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

Cher-Marie Scott, Head of DSOs, EMEA & LATAM at Ivoclar and Dr. Dev Patel, Founder & CEO of Dental Beauty Partners, join the GDN Show. We take the podcast global as the guests share their thoughts on:

Global expansion of DSOs
Technology & digital innovation
Managing global cultural differences
Working with channel partners
More

If you are interested in connecting with Cher-Marie Scott or learning more about Ivoclar and what they can do for your DSO whether you are located in the U.S or across the pond you can email her at cher-marie.scott@ivoclar.com or connect with her on Linkedin – Cher-Marie Scott | LinkedIn You can visit Ivoclar at https://www.ivoclar.com/

To connect with Dr. Dev Patel email Dev at dev@dentalbeautypartners.co.uk , connect with him on Linkedin – https://www.linkedin.com/in/dr-dev-patel-bds-pg-dip-41b54444/ . To learn more about Dental Beauty Partners visit https://dentalbeautypartners.co.uk/ .

If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.

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Global DSO Podcast.

Cher-Marie Scott & Dr. Dev Patel share their thoughts on the global state of the dental industry.

Bill Neumann: Welcome everyone to the Group Dentistry Now show. I’m Bill Neumann, and as always, we appreciate you checking in with us. We’re up to 194 podcasts right now, give or take. We’ve got two special guests on the show. It’s a great way, as we record this, where at the end of 2024, you may actually be watching this in the new year. So welcome to 2025. I’m really excited to have Dr. Dev Patel. He is the CEO and founder of Dental Beauty Partners on for the second time. So welcome back, Dev. Good to see you. Thanks for having me, Bill. And for the first time, Cher Marie Scott. She is the head of DSOs at Ivaclar. And Cher, thank you. It’s great to have you on for the first time and welcome to the show.

Cher-Marie Scott: Thanks, Bill. Thanks for having me.

Bill Neumann: Yeah. Cher, why don’t we start off with you, if you don’t mind, a little bit about your background and then your role at Ivaclar.

Cher-Marie Scott: Yeah, of course. Um, so without boring everyone, I’ve got 20 years experience in the, in the DSO field. So originally I started working within a DSO. Um, when I first joined the industry originally as a dental nurse, and then I went into practice management, group ops management, um, all still within the DSO space. And then 10 years ago, I actually joined the commercial side of the business, um, within Ivoclar. So recently I just celebrated 10 year anniversary at Ivaclar. So really half and half of my career has been one kind of on the customer side and now on the commercial side. And that helped me a lot day to day with what we do at Ivaclar and in running the DSO team and segment to really kind of understand the customer needs. So yeah, that’s a little bit about me.

Bill Neumann: Sure. So a lot of our audience is US-based. So I think it would be great to kind of give people a little bit of perspective as to what parts of the globe you manage for Ivaclar.

Cher-Marie Scott: Yes, so I look after the EMEA region, so Europe, Middle East and Africa. In all honesty, the majority of our DSO business and focus at the moment is predominantly in mainland Europe. For example, in the UK, Nordics, Spain. Netherlands in particular we have a really high number of DSO customers so for us those are kind of focus markets. We also have in each country at least one key account manager per country and this was a structure that was set up in 2020 and the idea behind it was that we always have someone kind of at eye level for these type of customers in the market but also connected to the head office Previously, the way IvorCloud worked with DSO customers or group customers, everything was kind of handled locally, which we know these groups, especially when they’re kind of pan-European groups or sometimes even global groups, they need additional support, which is why our team was founded in 2020.

Bill Neumann: Thanks, Cher. Dr. Patel, great to have you back on. Like you said, it’s been almost two years, March of 2023. I was looking back through and I’ll make sure we drop a link to that podcast too, so people can kind of check that out too. And might be interesting to look at, you know, now and then to see some of the big changes that have happened, you know, in your life and with Dental Beauty Partners, but CEO and founder, can you talk a little bit about your background and about your organization?

Dr. Dev Patel: Yeah, sure. And thanks for having me back on again, Bill. So I graduated as a dentist, still a dentist on paper, haven’t worked clinically for around five or six years now. So I’m not sure I’m technically a semi-retired dentist or not, but Hey, I still know my clinical stuff. Um, I, I’m a very, I spent the first three or four years really, really, um, doing every possible course or as you call it, see, um, under, you know, we’ve been the owner of Europe, I think. So I did two years of training in implants, two years of training on Vicks or Podontics, I did two years of assistive training, every composite and cosmetic course you can do within probably the world. So I really focused a lot on how to maximize my clinical skills. And then after I realized that, you know, I can only help a few hundred people a year in terms of my clinical abilities. I decided to buy my own practice and bought my first practice in Kent in the UK in 2015, so three years after graduating, which is quite early for most dentists in the UK. I’ve not bought a practice for the first 10 years, but being quite entrepreneurial, I thought I’d buy my first one. And also in that same year, a year before that, I set up Little Circle, which is another network for dentists, which was a startup and is the biggest network in the UK, half the UK dentists and professionals, nurses, hygienists and therapists on my network. So that was another piece of the puzzle, which I’ll get back into in a second. And yeah, set up the group. From the first practice initially, kind of spent the first three years kind of mastering the model of the blueprint of how we can grow our practice from half a million turnover to a million or two million turnover. And just making sure that we gave the best customer journey for our patients. Um, treat them, you know, as if they’re five star hotel guests, give them in-house services with all different specializes in one practice, the best technology, the best environment. Um, and just, you know, really educated patients, CC photography and spending time to really, um, get to know them and build upon them. A lot of practices in the UK are very focused on five, 10 minute appointments in and out then street because of the government system that we have called the NHS. And then after kind of mastering that first practice model within the first two or three years, I ended up getting one of my dentists in the practice to buy into my exit, my first practice for week 10 of it. And that kept growing every year for about two or three years, even though I wasn’t working in clinical practice and I had some other businesses I was running actually in the States. So what actually happened was I realized the penny dropped when in the US I was meeting all these DSOs who were saying that their groups have all got dentists, most of them got equity in some sort, in every sort of practice. And the UK, every single group, every sort of DSO is owned by singly, by one entity at the top, and there’s no equity for anyone else in the whole company. which didn’t really make any sense to me because, you know, we’ve been doing DSOs in the UK for 20, 30 years now. Actually, we’re one of the biggest ones at one point 15 years ago. My dentist, I think, was the biggest in the world 15 years ago. Now it’s, you know, a little bigger. So, you know, I think looking over time and looking at history and learning from that, it kind of dropped when I saw the U.S. models and saying, you know, Pacific Health, ASPA and all those other guys with lots and lots of practices, two or three times more than, you know, the biggest ones in Europe. but doing really great like for like numbers and growth over a long period of time based on having a dentist of equity that practice. And obviously with my first one having a partner in there, it kind of made sense to use my network Federal Circle, which had half the UK on there to bring in partners and get them to, you know, it’s actually buying to my vision of having more practices, but with a partnership model. So joint venture and 51 49. And then it kind of just took off from there. So February 2019, we bought a second practice and I think we pretty much bought one a month since then. So we’re up to 55 now. And, you know, hopefully going to keep growing every month. But yeah, that’s what we’re up to now.

