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April 9, 2021: How does technology work in the dental world? Join David Baker, CIO for Pacific Dental on their Epic Wisdom journey. IT is no longer in the background or in the ivory tower putting stuff together and pumping it out. It's the opposite. It's a field with teams working out what will make our lives easier, our workflows more efficient and then designing and building those solutions. In dental there’s a lot of different devices than you would have in a medical setting. How do you work with Epic to build the integrations, device players and partners into the system? What about scheduling? Do you use AI? How do you keep things contactless? What about interoperability? How do you free the data? How do you keep a high level of consumer centric thinking in your innovation? And how do you maintain company culture during a pandemic?

Key Points:

  • One of the legacy areas of technology that we knew we had to implement was a practice management system replacement. A thankless task but essential. [00:06:05
  • User experience integration is very manual and very average. So we went through a huge analysis on what systems could we move to? [00:07:00]
  • We firmly believe in what we call the mouth body connection or systemic health [00:08:10
  • CLM - career limiting move [00:19:10]
  • The bat cave for IT is now called Innovation Test Kitchen [00:21:25
  • You’ve got to find leaders with the right mindset [00:39:16
  • Pacific Dental 

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Thanks for joining us on this week in Health It Influence. My name is Bill Russell, former Healthcare, CIO for 16 hospital system and creator of this week in health. It. A channel dedicated to keeping health IT staff current and engaged. Today we have David Baker, CIO for Pacific Dental on the show. David is one of my favorite people.

He is an innovator. He used to work for me and used to innovate all over the place in healthcare, and now he's gone into the dental space. He's innovating there as well. He's doing some great things with Epic and really just moving the needle in the dental space. I think you'll enjoy the show. Special thanks to our influence show sponsors, Sirius Healthcare and Health lyrics for choosing to invest in our mission to develop the next generation of health IT leaders.

If you wanna be a part of our mission, you can become a show sponsor as well. The first step. It's to send an email to partner at this week in health Just a quick note before we get to our show. We launched a new podcast today in Health it. We look at one story every weekday morning and we break it down from an health IT perspective.

You can subscribe wherever you listen to podcasts at Apple, Google, Spotify, Stitcher, overcast, you name it, we're out there. You could also go to today in health And now onto today's show. Today we are joined by David Baker, the CIO for Pacific Dental. David, welcome, uh, welcome back to the show. It's been a while.

It's been, it's been a while for sure. A couple of things went on in between and, uh, I'm excited to be back to you, bill. Yeah, I, I'm not sure I'm gonna hit the Covid journey all that hard, but I, I absolutely am going to have to get an update on Epic and where you guys are going. I don't know if you wanna start there or if you wanna start with, you know, our normal small talk that we, we, we get into, what people don't may not know is that we used to work together, you worked for me, you were the head of digital or head of experience, essentially.

It was internal and external experience and you were doing a lot of stuff. I, I jokingly call you my, my. Experience mentor my digital experience, mentor. 'cause you were constantly coming into my office saying, look, Amazon is, is focused on this. They have, they understand how the consumer thinks and they're, they're, and we have to get better at this.

And you, you were constantly pushing me in that direction and it's still, it's still in the back of my mind every time I see these innovations coming out. I think David would love this. This is very consumer centric and it's really gonna change the game. So are are, are you doing anything fun these days?

With, uh, regard to the consumer experience, probably nice stuff you ever, uh, said about me, bill. So first off, so enjoy. I did enjoy it. Being liberated and trying to lead through the eyes of the, the consumer, you know, the patient, the provider back in the day. And yeah, that's definitely, that continues and is still near to my heart.

It's taken many different, you know, iterations of what we used to call engagement manager and now just, you know, it's, it's, it's UX is what I would say we, we refer to it as, but a lot of the products that we're pushing out right now. It's really cool. I've taken it, that whole model is still, uh, in place, but only expanded where there is someone leading that user experience, you know, from the field.

So we've merged our operators and our clinicians, you know, into it almost. So there's, there's groups of folks and the products that designed, you know, I, I say field and I talk about our offices, you know. Field because there's, you know, big groups that kind of look after those offices. And when we're designing the product, it's not it in the background anymore.

In the ivory tower, pulling together stuff and jamming it out. It's the opposite. The field and our guys on the field designing, working out what will make our lives easier, our workflows more efficient, and then us building to their designs. You know, we're, we're gonna talk about the back cave. 'cause the last time I was at Pacific Dental down there in Orange County, you, you.

Into the back room and showed me some of the cool stuff you're, you're doing. But before we get there, bring people up to speed. Pacific Dental. How many offices? What do you, what do you guys, what, what do you guys do? 50 plus offices now, I'd say plus. 'cause, you know, new offices opening every week, had a little slow down just, you know, through, through Covid for obvious reasons.

But we're, we're an in-person business. We've gotta serve our patient population and our offices have, you know, remained open throughout, even through that emergency phase. Doubled down over that period. There was, there was talk of vaccine, uh, vaccinations, dentists doing vaccinations. Did that ever get any momentum?

A little, probably not as fast as, I guess, uh, folks would've hope. We, we were, you know, all over that in, in offering, you know, how, how can we help? There's a couple of offices that, you know are actually doing it right. Reading this morning, some started. Interesting. You know, planning around that for sure. So I don't know that we've been as effective, not through our own, for trying to, uh, help, you know, facilitate that.

