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Hello. This is Cameron Cortejano with the Becker's

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Dental and DSO review podcast.

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I'm thrilled to be joined today by Francesca

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Pergano,

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COO at SmileMakers

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Dental Center.

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Francesca, thank you so much for being here

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today. Thank you for having me. I am

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a frequent listener of the podcast and excited

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to be here.

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Awesome. Just to start us off today, can

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you introduce yourself and tell us a little

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bit about your background?

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Yes.

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So my name is Francesca Provano. I am

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the chief operating officer of SmileMakers Dental Center.

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We are a multi specialty DSO in Northern

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Virginia.

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A little bit about my background,

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I have nineteen years experience

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in the dental industry, specifically in operations and

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management.

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During this time, I also received my master's

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in business administration.

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I currently run the operations of our six

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practices

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with a focus on long term strategic growth

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and scalability.

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I do this by,

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focusing on building high performing teams that align

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with the core values

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of the organization,

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always

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also focused on delivering an exceptional

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patient experience.

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I work alongside our leadership team to create

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operating systems that are

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easily measurable and scalable

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with a,

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focus on KPI management for each job role

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and department.

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I also have a deep financial oversight into

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the organization,

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specifically

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monitoring the cash flow

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and profit and loss

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management down to each office level,

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always to ensure that we do what's necessary

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to maintain growth and profitability.

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Awesome. Thanks for that.

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First question today, what are some of the

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biggest issues,

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in the dental industry that you've been following

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so far in the first couple of months

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of 2025?

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So one of the biggest issues,

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is something that me and my team has

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been working on for a couple years now,

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and that is the shortage in the workforce,

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particularly

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among dental assistants,

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hygienists, and administrative

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professionals.

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So not only is recruitment difficult,

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but the long term retention

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remains a huge concern.

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Data shows that nearly half of employees in

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these roles leave within the first two years,

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And given that there's limited

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formal training for these support positions, it often

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takes just that long to fully onboard and

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develop these individuals.

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So

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at our organization,

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I've helped by taking a proactive approach.

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One of the most effective strategies

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was the expansion

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of a remote workforce.

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So that workforce includes a call center, an

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RCM team that

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measures,

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you know, or covers insurance verification,

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billing, account auditing,

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patient collection,

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a finance team, and

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trained dentists to perform chart auditing and compliance.

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So that shift really allowed us to tap

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into talent beyond our physical locations,

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not only to increase efficiency,

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but make the scalability of our operating systems

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possible.

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Also, to combat this issue, we've

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really redefined our onboarding and development

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with structured programs and check ins that focus

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on long term growth with our current employees.

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So we set clear expectations from day one,

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and that alone has dramatically improved the engagement

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of

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the team member.

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We also

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career pathway that will define their skills from

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fundamental knowledge to technical skills, leadership,

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all the way to business growth.

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So those skills are mirrored

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to a pay tier,

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and we're very open with the team members

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about their financial goals and the skills they

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need to achieve in order

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to receive their desired salary over time.

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So that has made training

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a collaborative

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effort

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and also took away a lot of unnecessary

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expectations

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that were very hard to match.

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But really most importantly, we hire and lead

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based on our core values.

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We're very protective of our team culture and

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the office atmosphere. And if anyone doesn't align

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with the core values,

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we part ways pretty early on.

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So it's not always easy, but we found

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that standing by our principles has earned us

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a lot of trust within our team.

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And in the long run, investing in the

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right people

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costs a lot less than holding on to

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the wrong ones.

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Yeah. Definitely. That makes a lot of sense.

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Something that I'm curious to to get your

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thoughts on are what are you most excited

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about when it comes to the dental industry

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right now, and and what are some things

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that are potentially making you a little bit

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nervous?

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So,

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yeah, that's a great question. So what I'm

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most excited about is

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really

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personal for me. So we are,

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planning an expansion

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of SmileMakers Dental Center.

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And

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I really love and get excited to wake

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up each day knowing that I have the

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opportunity

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to create something meaningful,

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for our team and for our patients.

