The Group Dentistry Now Show: The Voice of the DSO Industry

John Murphy joins the podcast to discuss how one of the countries largest DSOs, with more than 830 dental offices in 42 states and supporting 5.5 million patient visits in 2019 alone, has been growing and thriving during the pandemic. He talks about what life looked life for Aspen Dental branded network offices throughout the pandemic. He also discusses how the pandemic has changed human resources, hiring, recruiting and onboarding. If you want to understand the dental industry from a recruiter’s point of view, this podcast is for you!

John Murphy is the Senior Vice President of Talent Acquisition for Aspen Dental Management, Inc. He has been with the organization for 15 years and leads the recruitment division – responsible for hiring all dental professionals.

Our podcast series brings you dental support and emerging dental group practice analysis, conversation, trends, news and events. Listen to leaders in the DSO and emerging dental group space talk about their challenges, successes, and the future of group dentistry.

The Group Dentistry Now Show: The Voice of the DSO Industry has listeners across the North & South America, Australia, Europe, and Asia. If you like our show, tell a friend or a colleague.

Watch the video or choose your favorite listening app below and subscribe today so you don’t miss an episode! Full transcript is also provided below.

FULL TRANSCRIPT

Welcome everyone to The Group Dentistry Now Show. I am Bill Neumann, and today we are going to talk all things HR and recruitment in the DSO space. And things have changed rather drastically since COVID hit and we figured we would talk to one of the largest DSOs in the country and find out how they’ve pivoted their… Hate to use that pivoted a new normal, but you almost have to say that now. But we have John Murphy. And first off, John, welcome to The Group Dentistry Now Show.

John Murphy: Thanks for having me, Bill.

Bill Neumann:

So John is the Senior Vice President of Talent Acquisition for Aspen Dental Management. He’s been with the organization for 15 years and he leads the recruitment division. He’s responsible for hiring all dental professionals. So John, give us a little bit of your background. 15 years is a long time at Aspen, Aspen Dental Management. Maybe you can talk a little bit about your journey there and then what you did prior to joining Aspen.

John Murphy:

Sure. I grew up in the recruiting world and prior to coming to Aspen, I was implementing information systems. So I survived the dot-com boom and dot-com bust. And then probably in 2004, I met Bob Fontana and Sue Decker. Bob is our CEO and Sue is our Chief Human Resources Officer. And I joined Aspen Dental Management in August 2004. I’ve been really driving the staffing strategies to meet the demands of this pretty rapidly growing business for the last 15 years. Bill, it’s been an interesting ride. When I started, there was approximately 40 practices, may have been a 35 or $40 million business today as 400 employees. Today, there’s nearly 14,000 employees, it’s a $1.5 billion business. And we now have 830 offices across 42 states.

Bill Neumann:

You’ve seen over 20 times growth since you’ve been there.

John Murphy:

Yes. I look at it like we’re revolutionizing the delivery system in dental care in this country. For me, that’s what’s been exciting and fun, and I love the constant change and what comes with that, leading an organization to think differently about how people access oral health care in this country.

Bill Neumann:

Excellent. So you said 830 locations. In how many states are you in currently?

John Murphy:

42 states. 42 States. We’re going to be in first office in New Jersey coming up here very soon. So it’ll be 43 states.

Bill Neumann:

Wow. Okay. Yeah. We’re right across, and so are you, in New York. We’re in Pennsylvania. And where in New Jersey? Or can you not disclose that yet?

John Murphy:

Oh, good question. There’s a bunch of offices that are coming soon.

Bill Neumann:

Once you jump in, you jump in big.

John Murphy:

Well the efficiencies, when you have multiple offices in a market, are helpful. And that’s really what this is in my view. It’s a model of efficiency. Aspen Dental is a network of branded dental offices that are wholly owned by dentists and Aspen Dental Management, because of the dental support organization that streamlines service delivery on the business side to those dentists in their practices.

Bill Neumann:

Excellent. So you talked a little bit about the growth when you started 40 locations. Let’s talk a little bit about the pandemic unfortunately. It’s like any conversation I have, that comes up. And you’re still growing. You’re opening up in New Jersey. So it might’ve slowed you down, but as an organization, you’re certainly growing. Let’s talk about what life looks like for Aspen Dental branded network offices. So maybe it’s not necessarily at the management level, but the individual offices. Maybe you can take us through early March when things started to become serious, we started to realize this was not a flu, this wasn’t going to go away quickly. Maybe we can start there and take us to how things are right now. I know it’s probably a long story, but we’ve got time.