Well, it, it's just the, the quantity of vaccine didn't allow for it. I mean, there were so many organizations that didn't have, uh, enough vaccine and they had the clinicians to, to do it. So now we're getting to point. There. Alright, let's talk, we'll talk about the back in a little bit, but let's, let's first talk about your Epic implementation.

That was a, that was a, that was a bold decision back in the day. I, I didn't know of many, if any, epic implementations in the dental world. Talk, talk about that decision and how is that playing out for you guys? It could have been A-A-C-L-M bill. Remember you used to threaten me with that move, but panned out.

Okay. Really good. In fact, I mean, it's been a great partnership coming from the medical world. This is what's been great with, you know, dental, we're the second largest DSO in the US Dental Services organization. Our model, I think is, is pretty unique and, you know, seeing the success of these offices is just, is very fulfilling and one of the legacy areas of technology that we knew we.

Which I really didn't wanna do again in my lifetime, but was a practice management system, uh, replacement. You know how fun those things are. Right? Because it feels a little thankless. Yeah. That's, that's why I'm not ACIO anymore. I, I like being on this side of it. I don't, don't wake up in the middle of the night with.

But, but you had a, you, maybe this is too strong of a word, but you had a mess, right? You had a mishmash of systems and, you know, some, some client server stuff and, and whatnot. You had to do something about the practice manual lot, lot of client server stuff. And in fairness, the system was, you know, designed pretty well over the years from the traditional sense.

So it. The first billion dollars in revenue, but it's, you know, it wouldn't, it certainly wouldn't take us to the, to, to the next level. It was kind of tapped out. We're a big organization for, you know, when that product was originally designed and was only in a couple of offices, but, so it served us well.

But yeah, user experience, integrations not as all very, very manual and very average. So we set about and went through a huge analysis on. What systems could we move to? And the, it's an interesting space in dental 'cause I, I feel like it's all private practice, right? Mom and pop shops essentially one person practices, and then you get a few with, you know, a few groups, five plus.

And then, and then probably 3%, uh, of the market is in the, you know, the, the DSO space. There's, there's plenty of. Of opportunity there, but were underserved. The bigger organizations, the bigger DSOs, certainly underserved in the, in software that could help run an organization size in this space. Are the tradit, well, talking to healthcare market, are the traditional players in, in this space?

I mean, do you, I mean, you're, you're going with Epic Athena. All scripts. I mean, do they play in that space or is it very specific Dental's very specific. No, very specific. It's like se separate software. Right. And what we wanted to do, we believe, you know, firmly in what we call the mouth body connection, oral systemic health.

It's real. And, you know, we've found a lead. And, and Steve is, is is of force to be reckoned within the space. He passionate, believes in it and you know, not being that redheaded instead of child. Right. Of the healthcare industry. And we wanted to bring, you know, more information to bear around that. And, and those, you know, those, those true systemic links essentially.

So. We came up with the idea, you know, around approaching one of those, um, big organizations. Epic, I'd had some relationships with through prior life. I have to say, I've gotta be honest, right? It's, it's slow moving back in the day from on the medical side, it was different. Dental is very fast moving. Uh, obviously we're privately held as well, so it feels like it's even more entrepreneurial from our side.

We get things done real quick. So this was a big deal and it had to be, my concern was can Epic react quick enough to keep up with us and me and our aspirations to uh, you know, make the dental world a better place and give our providers some really yeah. Really great software that. So after multiple conversations, you know, the relationships started developing and they were interested in, in doing something, but being, did, did they have something already or did they start to develop it with you?

Sorry, I didn't, I didn't answer that original question. So, yes. They did, but Kaiser and a few of their multi, you know, facilities like who, who have medical and dental attached, they were using it. So Epic did have a module. It wasn't there. So ready for us with the speed that we needed to move at, you know, throughout our workflows and also the country of Finland.

Lit up on that module in their actual health service, you know, with their medical and dental. So that, so that they had a whole country on it, in fairness. So we just, you know, we, we've, we've looked at how do we, you know, turn the dial on, on making it DSO ready as we call it. So, DSO ready. So you guys are, are essentially dental service organization.

You're supporting all these, these practices out in the field, but it, it is distributed. It's not like, you know. Multiple. Rolling this out is probably more akin to rolling out the ambulatory system where you're going out to all these different locations. Uh, give us an idea of, of the, the process that the, I mean, let, let's assume that so Epic comes through with the build and we'll come back to that and you're ready to go out.

There's a, there's a training component. You're going out to some pretty remote places. You're getting this thing installed. Did you go with a cloud? I assume you went with a cloud type model? Or did you go, are you hosting yourself? What, what does it look like? So, yeah, you're exactly right. It is, it would be likened in medical to, you know, the ambulatory kind of setup.

The, the module that sits on top of that is wisdom. We, we've been the Vanguard partner to Epic and spent a year in the build out. So what I appreciate about, you know, Judy and Epic, and she's been remarkably engaged on, on this, which it's been really fun, you know, working so. What we help develop here is not only good for us, is good for the entire community.