Bill Neumann: Excellent. That actually, so 2024 seems like it’s been a really big year for dental beauty partners. And I mean, I’ve got some growth numbers here, which are really impressive. I’ll let you speak to them. But when you talk about this, I’d really love to get your perspective on why you think you’ve been successful, and what is the overall market look like? So you’ve had this incredible success. What do maybe, you know, what is, whether it’s the UK or Europe in general, you know, how are you performing compared to dentistry as a whole over there? Again, we’ve kind of, we’re over here in our bubble in the US sometimes, and we kind of, you know, we don’t look at things globally. And, you know, we’ve had our economic challenges here, and I think there have been global economic challenges as well. But you seem to certainly be growing in spite of that.

Dr. Dev Patel: Yeah, so I think the same challenges that you have in the US is almost identical to what’s happening in the UK and around Europe. And in summary, I’m sure it’s a bit of a harsh summary, but it’s truth. A lot of DSOs got excited, they bought those practices, didn’t integrate them, didn’t buy them in the right locations and therefore can’t recruit that easily anymore. They bought practices of owners who were generating lots of revenue as one single owner, had a bit of an equity tie-in or deferred payment, but the guy or the lady was going to eventually retire. And, you know, if you’re generating half a million to two million, three million dollars a surge, you know, as a lead principal dentist for 20, 30 years, and then you eventually retire and leave, no matter how good you are operating, you’re going to lose some revenue there for sure. And if you’re already paying seven, eight times EBITDA or in the UK it was at nine, ten times, you’re paying crazy multiples to net net, you know, in terms of what you’re actually going to get after five years. And especially you can’t recruit to system planning. So that was, I think, the biggest issue and still is, you know, now fighting a lot of those DSOs, you know, from the VAT side, because essentially you have to, the whole buy loads of practices, put them together, flip it in three or four years after the next PE cycle, you know, that was all good and well during the low interest rate cycles. But now the way it’s gone up again, and as you know, M&A, you know, on those kind of platform sales have been completely dead for the last two years, hasn’t really moved that much in the last six months either. And people aren’t aiming just to flip the whole, you know, their group they’ve put together and just flip it, right? So they’re actually holding them and saying, now I have to operate these practices properly and see what a life-like growth is, not just buy those practices and put it in there to get growth from the inorganic growth, not just from organic life-like. And I think that’s where a lot of people struggle because they don’t really have a plan. I mean, I’ve spoken to groups globally, especially around Europe and the UK, and I’m like, you know, what is your actual strategy? They say we’re one of the best, best group, the best dentistry and the best patient care. But what is the financial model for growth? And no one really did anything, especially in the UK and across Europe. I know some obviously great groups in the US doing some de novo models, which I think is the only way it can really work for like, you know, trying to make those kind of like double digit, high double digit growth numbers. But you know, there was no plan. And all I said to, you know, all of our partners and obviously as our board, our shareholders, was that if I’m going to buy any practice and I’m obviously, you know, got two hats on here, M&A and kind of operations, I want to make sure I could buy it and double it. So I can’t do that, but I can’t add value to my partners. You know, you’ve got a model that they’re buying into us for growth. I can’t add value to my shareholders or where best is. And I can’t add value to my personal, you know, shareholders in the company. So it was all just making sure everyone’s aligned. I’m making sure that we all believe that when we buy something, we can definitely almost guarantee double that practice. If we can’t do it, we shouldn’t buy it in the first place. And that could be some really simple things because you’re buying these, you know, two or three or four chair practices or you call them clinics. And most of them haven’t got any marketing, they haven’t got any branding, they haven’t got any in-house specialisms, they haven’t got any technology, they haven’t got the processes to keep track of their KPIs, they haven’t got the recruitment to bring dentists in, to train them and to make sure they can become the best version of themselves in these practices. And when you do all that together, it’s not really that hard to go from 50 to 60 pounds per patient to doing 400, 500,000 pound per patient, because you’re not offering them upper dentistry with photography on big TV screens and scans and et cetera. So it’s actually quite easy win in the UK because dentistry is so poor here in terms of the general market. And, you know, all the other DSOs just be focusing on getting 2, 3, 4, 5%, maybe 7 or 8%, you know, light for light growth based off 5% price increases and 2 or 3% volume growth. Um, whereas we’ve just been focusing on, you know, getting these really, really run down, you know, national health service practices or, or deliver those sites and then taking them and just, you know, sculpting, grow for marketing, bring new leads in there, bring the right dentists in there, train them up correctly, getting them to really look at their data on the conversion rates, um, make sure patient qualities, you know, as high as possible. And we’re shouting about it and marketing about it. Um, but it sounds really simple, but no one really did that. And I think. It might sound like I’ve done a really good job in terms of how many packs we bought, but I’ve always said from day one that I might try to buy 100 less sites over five years and have 50, rather than having 200 sites, while those 50 are now doing 2 million pound revenue averagely, and they’re operating at 23, 24, 25% average margins, rather than buying loads of practices that aren’t doing very well, and that are a lot more hassle to run, and just not having high quality of care at the end of it. So we have actually bought a lot less than I originally would want to buy in five years. But the quality is still there and obviously there’s like a one or two year gap last year because of rates and stuff and COVID in between that. So I actually think we could have been at 100, 200 sites easily by now, but I’ve been very, very kind of laser focus on just getting the best of the best opportunities that are almost guaranteed to double every single time you buy them rather than buying lots of things because it’s quick and easy to do it, even during the heyday of 2021 and 2022.

