Hi everyone, this is Erica Spicer Mason with Becker's Healthcare.
Thanks so much for tuning in with us today.
Today we'll be talking about dentistry, dental support organizations,
and a D S O model you may not have heard about before.
Joining me for the conversation is Dr. Mitchell Ellingson,
the Chief Clinical Officer and co-founder of Gen four Dental. Mitch,
thank you so much for joining us today.
Well look, looking forward to the conversation, and, uh,
appreciate you guys having me here, Erica.
Of course. So happy that you could join us. So, to get us started,
I was wondering if you could just share a little bit more about your background
and your current role.
Yeah, yeah, happy to. So, uh,
I've been practicing dentistry for the last 16 years here in Scottsdale,
Arizona. Um, over, over that period of time, done a, done a few things.
Been in the multi-practice where I owned, uh, a few practices of my own. Um,
also, uh,
started a software company in 2013 that eventually was
acquired by a group called Spear Education. And, uh,
then helped them to stand up their,
their business division called Practice Solutions,
which I ran for six years with a,
a really talented team there at Spear Education. Um, after,
after that kind of found, uh,
its its point of kind of winding down in my life, you know, I decided, uh,
to found another company kind of in line with my ultimate passion, which is,
you know, kind of really protecting the, the,
the specific type of dentistry that I'm used to doing, um,
that places like Sphere Education, Dawson Academy, all those train on is that,
uh, ended up founding Gen four to,
to really bring the best and brightest together so that we could,
we could do it together inside the consolidation space.
And that's where I am at today and,
and excited to kind of dive deeper into our model and how we make that work.
Great. Well, thank you so much for sharing all of that.
It's clear that you're the perfect person to be talking about dentistry today,
not just from the clinical side, but also the business and financial side too.
So I'm really excited to dig in here.
So I mentioned up top that the Gen four dental company has
somewhat of a unique D s O model.
I'm wondering if you can tell us just a little bit more about that model and
also what makes it different.
You know, when,
when I describe our model to any of our partners before they even come on,
you know, it is really about helping them to understand what,
what the structure of the business is. And it's not, uh, it's not to,
to sell them on the structure,
it's to make sure that it fits their life and what they want to get out of their
practice, right? So it's super important that they understand that,
that what they know and think about dental service organizations, um, is,
is really not what we are, right? It's not a hundred percent how we operate Now.
We fall in that category.
We have all a lot of the consolidated services in the background from hr,
treasury management, all that fun stuff, which is typical to these groups.
But when you dig into how we interact with our doctors,
that's where we completely differentiate, right? So it's in,
in a lot of these businesses, I would say it,
it's typically the strategy is gonna come from the top and work its way down.
In our business. We, we look to interact with every one of our doctors,
understand what their goals, what their visions are,
so that we can find the common threads and put together, um,
an action plan that aligns with what they're trying to get outta their career.
And then we move,
that's where our operations team will build plans around what they're hearing on
an individual practice basis so that they can help them to achieve, you know,
their vision of success and what they want to get outta their career.
So it's really, uh, it's the, you know, from the,
the service part of D S O, right?
I would say that we look at service from bottoms up,
whereas a lot of times I think, uh, it's looked at from a,
a tops down perspective, right? So, so that's where we,
we kind of get into something that we deem the, the collaborative doctor model,
and I, I know we're gonna go into that today and, and help to understand what,
what collaborative doctor model really means.
Absolutely. Yeah, and it really sounds, just based on what you described,
I can already tell how doctor focused your approach is, um,
which I think is a really important consideration when we think about
clinical autonomy,
which is something that we're hearing a lot about today in the space.
We're hearing that desire for clinical autonomy come up a lot.
And so I'm curious how you keep that promise of clinical autonomy and
also manage to still set up processes that you can make sure are
efficient and also scalable across your client base.
I mean, uh, I think clinical autonomy, autonomy in general is,
is kind of a buzzword that's out there right now that, you know, I, I,
I would argue it's, it's much easier to say than it is to actually do.