So there are many areas that are not gonna be proprietary. And what I appreciate about this is, that's good for us because we want dental to be able to rise together to the point where. If we do this implementation well enough, and it's looking like it's going that way, I would like to be able to offer the, uh, you know, opportunity to assist other DSOs through the, you know, community connect kind of initiatives.

So if there are other DSOs listening, I think what we have done is designed a, you know, a platform play that we can help, you know, propagate and other folks can essentially plug into maybe, maybe DSOs that are too small to

model. It's definitely more. And I'm just excited with, you know, the way that our teams came together took like I a year get it, of the build that we were looking for. And, and we've been very aggressive with Epic on the three monthly, you know, releases. So every month we're deploying offices and we're a couple of hundred offices deep now, which is great.

And just turning the product, turning the product, you know, rapidly. So is it a pretty easy transition from the operator and, and the dentist were, was that an easy transition or, or was it a significant UI change for them? It's significant. It's, there's no, again, around it, it's very different. Good. In a, in a good way.

In the most. Think of it like this. You remember the.

Yeah, the green screen with a little blinking cursor. So imagine that. But what you gotta remember, people have been with a company for say, 15, 20 years that it's like, becomes like a second language. So they're just hacking away. They go, oh, it's fine. So that some people were not upset. It was the new folks that came in.

It took four months of ramp time to get 'em up to speed back in the day. They're the ones that are like, what is this ? Why can't I use like my, uh, where's, where are the graphics? Where's the ui? So it's just, it's, it's different. But in a good way. The ramp time is quicker. First of all can be, you know, horrifying to folks because the change is enormous.

I think on the clinician side, the back, back office as we call it, is, is definitely, that's very quick. Right? It's familiar in terms of those, those layups and those flows. The big build for us has been on that front end, right? And the, and the automations that we're able to now provide around workflows that we couldn't before.

So. In, in, in, in the guts of the system, let's say. How, how, uh, because dental's different than medical, so in dental you have a lot of different devices than you would have in a medical setting. The integrations. Did the, the device players and partners, did they work with Epic to build the integrations into the system, or are there not that many integrations?

Oh, no, there's, there's a ton of integrations. So we have, we have our middleware team, if you like, our integrations teams, we call it. Between, you know, our, our true integration and workflow tech technology, there's a few pieces that are plugged into. Sometimes there's even more traditional integrations that are required.

We can get to like an RPA, like a robotics process automation kind of level to make sure that we we're still moving things around in as automated manner as possible. But ultimately, uh, a lot of folks have come together to do, you know, true API based kind of integrations, which has been fantastic. There are just a lot of them.

So I have a whole team specifically working on that. And then there have also been, you know, problems with some of the hardware vendors, I would say in, in dental. It's very proprietary. It's like folks are almost locked into certain ecosystems where they buy this software and then this hardware, and I'm like, it's very old thinking.

So we actually forged a, a dental advisory, uh, council where we invited essentially a lot of these vendors to the table. And we have, you know, three was three monthly, six monthly meetings now where we're kind of, you know, talking about why is it. Why is it good to lock something down? Right? We, we get that, but let's think about if we open some of this stuff up and we let the open market be able to develop on, on some of this stuff right with us.

Why do you care if you're selling the hardware that you also try and force people down a certain software lane? So I think that's been really good and, and certain vendors and partners have been mind blowingly open to. Right. Let's, we can do better. Let's, let's do this together. So, so it's been fun.

Interesting. The, uh, interoperability aspect, which is probably one of the reasons you went down this path, right? You wanna be able to share the data. With health systems to get, start to get integrated into that. Yes. Free the data bill. The data, I think I stole that from you. Free the data. So the, the interoperability, is it the same epic tools that we're used to today, the care everywhere and, and those kind things.

Epic MyChart and whatnot. Yep. There's a lot of that. I think they're way more open than, than most recall. And, and just, I think they've been a good driver in the interoperability actually in helping, you know, move some of that data around and not just, just obviously from a security standpoint, it's very important that you know it.

It is. To extent in a certain way, but there's much of that data that we need to liberate to be able to drive our other workflows. And there, and there are a lot, there have been a lot of successful methods that we're able to do that by, so. So let me ask you this. So this is the case scenario. So let's see who is, well, Memorial Care in your market is on Epic.

So if I'm a memorial care patient and I'm a Pacific Dental patient and I have MyChart. Am I gonna be see dental and medical yet? Yes. There you go. That's exactly why. Right. Finally, we.

In the US to bring this type of, you know, data together. So there's, yeah, there's a couple of methods, but assuming, and there is some, you know, versioning, dependencies on some of the medical side. But yes, ultimately with patient authorization, both sides of the care spectrum can see all of your data Finally, which is we think pretty huge.

Uh, what are you doing for scheduling, just outta curiosity? 'cause I know you're, you're constantly thinking about automation and, and making that process easier. Are you or. That you're just gonna continue on with and plug them in? No, it's a combo we've embraced as much of some of the, I mean, epic do things like, was it pass, pass at Disney?

Uh, concept. But essentially, if you want to, if you want get an earlier appointment, it will, you could say yes. If a cancellation comes up, then let know. And it.

Such a component, our business, because there

day we have.