Bill Neumann: Amazing. I mean, really, it’s great to see, you know, the It makes a lot of sense, and kind of to your point, I think, back to what you were originally talking about, it’s very similar issues here in the US. You had, I call it the acquisition hangover of 2021 and 2022, bought a bunch of practices, overpaid for a lot of them, and now a lot of the DSOs here are trying to divest of some of those locations that were underperforming. Same store sales growth focus, so it’s been relatively quiet with a lot of groups that were on acquisition tears two, three, four years ago. Some are really struggling. Others, I think, similar to what you’ve done, maybe not the same way, it was just smart growth. It was not, let’s just go and buy a bunch of practices up because we have the money and worry about the integration later. And that ties into culture, ties into a lot of things. So thanks for that, Deb. Cher, on your side of the business, I mean, Ivoclar has doubled their sales with DSOs every year. And you mentioned that department really started in 2020. So you’ve got a ton of growth there. Talk a little bit about the relationship that you and Ivoclar have with DSOs.

Cher-Marie Scott: Yeah, so for us, as I said, when I first joined Ivoclar 10 years ago, each country dealt with DSOs in their own way. And each way wasn’t necessarily wrong or bad, you know, some countries actually had a very good system going, but there was no coordinated approach. And what we realized as a global company, and of course, then working more with regional or global partners, we needed to have a structure that kind of matched And that’s why the team was formed initially. So for us, it’s important as well that we quantify and classify DSOs from sort of 10 practices and upwards. And regardless of size, regardless of revenue that they’re doing with us, they can have access to a support program from IBCLR. And that is encompassed with a number of different things. So even if they’ve only just acquired their first few practices, or for example, on depth scale, you know, where they’re a larger, group and then part of a pan-European group. We always have kind of a support mechanism for all kind of DSOs and also on the R&D side we’re really focused now on looking at different products, services, protocols that can support group dentistry because of course it’s very different managing 50 clinics or 400 clinics or a thousand clinics than managing an individual clinic with maybe two or three chairs. So we don’t see this trend of consolidation slowing down, we see it increasing. And for us, it’s really just a case of moving off the market, you know, mimicking what the market demands and needs and making sure we’re there to support our customers. So I think that’s attributed to our success. And I probably also have to give a big shout out here to the key account team in general. So all of our key account managers, similar to me, really, they come from a background with experience either with DSOs, super experienced salespeople, or dental professionals, you know, so they can really handle and support in their market what is needed from their group customers. So yeah, this is really a group effort, why we’ve grown so much. And yeah, let’s hope that 2025 brings more of the same.

Bill Neumann: Hey, Dev, what factors, you know, as you kind of take a look at things from where you sit and the growth that you’ve had, a lot of global expansion with DSOs. I mean, we see in the US, you see it in the UK, you’re seeing it across Europe. What do you think is really driving this?