And so you gotta go to the, the model of how we built gen four. Again, it's,
it's gonna connect to what we'll talk about when it comes to the doctor
collaborative model, but it,
it all starts with understanding what the desires are of our dentist and our
hygienist, right? So we look at it just our clinical team in general,
what do they want to achieve? And,
and helping them to express what that is because interesting enough,
when you ask someone what they want, a lot of times they,
they don't really know how to express their, their true desires ,
which you would think is easy. But, uh, at the end of the day,
that's why we have a very well trained team internally of dentists that help
other doctors to express what they want to get and then help them to define how
they're gonna go get it, right. So when they lay out those plans,
that's where the autonomy's at, right? Because they,
they are the ones dictating what they want to get,
how they're gonna get there with their team. What we do as a,
a response to that from the operation side is we just look at what they want and
understand the support that is needed. This is the, you know,
the service side of, of the,
the D s O side of the business is that we look at what is needed and then we
build our plans around what they're, what they're trying to do, right?
And so the,
the beauty of dentistry being a very niched industry is there's not gonna be a
hundred different versions of things that they want to do.
That's how this is all possible, is that, you know,
typically you're gonna see dentists that,
that want to focus in areas of cosmetics or surgery, implant placement,
maybe clear liners. But then we go to our hygienist and I can tell they,
they typically will focus in areas of like laser therapy and, and,
uh, myofunctional therapy. Those are gonna be things that they wanna focus on.
So as long as you understand how to deliver and support,
when someone goes to a different type of course, um,
or develops a different skillset,
we're able to just help them to get where they want to go, right?
Versus asking them to, to deliver on something that we need, right?
It's all gotta be aligned with the strategic imperatives of the business.
It's all gotta make sense. Of course, we don't just leave it wide open, but,
you know, it it,
it encompasses the ability for everybody to have the autonomy and flexibility
that they want to be able to do whatever they were doing before. Cuz our,
our entire model revolves around the fact that we are trying to maintain the
legacy and the practice structure that was in place when we partnered with the
group that we're with, right?
That's why partner selection's so important to gen four is that we have to make
sure that they're a perfect fit for what the organization is set up to be.
Right?
So that's why when we talk about clinical autonomy or a doctor collaborative
model, I'll go back to the point that I, i I made before, and that's, you know,
we don't use those as wizbang words.
It's to be very clear the structure of the business that we've,
we've created here and, and what that means to them.
Because we wanna make sure that if you're gonna partner with gen four, uh, that,
that we're a fit for each other, right?
That we truly align on vision and values before we, we go into the,
the, the relationship side of this, the partnership side. If that makes sense.
Yeah, that makes a lot of sense.
It sounds like your team has such a customizable approach while also
relying on some of those best practices and what you know,
to be true in this niche industry.
But I really appreciate you sharing that explanation cuz it really gives
some tangible insight to how you approach, um,
each of your potential and new partners. So that's really great to hear.
And I know we keep kind of going back to this concept of a collaborative
doctor's model. Um,
and so I think it'll be really important for our listeners to hear more about
that and also what kind of innovations or solutions and outcomes
are, are coming out of this type of approach.
Yeah, so, uh, the collaborative doctor model, I mean, I think that is, um,
you know,
I I think anybody who's been in a truly collaborative environment understands
the complexity of collaboration, right? And so when we're talking about it,
you could say, you know, a lot of times you'll hear like DR centric, right?
Is is what, what a, a business or group will say. Um, I,
I hope you kind of appreciate the fact that there's a word model in in our,
our label here. Cuz the collaborative doctor model is, again, it's not a label,
it's, it's a process, it's a system, right?
So we make sure that our doctors are supported as a network altogether,
uh, so that we can,
we can understand the synergies that we might find between groups that are
trying to do similar things between, um,
doctors that may have a skillset that they can help another younger doctor to be
able to have that skillset, right? When you look at our partners,
you're gonna see some of the industry leaders for, um, you know,
full mouth restorative type treatment, cosmetics, you know,
just bread and butter dentistry. I mean, you're gonna see mentors, leaders,
teachers, amongst our midst. And that's, that's on purpose, right?
Because when you're, when you're doing a truly collaborative model,
you need to have the resources to be able to do that.
So when you think of the things that,
that have come out from the innovation side of this,
which I think has been really fun, is, is that we have, uh, a group,
we have something called Gen Forum, right?