System that's been very successful on the, on the legacy practice management system. And we've, there's a combination, but yeah, in the most, we've, we've totally we're available online scheduling across the board and have been for some time. I think, you know, the UI looks good now. We're able to facilitate that through initially the, our, our office page and then ultimately my chart.

Yeah. So, uh, CLM you, you mentioned earlier, career limiting move. It doesn't sound like it, it's been for you. And actually the, the reason that, where that came up is you'd come into my office saying, I got this great idea. And I would say, great run with it. But it's, you have to own it. It's your, your idea, you're running with it.

And it really prepared you for this. I mean, these kinds of decisions are. The kind of thing where everyone's looking at you going, are you sure? There's probably a couple times during a project like this, people are going, are you sure? Are you sure? Yeah. And you're like, yeah, I'm sure I believe in this.

We're gonna do it. Tons, tons of people. Tons of people. No, and you're right. I I, I'm fortunate to have a great partner and, and CEO who's, you know, who's very digitally forward and, and just, you know, we work through it together. But I, you know. It's a huge deal, you know, pretty much over a 10 year package and it's, yeah, it's, it's a lot of money.

Yeah. It's a hundred million plus kind of initiative, so there's a lot of investment that's going into it. Yeah. And you guys are, are, are you guys privately held? Yes. Yeah. So you're not just printing money like some other organizations you guys? Actually, you, you, you work, work hard for your money. As Donna Summer, use, work hard for our money.

Look after, treat every penny as if it's your own as well. Was thought so? Absolutely. We, we do, let's talk about the back cave. I, the, which is what I called it. You guys just had a, a really cool innovation room back at the headquarters. Uh, down there, and you were showing me some things. You and Maafa were sort of walking around showing me how you were thinking about every aspect of the experience as the person walked into the, into the office, how they were received, even the chair.

I mean, you had certain aspects of the chair and, uh, just crazy stuff. You guys, you guys are, you guys really are looking at the, the, the entire experience and how.

It part of the organization was, was there somebody who was doing that before or did you guys just sort of just sort of step into a void potentially? You know, sometimes I say when you've got talent, it's just you got, you gotta find them, them a job. So when I knew my staff was on the market, I was like, all right, I gotta find the job.

And the perfect job is this. I is our innovation, so we call it test kitchen, where essentially we have, uh, a, a a separate group within, right, which is a spin out for PDS innovations, and that's what software leads and has the autonomy to fail fast and experiment. So there's a, there's some r and d budget.

Again, we're very fortunate. I pitched the idea and. He knows well received. Um, then of course, it's like finding some of the, essentially we'll look for gaps internally, right? This is what I love about the group. We'll look for gaps, and that involves a lot of, you know, observing workflows and, and, and folks in action in the offices, which is fun and seeing why they're doing it that way.

How can we give them time back or, you know, workflow savings or ultimately giving them, you know, more face-to-face with, with the patient, saving them money, whatever it may be in terms of one of those key, you know, buckets or the pillars as we call 'em, of, of why would we do this? Then they will come back and, and prototype Sometimes, you know, vendors come to us and we'll be like, you know, we'll take a look, but fun stuff goes on.

We've built out a pretty impressive team in the.

On, on the payment side. So give you an example. The way people pay for things is, is horrible and not very transparent. You know, similar to healthcare, not as bad actually, just because the healthcare space, just a bill turns up still on your, like how much, I'm not saying this. So dental is a lot. We have to do work a lot harder upfront to talk about this is what we've covered and this is what, you know, could be out pocket and.

And especially when you get down to a point, for example, of not only taking the Cardinal wants to touch stuff anymore. Right. So we had to get better with touches, better with QR scans better. We, we saw an opportunity to move away from those old school payment systems to iPad driven situations, right.

With, for taking payments. And then of course, if you needed, you know, financing for example. Horrible. Right? It's just kind of almost embarrassing, but once again, comes back to user experience. So you're interested in financing clipboard and a piece of paper, right? And now, right. We're a little more advanced, right?

His an electronic device. But we were like, we wanna spin this on its head. Everybody gets financed. We just have to set the deals up with the right partners behind the scenes. So now finance. Right. Using our AI and the platform that we've built the best, the best deal for you, essentially based a in. That now is seamless.

If you, you could scan the screen and it, and then you just apply for the credit essentially on your, on, on your own device. If you wanted, you could take the tablet. There's many ways, but I'll give you that as one example of that's the kind of stuff the team is looking to solve. You guys are doing the, like the implants and those kind of things.

I'm trying to think what I would need credit for. But, but you're doing the, the serious things where you're actually like replacing teeth with, with, um, yeah. We think about, I mean, yeah, we we're doing, you know, a number of procedures, you know, across the board that you do add up. And unlike healthcare, right, there's a cap.

So think about your dental insurance. Most people, if you're lucky, you're gonna have like a whole. 1500 bucks to spend every year. And you're gonna try . That's, that's exactly what I have is 1500 bucks. Is that, is that enough? That's a magic number. It, it depends on how much candy you're eating, bill, but not always.

Right. Not if you're gonna need an implant, for example. Right. And you're gonna need, you're gonna need, you know, a crown potentially. It depends. Depends on the treatment. So there are lots of scenarios where finance is required. And, and there's a large number of patients that that do that. And for me it's like, how can we do this in a way that is not obtrusive, not embarrassing, and just is part of the flow and makes them feel, you know, good about, about their decision to get the dentistry started.

