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

Josh Fotheringham, CEO, and Dayne Jensen DDS, President and Founder of Oragen, join Darci Smith, Strategic Account Manager, West of Planmeca USA.

They discuss:

The process of providing access to care
When to move a patient to a specialist
Technology and how it impacts the patient experience
Specialty financing assists in case acceptance
Bi-directional patient care
Much more

To learn more about Planmeca, visit https://www.planmeca.com/ or to connect directly with someone at Planmeca, email marketing@planmeca.com.

To learn more about Oragen, visit https://oragen.com/ or connect directly with Dr. Dayne Jensen at drdayne@oragen.com or with Josh Fotheringham at josh@oragen.com.

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

Our podcast series brings you dental support organization 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 North & South America, Australia, Europe, and Asia. If you like our show, tell a friend or a colleague.

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Full Transcript:

Bill Neumann:

Hey, I’d like to welcome everybody to the Group Dentistry Now Show. I’m Bill Neumann, and as always, we really appreciate you tuning in today. Whether you are listening to us on Apple, Google, Spotify, or maybe you’re watching us on YouTube, however you consume the podcast, we appreciate you being loyal listeners or viewers. And without having your loyal following, we wouldn’t have great guests like we do today. One of them, actually, this is the second time she’s been on the podcast. It’s been a couple of years, but Darci Wingard, welcome back to the Group Dentistry Now Show. Thanks for being here.

Darci Wingard:

Thanks. Happy to be here again.

Bill Neumann:

Yeah, it’s great. It’s been a couple of years. And actually, Darci was flying solo on the first podcast, so she actually brought a couple of guests in here and we are actually going to highlight their group and what they’re doing in the oral surgery space and specialty DSO. We have with us Dr. Dayne Jensen. He is the president and co-founder of Oragen. Dr. Jensen, thanks for being here today.

Dr. Dayne Jensen:

Yeah, excited to be here. Thanks for having me.

Bill Neumann:

Yeah. This is going to be good stuff, so excited to have you here. And we have the CEO of Oragen. We have Josh Fotheringham. Josh, thanks for being here.

Josh Fotheringham:

Yeah, thank you, Bill.

Bill Neumann:

And Josh is also the Executive director of Proceed Finance. Did I get that right?

Josh Fotheringham:

You did, yep.

Bill Neumann:

And we’re going to talk-

Darci Wingard:

[inaudible 00:02:03].

Bill Neumann:

Yeah, a couple of different hats and we’re going to talk about how Proceed Finance works in conjunction with Oragen, how you offer some special financing for patients that are working with your group. Why don’t we go back to Darci? Darci, could you give the audience, the ones that didn’t see the first podcast, a little bit of your background?

Darci Wingard:

Yeah. I have been in the industry for a little over 13 years now. I started in the dental industry with a startup company called Demandforce, if you’d heard of them, A patient communication and marketing software. And then I switched over to working at Henry Schein, the strategic accounts division there for about four years. And then I’ve been at Planmeca for the last three years focusing, again, on strategic accounts and our DSO customers, anything that’s not in a non-traditional model outside of DSOs as well, and focusing on the equipment technology side. Again, what’s wonderful is I’ve had probably now, gosh, over eight years on the strategic accounts DSO segment. I started working within the segment when mid-markets and emerging groups started forming. And I was working on the distribution side and now on the manufacturing. I can have a little bit of the experience on all sides of the business segment.

Bill Neumann:

And you’ve seen a lot of the changes in the industry for sure.

Darci Wingard:

Yeah.

Bill Neumann:

Let’s move on to Dr. Dayne Jensen. Dayne, I’d love to… Just reading your bio here, I’m not going to do it justice, so I’m going to turn it over to you and you can tell everybody about you’re not only a DMD, you’re an oral surgeon, a MD, full body cosmetic surgeon. Tell us a little bit about your background and then maybe talk a little bit about the why behind Oragen. And I want you to hold back a little bit there, because I want Josh to introduce himself too, and then maybe you two can talk about Oragen together.