And so gen Forum is where our doctors, uh,
talk about cases with each other. They'll post things,
they'll post questions and allow our subject matter experts and the rest of our
team to chime in to help them to go through a case. They might have a,
something that just came up in the middle of the day. They'll post it on,
on teams or something called Yammer. And uh,
you'd be amazed at the amount of support and response that they get, right?
Because these, these are truly partners, right? Because I,
I think part of when you become a bigger group and you become a little more
geographically dispersed, it's hard to maintain relationships at a deep level,
right? To the point where you can truly collaborate. Cuz you know, when,
when somebody comes in to any business, I believe,
like learning to collaborate and challenge each other in a thoughtful way and
to, to really, you know,
professionally disagree and professionally agree with each other, you know,
those things have to be taught and especially to a group of doctors.
And I think our doctors would would admit to this is that some of 'em have been
on their own for decades, right?
So collaboration isn't something they've had to practice in a decade plus.
So there's definitely a learning curve that goes along with that.
But once they understand how to push back on each other,
how to thoughtfully disagree and how to,
how to let that pressure kind of make an idea better, uh, it's,
it's amazing what what can be done, right?
And so like our gen forum of seeing people support each other,
that was an idea that came from collaboration. Um, you know,
we're gonna be launching an internal podcast part, which is again, a tool to,
to have people collaborate and hear each other's ideas. You know, we have our,
our doctors work in study clubs so that they can constantly iterate and,
and work with each other and see each other's skill set so that they understand
what questions they can ask each other.
So those pieces of innovation have created a network of doctors that I,
I will tell you that's why, uh, you know, I'll just,
I'll say this as a joke in inside of our, our podcast here, is that, you know,
that's why we had to deal with all of my,
my wonderful prompts cuz what are those?
That's our doctors all 150 plus of them constantly talking to each other,
right? Mm-hmm. .
Now they use different messaging platforms to do that,
but I would say 18 months ago,
like they didn't really know each other that well. You fast forward to today,
you get to see them constantly interacting.
Cuz I have a view where I get to watch their,
their communication and I could tell you it's, it's all the the time ,
right? They're, they're constantly working with each other and,
and I'm a big believer that every conversation leads to the ability to
collaborate better. Cuz you're getting to know each other better.
You're getting comfortable, you know, cuz I,
I think we can all agree that when we first meet someone,
our first thing isn't to try to disagree with them cuz we're not comfortable
with them yet. But, but eventually, you know,
once you get to that level of comfort,
you can truly challenge each other's idea.
And that to me is that's where innovation is made.
And I've seen innovation inside how we meet.
I've in seen innovation inti inside of how we teach each other, uh,
that has come from this cuz everybody's learning better and better ways to
interact inside the collaborative model. And so that's, that's where, you know,
our, our individual growth engine and how we help every doctor and hygienist,
um, has really proven to be fruitful. You know, it, it's, it's exciting to see,
you know, how they, they,
they come into even gen four thinking maybe that they're,
they're good to go and their, their career or their,
their skillset and then they start to get excited about learning again. And,
and we measure all that.
Like we do a lot of internal surveys to understand like how they think about
that. And it's definitive as we looked at it,
is that they really appreciate every doctor that comes in appreciates once they
understand what the individual growth engine is,
how it supports them in their career and how, and uh, it's not this, you know,
removal of autonomy as we were talking about, right.
And saying Here's what I need from you.
Cuz that's obviously the exact opposite of autonomy.
Absolutely. And just from what you described,
that level of engagement that you're seeing among the folks that gen
four partners with,
it really does highlight that craving for ongoing learning and
community and communication.
So it's really great to see that your practice has been able to really foster
that among the folks that you partner with. Yeah.
So the more I'm hearing about Gen four's approach and all of the
tools and resources that are offered,
I imagine most dental leaders who are listening to this podcast right now are
probably wondering, okay, I'm interested , how do I get involved in this?
Um, but I wanna go back to something that you mentioned.
It sounds like Gen four has a really strong, um,
approach to making sure the partnership works both ways.
So I'm curious if you could just shed a little bit of light on how dental
practices can approach gen for,
for a partnership and what does that process look like?