So. I think we've worked hard on that experience, you know, that that's coming to, to fruition. If you go on the, I, you know, look at like the Peloton site, right? A firm who are big in the FinTech space right now. Uh, for example, it's just like, Hey, bill, wanna split this bike up in six easy payments? Well, yeah, that would be, that's that, that's nice.

And gives me an immediate, like, okay, and then takes you through. That's what we're trying even more intelligence.

Pandemic has, has brought to the forefront this new term that we didn't really think about before, which was contactless, contactless experiences. Right. So it's, it's, it's not handing them a clipboard, it's not them a piece of paper. And now it's almost mandated. I, I talked to some CIOs who were essentially saying to me, you know, I, I tried for years to get rid of the clipboards and, and what I couldn't do over a three year period.

Covid did in two weeks. Yeah. Um, yet, no, nobody wanted a pen. Nobody wanted a, a clipboard that they were gonna carry around, that somebody else had just had. And so have you guys really thought, uh, is there a lot of areas where you had to adapt and, and look at contactless? Or were you already heading in that direction?

I think we were accelerated, definitely accelerated certain elements of the, of the contact list. We were pretty, you know, pretty paperless in the most anyway. Which was, which was great. But things like, you know, a good crisis, right? Drive some of this, uh, innovation for sure. And. We've made, we came up within two weeks, or I think it was penned for like a, you know, a 12 to 18 month initiative.

And that was the, the tele telehealth denal consults, which are like, well that's, is that a thing in dental? And I would say, yes it is. And it's, and it's growing and it will get, it will get better. There's only so much you can do, obviously. Right? Yeah. So, so is that like, Hey, I, I have some pain, or I have something, and then we get on a call like this.

Or, or are there a set of tools other than the, the initial consult like this? So, so now the initial consults like this, the gauge, you know, how, how, you know, how bad are the symptoms and how soon should we try and, you know, get you in as an emergency essentially, right? And how, how can we, how can we help with the, the tools available now?

Those said tools will are only advancing. We've got some really fun stuff going on with some, you know, interal opportunities and stuff and you know, phone-based situations where you can really get more of a, more of a closeup visual of the mouth. So. During the, you know, during the pandemic, it went from, we didn't offer Televisits to two weeks later, we were live across 800 and whatever it was, 20 offices at the time, I think.

And we did over 5,000 virtual visits. And in the, in the subsequent weeks, it was like inanity. So there was a demand. People just wanted to have that. Initial consult. What was also good was it built, you know, it built trust initially because we were picking up so many patients from offices that were closed and, and there's a need.

You know what it's like when you get two fake bill? It's like, it's like it's, oh yeah. It's, it's the worst. I agree. So then, you know, we did a big campaign because every 14 seconds. Someone with a toothache was walking into an emergency department, right? And essentially, what are they doing? They're gonna get narcotics, right?

To try and help the LPs, the pain there. So it's just not an ideal solution all around. So our, our campaign was that, you know, really we're open and, and, and we'll, we'll help you out. It's just like, dental pains the worst. So we focused in on those emergencies and we kind of doubled down on the, on the televisits initially, which worked out, you know, pretty well.

And I mean, they definitely, you know, declined only you gotta be in front of you. Right. But, but at that point in time, I think it was just a great bridging kind of solution to help, to help in the initial engagement. I, I, I learned a ton of stuff from you around culture. You invariably always had the most fun team in our IT organization.

And if, if June and, and Rob are listening to this. I'm sorry, but, but David's team always seemed to have more fun than the other, the other teams that were there. But the, the, the, the pandemic sort of put a crimp in the face-to-face things and the, you know, hanging out with the team and all that stuff. How, how have you adapted and, and kept the culture, uh, moving forward?

It's a great question. I think it's the most important thing to me is that, you know, outside of a good structure is the, is the, is the culture. I'm fortunate to have some phenomenal leaders. It's still the most fun department. So likewise, if I've got my, my PD, my p ds rather in listening. Yeah, we are definitely, we do have a lot of fun.

I do. I coined a few things from you. Again, shame shameless, right? But I think it, some of the stuff you did was fantastic with the town halls and that we have town hall, you know, two 50 folks on, on there, and. I make sure everyone's connected with the overall kind of, uh, vision. Obviously a ton of video.

We're a big video company as everyone is, in fact, probably overly so. It's like, do we really need meetings for this? Because I, I'm a strong believer in not having me is for me's sake, but video is the next best thing, right? So. We've got, a lot of us are out when we're out in the field or we are, you know, coming together.

It's with the PPE and stuff, obviously a dental company is pretty, pretty good at that, that those practices anyway. But all the knowledge workers, there are obviously lots, you know, that were moved to home in short order. Thankfully we had a lot of that tech in place. But it's important to have, you know, regular open communications and it helps.

To have a little fun around some of those meetings. So I, I, I think it's still prominent and we've been, we've been fortunate that I think we've got amazing culture, especially in, you know, our IT group passionate about keeping everyone together and getting after it. Yeah. Well, so talk to me about the priorities going into, into 2021.