Dr. Dev Patel: I think two things. Number one, obviously, it’s the ones with the money, the top, you know, the Palm Equity guys, you know, family offices, and, you know, even, you know, individual dentists to decide to have, you know, investment practices and their groups 10, 15, 20, 30 years ago, and now keep expanding. I think there’s just an obvious consolidation play because every healthcare industry in the UK, from veterinary to pharmacy to opt-op, they will have the same kind of consolidation over a 10-20 year period. We’re just the last ones in line of that. So we’re at 35% consolidated right now in the UK, we’ve still quite a lot of room left to consolidate the fragmented market. I think why is because they’re happy to pay high multiples. So it’s buy and sell, right? When it comes to sell you perhaps as an individual, you’ve got to sell to a corporate who’s got guaranteed funding and can get deal done faster and can pay high money to you or sell to individual. You know, you’re retiring, what are you going to do? You’re going to sell to someone with a nice amount of money who can do a deal quicker. So that’s probably why. And they have the funding, right? They’ve got the private equity kind of a war chest behind them or the debt funding behind them to kind of get more deals done, you know, than everyone else. And then what’s the traction from a private equity point of view? I mean, healthcare is pretty resilient, even though I’m saying that there’s been not a great performance from a lot of the DSOs, it’s still better cash flow than you would do, say, for retail or for, you know, for the beverage and other industries that they’re in. So, you know, it’s not, it’s not bad market to be in. And, you know, even during the downturns or recessionary going around, we’ve been in the last few years, we haven’t really seen a massive drop off in terms of demand for treatments with Rizaline or implants, you know, that typically was there and a bit more discretionary during the, you know, GFC period. So I think, you know, there’s a strong demand from, from these kinds of institutional investors to get involved with, in healthcare and dentistry specifically. And like most things in the biomegrity world, everyone just follows the wave, right? And once it’s two or three good exits, and it’s like 15, 16, 10 times, or whatever multiples are out across the world, everyone goes, oh, I’ll do the same thing too. And I’ll just follow on by a platform and flick it after three or four years and get 17 times multiple on it. Very, very basic way of thinking, but that’s what everyone did. So I think that’s the reason why there’s an investment and obviously why the sellers are selling. And then from an industry point of view, I think it’s needed because most mom and dad or individually owned solo practices don’t have the time and effort or the real desire to put in systems or processes to make your business actually operate like a proper business. If you go to look at most of the practices I’m looking at, They’re still using Excel spreadsheets to pay bills and to pay associates at Temple Dentist and trying to work out what their results are once a year based off the end of year accounts they do, not looking at it monthly and seeing how they’re tracking ahead or below targets they’re setting for themselves, if they haven’t reached targets at all. And it’s just a very much kind of like relaxed, don’t really care how it goes and just see what happens over the year. As long as I’m getting my pay each month and I do the work, I’ll be happy as a practitioner. So they’re not really running it as a business, they’re working in the business. So I think that’s the big benefit. And I think technology investment in CapEx and refurbishments of these practices is really needed. And some of the other ones you’re looking at, most of them are just, you know, not very attractive in the UK, or probably that compliant, to be honest with you. So it’s a good thing for the industry, as long as the DSOs that do acquire them have the investment in the practices and take care of them properly, and operate them well, it will be better for patients long term. But there’s a big but there, if it will not make sense.

Bill Neumann: Yeah, sure does. Sure. is kind of look at this globalization of DSOs as it relates to, you know, the economic environment, which sounds like it’s very similar, you know, pretty much globally. I’m sure there are pockets that are doing better than others, but certainly challenging. Do you think we’re going to see international groups splintering off or is more likely that we’re going to continue to see, you know, expansion opportunities? What are you seeing? Because you obviously have a really great perspective on things.

Cher-Marie Scott: Yeah, I think Dev touched on it earlier. I think we might see some individual cases where they divest or maybe sell off some practices or maybe even split some countries off if it’s a pan-regional group. But I think for the most part, the consolidation isn’t going anywhere. And if you look at the other industries like veterinary, optical, general health care, Dentistry is always just a little bit behind. So I think regardless of the environment, the consolidation will still continue. We know from market research that in the mature markets, the growth is still around three times the growth that you would expect from independent practice. And in the gross markets or the emerging markets, it’s around 10 times. So this doesn’t seem to be affected even with the cost of money, the rise of inflation, recruitment challenges. I think if anything, DSOs have the upper hand a little bit there because they have, um, for example, they could have decentralized ops, which wouldn’t be a normal thing you could have in a normal practice or a normal lab, for example. So I don’t think things are going to necessarily go backwards. Maybe it’ll slow things down a little bit, but, um, consolidation will continue to grow and grow.

Bill Neumann: Dev, from your perspective, what are some interesting markets for new DSO development?

Dr. Dev Patel: Markets as in geographical or as in different aspects of how you can grow your DSO, sorry, just to clarify.

Bill Neumann: Well, I think we could go about that either way. That’s a great question. Why don’t we start with, Izzy, when I think of markets, and maybe it could be when we focus on same-store growth, where are the opportunities at Dental Beauty Partners to grow?

Dr. Dev Patel: Sure. Um, I’ll just talk broadly, not just about Dance of Beauty, but just generally I think broadly, I think there are three areas that I would focus on what we are focusing on, I guess, next year is one, it’s almost every year to be fair, is patient journey. How do we make that patient experience better, more efficient, and less manual. So, you know, Online check in you know when you get to the practice how do you avoid having to have a huge reception you have to have a kiosk to check in and make payments on these kind of things that we’re looking at to make. I think the whole patient journey more digital and seamless. I think that also includes stuff like Pearl AI and kind of explanation and education around treatment options within the chair and the surgery. And then afterwards, making the payments for those through different finance options more seamless and easy as well, and to avoid friction of conversions of patients going ahead with different treatment plans. So that’s kind of the thing, the first thing. The second thing I would say is you know, just as important, um, is from a, uh, a central point of view is how do we use the KPI and data, data that we have now to influence the clinics and the clinical directors, uh, through just lots of training, um, you know, mentorship programs we’re doing, um, between senior partners and younger partners. Um, how do we use the data to influence the past managers to make sure that I met. make the right decisions, but also using AI to look at the data, analyze it, to say, do these five things for you. And to essentially look at all different levers and KPIs of the practice and say, these are the four or five things you should be doing this week or today that will help with the needle for you. Because I think a lot of A lot of times, operations for a very good operator on a single solo hit can be 5 or 6% margin difference between operating it okay in an individual clinic. And if you do it in a group level, that amplifies even worse because you have less attention, less time and effort on a group level. So if you were to, we want to achieve 29 state set margin, you know, before kind of our, um, our health is costs and that take now 5%. So 23%, you know, all in kind of margin to get to that level, you’ve got to be operating super slick at every single different part of the business. Uh, we just want to make sure that we can use our partners, our masterparts managers, to almost make them experts at every single part of that business locally on every sort of practice. So we can really maximize opportunity. Stuff like white space of diaries, you know, people can’t see appointments or call them back and book them back in again, make sure payment is taken, you know, and chased up in terms of treatment plans being opened. These are all the little basic things that add up and really help, you know, the small things. So get your numbers up. And then I think the last thing I would say is technology and some of the equipment. We’re looking at a lot of 3D printing options now, photogrammetry for implants, just, you know, lots of physical technology that can decentralize the typical just, you know, everyone uses five or six laboratories, because they’re great laboratories to go for. And it’s great. But actually, if I could do it in house, with shorter lead time, and a lot lower cost, and more, you know, customized, because it’s all done within, you know, the same dentist and the same surgery, I think that could be a great, it’s already working for us well now, but it can be even bigger and better. And over the next, you know, 12 to 18 months with the materials coming out, especially the sprint rate, So we feel we can make some big savings there. And I think the other technologies that we’re looking at right now is stuff like Pell AI that would be really useful for helping our conversions in the clinic, but also from a compliance point of view, because we can now see what dentists are actually talking about to patients on a global level. And from that, looking at this edition proposed four fillings, because there’s four areas to carry on the x-rays. But there’s only one filling based off the data we’ve got from the dashboard and therefore there’s high discretion of dentists about compliance and not offering the right fillings in the first place or conversely offering too much treatments for no reason. So it’s a really good way of actually having some amazing data for the first time we can see on a much, you know, on a global level, a much more, you know, kind of laser focused way of saying who’s clinically doing the right thing and the wrong things and who needs more training. And that can help our L&D kind of an academy much better to make sure we get the right training to right people in the organisation.

