Hello. This is Arianna Porta Lattan with the
Becker's Dental and DSO review podcast.
I'm thrilled to be joined today by Ian
McNichol, the CEO at Icon Dental Partners. Ian,
thank you so much for being here today.
It's great to have you. Yeah. Thanks for
having me. Excited to join you. Great. To
start us off, can you introduce yourself for
our listeners and tell us a little bit
about your background?
Yeah. I'd be happy to.
My background is a little different. I didn't
didn't start in the dental industry. I actually
began my career as a mechanical engineer. And
so I worked in the high-tech industry for
about ten years and,
semiconductor manufacturing, pretty interesting stuff.
But, I kinda felt like I wanted to
be an entrepreneur. So towards the end of
that, I I got an MBA from University
of Washington. And about twenty years ago, I
quit my job and decided I'm just gonna
become an entrepreneur, and I've been building companies
for the last twenty years. And so got
into the dental industry about fifteen years ago.
Originally,
cofounded a dental marketing agency called Weo Media.
And that company had done really well, and
it's kinda still doing plugging along just fine.
But about five years ago,
I,
decided to get into the group space. And
so
partnered up with one of my former clients,
doctor Jeremy Dixon, who's been in the the
group space for about twenty years himself.
And, yeah, we we started kinda doing some
DSO type consulting work for a few years.
And then after a few years of that,
we decided to build our own group. And
so
that's kind of how ICON got its start.
ICON's a pretty unique group, but it's it's
been a ton of fun. So that's kinda
how I got into the group space.
Very nice. It's always super interesting to hear
from executives and even practitioners who sometimes,
have started off in other industries.
What attracted you initially to the DSO field?
Well, I like I like building companies and
running companies. I like solving problems. I think
that's probably the engineer brain in me.
But, really, it was the consulting with Jeremy.
You know? I kind of started consulting with
him originally just like, oh, I wanna learn
more about these these groups. And this is
back in 2018,
you know, seven years ago when we started
consulting together.
And after a few years of that, you
know, I just got to learning a lot
more about the group
space. And it's like, man, this is this
is really interesting. I like dental. I like
building companies. This just makes a lot of
sense. And, you know, we we spent a
fair amount of time,
you know, analyzing some of the weaknesses and
a lot of current DSO models. And so
we spent a lot of time carefully
thinking how do we change the model to
address a lot of the shortcomings and then
more of the corporate model. And so our
partnership model is really
much better for the doctors. And so,
yeah, I just felt like, you know, we
we wanted to build a better mouse trap,
and I think we've done that. So, yeah,
it was it was kind of a a
challenge that needed to be solved, and so
we we set about to do it.
Great. And I always like to ask this
question when I speak to people who come
from other backgrounds. But is there anything that
you take from your experience in mechanical engineering
into your work today leading a DSO?
Oh, absolutely. Yeah. I mean, obviously, it's a
very different world. You know? But
the the ability
to kind of look at a situation and
and try to understand what are the different,
you
know, variables that are that are causing a
problem here, and how do we kinda break
it down, you know, systematically and just figure
how do we solve this. And it's, you
know, engineering is
we teach a lot of Kaizen back in
the day, and it's become more popular in
the business world now. But it's it's essentially
a continuous improvement process. And so that philosophy
applies to any kind of whether it's a
technical issue, a science issue,
or a people issue.
It's it's the same kind of mindset. And
so,
you know, when you're when you're running a
dental group,
like I do, it's it's it's people. Right?
I mean, yes, processes, of course, matter, but
it's really about the people.
And so,
making sure that you're building the culture the
right way and and solving all these kind
of challenges technically and remote workforces and all
kinds of things that we have nowadays with
Zoom and stuff like that. It's it's been
a ton of fun. It just it it
continues to, you know, challenge the the problem
solving side of my brain that I enjoy.
So, yeah, it's it's been a lot of
fun.
Great to
hear. Next question here. What are some of
the biggest issues you're following in the dental
industry this year?
Yeah. There's been some pretty interesting stuff happening
for sure.