Uh, obviously you're at. You still have a fair amount of the organization to go if, if you're only at 200 offices? Yeah, just a couple. So yeah, we'll be, we'll be 500 deep by the end of the year. We'll be, we'll be completed next year. Uh, in q1, you know, it's getting into a good cadence. It gets to a point you get that, you hit that tipping point where people, you know, those early adopters are like, all right, this thing is, is now moving.

It saves time in these areas. And you know, there's, so are you using because. What people may not recognize is, I mean, you're, you're in a lot of states and you're in, uh, you're in a lot of states, a lot of remote places. Are you using partners to, to roll some of this stuff out? No, we've, we've got a team that travels, you know, extensively on this.

We've looked at a number of different models and because you have to be kind of so deep with the product and, you know, have the confidence to be able to, we have at the hip support on those, on, you know, that, that first week, and it's always different. You can go into any training class, right? I've done some of the training classes myself.

When you're there in an office. Behind that front desk and patient comes in, you know, and they're in pain. You're like, okay, it's showtime. You're like, well, I just forgot everything. What do I do again? What's your name? So it's, it's, it's, it's totally different when, when you are, when your live patients in front of you.

And I think we've just got, I think we've got an outrageously talented team who travel, light 'em up, you know, enjoy the work they're doing and, and then we, you know, we get them flying as fast as possible. I mean, they're literally seeing most of America then. I mean because, yes, because you guys, you guys are all over.

Yeah, about 17 states I think. I haven't got the official stat. Changes. Changes regularly, but yeah, we, we are. But we do also have, you know, we have big support presence across obviously California, but uh, a large presence in Vegas where I'm moving to, and then Texas as well. Right? There's some big hubs there.

So there are, when we're now, when we're recruiting, the beauty of having this kind of size is we can attract talent from the talent. Doesn't all have to be in, you know, one geography. Are, are, are you up for talking about healthcare in general? I know you've been out this, out of healthcare, the healthcare provider space for a while.

I know you're still in healthcare at Pacific Dental. Yeah, we've still got tons of friends in there, but it, it does, it is a boring subject bill because there's a lot of talk and not, not much action as you know. So. All right, so let's talk about the action. The action, you know, just this week, if so, people will be able to figure out when, when we're recording this, Amazon announced Amazon care to 50 states.

For their employees first, first and foremost. And as you've, you know, told me many times, nobody understands the consumer better than Amazon. I mean, they have a ton of information on 'em. They, they have that mantra of designing everything around the consumer, and then they are going to essentially find the weak spots that exists.

And one of the weak spots in healthcare is it's inconvenient, hard to schedule it. It's just all those things that, how did, how, how did, Feinberg said it this way. He said the, the waiting room represents all that is wrong with the healthcare. With healthcare, we call, we make our consumers come and come to us, sit in a room and wait until we're ready.

We, we make them wait 10 minutes longer than we told them they were going. Then we put 'em in a room. They don't even talk to the person that came to see. They, you know, they sit in that room, then we close the door and they sit in that room by themselves for another 10, 15 minutes before the person they came to see actually comes in.

That person spends about five minutes with them leaves, and then they go and. I don't think that's gonna be the experience with Amazon. Amazon has, Amazon Care is a concierge level service. They'll come to you and they will ship your meds to you. It's, and if you do get sick as an employer program, if you do get sick, if you have cancer, they'll send you to the City of Hope or they'll send you to some other really, you know, reputable academic medical center around the country who is known for that specific disease state.

And it, it feels to me like we are starting to see what we, we chatted about maybe five or six years ago, this, this, the tech players finally figuring out healthcare and giving us what we all want as consumers. Is, is that what you're seeing or is that what you think when you hear about that? Yeah, totally.

It's all about, I think it's about bringing the backend together and then, you know, disrupting essentially that traditional workflow. Like you say, front office, sit, wait, go to this other, you know, another office, another room. Wait, someone knock on the door and then, you know, eventually you might get, see the docket if, if you're lucky.

So it's that, it's an inconsistent experience. So the difference I'd say, and I've been lucky to have the opportunity to be part of one, is. Is more of the concierge medical and that being the gateway, you know, little like the, your PCP right? Your primary care physician is, is that gateway for jack full trades, if you like.

So you are a part of a concierge, medic medical program. Yes. And it's, you know, it's 24 7, I could text my doc now, he'll text back. We have a relationship, right? And it's, it, it's really cool. And yes, you know, there's always gonna be that added expense, but I see the model becoming more normalized like that where you have, you know, more technology, advanced areas that are, are looking at, you know,

Way more measurables they have before, right? Everything from, you know, DNA to the food allergy testing or you know, I do a full annual checkup, which is like insane. And I usually say, let's do more. I love, you know, studying what foods I'm, could I be allergic to? How can I get more energy, you know, every day.

How can I, so we run through true wellness, right? I love playing around with, you know, I'll track diet, I'll track. That's, that's kind of fun to me. And, and the, the difference is that when, when something, you know, I had a bulging disc, which I didn't expect. At some point I was like, oh my goodness, what's gonna happen?

Right? And then they took me on that kind of referral through the specialist kind of network to get, you know, to, to get me where I needed to go. So it's like, it's guided, it's like a healthcare navigator, if you like. And that's what I think is, is starting to, to hit a tipping point. I see more and more of these concierge places open up.