Dr. Dayne Jensen:

Yeah, no problem. I did dental school at UNLV. I think I was the fourth class to go through there. Had a great experience there. I did my oral maxillofacial surgery training at the University of Nebraska where I also got my medical degree there. And then I went to Oklahoma and did my full body cosmetic fellowship there. I am board certified in oral maxillofacial surgery, cosmetic body cosmetic surgery, and then facial cosmetic surgery. Love practicing in all the different areas there and decided to co-found the company with Josh Fotheringham because we felt like there were so many advantages to being a part of a DSO and there were so many disadvantages. And so, we wanted to find a way that we could maximize as much good as possible from both worlds. And so, that’s why we founded Oragen, specifically for oral surgeons. We’ll dive into that later, but that’s my little blurb.

Bill Neumann:

That’s great. Perfect. Josh, tell us a little bit about your background and we can talk a little bit about Proceed Finance as well.

Josh Fotheringham:

Yeah, you bet. Thanks for having us today. We’re excited to be a part of this community. Just quick background. I’ve run a bunch of different smaller companies and startups, also larger Fortune 500 companies internationally, and even down to being in a software designer at Apple. I’ve had quite the diverse background, but I’ll tell you right now where most of this all started was running a venture group for a family office based in Denver, Colorado. And with that, we were early investors in ClearChoice, many years ago before the institutional investors came into play, and we learned a little bit about this space, the growing market inside of high-end dentistry. About seven years ago, we started Proceed Finance, which today is the largest financing of patients across the US for high-end dentistry. And we were looking to get into the DSO market, so we were looking for an expert, someone that understood it well and also had the clinical background. And that’s when we were connected by a good friend to Dr. Jensen, and the rest is history with what we’ve created now, which is Oragen.

Bill Neumann:

I’ve had the opportunity to spend some time on your website and talk about being a doctor centric organization that helps oral surgeons start, sell or transition their practices. And I see the theme throughout your website, doctor centric, over and over. Dr. Jensen, maybe you’d like to talk a little bit about that.

Dr. Dayne Jensen:

Sure. One of the things that we wanted to make sure when we created this company, the advantage of starting something from scratch is you can pick your non-negotiables, if you will. And one of our non-negotiables is that we want to create an environment where the doctor feels that his or her best interest is being taken care of by us. And so, we have some situations where the doctors are like, “I want to walk in five minutes before surgery and I want to walk out five minutes after,” and we will then build a complimentary infrastructure around the surgeon so that they can do those things. And we realized very early on, that’s what we felt was one of the biggest gaps that we wanted to differentiate ourselves with, was it doesn’t matter how good of a system you have in place, or it doesn’t matter how good of a marketing arm you have, or it doesn’t matter how ideal of a location you have. If you don’t have a happy surgeon and if you don’t have a surgeon that’s willing to go out and grind with you, you really have nothing.

And so, that’s why we decided that every decision we make within the company, we ask that question first is, “Are we serving our doctors and are we making their lives better by doing this?” Now we don’t say, “Are we making it less painful?” Because sometimes the best decisions are those that are a little bit more painful, but we always ask ourselves, “Are we serving the doctor and are we remaining doctor-centric like we said we were going to be?” Because that’s what we sell ourselves on. That’s where that model came to be. And Josh creates all the systems from an executive level to be able to support the doctors that way. I live in the clinical realm making sure that, “No, that won’t work.” And we beta a lot of the things in my personal practice because I still practice full-time and then we come back and we say, “No, the doctors aren’t going to like this.” And then Josh orchestrates on the backside all the appropriate steps and procedures that need to be taken into place.

Bill Neumann:

Josh, is this solely acquisition based or partnership based, or what does the model look like?