John Murphy:

Yeah. Chaos. What’s going on? How do we understand the virus? You’re getting direction from different organizations, the CDC, state and local authorities, World Health Organization, just trying to understand the virus, its impact on the practice, what that means for patients and what that means for our teams. Of course, in late March, every state, dental practices were shut down, mandatory shutdown, open for emergency care only. And that had a drastic impact on what we were doing at the time. Schools are closed, they’re shut down. Kids are learning virtually from home. And so availability changed. People’s willingness to come into a dental practice to work and/or to see the dentist was more difficult. And so again, we had a task force constantly thinking about these challenges and working through solutions to do what’s in the best interest of both patients and team members. So I don’t know, that’s maybe a long-winded answer to your question there. That’s just the dive down, right Bill?

Bill Neumann:

Right.

John Murphy:

Coming back out, what do you do differently? How do you think differently? How do you adapt? And I think we did an excellent job. I’m biased, of course, but the communication within the organization was critical in terms of communicating with all team members across the network, in terms of what was happening, what we were doing to support them, what the timeline might be. And our CEO even, he communicated daily with practice owners. He recorded video messages and we quickly sat up a portal so that employees could access the information. So they knew what was going on with respect to their employment constantly all along the way. And then of course, as things started to pan out, the timing of those communications stretched and started to return people to work. You continue to leverage the virtual platform and really use that as a way to think differently about triaging patients and helping them feel more comfortable about seeking the care that they need.

John Murphy:

We quickly put into place what we refer to as our Smile Wide, Smile Safe Promise, which is basically a documented place that our patients and team members can go to learn and understand the real risks of coming to the office and seeing the dentist, or working in the office and the things that we had done to protect them. And of course, procuring PPE was the bread and butter of being able to do those things. And so we’ve got a [inaudible 00:09:00] team here that’s done an unbelievable job of ensuring that all of our offices have the PPE they need to sustain a long period of time. And of course, the efficiencies in the patient flow change, right? You can’t see people and have them in the office, they’re waiting in their cars, you’re texting them to come in, right? You’re thinking and making sure that they’ve taken the precautions and you’re taking temperatures, and you’re doing all of these things to ensure safety. Well that reduces the number of people that you can see.

Bill Neumann:

Right.

John Murphy:

What’s the solve for that? So what we’ve been working on and started right in the middle of everything was thinking about how do you extend hours, right? How do you create more convenience for people whose availability has shifted? And they just can’t get to the dentist, because of all the other things happening in their lives and in the world around us. And so it’s been a bit of a roller coaster ride as a fast dive down, it’s been a very, very fast climb back up. And I feel like now, we’re in a good position to continue to learn and watch and understand and make the right choices for our patients and our team members.

Bill Neumann:

Excellent. So as far as this ride back up, well let me step back. So when you were shut down and you were doing emerging care, were just certain practices open for that in a geography? Or were all the practices open just limited hours? How’d you deal with that?

John Murphy:

You did your best to make sure that people had access while also limiting exposure, particularly in late March and early April, and didn’t know much about the virus and its spread and how contagious it might be and that sort of stuff. So we minimized, we had offices, it was a little bit more regional where the patient was triaged and then referred to the practice that made the most sense based on their geography.

Bill Neumann:

Excellent. So you opened back up and seems like now you have a rhythm. Of the office hours, you mentioned office hours being extended, is that still the case? And is that geographic-wise? Is that how you determine that based on? Or are you still working on that?

John Murphy:

It’s a little bit of a work in progress. The owner doctors, they’re the ones that have to make the decisions, right? So we’re just making recommendations to them based on what we’re seeing and what we’re learning across the network. Extending offers of course means you need more PPE. It means you need additional staff to work those hours, right? And so how we think about staffing and scheduling patients was at the core of the challenge there. And it’s not like you flip the switch, it’s continuous learning, it’s continuously making adjustments and trying to do what makes sense for the local teams given the demand in that office. So it’s a work in progress for sure.

Bill Neumann:

So everything’s open back up, it sounds like you’re growing again. So you’re opening up, you talked about New Jersey, you’re opening up additional practices. Let’s talk about why you think Aspen’s able to do that in spite of the pandemic, talking to some other groups, individual practices. I mean there are some practices that still have not opened back up in parts of the country and don’t know if they ever will. So talk a little bit about your growth and then why you think you’re able to do that.