Yeah. And that's, uh, I think that's what we want from, from our healthcare providers. But I mean, you worked at a healthcare provider. I worked at a healthcare provider. It's, it, it's, yeah. It, it's not just the technology. We could probably stand up the technology to do it. Right. The, it's, I mean, because you can do it with a, with a phone and, and texting back and forth and it, it, it's really rethinking the workflow.

That has been in place for decades. And that's the, that's the hard part. It's redesigning it in, in a way that is consumer-centric. How do you, how do you get that, that level of design thinking, that level of consumer-centric thinking in, in your innovation? Is it just hiring the right people to think that way?

Is it hiring onto an organization that already has that culture?

You know, you have a team, you have a leadership team that thinks, innovate, innovate, innovate, and you hired Mustafa, so you were able to build the team that you wanted to, to build. But imagine, I, I, I just hired you back to where you were before, and we have to do this, we have to sort of change the experience.

We have to rally a whole bunch of doctors to really change the culture. I mean, what's, how do you approach. You've got, you've gotta find the leaders with the right mindset because you are gonna find folks as we did, you know, regularly. I think the Eds were some of our toughest customers, but it was, it was important to build the relationship with the leadership in the ED and then the right docs with the right mindset and let them know, you know, that.

They don't think you understand the pressure they're that they're under. Right. And I think a lot of times you don't, until we pull an all night out and sit in the ED all night watching them and watching, you know, horrific things happen and amazing things happen where they're literally saving lives.

That's, you know, I don't miss that pressure and all I've gotta say, but that's where, that's the only way you can kind of shift the mindset. Insane. Just because it's always been done this way, is this right? And, and with the, it's with, it's getting those right folks behind you and then having them be part of potential new designs that you can quickly iterate on and fail fast on.

Right. So like you said, it's not just the technology, it's the workflow. So while you're running across that room to pick up a, a prescription on a printer that's, you know, a hundred feet away, it makes sense. So why would you not move? Simple stuff like that all the way, you've gotta start the fundamentals, right?

There's a lot of good teachings, I guess, in, in the, you know, the agile workflows and stuff and in, in, in those clinical settings. But ultimately it comes down to. Finding the people the right mindset, because if you have people that are gonna tell you it's gonna foul and never work, it's always been done this way, then nothing's gonna change.

So you, you got, you gotta change the folks driving the bus. Yeah. And you, you did preach, you know, walk, walk in their shoes, get out there and walk in their shoes. Hang out, get outta the ivory tower. Hang out there. I mean, yeah. You sleep in, sleep in the beds, in the, in the ed. I'm always my best time are in the practices with, with the docs running around.

Well that's on the get out there. It gets harder when you get into that CI have so. Always, you have to make time. It's easy to, there's two things that are easy to kind of just push off. One is being in the field, right, with your actual customer. And then two is, you know, the strategic planning components.

Something always feels like homework. Some of the best, like weight comes off your shoulders. You have a plan, the team are marching towards, you know, the ultimate strategy. But it's so easy to say, oh, I'll do that next week, next week, next week. And help your teams understand what success looks like. Very important.

I'll push, you know, we're getting close to the end of this call. I'll push you at just like a, an executive coaching session. How's, how's your work life balance? Do you have work life balance? ? I hate that term. Bill. I'm really, I I, it's an awful term. It's work, work balance. Is that what you're saying?

There's no such thing. If you have worklife balance and you must hate your work. Only option there is, is Work Life Blend. They're both one and the same. I love doing, uh, being at home with family. I love my work too. It's like, and I can't just, I'm not gonna switch off at five o'clock. It's impossible. Right?

So, but when I need time back, I'll take the time back. The New World is having a little more autonomy. So honestly, I think I, I really believe in that work-life blend. It's, take the time when you need it and go all in. When you, you know, when, when you work. So essentially what you're telling me is. You're, you're a lot more relaxed since you're not working for me anymore.

Yeah. You making me punch that clock every day. But no punch the clock. We, we always had, we had, you know, I always enjoyed that autonomy. If you are, you need those strong leaders in there, right? And then they can build that culture with people that passionate about what they do. Like, and, you know, we've spoken about it for opportunities just don't land on.

Lap every day. So the folks that are there hating their jobs, hating their lives, I, I always sell to say to everybody, if you don't like what you're doing, then you've gotta take, you've gotta be the change agent for yourself. Invest in yourself. There's so many opportunities right now. I mean, what I'm telling people is essentially 70% of the time you have to like your job.

If not, you should, you should be looking for something else. Because 30% of our job, we're never gonna like, I mean, you just. You sort of go, ah, today's one of those days. I just gotta do the 30%. Yeah. You're not gonna, it's not unicorns and rainbows every day for sure. But if more of your day is spent hating what you're doing, then you got, life is seriously too short.

I know it's an all cliche, but you've really gotta, you've really gotta do stuff that makes a difference. So you were a big runner and, and both adjectives actually work. You're six foot whatever, six foot a hundred. What are you're? 6, 6, 6, 7, 6, 8. Stop ing me. Six, eight. Six eight. Six, eight. Runner. That's, that's not a normal thing I guess, but, uh, are you still running a lot?

