's ultimately where you have effectiveness 132 00:05:38,515 --> 00:05:39,575 of, of scalability. 133 00:05:40,965 --> 00:05:43,425 - And my final question for you today is 134 00:05:43,535 --> 00:05:45,825 what will the most effective healthcare leaders need 135 00:05:45,845 --> 00:05:48,305 to be successful in the next two to three years? 136 00:05:49,495 --> 00:05:52,755 - So, leadership has talked a tremendous amount in, 137 00:05:52,755 --> 00:05:54,475 in the medical world and healthcare space. 138 00:05:54,535 --> 00:05:56,915 And so I, I've been fortunate to learn from, 139 00:05:57,075 --> 00:05:58,245 from that arena first. 140 00:05:58,305 --> 00:06:01,685 And the way I I view leadership is, you know, you have 141 00:06:01,685 --> 00:06:04,605 to be able to inspire, instruct, and inspect, right? 142 00:06:04,625 --> 00:06:06,485 So inspire team for a vision 143 00:06:06,545 --> 00:06:09,285 and a goal, instruct your team knowing how to get 144 00:06:09,285 --> 00:06:11,445 to certain, um, milestones and checkpoints 145 00:06:11,865 --> 00:06:14,725 and then inspect to, to make sure we're course correcting 146 00:06:14,725 --> 00:06:16,445 and make sure we're all on the same page, right? 147 00:06:16,985 --> 00:06:19,885 But in order to do that successfully, I think leaders have 148 00:06:19,885 --> 00:06:21,085 to be able to demonstrate 149 00:06:21,185 --> 00:06:25,085 and understand empathy if they do not understand empathy, 150 00:06:25,145 --> 00:06:28,565 and they struggle with, um, being able to empathize 151 00:06:28,565 --> 00:06:30,765 with their doctors that they're bringing in who have 152 00:06:31,455 --> 00:06:32,685 three times the amount 153 00:06:32,685 --> 00:06:34,965 of student loan debt than they've ever had before. 154 00:06:35,465 --> 00:06:38,605 If they're struggling to empathize with their clinical, um, 155 00:06:39,735 --> 00:06:41,045 their dental assistant team, 156 00:06:41,745 --> 00:06:44,885 and why, you know, maybe as dental assistant doesn't want 157 00:06:44,885 --> 00:06:48,885 to, to work more hours, drive across town 158 00:06:49,585 --> 00:06:54,005 for a job that pays the same, if not less than retail 159 00:06:55,125 --> 00:06:57,285 restaurants, Starbucks that's offering insurance, right? 160 00:06:57,705 --> 00:06:58,845 So as a leader, 161 00:06:58,965 --> 00:07:01,045 I think empathy is gonna be critical in understanding 162 00:07:01,145 --> 00:07:04,365 how are you gonna build a culture around, uh, 163 00:07:04,365 --> 00:07:05,445 understanding your team. 164 00:07:05,445 --> 00:07:06,685 We're still a team business. We're not, 165 00:07:06,685 --> 00:07:09,005 we're not a hundred percent, you know, AI focused. 166 00:07:09,005 --> 00:07:12,925 We we're, we're still, um, reliant on, uh, 167 00:07:13,515 --> 00:07:16,445 doctors and assistants and, and operators. 168 00:07:17,135 --> 00:07:19,195 So that, that, I think that's the biggest component 169 00:07:19,195 --> 00:07:20,915 where leaders need to be able to move and, 170 00:07:20,935 --> 00:07:24,235 and be open-minded to is, uh, the empathy side. 171 00:07:25,105 --> 00:07:27,315 - Very good point. Well, Santosh, thank you so much 172 00:07:27,375 --> 00:07:29,835 for joining me today on the Becker's Healthcare Podcast. 173 00:07:30,365 --> 00:07:33,315 Again, we're live at the business and operations of ASCs 174 00:07:33,315 --> 00:07:35,115 and the future of Dentistry Roundtable. 175 00:07:35,465 --> 00:07:36,635 - Yeah. Glad to be here. Thank you. 176 00:07:39,265 --> 00:07:41,835 - It's so important for leaders at the top of organizations 177 00:07:41,835 --> 00:07:44,235 to keep learning, stay sharp, grow their networks, 178 00:07:44,625 --> 00:07:47,035 help our audience better do this in a more simplified, 179 00:07:47,035 --> 00:07:48,915 personalized, and meaningful way. 180 00:07:49,475 --> 00:07:51,915 Becker's Healthcare has launched my BHC, 181 00:07:52,425 --> 00:07:54,395 it's your trusted Becker's healthcare experience 182 00:07:54,395 --> 00:07:56,635 and more with content, connections, events, 183 00:07:56,655 --> 00:07:57,675 and learning opportunities. 184 00:07:58,385 --> 00:07:59,475 Join the community free 185 00:07:59,475 --> 00:08:04,035 of charge@www.my dot becker's hospital review.com 186 00:08:04,215 --> 00:08:04,955 and we'll see you there.