John Murphy:

Yeah. I think the pandemic continues to affect everybody a little bit differently. And I’m watching what the Health Policy Institute is doing, and still as of last week, they were saying maybe approximately 2% of dental practices are still closed. [crosstalk 00:13:36] Bill, there’s only 160,000 active practicing dentists in the United States. Maybe there’s that many practices, 2% of that’s 3,000 give or take. It’s tens of millions of people who were affected just by the closure of 2% of practices. And so for us, we really have to be thoughtful about how people can seek care, how they can find us. And I think that’s an advantage of a branded network and an organization like Aspen in that we’re top of mind. And when people think about needing oral health care, they’re finding us. And so we’re seeing demand increase pretty quickly given where we were pre-pandemic or pre-shut down, if you will, and then during the shutdown.

John Murphy:

And still 40 some odd percent of practices are open, which is great, right? But they’re not able to see the volume of patients that they were once before. And there’s probably a variety of factors, right? Having the PPE do that, having the staffing to do that. And so we look at that as a challenge and we need to continue to break down the barriers that exist and create access. And so we’ve stayed true to who we are in making investments, in growing the network and opening new offices. And this year, we’ll still open or add 65 offices to the network. 65. We were looking at maybe 80 or 85 coming into 2020. And of course, the pandemic has really affected that. But we feel good that we’re going to create access for millions of people by opening 65 new offices this year.

Bill Neumann:

That’s incredible given the pandemic.

John Murphy:

Yeah. I think it’s highlighted the value of the DSO or the support organization more now than ever. And of course, it’s a vertical here that is still in its infancy in my opinion. Maybe you know better than I do how many dental practices are affiliated with a support organization. 10, 15%. It’s still a very traditional private practice model.

Bill Neumann:

Right.

John Murphy:

And so I think that the pandemic will maybe accelerate the growth of DSOs and you’ll maybe see a little bit of consolidation. I know there’s some DSOs that themselves have struggled. But we feel really good about the actions we’ve taken and how we’ve responded and how we’ve communicated with our teams, and what we’ve done to protect the business so we can continue to grow now looking forward into 2021.

Bill Neumann:

So your position has probably become a little bit challenging as you’re still growing during a pandemic. You mentioned it earlier, you have people that were making more money on unemployment. There’s the fear factor I’ve heard across the country, dental assistants, some hygienists not coming back. So you may be bringing in, especially on the assisting side, the office managers, people that have never worked in a dental setting before. So there’s that training people that have never been exposed to the dental practice. So let’s talk a little bit about that. You’ve got growth going on, you have all this turmoil, you have people not coming back that you thought would come back. How has that been and how have you all been able to manage that? Oh, and then throw in not really being able to meet a lot of people in person, so virtual recruitment as well.

John Murphy:

Yeah, there’s a lot to unpack there I think, Bill. Of course, just like everybody else, we saw particularly dental assistants and hygienists choose not to come back to work. And so we’ve got to move quickly. My role as a recruiting leader and a talent acquisition leader is to help put strategies in place and to think differently in terms of what we’re doing now given what we were doing just a few short months ago. And so when you understand the impact that this has had on people and you think about their availability and what they need, I think about employment along the same lines that I think about patient access to care. We need to create access to employment for our people, right? They can’t work maybe the traditional hours, but they still need to work. And so as we align our strategy and extend ours to create access for patients, I think that creates access for employment as well.

John Murphy:

And so now it becomes more about being flexible and thinking about on demand staffing. And again, you’ve got the virus and the way in which the world is behaving in the back of your mind, and you want to remain agile to dodge and [inaudible 00:19:09] what we might have in store in the months ahead. And so we’ve really started to put some focus on the part-time flexible schedules, thinking about odd hours. We’ve just entered a new partnership with an organization that has a technology platform that makes it easy to communicate shifts, right? And openings that we have in our business to people in local communities where they can see it, maybe they sign up, they’re pre-vetted and introduced to our organization and to our culture and to who we are and why we do what we do. And then they can accept the shift work, or they can accept and come in for an interview for a permanent job on a set schedule. And so we’re trying to be flexible and to consider the changing needs of the workforce in very different ways.

John Murphy:

The other thing that we’ve had to do, particularly with respect to recruiting providers, which there is a constant supply issue in this country, right? You get about 5,500 new graduating dentists every year and we probably have about the same number of dentists, right, retiring or reducing hours at the tail end of their careers. And so supply is a challenge certainly, and with increase demand in our business, supply becomes even more important. So there’s more of an acute focus on my team and what we’re doing to help support the practice owners so that they have the providers they need to deliver care, particularly if they’re choosing to extend those hours, right? And the dental school’s chaos.