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So I work closely with our CEO, and

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I love the challenge

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of turning his vision into action.

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And we celebrate

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the day to day wins,

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with the team at the office level

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that really build momentum towards long term success.

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And then I really stay energized by seeing

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a culture of

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ambitious leaders hit their goals

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and lead their teams at the office level.

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So me and the practice leaders, we have

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a strong meeting cadence,

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that involves

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analyzing the data, training,

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and collaborating

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on the standard operating procedures to identify any

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changes that need to be made.

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And it's always

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exciting to show them how their data is

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telling a story.

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It's very eye opening to them,

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and

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in turn, it's very rewarding to see my

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training

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and feedback pay off.

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Also exciting is just how fast dental technology

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is evolving.

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So AI diagnostic tools and three d visualization

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are really transforming patient education and case acceptance.

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We trained our doctors to embrace these tools

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daily.

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In turn,

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that's allowed them to diagnose at a higher

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level and produce more comprehensive

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treatment plans and with that, the patient response

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has been incredible.

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So,

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very excited to continue on this journey and,

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again, very rewarding to see how this kind

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of innovation has elevated the clinical care and

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overall

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performance of the business.

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What I'm most nervous about right now, I

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would say, is

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really the stability of the economy

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and how it's going to impact

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the talent that we have,

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the talent pool.

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Not only that, but the patient's ability to

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afford treatment.

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That's all going to really impact the profit

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margin

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also due to the tariffs and supplies, lab

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costs, and equipment.

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Also, what makes me nervous is not all

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patients are educated on

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the oral systemic link and don't realize their

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health is so critical.

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Couple that with the limited dental coverage many

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of them have and inflation, patients are going

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to begin to value going to the dentist

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even less.

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Yeah. I think those are some great points.

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When you talk about expansion

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at SmileMakers,

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what are some of your goals around that

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and kind of what's like your your timeline

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at at the organization

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for kind of that expansion?

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Well, we have spent the last

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about year and a half really

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making sure that our operating systems are scalable.

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We have continued

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to grow,

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vertically

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within the six that we have,

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and we are actively

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starting to look for new practices

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to acquire. So we want to,

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you know, acquire more locations, serve

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a greater population in the community with really

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excellent dental care.

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Awesome.

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And then just our last question that we

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have today, in your view, what will the

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most effective health care leaders need in order

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to be successful over the next two to

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three years?

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Yeah. So

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health care leaders in the next two to

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three years have to be

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visionary

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and

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adaptable.

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So

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I see a lot of dentists or other

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entrepreneurs.

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They wait and see when it comes to

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technology.

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And

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what we,

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found is that those who are delaying the

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integration of AI and digital workflows

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are risks

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are risking falling behind.

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So we've been able to use AI to

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help streamline our operations for about three years

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now, and we're still not seeing many others

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use it at our level.

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So

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my feedback would be for them to be

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proactive

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in testing new solutions,

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evaluating its performance,

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and scaling what works and doing that quickly.

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Beyond technology,

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the most effective leaders will need to establish

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their organizational culture.

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So they're going to need to build teams

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that are not only skilled but aligned to

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the mission.

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And the that balance of technological

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innovation and human leadership is where we, as

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a leadership team, found true success.

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Lastly,

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health care leaders have to, without a doubt,

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be well educated on their day, data.

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You can never have enough, and understanding the

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KPIs

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by department

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is what's going to allow high level executives

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to be strategic and adapt to changes quickly.

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So, again, you really can't wait and see.

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And I train my team that the only

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time we have to make a change is

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today,

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not tomorrow.

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So when they put their focus on hitting

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their daily goals, they're winning almost every time.

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Yeah. I think those those are some great

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insights and great points and and great advice

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for health care leaders going forward.

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Well, thank you for joining us today, Franchesca,

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and sharing your valuable expertise and insights into

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the dental space.

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It's been a pleasure speaking with you today,

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and I look forward to connecting with you

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again in the future.

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Yes. Me too. Looking forward to it, and,

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you're doing a great job. Thank you again.

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Thank you. Have a good one.