Josh Fotheringham:

It’s a good mix. We’re acquiring practices as well as starting de novo practices. Back to what Dr. Jensen said, once we find a surgeon, that’s the key. And if they’re already part of a practice and fantastic, it’s an opportunity to acquire that practice. And if they’re looking to start a practice or want to be part of a practice in a different location and it makes sense to put a practice in that location given some demographics and other research, then we’ll do a de novo practice for that specific area.

Bill Neumann:

Okay. And what states are you currently operating in?

Josh Fotheringham:

We’re at 20 practices, we started a little under two years ago. Utah, Arizona, let’s see, Oklahoma, Indiana, Kentucky, New Mexico, soon to be Idaho. Did I miss any, Dayne? I think that’s our group.

Bill Neumann:

Yeah, I think you got them all. But based on what I have here that [inaudible 00:10:34].

Josh Fotheringham:

[inaudible 00:10:34].

Bill Neumann:

I have a cheat sheet. You had to do that off the top of your head. Talk to me a little bit about Rain Dental Implant Centers.

Josh Fotheringham:

What we started here with the practices we have is centered around full scope oral surgery. Extractions, implants, sinus, buildups, bone graft, those types of things. But also we have the ability through our financing engine through Proceed Finance to be able to find patients for much larger surgeries, especially all-on-fours, all-on-X. And so, we’ve created a sub-brand that will be attached to each of our practices in time. We’re starting with just three practices. One in Oklahoma City, one in Salt Lake City, Utah, and one in Austin, Texas. I missed Texas. That’s one of our states that I miss, so my apologies.

Dr. Dayne Jensen:

Yeah, that was Josh. Not me.

Josh Fotheringham:

We love Texas. Do not blame Dayne for the miss on Texas. This is a sub-brand because each of our practices retain either their original practice name or a new practice name based on the location. They don’t carry the Oragen brand. But now as we start pushing for the all-on-fours in these practices, we will attach Rain Dental Implant Centers as a sub-brand to these practices. And our goal is to do all-on-fours, all-on-X, Monday, Tuesday, Wednesday, and full scope oral surgery Thursday, Friday. And with that, it keeps our docs happy for a lot of reasons. One, there’s a diversity of the types of surgeries and treatments that they do, and at the same time it’s a good way to just pad their pocketbooks a little bit, because the amount of volume that’s coming through these practices.

Bill Neumann:

And Darci, you were kind enough to bring on Josh and Dr. Jensen. Talk a little bit about your relationship with Oragen, Planmeca’s.

Darci Wingard:

Yeah, we started working with or about maybe, gosh, about nine to 12 months ago for about a year now. And so, as Josh mentioned, they growth is by acquisition as well as de novo. I think we’ve been working primarily with them on their de novo practices and again, with our [inaudible 00:12:55], our imaging software, one thing where we love working with DSOs that have a specialty model like Oragen that are growing through both the acquisition and de novo, is, “Is it an open architecture?” I think that’s one thing that when they were looking at options of this is great that they have an imaging software that is open and integrates and any other type of existing equipment technology and some of their practices that they have utilized existing can plug and play. We play nicely in the sandbox with everyone and it allows to scale and grow.

But yeah, when it comes to the specialty need as well as the oral surgeons, when you’re looking at some of our larger field of use, CBCTs, you’re going to get some of the proprietary software that’s going to be able to do things a little bit differently like our [inaudible 00:13:45], which is an automatic patient movement correction, as well as our ultra low dose. We know that we are keeping… You guys talked about being doctor centric. We want to make sure we’re also very patient centric and making sure that we are raising that level of clinical care for the patients and lowest radiation, the better. And then again, those proprietary softwares are going to make for a very efficient running practice and a great experience for the patient.

Bill Neumann:

Back to Oragen. Maybe we start that conversation around providing access to care. Dr. Jensen, do you have maybe some steps that you use with the Oragen team to how do you start providing access to care? And then I’d love to figure out how specialty fits into that.