Bill Neumann:

Right.

John Murphy:

What’s going on there? And so look, it’s a supply issue. It’s also, in my view, what’s always been a challenge is a distribution issue, right? Getting the dentists to where they’re needed the most. In our model, we’re in rural and tertiary markets, secondary markets, right? That’s where people need the most help. And so that’s good for the practice and the dentist who owns the business. It’s good for the community. But the challenge is a lot of times, there’s not a lot of local dentists that want to relocate to some of these markets, right? 60% of the 150,000 dentists in this country are in five major metropolitan areas. So you’re redistributing, that’s really the challenge that we’ve had on our plate for a long time. And now, how willing are people to relocate? I mean the New York governor has got a long list of states that you’ve got to quarantine if you visit and relocation is difficult. And so there’s a lot to navigate there.

John Murphy:

And so we’ve always had an acute focus on the new graduate. They’re active job seekers first and foremost. When they graduate dental school, they’re looking for work, right? And nowadays, particularly millennials, they don’t necessarily want to take on more debt to buy or start their own practice, right? They want peer to peer interaction, they want mentorship. And these are all things that the Aspen network delivers on, right? There’s 1200 general dentists, there’s over a hundred specialists in the network. They have access to the technologies and the platforms to stay connected. They have access to mentors and other people who have had similar experiences that they’ve had. And there’s tremendous value in that right now. Of course, our strategies were always to go into the schools and build relationships, right? I think maybe I said that earlier before we got online. There’s nothing more important in this business than the relationship that we have with the dentists and their teams.

John Murphy:

And developing those relationships require face-to-face, being in person. And so again, much harder to do. Introducing dental students to the career opportunities that exist here in the Aspen network is more challenging. So one of the things we’ve done, this stand up what we call Ask Me Anything sessions. And so we’re leveraging that academic team to continue to liaison with the schools and the residency programs. And we’re hosting virtual sessions where we have actual dentists online live that share their stories and can answer questions for people in different stages of their careers. Of course, students is where the focus really came from. But what we’ve learned is that when you’re virtual, you can invite anybody from anywhere and it offers certain advantages.

Bill Neumann:

Right.

John Murphy:

And then they get to hear from people living through this pandemic in a network like Aspen, being supported by an organization like Aspen Dental Management, Inc. And we’ve really had to figure out how to hone that technology and that platform to continue to meet the demands, the staffing demands of the organization. So it’s been interesting in terms of thinking differently about recruiting and what we can do and having to move quickly, right? That is probably one of the most critical aspects of what… You’re moving fast and you’ve got to be ready to make a mistake, screw things up, learn from it and keep going. And believe me, we make our fair share of mistakes here. This is by far not perfect. But the more we get it right and the more we learn, the better and stronger it becomes. And that’s never been more true than it is right now.

Bill Neumann:

Interesting challenges. You talked about trying to get clinicians to maybe locate to areas where the underserved are, but they might not necessarily want to live. Although with COVID and some of the [inaudible 00:25:50] out of cities now, maybe there will be changes in where people end up wanting to practice. So that’ll be really interesting to see how that starts to evolve.

John Murphy:

Interestingly enough, when the offices were shut down, we maintained… I call it a skeleton crew, because it wasn’t quite as large looking back as it might’ve been beneficial to us, but we maintained a crew of people that were as busy as ever, right? Every dental practice in the country were shut down, there was uncertainty people didn’t know. And so private practice owners and employees in private practices were like, “Hey, what are you doing? What do you know? What can I learn from?” And so we were pretty active when we were at the peak of this thing and everybody was in lockdown. First, you’re available. If I call you, you answer the phone, you’re at home, right?

Bill Neumann:

Right.

John Murphy:

You’re not off with the kids and running around the practice and doing this and that and the other thing, or working, your home. And so we had a nice opportunity to build pipeline and to get to know some people that we may not have otherwise gotten to know. And I think it was interesting, of course, as things have returned to, I want to say normal, but to more of a normal situation. The pace slows a little bit and you continue to work hard to leverage these tactics to build those relationships with people.

Bill Neumann:

Excellent. And one thing I also want to mention, too, I know during the pandemic, you also opened up your learning platform to clinicians that were outside of Aspen. So it was pretty much built for your employees, right? The supported practices that is and the doctor owners. But it was opened up a couple months back to all clinicians. So that was certainly a great thing that you did for the industry and hopefully, that helped out a little bit with recruitment as well.

