Hello. This is Cameron Cortejano with the Becker's
Dental and DSO review podcast.
I'm thrilled to be joined today by Francesca
Pergano,
COO at SmileMakers
Dental Center.
Francesca, thank you so much for being here
today. Thank you for having me. I am
a frequent listener of the podcast and excited
to be here.
Awesome. Just to start us off today, can
you introduce yourself and tell us a little
bit about your background?
Yes.
So my name is Francesca Provano. I am
the chief operating officer of SmileMakers Dental Center.
We are a multi specialty DSO in Northern
Virginia.
A little bit about my background,
I have nineteen years experience
in the dental industry, specifically in operations and
management.
During this time, I also received my master's
in business administration.
I currently run the operations of our six
practices
with a focus on long term strategic growth
and scalability.
I do this by,
focusing on building high performing teams that align
with the core values
of the organization,
always
also focused on delivering an exceptional
patient experience.
I work alongside our leadership team to create
operating systems that are
easily measurable and scalable
with a,
focus on KPI management for each job role
and department.
I also have a deep financial oversight into
the organization,
specifically
monitoring the cash flow
and profit and loss
management down to each office level,
always to ensure that we do what's necessary
to maintain growth and profitability.
Awesome. Thanks for that.
First question today, what are some of the
biggest issues,
in the dental industry that you've been following
so far in the first couple of months
of 2025?
So one of the biggest issues,
is something that me and my team has
been working on for a couple years now,
and that is the shortage in the workforce,
particularly
among dental assistants,
hygienists, and administrative
professionals.
So not only is recruitment difficult,
but the long term retention
remains a huge concern.
Data shows that nearly half of employees in
these roles leave within the first two years,
And given that there's limited
formal training for these support positions, it often
takes just that long to fully onboard and
develop these individuals.
So
at our organization,
I've helped by taking a proactive approach.
One of the most effective strategies
was the expansion
of a remote workforce.
So that workforce includes a call center, an
RCM team that
measures,
you know, or covers insurance verification,
billing, account auditing,
patient collection,
a finance team, and
trained dentists to perform chart auditing and compliance.
So that shift really allowed us to tap
into talent beyond our physical locations,
not only to increase efficiency,
but make the scalability of our operating systems
possible.
Also, to combat this issue, we've
really redefined our onboarding and development
with structured programs and check ins that focus
on long term growth with our current employees.
So we set clear expectations from day one,
and that alone has dramatically improved the engagement
of
the team member.
We also
career pathway that will define their skills from
fundamental knowledge to technical skills, leadership,
all the way to business growth.
So those skills are mirrored
to a pay tier,
and we're very open with the team members
about their financial goals and the skills they
need to achieve in order
to receive their desired salary over time.
So that has made training
a collaborative
effort
and also took away a lot of unnecessary
expectations
that were very hard to match.
But really most importantly, we hire and lead
based on our core values.
We're very protective of our team culture and
the office atmosphere. And if anyone doesn't align
with the core values,
we part ways pretty early on.
So it's not always easy, but we found
that standing by our principles has earned us
a lot of trust within our team.
And in the long run, investing in the
right people
costs a lot less than holding on to
the wrong ones.
Yeah. Definitely. That makes a lot of sense.
Something that I'm curious to to get your
thoughts on are what are you most excited
about when it comes to the dental industry
right now, and and what are some things
that are potentially making you a little bit
nervous?
So,
yeah, that's a great question. So what I'm
most excited about is
really
personal for me. So we are,
planning an expansion
of SmileMakers Dental Center.
And
I really love and get excited to wake
up each day knowing that I have the
opportunity
to create something meaningful,
for our team and for our patients.
So I work closely with our CEO, and
I love the challenge
of turning his vision into action.
And we celebrate
the day to day wins,
with the team at the office level
that really build momentum towards long term success.
And then I really stay energized by seeing
a culture of
ambitious leaders hit their goals
and lead their teams at the office level.
So me and the practice leaders, we have
a strong meeting cadence,
that involves
analyzing the data, training,
and collaborating
on the standard operating procedures to identify any
changes that need to be made.
And it's always
exciting to show them how their data is
telling a story.
It's very eye opening to them,
and
in turn, it's very rewarding to see my
training
and feedback pay off.
Also exciting is just how fast dental technology
is evolving.
So AI diagnostic tools and three d visualization
are really transforming patient education and case acceptance.
We trained our doctors to embrace these tools
daily.
In turn,
that's allowed them to diagnose at a higher
level and produce more comprehensive
treatment plans and with that, the patient response
has been incredible.
So,
very excited to continue on this journey and,
again, very rewarding to see how this kind
of innovation has elevated the clinical care and
overall
performance of the business.
What I'm most nervous about right now, I
would say, is
really the stability of the economy
and how it's going to impact
the talent that we have,
the talent pool.
Not only that, but the patient's ability to
afford treatment.
That's all going to really impact the profit
margin
also due to the tariffs and supplies, lab
costs, and equipment.
Also, what makes me nervous is not all
patients are educated on
the oral systemic link and don't realize their
health is so critical.
Couple that with the limited dental coverage many
of them have and inflation, patients are going
to begin to value going to the dentist
even less.
Yeah. I think those are some great points.
When you talk about expansion
at SmileMakers,
what are some of your goals around that
and kind of what's like your your timeline
at at the organization
for kind of that expansion?
Well, we have spent the last
about year and a half really
making sure that our operating systems are scalable.
We have continued
to grow,
vertically
within the six that we have,
and we are actively
starting to look for new practices
to acquire. So we want to,
you know, acquire more locations, serve
a greater population in the community with really
excellent dental care.
Awesome.
And then just our last question that we
have today, in your view, what will the
most effective health care leaders need in order
to be successful over the next two to
three years?
Yeah. So
health care leaders in the next two to
three years have to be
visionary
and
adaptable.
So
I see a lot of dentists or other
entrepreneurs.
They wait and see when it comes to
technology.
And
what we,
found is that those who are delaying the
integration of AI and digital workflows
are risks
are risking falling behind.
So we've been able to use AI to
help streamline our operations for about three years
now, and we're still not seeing many others
use it at our level.
So
my feedback would be for them to be
proactive
in testing new solutions,
evaluating its performance,
and scaling what works and doing that quickly.
Beyond technology,
the most effective leaders will need to establish
their organizational culture.
So they're going to need to build teams
that are not only skilled but aligned to
the mission.
And the that balance of technological
innovation and human leadership is where we, as
a leadership team, found true success.
Lastly,
health care leaders have to, without a doubt,
be well educated on their day, data.
You can never have enough, and understanding the
KPIs
by department
is what's going to allow high level executives
to be strategic and adapt to changes quickly.
So, again, you really can't wait and see.
And I train my team that the only
time we have to make a change is
today,
not tomorrow.
So when they put their focus on hitting
their daily goals, they're winning almost every time.
Yeah. I think those those are some great
insights and great points and and great advice
for health care leaders going forward.
Well, thank you for joining us today, Franchesca,
and sharing your valuable expertise and insights into
the dental space.
It's been a pleasure speaking with you today,
and I look forward to connecting with you
again in the future.
Yes. Me too. Looking forward to it, and,
you're doing a great job. Thank you again.
Thank you. Have a good one.