Well,
I I will tell you that referrals are typically the way that,
that we find partners right now, we, we have a,
a great mergers and acquisitions team, but you know, I will tell you that it's,
it's usually that they're gonna be introduced from someone that is already a
partner that knows about us, right? So that is our most,
most common pathway to have the conversation with us.
But should you know someone as they listen to this, you know,
want to get more information first, I would say go to the website,
start to look at those things and just understand what Gen four is all about.
Cuz you know, we're, we're, we're definitely, uh,
a passionate group about supporting docs. Um, but you know,
there we have a very defined model of,
of the type of doctors that we think are the best fit inside of here, right?
Because, um,
we have to put together the right group of people cuz it's not fun for anybody,
you know, the doctor or for us if, if the partner that, that,
that would come on, it doesn't embrace the model that we just talked about.
Right? If that doesn't excite you, then then Gen four would,
would probably not be the the place that would feel fulfilling to you.
But if it resonates with you, um, and let's say, you know,
someone that's part of the group and that's where you can go on the website and
kind of understand is that may wanna reach out to them first and say how,
how it's going, right? Because, you know, like, I'm gonna be self-serving.
I love my business, I'm gonna tell you how great it is.
I would reach out to people that work with us and ask, you know,
what their thoughts are and, and if that makes sense then, you know,
look for a referral into gen four, right? And there's also,
there's also ways that you can reach out, you know, from from the website to,
to ask for more information should, should there be some interest.
Sure. Thank you so much. That's really helpful. Um,
and a great takeaway for those listening.
And I also wanted to take that a little bit further.
Once a dental practice does partner with Gen four,
do you have any examples of how they can see,
expect to see their practices grow, maybe become more productive or efficient?
Any kind of just quick success story or, um,
anything you can share that would highlight what they can expect as a result of
the partnership would be great.
For sure. I mean there's, there's a, a, a,
a bunch of examples I could throw out there, but I'll, I'll throw out, you know,
one, one in particular, right? That, you know, when we're working with doctors,
I mean, it, it, it, it happens where a doctor can get complacent, right?
And they can be in, uh,
kind of just doing dentistry for the sake of doing dentistry,
working their their nine to five and don't realize that they're kind of stuck in
a rut. So, you know, when they, when they come on with us,
and I'm one group in particular that, you know, I,
I would tell you that they'll, they'd even met,
they were just kind of in that place where business was great, but you know,
they,
they kind of stopped doing the things that they loved at the level they wanted
to do. So, you know, we started to work with, it was multiple partners,
so I'll just kind of refer to two. And they had very distinct interests. One,
one decided after we talked a little bit more that, you know,
their passion really was, was locked up in,
in wanting to do more clear liners and tooth movement.
Another one of the partners, same practice,
was more about placing implants and doing more surgical procedures. So we,
we help them to define exactly how they can achieve both those goals. Again,
going back to our, you know,
our individual growth engine and our collaborative doctor model is that we
understand what they want, we build the plan around how we,
we think they can best get it. And then they have to,
they have to bless that plan once they're in, we just go into execution.
And what was really fun about this group is that, you know,
I I was just looking at, you know, the, the growth that they'd had,
cuz now they've been on with us 18 months, is that, you know,
that one doctor went from doing, you know, he did five, six aligners a year.
Now he's doing 70 aligners a year, right? So,
and he's continuing to grow and that number is just the beginning. You know,
the, the other doctor was, was doing, you know,
a handful of implants a month now,
now that doctor is doing 10 plus implants a month and,
and enjoying it more cuz that's where, you know,
his passion was he just couldn't figure out how to make it, um,
hit the ground inside of his practice. So, you know, it's,
it's variable for everybody. A and it goes from doing cosmetic dentistry,
more complex cases, t m d more large, full large surgical type procedures.
You know, there's,
there's an example in each one of those that followed that same path.
It was basically either working with a younger doctor that was trying to build
that skillset, um, or it's,
it's with a doctor that has that skillset that just somehow it stopped becoming
what they were doing on a regular basis. So that's, that's a,
a very typical interaction coming into gen four. Uh, cuz our model is,
is not about not about speeding up and seeing how many patients you can see.