Dr. Dayne Jensen:

Yeah. When you’re evaluating, growing or building a practice, that’s maybe one of the biggest hurdles you have to solve, is how do you provide a higher level or a more efficient way or efficient access of care to these patients? And so, when we evaluate an area, we look at what portion of the population is going to fit in the different demographic buckets of insurance? Are they going to be a state funded insurance? Are they going to be a private pay or are they going to be a cash pay type of patient? And so, we make sure that our practices across the board are providing an appropriate amount of care in each of those buckets, because we believe that everybody across the board through our platform should have the right to be treated in the access to care. Some of those insurances are a little more difficult to deal with because of pre prior authorizations or things like that, that you need to get clearance before you can treat them.

But we make sure that patients can reach us either via online forms or we have community contracts oftentimes with underserved situations, like a lot of our practices have military contracts or have Department of Correction contracts. And so, we’re very proud of the fact that we’re wide-reaching in who we treat and how we treat. And we also are proud of the fact that a lot of our practices have affiliated surgical centers with them so that our special needs patients and patients that would not be able, regardless of the level of anesthesia that is provided, to receive care in the outpatient setting, we can take them to the surgical centers that we participate in and get them the care that they need. I think it’s a huge part of owning and managing a large group of practices because the higher patient volume you can get through the door, the happier the community’s going to be, the happier the surgeon’s going to be, the busier the office is going to be. And so, access to care is something that we talk about weekly amongst our practices.

Bill Neumann:

On the clinical side of things, I’d love to talk about efficiency. Especially when you’re doing large cases, you’re doing oral surgery, the patient many times has to come back in for multiple visits. Can you talk about how Oragen is leveraging technology, really, to reduce the amount of time patients in the chair, the amount of visits? Because the industry is technology focused, but sometimes when you hear that term, your eyes glaze over because technology’s in everything. So how are you leveraging that to really provide a better experience?

Dr. Dayne Jensen:

Well, I would say that’s one of the ways that we got plugged in with Planmeca is because we wanted the imaging capabilities that would be able tip of head all the way down to be able to… We didn’t have to send patients off to the hospital to get the quality of scans that we needed. Back to being doctor centric, we don’t force any of our providers to take trauma or to do full scope oral surgery, but we encourage it. And so, if they want to be able to do those things, there’s certain medical insurance and different technologies that you have to have in your office.

And I think that’s how we came into contact with Planmeca, because they offered those things for us at such a rapid rate, that we were able to get our surgeons off the ground running from a trauma perspective because we could see and treat everything that we needed to treat. But I would say the biggest way that that’s changed for us is where we are focusing on these all-on-X type treatments, we’re able to do those in two to three visits now instead of 12 to 15. And so, that makes everybody happier. That makes the patient happier, that means our providers can start and complete more cases. It also helps our reputation out in the community because we won’t have people getting nickeled and dimed 15, 12, 17 patient appointments later. And so, we’ve incorporated all the technology that is not fluff. It’s stuff that will make it so that we are able to speed up the completion of the case for the patient.

Bill Neumann:

Josh, this one’s for you. As far as specialty financing, can you maybe talk a little bit about the differences when your financing cases maybe are quite a bit more expensive, and how do you leverage your experience to provide that at Oragen? And then you mentioned you work with a lot of different groups as well.

Josh Fotheringham:

Yeah, it’s a good question because as the changes in healthcare move more towards elective surgeries and paying by the patient as opposed to insurance pay, some of these treatments, they’re pretty expensive. And so, the only way it’ll really work for a patient is if it can look like more of a monthly car payment as opposed to a mortgage payment. As soon as it starts feeling more like a mortgage, it makes it really difficult for a patient to say yes to a treatment, especially if there’s an elective nature to it.

And so, really, the key is figuring out how to get that low payment, and that comes from long term, up to 10 years on these loans, and then lower interest rates. And you can only go so low on your interest rate for a couple of reasons. One, because you need to cover the risk of those loans that may default. And two, as the cost of money in general with our current Fed making some adjustments to the interest rates, those just keep growing. And so, what we do is we do a shared risk model where the provider, like Oragen, helps pay for a small portion of the risk of that particular loan. The patient does their part and then Proceed Finance also takes a much smaller cut so that it’s more a volume-based opportunity. But all of that together makes it such that there’s a low enough payment on a large enough sum of money, that patients who haven’t had access to care, especially these larger surgeries have the ability to do so.