I think something that just was out of
the blue that nobody saw coming was this
Delta Dental of Wisconsin,
acquisition of Cherry Tree Dental. That was pretty
shocking. I'm still shocked about that.
I'm really curious to see how that plays
out in the courts and so forth if
that's allowed to stand.
I think there's a fundamental conflict with an
insurance company owning a dental group. Don't think
that's great for dentistry,
but that's super interesting. I didn't see that
coming.
Also the current administration,
you know, with the Medicaid cuts,
that's, you know, a bit concerning.
And so we'll see how that plays out.
The last thing we want to do is
is cut health care to low income people.
I think that's the wrong way we should
be going.
So that's got me a little, you know,
concerned checking that out.
You know, staffing shortages is continuing to be
a problem. It has been since COVID. Obviously,
COVID made it worse. That's something, you know,
we we are always focusing on and struggling
with, you know, in some of our practices.
So that's that's an issue. And then the
other big issue that's not really an issue,
but an opportunity, I guess, would be just
this proliferation
of all the new AI
tools and services rolling out. It's just it's
just at a a breakneck speed. It's kinda
crazy how many new things are coming out,
and a lot of them are not well
developed yet because AI is still in its
infancy. But, I mean, three to five years
from now, I think the amount of things
we can do with AI in this industry
is gonna be mind blowing.
Okay.
And some of the things you just mentioned
might,
play into your next answer here, but I
was curious to know what are you most
excited about when it comes,
to dentistry right now, and what makes you
nervous about dentistry?
I think what I'm most excited about, yeah,
is would be the AI stuff. You know,
we are piloting,
I mean, four
four different AI technologies right now across ICON,
across our platform.
And it's it's really interesting. You know? The
the AI, you know, it can relieve pain
points both at the practice level and the
platform level. And so we're looking at things
to help with revenue cycle management and
marketing and, you know, AI receptionist type services
and insurance verification and eligibility checks and all.
Just a lot of stuff that is
not, you know, the sexy part of running
a practice that the team members don't typically
love to do. I think to the degree
that these AI companies can continue to solve
those problems, it's gonna really help the practices
and the platforms out quite a bit. Our
philosophy is we're not trying to make them
more productive so we can let people go.
In fact, we purposely structure our company, so
we have no control over the practice staffing,
which gives the doctors that full control that
that, you know, full autonomy that's at the
staffing and clinical decision making and all that.
What we wanna do
is let's take burden off
of the team members shoulders, you know, so
they can spend more time on patient care
or doing recall or do you know, having
people do things that the technology can't do.
Right? Let the tech do what the tech
can do. Let people focus on things that
people are better at. And so I'm really
excited to see how AI continues to solve
some of the pain points, but also just
making us all a lot more productive and
ultimately more profitable.
That's that's a pretty cool thing that I
think I'm excited about. I think probably most
people would share that that that that viewpoint,
but with the AI coming on board.
Nervous.
I think the stuff that makes me the
most most nervous would be,
you know, the economy a little bit and
related to that, like I said, the Medicaid
cuts and just what happens with with those
types of things with insurance reimbursements going down
constantly. Those are not great things for the
industry.
Staffing, I think just continues to be a
bugger. You know, I think
associate doctors,
getting them onboarded and training them up, that's
that's a big thing.
And just, you know, hygienists to a large
degree continues to be a challenge. And so
I think it would be great, you know,
if the country can open more dental schools
and more hygiene schools and more assisting schools,
you know,
that would be super helpful. So those are
the things that I guess would make me
a little bit nervous that I'm keeping an
eye on.
Yeah. Definitely. And that's something I've heard from
other dental leaders recently is just,
you know, there's no shortage
of necessarily people who want to be hygienists
or dentists, but maybe we're not
producing as many,
as far as, like, the
dental assisting and dental hygiene schools and then
the dental schools overall.
Is there anything that Icon is doing differently
this year to help attract more hygienists and
dentists?