Bill Neumann: Sure, I’m going to ask you that same question, but instead of from the focus of technology and same store growth, maybe we can look at it geographically. So are there specific markets that you see where there’s DSO growth opportunity?

Cher-Marie Scott: Yeah, for sure. I think within Europe, in Eastern Europe, we’re seeing, for example, in Croatia, Slovakia, there are more and more DSO groups cropping up. And I think the interesting thing is, as well, these groups that are starting in the emerging markets, they kind of have the advantage of looking at the previous mistakes, for example, the likes of the UK, maybe US have made in the past, like Deb was saying earlier, just the the buy and build or the crazy kind of growth. I think those days are long gone. And these new DSOs and new emerging markets have kind of learned from that. And then also, I would say in Latin America, at the moment in the UAE, for example, in Dubai, there are a handful of DSOs. But again, that seems to be a trend that’s continuing. So I think Depending on the regulations really in the country or what the monopoly laws are like, that really has a bearing on how much the DSOs can develop. But generally, once one is successful and cropped up, you know that the growth is then just going to continue and continue. So yeah, for us, those are kind of the interesting markets at the moment.

Bill Neumann: And, and Dev, you know, you, you have your partners at European dental group and they’re managing, you know, internationally. And so you’ve got different cultural expectations, the regulatory environments tend to be different in these different countries. Yeah. How, how do your partners tend to manage that? It’s gotta, gotta be a lot of work.

Dr. Dev Patel: Yeah, fortunately, that’s sort of in my remit, so I don’t have to deal with that. But look, obviously, we work very closely as a team. And I think it’s fair to say that there’s only probably one or two properly planned European groups across Europe. I mean, you know, multiple, more than three or four countries that have actually got scale in each of those countries and are market leaders. So there’s not many of us out there. But the one thing I would say that we’ve kind of looked at and said, what actually is common between all these countries? A lot of those are, you know, finance, dashboards, KPIs, procurement, you know, showing best practices for operational excellence and, and, you know, patient quality in terms of, you know, what are the best technologies and equipment to use between all sites and clinical outcomes and workflows. I think, you know, us showing that knowledge alone, regardless of the different countries, different cultures, the different language and different regulatory environments, is powerful enough to make sure that we’re all operating in the same level of quality and, and, and, uh, efficiencies, because I think. no matter how big or small you are, if you’ve got that blueprint of what works and how you grow a clinic, it can be replicated in any country in the world. If I did what we did in the UK, in the US, or in Germany, in France, or anywhere, it will work, because actually, we’re talking about dentists, to work with dentists and patients who have all got the same mouth and problems in the mouth. So as long as you’ve got a model and you can tweak it and you can customize it, I mean, obviously, we’ve got some great groups in the US doing similar-ish models with Pacific and Aspen and DECA and all the other guys out there, you’ve got, you know, other ideas, so it’s replicating what we’re doing, just in a more different way or their own version of it. But the actual premise and the fundamental model of treating extentists really well, taking care of them as your customers from a central point of view, and then focusing on patient care and giving great customer experience, they always work. Um, so I think we do a great job with an EDG group. Um, and I think other, you know, pan-European groups, if they do ever want to merge like that and focus on that, should really focus on, you know, what are the fundamentals that is actually synergistic and what is just, uh, you know, a unique niche regulatory thing in this one country, which actually won’t make difference on the basics of the model.

Bill Neumann: Sure, what are you seeing? Dev touched on this in an earlier question. We’re focused on same store growth, technology and digital innovation with your customers. And I know Ivoclar really has been innovating with whether it’s clinical products or now with a lot of the solutions that you have. Are you seeing this adoption of technology And if so, because again, sitting here in the US, everything’s AI. Everybody talks about AI. Everybody talks about technology solutions. And I think sometimes from a DSO’s perspective, it can be pretty overwhelming because you’ve got all these different solutions. They all sound great. First off, it’s hard to, you know, find the time to evaluate all these different solutions and, and, and while you’re, you’re doing everything else of running a DSO. So can you talk a little bit about Ivaclar and, you know, your focus on technology and innovation and then how you’re providing those solutions to DSOs that are, you know, I, I would say they’re, they’re pretty overwhelmed with the opportunity, the options. Great, great, great opportunity, but, but sometimes too many opportunities to choose from.