Bill Neumann:

Dr. Jensen, again, we talked about technology in that last question, but what advances are you seeing in the oral surgeons in your group? What are they leveraging that really is making things just easier for the clinician and also better for the patient? Are you seeing any innovation that you’re able to say, “Wow, these are some game changers”?

Dr. Dayne Jensen:

Yeah, the nice thing about being a group the size we are and growing is we get pitched a lot of things that are coming down the pipe. And I would say the biggest thing that we’re noticing for our Rain Dental Implant Center side of the practice is facial scanning. And so, with the facial scanner, everybody’s familiar with the intra-oral scanner. But now with facial scanning, it’s making it so that the smile is designed before you even start the treatment and you’re able to evaluate that with the patient, and that’s been a big game changer for us. Photogrammetry is another one where you’re able to freehand the dental implants and not have to use guides or stents, which are big and bulky and are only as good as the information you sent the lab. And so, the surgeons like that because they’re able to freehand their implants now and then the lab is able to get a pickup of exactly what the surface or where the position of those implants are.

And then there’s exciting things coming down the pipe that we get pitched all the time, like drillless implants. We have a company that’s presented that to us and has asked for our input. There’s a lot of really great and exciting things that are coming down the pipe, and I think are going to greatly benefit all of us as we adapt them. On the marketing side of things, there’s artificial intelligence that help you coordinate your patient communications and things of that nature. I would say those are the exciting new things that we’re incorporating in and helping us to get reviews and patient feedback in an artificial manner.

Bill Neumann:

Darci, I’d love to get your feedback. I know Planmeca’s constantly innovating, so what are you doing? I know Dr. Jensen mentioned a couple of things already that you’re working on.

Darci Wingard:

Yeah, as I mentioned earlier, some of, again, the proprietary software that we have embedded in with our CBCTs is something that’s very different. And I know Dr. Jensen mentioned that they’re utilizing the full head anatomy. Our Viso units are the 30 by 30, so one of the largest fields of views out there and it does a single scan. Again, it helps with the patient experience, eliminating having to do multiple scans. And then we also have what we call our ProFace, which is part of our Viso line as well. They’re basically built in cameras and the LED light strip’s capturing the actual photograph of the patient. You combine this with the intraoral scans or your CBCT images and it really helps enrich that treatment plan, accepting those treatment plans by really creating the virtual patient. Like the ProFace goes in hand in hand. And that’s something again that we have on our larger Viso line that Dr. Jensen was just discussing.

Bill Neumann:

Let’s switch topics to scaling up. Josh and Dr. Jensen, I know that you’ve scaled rather quickly and specialty DSOs are rather popular now. A lot of investors in the past two or three years have looked at specialty, especially oral surgery and endodonic platforms I’d say in the past like two, three years during and after COVID. Let’s talk a little bit about scaling specialty group and maybe some challenges and some tips for some people in the audience.

Josh Fotheringham:

Yeah, I’ll start with that and then we’ll have Dr. Jensen clean up some of my mess. But there are plenty of challenges, but it’s also such a fun space to be in right now, a lot of opportunity. Part of where we’re seeing our success is that we’re funded by a family office instead of maybe a private equity group or some other form of funding. And why that’s important is you usually have a group that’s buying these practices that are funded by a private equity group, that’s funded by a bunch of LPs that are feeding all the funds into that group.

We’re at the top of that food chain of being an LP or a limited partner that can do all of the funding and have patients and determine when we want to purchase a practice and when we want to do a de novo. And it gives us a lot of flexibility as opposed to having to satisfy a whole pool of investors that may be in a fund that needs to make a certain return over a certain period of time. That flexibility of capital source is one of the things that’s helped us really grow and scale.