Yeah. That's a great question. I mean, it's
something that I think every group is is
always noodling on and struggling with and and
testing things. You know?
So, you know, our our team, we've done
a pretty good job of,
you know, finding good candidates in in in
general. But it's interesting as we look across
the platform,
you know,
we
we have most of our practices are doing
really well financially. They're growing. Their EBITDA is
up. Margin improvement, great stuff.
The practices
that are struggling are flat or down in
revenue production EBITDA and so forth.
It's almost always been tied to shorting of,
like, associate doctor left, haven't been able to
replace them. Hygienists left, haven't been able to
replace them.
When we look across our platform,
the practices that are down or or or
struggling a bit, it's almost always related to
staffing.
And so yeah. I mean, you know, creative
things that we've done to try to solve
that problem. You know, we have a pretty
strong HR team.
We call people and culture as as as
HR.
But, yeah, I mean, you know, a lot
of the the typical stuff. Right? Social media
groups,
reaching out, you know, personal people's personal networks.
There's lots of different, I guess, strategies that
that we all use to try to get
in front of doctors and stuff like that
and and the hygienists. But I don't know
that we've figured out anything new or innovative.
We're just trying to execute really well on
on kind of a tried and true plan.
So
Alright.
And last question here. What will the most
effective health care leaders need to be successful
in the next two to three years?
I don't think that that really changes much,
honestly, from past to to future. It's really
focusing on people and culture. I think that's
always the secret sauce in any company. It
doesn't really matter what kind of company you
have. If you can
do a good job on,
you know, onboarding the right people that fit
your culture and then making sure you're doing
things to maintain the culture. Definitely
process matters and having good management systems matter.
And all all these things are super important.
But if I had to rank them, you
know, if if you don't get the culture
right, it's gonna make everything else more challenging.
We just came off of a executive retreat
this week, and we had, you know, our
our directors, VPs, and c suite altogether for
the week. And it was just an awesome
experience.
We try to do it once a quarter.
And it's just it's it's a really critical
ingredient because, you know, with most companies now,
we have remote workforces.
And if you stay fully remote and don't
ever really get to connect with your coworkers
and colleagues, it really makes it tough because
inevitably, every company is gonna have struggles and,
you know, challenges. And if you don't have
that personal relationship with your coworkers, it really
makes it more challenging to navigate that stuff.
So to me, like, I'm always focused on,
like, how is the team doing, culture, communication.
Do we have any problem spots? Let's resolve
them.
That is probably the the biggest thing I
focus on. But beyond that, certainly, the process
optimization stuff. And, again, that's my engineer brain
seeping in there here and there. But,
you know, we have a lot of things
that we're doing to,
you know, project manage effectively to drive, you
know, goal setting and and driving towards those
results. And so
and I and this is not nothing new
that anybody listening to this podcast probably doesn't
realize. It's really about the execution. You know,
how do you
maintain, you know, develop and maintain a great
culture, and how do you effectively,
you know, optimize the practices?
One of the things that I know has
become a lot more prevalent on people's minds
over the last few years due to COVID
is organic growth at the practice level.
You know, investors
and people are generally wanting to see, you
know, hey. It's great that you can do
go out and do acquisitions,
but, you know, can you actually grow those
practices once you've acquired them? And that's that's
another huge thing that I think we're focusing
on is our ability to
to execute on on the growth. And again,
it gets but it gets back to the
people in the culture. Right? If you can
maintain
a great culture, you're more likely to retain
your doctors and hygienists and be better at
recruiting doctors and hygienists. And so if that's
our biggest, you know, challenge with with EBITDA
right
now, then fixing it is to a larger
degree recruiting. Yes. But culture is is is
as as important as well. So it all
kind of ties back to people at the
end of the day, one way or another.
Very true. Some great thoughts from you there.
So thank you for sharing that. That is
all I have for you today, Ian. Thank
you so much for joining us. It's been
a pleasure speaking with you, and I look
forward to connecting with you again in the
future.
Thanks. I appreciate it. Enjoy the rest of
your day. Bye bye. Bye.