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Welcome to the Becker's Healthcare Podcast. My name

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is Chanel Banger. And right now I'm recording

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live at the Becker's Healthcare 2024

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future of dentistry roundtable. And I'm sitting with

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doctor Efren Coronado,

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the dental director of Sage Dental.

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Doctor Coronado, thank you so much for joining

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me today. Oh, thank you for having me

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here. It's a pleasure to be here and

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excited to see everybody working so hard and

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dedicated to the profession.

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Love to hear it. Well, to get us

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started, could you please introduce yourself and tell

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us a bit about your background?

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Yes. My name is Efrain Cornetto. I'm a

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general practitioner, general dentist.

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I also have the role of clinical director

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for Sage Dental.

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I've been in practice doing dentistry for about

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26 years.

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I graduated from the University of Maryland in

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Baltimore,

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and, I I've been also involved as a

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dental examiner for the state of Florida. I

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did that call for, like, 4, 5 years,

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and then I've been doing some missionary work.

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And I've also worked in private practice, but,

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majority of my time, I worked, in a,

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primarily in a DSO for the last

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20 years.

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Thank you so much for that introduction.

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Now moving forward,

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what key experiences

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have shaped your leadership journey

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in the dental and DSO industry?

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Like I said, majority of my lifetime as

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a dentist has been working for a DSO.

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So I pretty much I I like to

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say I grew up within that family of,

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of DSO. The, I started with, Sage when

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it was 12 offices.

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So my primary experience was has been living

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out the growth and the development of a

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DSO,

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going from a few offices to now more

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than 120 offices.

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So it hasn't been really a specific

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experience, but a multiple of small experiences throughout

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the years of dealing with corporate,

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also interacting with, individual practitioners and the staff

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and just throughout the growth.

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I like to say I I have one

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story that, my wife and I had. We

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met,

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family few years ago.

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They had 10 kids.

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Yes. That's 10. 10 kids. And they were

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the most loving,

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cheerful couple.

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And we approached them and said, how do

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you do it?

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And they said, well, it's a lot of

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I'm sorrys.

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And and that stayed with my with me

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for so many years that I still remember

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up to today is that's what a relationship

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is. The same thing within a a DSO.

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You have to strive and and work through

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the challenges that you have

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and just say I'm sorry and and see

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what the fault is, what it is, and

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and and work through it. So that has

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been my experience of,

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working in a DSO for so many years.

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It's it's really takes a a a big

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effort and willing to face the challenges that

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you have with other people.

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I can imagine having 10 children. You have

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to have a lot of strategy involved. And

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speaking of strategy,

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what strategic

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initiatives are you, prioritizing

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for growth and patient care, say, currently?

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We're we're working now in DSO. We're very

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big on, education

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of the connections between teams

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and communication

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in general and also creating some of that

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workflow and technology.

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I must say I must give credit to

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the leadership and and the DSO that I

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work at Sage

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under the leadership of, doctor O'Rourke and, Missy

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Madeline. They're doing tremendous work.

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So it's not me. It's, it's a whole

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team effort, and I'm following them.

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Where I'm big at is, as far as

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initiative, I think is very important, especially for

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young doctors, would be, mentorship

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and presence,

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just being there. Sometimes I visit offices and

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and have to do a lot of work

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with them.

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Sometimes they just say hi and be there,

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but I I can feel they get comfort

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of having that support. And I think that's

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that's one of the strengths

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that we have to capitalize on our DSO,

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of having different talents available, especially when you

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need it. We'll have our different strengths and

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and skills.

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But I think the the major one is

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is being there, having that presence. And the

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other one, like I just said, mentorship,

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showing how to work through the issues, how

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to the technical or the clinical or just

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how to human behavior, how to handle,

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different situations.

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Yeah. I feel like it all comes back

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down to communication.

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Yes. Yes. Yes.

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And moving forward, what significant challenges

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are dental and DSO leaders facing currently? And

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how are you addressing them at your organization?

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We must realize that there as a DSO,

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there's many, many different type of challenges.

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I like to focus on 2 primarily, which

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is,

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retention of the staff and personnel.

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And the other one that I like to

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call is identity, is a DSO identity.

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Sometimes

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with the growth of the DSO,

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especially now and, I've been listening to the

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different conferences

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this morning that I've I've been to. And

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I think in all of the panels I

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assisted,

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the recurring word was growth. The DSOs, they're

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not gonna go anywhere. They're just gonna keep

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growing.

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So it's like the elephant in the room.

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We have to tackle that and see it

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as a positive thing. It's, I'm very excited

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that that DSOs are growing. And like I

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said, there's a lot of opportunity and potential

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for that. But something that DSOs wants to

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develop and not lose is is that identity.

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I remember when I was a kid, I

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used to go to play with my friends

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in their houses and when and I don't

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know why. Even as a adult, you go

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and it happens as an adult when you

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go to somebody else's house.