Yeah, it's my, I do a little bit more, uh, more pellets on now. It's, it's, it's, it's quicker and a little bit more, uh, in intense, I guess. I'm not a runner's frame, but no, I still run. It's fun. It's fun. It's a good all mind and body kind of workout. I, I'll tell you what, David, almost everybody I know who ran.

Has given it up as they've gotten older because of the pounding on the, on the knees and, and, and back. Really? Yeah. Yeah, definitely. So plus I was scaring people running down the street, so, so tell me about the Peloton experience. I'm sorry, I, I got another five minutes with you, so I'm gonna get every minute I can outta you.

Tell me about the Peloton experience. I mean, is that, I mean, was that, was a, a healthcare type purchase? Yeah. I mean. My wife does a lot of running and stuff. Same thing. Gets a bit creaky, right? So we, we started spinning and it was fun. Covid hit and then we bought, we have a, a home gym, which was, which was lucky and, and has been great, especially, you know, from a time perspective and the fact that we can actually work out.

So we bought. A Bowflex machine, first of all, I'll drop some names here because their customer service sucks, . Uh, but here's what, here's what happened. The thing turned up and, and it's actually pretty cool, and it links into the Peloton system and it's way cheaper, right? The experience is good. It's not like being on a Peloton though.

So we ended up, you know, I use it a ton and then we said, let's just get a Peloton. The new one came out and that's a game changer obviously. I was like seeking out, you know, the best gadget again. But screen's huge. The sound's amazing. And here's the thing, then new machine. You gotta love this right as you're doing the class.

Instead, before you're tweaking the dial and putting the resistance up or down. Now they do the automated resistance for you. If you want in, you just hit a button and they change the resistance. And I'm like, this is like now you can just focus fully on the class and experience more what they're going through.

So I'm like, that's a game changer for me. Such a good experience. Is it weird having, you know, people come into your house and you're riding with and have them yell at you like they do at spin classes on the screen? It's less intimidating, I guess. , I don't know. I, I, I, I, yeah, I don't know the, although the Peloton experience has been something that people have talked about and said it a, you know, phenomenally well thought out.

When we buy an apple over an air Android, somebody said, you know, why would you spend so much for the, for the apple? And I'm like, you've never owned an Apple phone. It's like, no, I haven't. Like you wouldn't ask that question if you owned an Apple phone after owning an Android. Exactly. Right. And that, and that's what they did.

And you know, I was like, I'm not wasting that money. That monthly's, you know, seems excessive. And so I go down the more economical route, which was okay. Now I can tell you as a convert, the experience is so different. It's like I get my, the Apple experience on the exercise by there. Gosh, back back when I knew you, you were a penny pincher.

Now you, now you own a Peloton. That's, uh, you know, that's, that's significant, significant change for you. I'm investing in my healthcare. Uh, yeah. Actually you, yes. You've actually given books about my health, so that's.

To help you stay alive. So, um, are you running, are you running still, bill, just after be? I am. I, no, I, I, I, I really, I gave up running a long, long time ago. I do bikes, but, uh, not nearly as much. It's not spinning, it's biking. Literally. It's driving, going, going around this, uh, circle, uh, roughly a. And I go around it a couple times, but it's, uh, it's, it's not the same for, for me, I, I need to get into a, uh, routine of some kind.

How did this turn into being about me? You see that Psychology 1 0 1, I might me just spin it there. So, yeah, I've, I've, I've gotta work on it. David, fantastic conversation. I, I, I love following this journey, we were there when you guys made the decision. Epic. Wisdom. Wisdom. And I've talked to your CEO and a couple other people from your company as well, and, and got to interview you and Mustafa in the, in the office and to see it finally get to this point 200 offices in.

It'll be interesting to see when you get to, well, you'll never be at a number. I mean, Pacific Dental, you guys are always. There's always more offices to, there's so much opportunity. No, it's true. And it's, yeah, it's, it's been a crazy ride. I love, you know, hypergrowth, it's been awesome. We're always looking to hire, so if anyone hears this, what, and this is an, this is a case where the technology becomes a game changer, right?

I mean, you, you get epic wisdom in there. It's highly integrated. You have the stuff that Mustafa's doing around the experience, and now all of a sudden somebody comes in and looks at it and goes, wow, that's a lot better than what we're doing.

And that's, that's where the, I mean, that's where technology really takes an organization, any company to the next level. Yeah. Proven technology. If you think about, you know, Dennis coming out school, uh, this is a great model for them to accelerate kind of their, their business ownership and, and growth. And part of that is, you know, our proven technologies were the biggest, you know, biggest same day.

Crown Miller in the in, in the us. So, I mean, we do, you know, chair site, no more putsy in the mouth and sending off things to, to labs in, in the most right where you can. We will literally three D scan you and mill your crown while you are sat in the chair. So things like that, technology wise, I would certainly say gives you the edge.

Same day. Dentistry is real. Awesome. David, thanks for your time. Really appreciate it. Thank you, bill. What a great discussion. If you know of someone that might benefit from our channel, from these kinds of discussions, please forward them a note. Perhaps your team, your staff. I know if I were ACIO today, I would have every one of my team members listening to this show.

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