Leverage Clinical Management with Metrics and Qualitative Data

The founding dentist and former president of a private equity-backed midsized DSO shares some insights about transitioning from line-of-sight management to management by metrics.

Growing up playing sports it was all about God-given athleticism, skill, and raw talent. Being 5’8”, however, I ended up a mathlete rather than an athlete and later a dentist. It’s no surprise now that predictive sports analytics are an interest of mine.

Let’s imagine for a moment a team full of five Michael Jordans. Probability says you could consistently get 30 points a game from one MJ, but if there were five of him you couldn’t achieve 150 points a game. You’d need other high performers that could provide rebounds, assists, and other specialty skill sets.

The way I see it, every dental office is akin to a high-performance sports team. It should consist of high financial performers, but also others with specialty skill sets that keep each day moving. The goal for a dental office should be to have each dentist and hygienist provider be the best versions of themselves year-over-year and to keep putting wins on the board. To keep in line with our analogy, this shows them they’re part of a consistently growing championship team.

As more institutional investors begin pouring capital into healthcare services, specifically dental services and DSOs, it’s crucial that we as clinicians harness the power to impact our team’s performance and attain better and more predictable patient outcomes. How? By identifying and understanding crucial key performance indicator (KPI) metrics and qualitative data.

Manage with Metrics

Patient care and outcomes have always been paramount. When I first started working in the private equity-backed DSO space in 2015, I, like many clinical leaders, was used to managing clinicians by line-of-sight. I would spend hours with each of my doctors every single week analyzing what their chairside manner was like, witnessing their treatment planning and looking at how comprehensive it was. I’d track how many patients scheduled treatment while also looking at their crown and bridge impressions to ensure consistent, quality dentistry was being completed.

As the DSO grew through acquisition, it became abundantly clear that people are not scalable, and I alone was not going to be able to continue managing by line-of-sight. We needed a better mousetrap to make sure patient care wasn’t slipping through the cracks. We invested in clinical dashboards, created treatment planning funnels, and set KPIs. Our KPIs tracked things like production per hour, production per patient, reappointment percentage, and treatment plan and case acceptance percentages. These all helped ensure consistency within every practice and throughout our group, but what mattered most were the trends found over time in the KPI metrics.

Learn to Identify Trends

A mentor of mine told me, “If you can’t measure it, you can’t manage it.” As DSOs continue to proliferate, there are more dental companies popping up, armed with useful data that show aberrant patterns and trends. The issue is that most dentists don’t know how to interpret these patterns.

Once a clinician understands how to interpret these KPIs and trends, they can easily identify correlations and trends. So, how do dentists learn how to interpret these and make clinical decisions based mainly off of just numbers?

The short answer is trial and error, but who wants to leave patient care up to chance? To start, there are many great clinical dashboard vendors out there that can provide an API into your own practice management software like Dentrix, Eaglesoft, or OpenDental. Dig around a little, demo a few, and see the one that best fits your current needs.

Get Out Into the Field

Start looking at trends in the office and then individual providers. Learn more about the individual providers within your DSO or multisite healthcare services group. As your provider network grows, you’ll be able to see where clinicians should fit in a hierarchical dashboard. Depending on skill set, years of private practice experience, and patient load, you’ll find not everyone will be an all-star provider— nor should they be.

Layer in your knowledge of the provider and office and start to look for aberrations. Believe it or not, you’ll see them faster than you think—especially as your team grows. However, you can’t solely rely on metrics. You need to make an effort to get out into the field when possible. That’s where the dentistry is done and the dollars are created.

The key takeaway here is to remember that when transitioning from line-of-sight management to management by metrics, it’s important to understand that metrics are only part of the equation. Yes, it’s crucial to understand how to interpret key metrics, but there is a significant qualitative aspect that applies because we are treating patients.

Written by Dr. Roshan Parikh (Dr. Ro)
Dr. Roshan Parikh (or “Dr. Ro”, as he is known in the industry) is a proud graduate from the University of Illinois at Chicago (UIC) – College of Dentistry. In addition to his DDS degree, he also obtained a Master’s in Business Administration (MBA) from Loyola University with dual emphases in finance and marketing. He later capitalized on the opportunity to utilize all three when he purchased his first practice in the south suburbs of Chicago in 2008, where (despite a historically difficult period in the country’s economy) he led the practice on an exponential growth path from three employees operating in 650 square feet of space into a 20+ network of multi-specialty dental group practices with north of 75 dentists and dental specialists.

In 2019, Dr. Ro founded the dental consulting firm DSO Strategy, LLC, which was created to help entrepreneurial dentists strategize a growth plan for their dental group practices that would transform each not only into a thriving DSO, but also an investable platform for institutional capital.

Dr. Ro’s passion lies in building functional and strategically patient-centric business models that help providers to be both first-rate caregivers as well as successful businesses, and he is thrilled at the opportunity to help that philosophy come to light in a nationwide operation as he joins the team at Walmart Health as their Head of Dentistry.

“Good medicine is good business and by doing things the right way (by always putting the patient first), success will follow. In my dental practices, I work to maintain relationships as a reputable clinician and do right by the patients and people I work with each day. My passion for dentistry runs deep, which is why mediocrity is never an option.” – Dr. Ro

In his free time, Dr. Ro enjoys traveling, biking, basketball, tennis, and running through the park with his Goldendoodle, Jordy

Read Dr. Ro’s other article, “Are You Really Saving Money With Cheaper Instruments?“
Click here to read more about Dr. Ro, “Meet the Former DSO Executive who will Lead Walmart Health“
Click here to read more about Walmart Health and their new dental clinic.

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