And the other piece that we believe is very important is as all of these practices and specialty DSOs start to come to market, there’s a big difference between those that are simply purchasing practices and rolling them together, and those that are actually developing practices and furthering the growth at an individual micro level as opposed to just at the macro level. That’s where we really feel like not only do we have a passion to help these surgeons grow their own individual practice and we create pockets of equity for them in their own practice as opposed to an umbrella group, but we also can do it with a lot of different surgeons together, bringing all their heads together. It’s a lot of fun to grow in that way. And that’s our goal, to grow the platform and have the ability to have a platform grow any practice that may be included as part of our specialty group. Dr. Jensen, I don’t know what else you would add to that.

Dr. Dayne Jensen:

Yeah, I really like the second thing that you had said. It’s been interesting for me to watch as flipping back and forth my hats as an executive of the company to a practicing surgeon to watch almost the skepticism that has now entered into the market when we meet with the individual surgeon or the small group that we’re looking to acquire. It’s almost like there’s now been people that… I think it was like a land grab for the… 20 months ago, 24 months ago, it was almost like if a practice came on the market, it didn’t matter what it could do or where it was at. It was almost like each group was trying to show how capable they were by acquiring the practice. And now we’ve seen this settling out where it’s like, “Oh man, what have we bought and what can we do to grow it and how can we do so?”

I would say if you are somebody who is watching and thinking, “Man, is this something that’s right for me or is the world that I want to join?” I would say that you need to look at what has happened with the previous five, six, seven transactions after they joined the group. Did their numbers go up? Did their numbers go down? Did the surgeon leave quickly? Did the practice grow? Was there technology that was inserted into the practice? Did the group spend money to make the practice better? Did the staff get bigger? Did the electronic medical record become more helpful? And so on and so forth.

And so, I would say if I was in the provider’s shoes now looking to sell my practice now, because I still think it’s the way to go because the exit and the help that you can get and the competitive market rate that you can get on all of the different supplies and things like that, I still think it’s the way to go. But I would request the last five to seven transactions that the group had made, and I would say I’d like to talk to them and I would ask those types of questions. Where are you at? Have you become better? Have you become worse?

And I think one of the things that we’re proud about is that we can check the box on all of those things and say that we have done those or we are doing those in some of our more recent transactions. And so, I would say that’s the biggest challenge now is the skepticism we face when we’re fortunate enough to sit down with the doctor and say, “Hey, you’re going to be cared for by us.” “Oh, no we’re not. I’ve heard stories of what will happen.” And so, we love that opportunity to show how we actually will care and grow the practice.

Bill Neumann:

Be interested to hear from both of you. De novo or acquisition, how do you determine that? I’m sure you have some markets that you’re interested in, focused on. Why choose one over the other in a particular market?

Josh Fotheringham:

I’ll start with that and then Dr. Jensen, you can finish up, but it’s really opportunistic. When we find the right type of surgeon that fits with our culture, that fits with our mentality of patient first and then benefiting collectively as a group and one that wants to retain some equity in his or her practice, it is a really good fit. Some of it on the acquisition side is more opportunistic. As far as de novos, again, as we find the right type of surgeon that wants to start a practice in a certain location or if we have some insights based on our data, we really like to stay for the most part in the mountain west. That helps too. That’s where we focus most of our data. And when we find locations where there is an opportunity and where a payback period would be shorter than somewhere else nationwide, that’s when we start looking at doing a de novo.

Bill Neumann:

Great. How do you find… Dr. Jensen I was going to… Maybe you can answer this one. How do you find the right surgeon where, what’s the strategy there? Because that can certainly be a challenge.