John Murphy:

Bill, when I think about the work that the learning and development team here at Aspen Dental Management has done with their clinical partners, I don’t want to say it’s heroic, but it’s heroic. We’ve stood up virtual onboardings, we’ve stood up virtual training programs so that you can continue to assimilate people into the culture and help them understand who we are and why we do what we do, and continue to provide them with the development that they need to learn and to grow and to be better. Opening up, I think that’s what you’re referring to, is we opened up our online continuing education platform, Aspen Dental Learning, which was only available to people who work in the Aspen Dental network. And we felt like it made really good sense to share that content and to allow people who are at home or who aren’t working, or who have been shut down because of the regulations imposed on them by the states.

John Murphy:

And we stood up aspendentalce.com. And I was looking just the other day, over 3000 dentists, dental students, hygienists, dental assistants, lab technicians, registered and joined and took advantage of the content on that platform to the tune already in just a few months of over 6,000 CE credit hours.

Bill Neumann:

Wow.

John Murphy:

That to me, it’s amazing. And none of those people work at Aspen, that’s value that we’ve provided to the marketplace. Of course, yes, we’re trying to create awareness.

Bill Neumann:

Sure.

John Murphy:

But we feel like we have a role to play in helping the industry at large, continue to stand up and survive and make sure people have access to the things that they’re going to need to maintain licensure and things of that nature.

Bill Neumann:

Absolutely.

John Murphy:

And of course, one of the… Sorry, just one of the things I noticed that I found interesting, the users on that platform, they’re looking at content related to COVID-19 and the safety and infection protocols. And there’s been nearly $800 accessed around that type of content.

Bill Neumann:

Well that’s great. And there’s a lot of confusion around that. Obviously, right? So you mentioned onboarding in being a challenge. So let’s talk a little bit about how that’s changed and what that looks like now as we come out of COVID. Well you talked about not normal, but more normal. You recruit, you find somebody, well what did it look like before? And then what does it look like now? What are the differences?

John Murphy:

Sure. Before, it was in person. Every new dentist, we try to assign them a mentor or somebody that they have that they can access as a resource from day one. And then of course, we have development programs that introduce them to the practice, that customize schedules based on their own unique skills and the pace and the things that they do in the office, the types of procedures they do or don’t do, things of that nature. And that was all done manually in the office, they were chairside, a lot of observation and we’ve had to convert that to an online platform. So we created a program we call Discover Aspen that every new dentist will go through that allows them to make the connections that they would have otherwise made much sooner.

John Murphy:

I think that the learning development programs are a real differentiator when I think about Aspen Dental versus other career choices that people have. And they’ve got a dedicated development path, if you will, from day one when they enter the organization that allows them to feel a part of a community, and to understand what their role within the team is and how to think about who our patients are and understand who the patients are that they’ll see. And so the learning development team has just converted a lot of content to a virtual environment in a very, very short period of time. And the feedback we’re getting right now is tremendously positive. It’s been exciting. Yeah.

Bill Neumann:

Good. Yeah, we’re going to be doing a lot of virtual things for the foreseeable future. It’ll be nice to get back to in person. But until then, yeah, it makes a lot of sense. And if you can do it in a way it keeps people safe and it’s easily replicated as well. I think that certainly makes a lot of sense. So we’re almost at the end of the podcast here, and I appreciate your time, John. Any closing thoughts on what you see the future of Aspen in 2020, the industry, anything you want to tell us?

John Murphy:

Oh, I think in my view, there’s never been a better time to practice in the Aspen Dental network than right now. I think the career opportunities are limitless. I think actually right now, it’s about so much more than dentistry, right? It’s about the community and the support and the development and the flexibility and the constant learning. And I’m really excited about the future given the rollercoaster ride that we’ve all been on for the last six months or so. And I would encourage anybody that’s considering a career in dentistry or is in dental school or hygiene school, or whatever the situation, that they take full advantage and they learn more by visiting aspendentaljobs.com, which is a great resource to learn and understand what opportunities are available for them across the country and what we stand for, what we believe in and what it means to be a part of this organization.

Bill Neumann:

Excellent. Well thanks, John. Again, we had John Murphy, Senior Vice president of Talent Acquisition at Aspen Dental Management. Great information and hopefully, we can get you back post COVID, when things are normal.

John Murphy:

Post COVID. I’m not quite sure when that is, but I’ll be glad to come back though.

Bill Neumann:

Sounds good. All right. Thanks everybody for listening and watching The Group Dentistry Now Show. Until next time, I’m Bill Neumann.