Cher-Marie Scott: Yeah, I would totally agree. I think operational efficiency and operational effectiveness is probably the two biggest demands we see from all customers actually, but it’s more relevant to DSOs and for example, huge commercial partner labs. So from our point of view, from a technology perspective, printing and AI are the next phase. I mean, they’re already here. From our side, we recently announced our partnership with Sprint Rake. So for example, the printing materials, it’s our competence, so it makes sense for us to partner with someone with competency on the printing side. Again, that’s not going anywhere, and we feel like It builds on what we have in the traditional analog way of our workflows, the consumable side. We kind of have the basis there, so it makes sense to have the next step. Regarding AI, and maybe a good example I can give, recently I was at an event two weeks ago, and I think there are so many AI companies now, as you mentioned, really good technologies like Pearl AI, Deep Care, CareStack recently, this event I was at, they were talking about a feature that they have recently launched called VoiceStack. And essentially what it does when a patient phones into a DSO group, the receptionist, the call would be recorded, and it would basically identify certain words or phrases and then put them into this AI technology, which would give a probability outcome that a patient is likely to book a certain type of treatment. And I think this is just advancing way faster than anyone’s really expecting it to. I mean, back in the days, especially in the UK, I don’t know how prevalent in the US, but we have a role called treatment coordinators. So they would have taken on this type of role. Traditionally, the receptionist would kind of pick up sales cues or treatment cues. It would then go to a treatment coordinator who would then explain all the benefits and options. But I think all these types of things can become automated through AI. And as much as it’s kind of scary, to be honest, from a consumer and patient perspective, it does mean that patients are going to have more options. They’re going to be listened to really better than what they would necessarily be. from a human and have things brought to them that maybe in the past would have been missed. For me, this was a highlight of a real tangible solution to a problem we have today that could be implemented tomorrow. We’re not talking now in the future, five, 10 years, this is something that’s already here. It’s just the understanding of what technologies to use and how is it really beneficial to the groups, which I think is the challenge. It is a little bit overwhelming at the moment, but if you have a clear goal in mind, like what Dev mentioned earlier, you know, if you have a focus that you want to give good patient journey, you really start to map out what that patient journey looks like before they even enter the clinic. Then you look at what technology fits the bill or what products fit the bill. I think that’s the best way all around. And then you can make sure that your kind of group is focused in the way you want it to be.

Bill Neumann: So you mentioned patient journey, Dev, patient care. So as you scale up, you have this incredible growth. How do you ensure that patient care remains personalized, the highest quality, uh, which can be challenging. So talk a little bit about, you know, that, that the secret to the success that you’ve had about really ensuring that in a patient care, you know, above all else.

Dr. Dev Patel: Yeah, I think you could break it down, Bill, because I think everyone gets very… you know, focused on scale and how big you are and how much practice you’ve got. But I just like to keep things simple, right? Kiss, whatever it’s called, you know, keep it simple and stupid. If you just think about individual practice that runs really well, so just think about the best practice that you know. That best practice has got one leader who’s a dentist, who is very passionate, very clinically, you know, trained, well-trained, constantly going to courses to develop themselves, and loves mentoring the rest of the team. We have then every single practice. So average age of our partners are 35 years old, they’re all young, they’ve all been trained for the same academies and the same training modules as what I’ve been trained when I graduated. And then every dentist has been put for the same academy in 18, you know, hands on courses over a two year period. So every single dentist is trained exactly the same way in terms of their ethics and the way they think, the way they treat patients, the way they treat and plan. So that way you’ve got almost like clones of every single dentist in the group all being exactly the same. And what you find after you’ve got the right partner in the clinic is they only hire, recruit and want to work with people who feel like them. So then you basically always have this kind of like pyramid effect where I’ve got my kind of ideal technical workflows and how patients to be treated. I’ve been had five or six partners who worked for me originally, who then became partners in their clinics. They then hired 15 dentists in between their five clinics. Those 15 now become partners and they will board their own clinics with us as well. And it just basically spreads that you have the exact same culture, ethos and workflows. And because we have this very kind of regimented and the D platform where everyone joins us has to go through a certain induction, the same kind of training programs quickly and they go through the same hands-on courses. At the end of that, it’s like an academy of sports, you know, footballers or baseball players or whatever you want to call it. You end up just bringing out the exact same kind of people every single time in terms of conditions. And that’s how you then, on a scalable way, can make sure your clinical care is the right thing every single time. Now, you’re never going to be able to ever track every single dentist’s exact filling, or their exact root canal, or see the quality of every single procedure, because this is impossible, right? Even if you’re a clinical director of one individual clinic, You haven’t got time to watch eight dentists and check them every single day. You can do your annual audits, or you can do your x-ray audits, your no keeping, et cetera. But you can’t watch every single day. But what you can do is make sure you set up the right platforms and have been trained the right way. You’re showing curable cases, discussing them every single week. There’s a peer review session with dentist meetings. You’re going through complaints as a team, so you want to understand what went wrong and how you’re reflecting them. And by doing this, it’s very hard then to have any kind of major clinical issues. Because if you’re, you know, the road dentist doing some dodgy dentistry in the practice, you always stick out of a sore thumb, because the dentist, the nurses, everyone that team will know that everyone’s doing things correctly, the principal is doing this correctly, everyone’s easy rubber down, for example, but there’s one dentist that’s decided not to do it. And then straight away our partners are on top of me straight away saying this is not going to work anymore. Let’s kind of separate ways and bring someone else in. And we have a great recruiting platform that doesn’t force our dentists and our partners to have to keep people who are not clinically great because they’re worried about having recruitment gaps because actually tomorrow I can get you to my dentist. because of what a mouth on the group is so great that you’ve actually got good locations and people want to work for us. So I feel what we don’t have a magic answer to how do you keep quality higher for every single dentist because you can’t watch all of them. All we can do is make sure the fundamental structures of the business And the learning, the L&D platform, the actual deductions, the training courses you do for your dentist, the culture and ethos of what you’re recruiting in the first place, and having the regular meetings from the practice and audits mean that it’s very difficult to, you know, to kind of go away from the, the kind of the blueprint that you’d originally created. As long as we keep very diligent on what we do recruit and that we have exactly the right criteria for our training and development and audits and meetings, I think we’ll be okay going forward. But look, we’ve been very fortunate so far. I mean, recruitment gaps, where we had 200 practices, I’ll let you know in a few years time. But so far, all good.