It's about being methodical with the patients that you're seeing.
And and I would say more often than not,
we're asking the doctors to just slow down a little bit,
spend some more time with the patient connect, right?
Because sometimes you don't even realize that you're not connecting. And,
and we have a,
a pretty strong data set that helps us to identify when a doctor's able to,
to connect with a patient even in a periodic exam or a new patient exam and to
just show them like that level of connection so that they can tweak what they're
doing to, to further the type of dentistry they want. So that's,
that's where it gets fun because you get to see doctors kind of reinvigorating
the passion that they have in dentistry. And once they take that first step,
what we see is they just keep taking more and more steps to grow their,
their skillset and, and organic growth falls in right behind it. So it's, uh,
it's probably my favorite thing to watch, to be honest,
is to watch someone find their path again or to be able to just go stronger down
the path they were already on and, and just do more dentistry they love.
For sure.
And I really appreciate how you explained that almost
delicate balance of getting doctors to slow down with you in the process
to be intentional about their goals and what they wanna achieve.
But then also I'm hearing that you're seeing results in your clients within 18
months, if I heard you correctly. So, um, it's really,
it's great to hear that there is that balance of getting things done
intentionally, but also getting results quickly.
Yeah, and, and I'll, I'll correct it just a a little bit. I mean,
it 18 months is like how long they've been,
they've been working through this thing, but, you know,
typical growth pattern to get like kind of spun back up, it's,
it's about five to seven months, right? And so that's,
that's where it usually takes getting all the systems and process aligned to,
to support a doc in, in what they, what they're trying to do.
So it actually happens more quickly,
but it just continues to build up momentum after that.
Great. Now thank you for clarifying.
So I think this is a really great kind of note to wrap up on.
I'm just seeing so much innovation within gen four and then you as an
individual, Mitch, you've, you are such an innovation focused person yourself.
So as you look to the future,
what do you think is on the horizon for dentistry and DSOs and what's exciting
you right now?
You know, I, I think the, the most exciting thing in the, the, uh,
the consolidation space is, you know,
I think doctors understand, you know, that, that this is,
this is the future of the profession, right? And,
and they've gone from a place of, of wondering if it's a part to kind of, uh,
understanding that it is, it's, it's the future of our profession.
And so now we need to understand how to, as dentists, um,
help guide it to a place that's good for dentistry, right? And that's,
that's what's exciting about, you know, just gen four every day,
is that the doctors that join our group are very passionate about, um,
doing great dentistry and, and really passionate about a profession that,
you know, they helped to build where it's at today. So, uh, I think the,
the future is bright for the consolidation space. And what I think is,
is exciting is I think people are realizing to, you know,
identify groups like a Gen four or any other platform and just learn who they
are, right? So you can see that they're, they're the right fit or not because I,
I think there's a place for, for everybody, and I think it just takes, um,
being detailed on the doctor's side as they look at groups like a gen four to
make sure that it's truly a vision and value alignment, right? And that's,
that's the part that I, I think is very exciting.
But also like anybody that's listening, like take that advice,
vision and value alignment before monetary alignment. Make sure that, you know,
the,
the groups that you are talking to kind of check the box of like when they're
talking about what they do, that it resonates. And I,
and I think if we do that in a good way, you know, consolidation will,
will go in a very concerted effort that gets every doctor in the place that they
should be so they can be supported in the way that they want to be supported.
And so that, that is, I see that happening at a much,
much higher level and a much more nuanced level within the consolidation space
today, which I think is,
is what dentistry needs and I think the consolidation space needs as well.
Mm-hmm. , definitely. Well,
thank you so much for sharing that outlook.
I think our listeners have a lot to think about and a lot to take away and some
actionable steps that they can take if they're interested. So Mitch,
thank you so much again for joining us for the discussion.
It's really been a pleasure speaking with you.
Wow. Thanks for having me. And, uh, love the topic.
So anytime you want to have me back, throw the invite my way.
. Wonderful, wonderful.
I'd also like to thank our sponsor today, Jen, for dental.
You can tune into more podcasts and virtual events from Becker's Healthcare by
visiting becker's hospital review.com.