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But I don't know why I remember when

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I was a kid, 10, 11 years old,

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and somebody visited to their house, you go

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in and the first thing you notice is

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the house has a specific smell.

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And you don't notice that in your house,

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but when they come into your house, they

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say something. Hey. Your house smells good. It

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smells this. And you know you don't notice

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because you live in it. So my question

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to DSOs is,

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what does your DSO smell like?

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And if you don't,

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then let's try to find out. But I

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think definitely the strength of a DSO has

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to be its unity,

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its identity,

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and, it's easy it's easier said than done.

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But I think that's one of the challenges,

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especially with the growth of DSOs.

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Even now we're going into multistate,

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DSOs,

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even breaking 1,000,

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practices number.

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I think

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the leadership,

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which obviously we cannot lose sight that that

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the ultimate focus obviously is patient experience and

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health care. But in doing so, we must

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develop an identity,

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something that shows who you are as a

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DSO. And I think you work that on

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on on a different different levels on 1

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to 1 with the practitioners.

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But also, I wrote a a an article

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a while ago in group dentistry now, which

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I discussed that it is very important for

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DSOs to establish a medium

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where you can hear the voice of the

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practitioners at the different offices, especially the more

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you grow, you need to hear their voice.

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And sometimes just being listened to out of

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that, the fruit out of that, it becomes

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a culture that you create.

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And it it and an identity that you

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develop even with multiple offices, even with a

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thousand of different personalities that everybody has.

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That's one strength that we have to capitalize

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on, which at the same time, it is

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a challenge for DSOs.

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For sure. And I feel like you've already

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shared so much advice, but with all of

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your missionary

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work and your experience and your mentorships,

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what essential qualities or skills would you

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suggest to emerging leaders in this industry?

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I know there's

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I mean, there must be thousands of books,

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related to leadership

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in healthcare and outside of healthcare.

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There's 2 persons I like to point out.

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1, actually for I don't know if it's

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coincidence. They're both at a Harvard, Business School,

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actually. 1 is Moss Kanter, and the other

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one is John Kotter.

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Moss Kanter,

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what she describes is the the the four

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c's that a leader should have, which is

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congruency must be competent, consistent,

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and caring.

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And, obviously, we'd find those same factors in

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in us clinicians.

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But I I like to focus on on

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on having the competency, the ability to to

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treat somebody else. I think as a leader,

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you need to under that title.

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I think you need to be able to

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adapt and to be a learner leader. In

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other words, when

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when as a leader, somebody

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says, I have it under control. I know

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everything.

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I think that's when we have a a

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problem. We have a big issue.

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So it's not to live in constant

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anxiety on the other extreme and questioning every

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move or decision you make. But I think

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as a leader, it's very important to always

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have that

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space of learning more and learning more, and

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you learn that from the outside. But a

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lot of times you, like, learn a lot

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from within your own DSO

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just by talking to the especially the young

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doctors,

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talking to the to the staff, to that

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many different teams, you have to learn. And

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the other big thing, which is very important

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in this as a leader, is you must

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learn how to recognize talent.

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Problems are

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better dealt when they're prevented.

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So being able to

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attract the correct people they have back to

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your identity, the same philosophy, same similar culture.

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But when they don't or when it's different,

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we have to learn from different people

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and recognize

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within your DSO

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where somebody can be at a different role

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within your DSO. Why? Because their scale,

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their scale or their capabilities are better suited

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for a different role where they're at. So

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it's good. And and people change. People grow.

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So it this is something as a learning

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from your staff, from your doctors. It must

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be, a constant thing. And the last thing

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I'd like to say is

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from, John Carter. He explains, it's like it's

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like a boat, like a ship. You have

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a little boat. You have you have a

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a motor. You have the captain and you

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have the steering wheel.

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So the motor is the energy.

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The steering wheel is the competency to be

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competent. And then you have the captain, which

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is honesty. So you need those 3 ingredients.

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You have energy.

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You have to know the know how, which

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that's why we take see courses, business courses,

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technology that makes us competent in what we

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do. But at the end of the road,

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we have to be honest.

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Because if you have let's say, you have

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a boat

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and no motor, well, you have all the

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knowledge,

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all the honesty, but that boat's not go

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anywhere.

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Now if you have no steering wheel, you

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can have energy. The motor, you can you

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can have the honesty,

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but that boat, that ship is gonna go

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anywhere.

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The worst case scenario is when you have

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a motor,

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you have all the energy, you have all

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the knowledge and capability,

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but you don't have the honesty. You better

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brace yourself where that boat's gonna take you.

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So those three things are very, very important

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today's,

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leader in the dental field as well. I

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love it. I think the overarching themes are

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communication,

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identity,

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mentorship through mentorship, kind of. And

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yeah. Thank you so much, doctor Coronado, for

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joining me today on the Becker's healthcare podcast.

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Yeah. I appreciate it. And like I said,

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again, it was a pleasure to be here,

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and I'm still learning a lot. There's more

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to learn. Thank you. Thank you very much.

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Thank you.