Bill Neumann: That’s great. Hey, so Deb, you’re, you’re obviously you’re on the podcast with Shara from Ivaclar. So can we talk a little bit about the strategic partnership that you have with Ivaclar and, and, and the importance of that? Uh, you know, we’ve got an audience that’s real mix of both vendor partners, uh, and then also in a DSOs and, and in different stages of scale. three locations up to heartland right and then so just I’d love for you to get your perspective on the importance of you know partnership and I know partnership is a term that’s it’s thrown around quite a bit so obviously your partners here you’re on the podcast today. How do you leverage the knowledge that Ivoclar has, that Cher has? I was at a competing company for a long time, and I will have to say that Ivoclar had some of the most knowledgeable salespeople that I’ve ever met from a clinical perspective, knew so much about the products that they had. And again, I was competing with them with a lot of different product lines, so it was a little challenging, quite frankly. Can you talk a little bit about that partnership and the importance of that?

Dr. Dev Patel: Yeah, look, I think, not just on my Ivaclub, but just in terms of generally, when I look at partners who I want to partner with in industry, I’m looking at three things. Number one, the actual product is amazing, right? Like, I just don’t want to work with any company that hasn’t got the best of the best products in the market, because otherwise, our whole You know, ethos have been the best clinical group in the UK and the best dentists are always in the best materials, whatever, you know, it won’t sound true. I think we always want to do what we say. So if I’m telling our dentists I’m hiring, you get the best materials and the best equipment and the best, you know. And all of this are the things that we don’t want to use from the best courses. I expect that our partners are delivering that and that’s who we work with and have a close relationship with. So I only have probably like, you know, probably eight or nine partners I really want to spend time and effort with because I know that those materials are market leading or the equipment is market leading and that’s who I want to be working with for the next five, 10, 20 years. to keep developing while they’re developing and bring any products out, we can hopefully trial them out in our group and work closely. Second thing is knowledge and support. It’s really, really important that we essentially always have the best possible actual people on the ground that we speak to readily to have the best support, like, you know, from on a ground level, because a lot of these other DS, you know, other kind of, you know, people in industry in terms of companies, They say they want to have the best partnerships with you and the best support, but there’s no one in the physical country to talk to, you know, send emails to people, like, you know, talk to robot. So it’s really important that you do have people on the ground, people like Cher, you know, they’re really, really incredibly knowledgeable, and the rest of the team at Ivaclar. But also that they’re there for long term. I mean, I’m sure Shay could agree with this. In the UK, almost every single person who works for any company, just every two years, flips job. And this works for my company, another company, another company, another company. And I don’t know, I can’t give up anymore. I’m like, I almost lost track of where they work. But it doesn’t really make it easier for our teams and say that I’ve got this area manager, territory manager who I can go to and I trust it’s been there for 10, 20 years. And you just go to St. Hurst and have that relationship with them and can give them a call when they feel like it, if I’m in a question about X, Y and Z. So I think the fact that they’re family owned and still, you know, they’re not focusing on like, you know, constant, like, you know, three or four or five year terms, like investor or, you know, potentially other payback companies, you have this kind of family feel about them. And it’s incredible because, you know, being family and company for, is it like 100 years? Is that right, Cher? I think it’s 100 years, right?

Cher-Marie Scott: Yeah, 101 years now. So let me ask you. There you go.

Dr. Dev Patel: Yeah, I thought so. It’s 101 years. I mean, that’s, that’s incredible for any company, right? So I think, you know, having that really long term, kind of, you know, really dedicated and passionate team is critical. I’ve actually know what talking about as well. The worst thing is you get a new company or a new product that you just buy from one of the companies and the person says to you, you’ve got no idea how the thing actually works. And you’re like, well, you don’t know, I don’t know. What happens now? And then the, the final thing is just, I think, you know, being really kind of open that we are not just a company selling a product to a DSO, right? We’re actually a partner. So let’s listen to our customers, let’s listen to the DSOs, let’s listen to what they want and what I need, and let’s make it for them. Because a lot of times, every single day, a new product from a new company, I’m like, great, that’s got no relevance to my life or to help me in any way with my problems I’ve got right now, or my conditions, so why you made it fall? And I think some person in the head of the development team thought it was a great idea, but actually it’s nothing that we need. So I think the fact that I was thinking about that kind of stuff and always asking the right questions and thinking about the R&D pipeline by actually asking the customers and working with them together is great in a way of a true partnership. So that’s kind of what I would say.