Dr. Dayne Jensen:

I think the answer is probably simpler than it seems. And we know very quickly once we sit down with one another, because the right surgeon for us might not be the right surgeon for another group. We’re looking for surgeons who are entrepreneurial at heart, that they want to grow with us, and people that trust the way that we’re doing business, meaning that the surgeon’s going to maintain equity in his or her practice locally. And some people like the comfort of knowing that equity rolls up into a mothership, and whether they work three days a week or five days a week, their pay structure is probably not going to change that much.

But with ours, the right type of surgeon for us is somebody who wants to be able to directly affect the income and quality of their life at the local level of their practice, and then is willing to grow once we’ve made it, so that location or that practice is successful. We’d love to do that again, and we’d love to bring somebody else in and do it.

And so, as long as we’re honest at that dinner, we always say, we make a lot of deals over sizzling steak and hot butter. As long as we’re honest with each other in that dinner, we’ll know by the end if we’re a good fit or not. And there’s been circumstances where we have not been, and we’ll make referrals to other organizations that might fit better. And that’s always received with some hesitation, like, “Oh my gosh, why are you referring the most valued asset of the practice to us?” And it’s because we hope that we want to maintain true to our integrity, which is being doctor centric. And it doesn’t matter if they’re our doctor or any doctor, we think that the specialty is bigger than any of us. And so, as long as we’re treating each doctor with the highest level of respect, if we have to place them elsewhere, we will.

Bill Neumann:

Do you get a lot of requests for… When you’re looking the doctors over steak and butter. Love it. Yeah, I’m getting hungry already. Does training and mentorship and things like that come up as something that they’re looking for, support like that?

Dr. Dayne Jensen:

Yeah, I think especially in the residents that are coming right out of training, I think it’s not only… I think it’s very synergistic. And so, I think the older surgeons that we have that are burnt out, that are not excited about it anymore, that are like, “Well, it doesn’t really matter if I do this last case, let’s punt until tomorrow.” I think if we can pair them with a young surgeon who’s hungry and wants to learn, that reenergizes the entire practice. And so, I think there’s some tricks to the trades, especially with anesthesia. That’s where we’re finding most of our residents coming out hesitant is with anesthesia. And it’s different when you’re putting somebody to sleep and you have an attending outside the hall and three other residents down the door and you have an emergency department three steps away or whatever, versus you’re alone, 90 minutes away from the closest type of hospital. That can be nerve wracking.

And so, we think mentorship is invaluable, but both directions. And we found younger surgeons teaching our older surgeons school new things that they learned in residency, which re-energizes the surgeon and vice versa. Like, “Hey, listen, you need to dry that patient up before you give that medication, or they’re going to cough and cough and cough and cough.” It’s been very, very interesting in Oragen, the number one problem that we faced with our older surgeons is that we’ll come into a practice and they’ll say, “I’m giving you 12 months and 12 months alone. That is literally all you’ll get from me.” And then at six months it’s like, “Man, is there any way you could have me another 12 months?” And then at the 12 months mark, it’s like, “Ah, I think I want to stick around 36 months,” because that’s why Oragen is what it is, because surgeons were leaving earlier than they were ready to leave because the grind of the practice was just so breaking and so hard.

And so, we’ve taken all of that off their plate, brought in new technologies, brought in the appropriate amount of staff. We found that tons of people were understaffed. Brought in the appropriate amount receptionists, back of office support, and now we no longer fall for the old, “I’m only going to be here six to 12 months any longer.” We know that once we signed, we were going to have him for 36 to 48 months, even if that’s not what they’re telling us.

Bill Neumann:

Well, while we’re focused on training and education, Darci, I’d love to talk about that because as Oragen brings in new surgeons, they might need to get up to speed on some of the new technology that Planmeca has brought to the organization. How do you help train these surgeons?

Darci Wingard:

We have an entire team dedicated just to the DSO strategic account space. And so, kind of like I guess what you’re saying is what we call the post-sale process. Once we are ready to install into one of the Oragen locations or any DSO location for that matter, any of those affiliate locations, we work really closely with our distribution partners and make sure that we do have outlines of installation, implementation checklists. We make sure that we understand the practice management softwares that these groups currently have, other imaging type of softwares, any other type of equipment technology. We make sure before we even step foot with getting those units installed, that we are educated ourselves of what those practices are doing and where they’re centralized and streamlined with networks and everything on the backend.