Bill Neumann: Hey, Steph, share a little bit of maybe perspective from your side of things. Ivocar’s obviously invested a lot of time and energy in the DSO group practice space. So what makes a partnership successful in your estimation?

Cher-Marie Scott: I think, um, what was important for me when we, when we founded this, um, segment or, or team within Ivaclar, I really looked at it from, you know, what was the support that was lacking really when I was on the customer side. Um, and Dev is absolutely right. You know, consistency of having the same people to speak to, even knowing how or who to get ahold of someone. It sounds really simple, but it’s, you’d be amazed, um, It’s not that straightforward. Of course, the knowledge is also helpful as well. But talking from kind of a personal perspective, I think what we do at Ivoclar is we’re fairly transparent. We don’t always get everything right, but we’re also willing to try new things. So for example, if we have a DSO customer and they have an idea whether it’s for a product or I don’t know maybe they want to tweak a workflow to be verified for their group we’re always willing to give it a try and we always say you know we make products from dental professionals for dental professionals we don’t make paper clips or any other, you know, cars or anything else alongside everything we’ve ever done at Ivoclar is being by dental professionals for dental professionals. And I think that goes a long way in kind of speaking the same language. You know, we understand what the customers need on their end and we try our best to try and support them. That’s a true partnership in any sense of the in any sense of the word. And then further on from there, I would say from us as Ivaclav, with our strategic partners, so for example, you know, our distribution partners, the likes of SprintRay, as I mentioned earlier on, we are fully aware we’re not going to be the masters of everything. And that is not our goal. But where maybe we have a grey area or we can’t help, it’s really important for us as well to provide a platform or a, you know, a gateway for our customers to be able to support them in that way. This is just everything always comes full circle, you know, if you can help people out, it’ll always be reciprocated in some way in the end. So partnership is two way street. And yeah, I mean, interestingly, Dev and I both met prior to being kind of in the DSO space together, but I think something we’re both kind of passionate about is this network and connection within the industry as a whole and kind of connecting people, helping people wherever you can, whether it’s someone from your own company or not. It’s a really important part of partnership.

Bill Neumann: That’s that’s great and i remember on our first podcast that talked about the network that he bill and i think that just seems to be something that. It still is a relatively small industry and you can’t possibly do everything is an organization. So to have those resources and to be able to point people in the direction of trusted partners, trusted resources, is certainly essential. OK, final question here, and we’ll wrap this up. We’re in 2025, or when this is broadcast, we will be in 2025. So maybe, Dev, from your perspective, As you focus on the new year, opportunities and maybe some challenges that you may expect, and then how do people get in touch with you and find out more about Dental Beauty Partners?

Dr. Dev Patel: A lot of questions there in one go there, Bill. OK, so I think the first thing is opportunities next year. I think we mentioned it earlier, but yeah, you know, really focusing on, you know, how do we pull the right levers to improve the patient journey and customer experience and what technology we can implement and roll out across the group. Uh, as Cher mentioned stuff like Sprint Ray, um, the AI with, you know, x-rays and such, even phone recording and that kind of. Um, leveraging technology to make life easier and working smarter rather than working harder. I think it’s going to be our biggest opportunity next year. Um, and hopefully coming out of a two year recessionary kind of hump. I think a lot of people have been worried about interest rates and not wanting to spend as much and potentially bigger treatment plans. And, you know, there were in 2021, 2020, uh, prior. So, yeah, big opportunities for marketing and getting this kind of, you know, with the right kind of systems and processes and thing on the pulse. I think we can really take advantage of the opportunities for the patients who are looking for treatments and, you know, being the best option for them. Challenges in the UK, we’ve got, you know, they have a government in place now, so who knows what happens there, you know, from a government point of view, new policies they bring out. But yeah, look, I think every year has its challenges. I mean, I think I was saying the other day to someone, you know, we started in 2019 and every single year we’ve had a different challenge to deal with. I think in the end it just comes, you know, when a challenge comes, as long as the team can pivot and deal with them, I think we’ll be okay. So I haven’t got any major thoughts on major challenges next year, but I’m sure something will come up in the year. And then, yeah, if you want to get a hold of me, just drop me an email, dev, I don’t know, beautypartners.co.uk. I’m a link to your profiles, you know, you can always message me directly as well.

Bill Neumann: Excellent. We’ll drop a contact info in the show notes. Thanks. Thanks, Dev. Sure. Final thoughts, challenges, opportunities?

Cher-Marie Scott: I think 2025 is going to be an interesting year for us at Ivoclar. It will be quite a big year because for the first time in the last couple of years because of MDR registration we’re launching quite a few new products and services so I’m quite excited about next year. For anyone listening that will be attending the IDS show in Cologne and all of our new innovations will be showcased there. But yeah, I think it will be a busy year, but an interesting year.

Bill Neumann: Excellent. And sure, if people want to find out more about Ivaclar or they want to contact you, I’ll drop your LinkedIn profile in the show notes. Can you shout out your email address?

Cher-Marie Scott: Yep. Fantastic. Yep. So, my email is just the Ivoclar email address. So, it’s fullname at Ivoclar.com.

Bill Neumann: Excellent. All right. Thank you, Cher Marie Scott and Dr. Dev Patel. Great conversation. It’s always great to get the perspective that we don’t always have here in the US. It sounds like A lot of the challenges, a lot of the opportunities are very, very similar. It doesn’t seem like there’s as many differences as I would have thought. So I am cautiously optimistic for 2025. I think it’s going to be a super exciting year. And I really appreciate you sharing the last hour with the Group Dentistry Now audience. So until next time, I’m Bill Neumann, and we appreciate you checking in with us. Happy 2025.

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