And then training. We understand, especially with groups that things need to be done differently. Just as Josh and Dr. Jensen were saying, they have their own secret sauce and you can really truly feel the passion and the camaraderie that the Oragen group has from the executive level or procurement even at the clinician level when we’re talking with their individual locations.

And so, we want to make sure that we are focused the training needs on what they need. We have templates and we can create these customized trainings to make sure that every practice is trained the way they need to. We also have programs that we can do what’s like a Train the Trainer. If they have someone there that is a lead of education, we can make sure that they can be a first line of defense too, if there is any revolving door with team members or anything like that. We also offer advanced training and clinical courses, so a year or even six months after our initial trainings, there’s advanced education that we will provide if the clinicians want to take those on. Again, I think at Planmeca, we really pride ourselves again on that post-sale process and making sure that we really hold the hands and help the clinicians that have our technology installed. To make sure, again, that they’re utilizing it to its full efficacy.

Bill Neumann:

Thanks, Darci. We start to wind things down. I’ll offer this up, this last question up to both Josh and Dr. Jensen. Give me an idea of what the future next couple of years looks like for Oragen, and then maybe just an idea of what you think where the industry will be at that same time, too. Oragen and then the dental industry as a whole.

Josh Fotheringham:

Yeah, I’ll start. With the Oragen, we’ve created quite the foundation, and that’s the idea, is create a foundation that can handle the growth as well as with the capital that I mentioned from a family office. It’s very patient capital. The opportunity to divest if that were to come at some point in time will be when it’s best for everyone involved, including the physicians who have the exact same class of stock as we do. It’s a benefit for them and a benefit for us. As far as where it’s going, we’ll continue to grow through acquisition, through de novos. Each year, hopefully add a chunk of practices to our portfolio. And now with Rain Dental Implant Centers, we’re diversifying our brand and our group so that we’re doing both full scope oral surgery as well as all-on-X cases.

As for the market, Dr. Jensen mentioned it before that the consolidation started happening very quickly at a blistering pace and maybe has slowed a little bit, but part of that is due to the practices that are still available to be acquired. And over time, I assume that the larger practices that have been gobbled up by some of the larger private equity groups will start to fade and they’ll look to groups maybe of our size to acquire, as opposed to the smaller end of the onesie twosie practices that we typically focus our attention on.

Bill Neumann:

Dr. Jensen, anything you’d like to add?

Dr. Dayne Jensen:

Man, I have a good CEO. He just knocks it out of the park every time. The only thing I would say, I agree with everything he said, but one of the things that I had to transition to the most when I came out of dental school and then residency was so many people were like, “Man, the golden days are over.” Everybody missed the… “It used to be so much better,” and I just could not disagree more. I think that the golden age is now. I mean, how amazing is it that you can have a patient come in, you can scan their face with them smiling, you send it off to somewhere, and it comes back with a smile in 45 minutes that you can print in your office and put it right into their face? How exciting are all the treatments that we have to offer?

And I think the golden days are only gone for those who are not willing to adapt to the changing environment of the market, which is embrace technology, embrace collaboration, and serve your patient to the very highest level that they can be served, and you will have more patients and more opportunity than you could have ever dreamed in your training. And everybody I talk to at the different conferences or meetings is like, “Man, it just feels like I missed my opportunity,” and that couldn’t be further from the truth. The opportunities are abundant and the next 10 years, things will evolve faster than they ever have, and treatments will become easier than they ever have, and you’ll be able to impact people’s lives better than you ever could have before. Exciting future for not only Oragen, but for all of those in this space.

Bill Neumann:

And if any listeners want to find out more about Oragen, how do they do that?

Dr. Dayne Jensen:

I think go to our website, www.oragen.com, O-R-A-G-E-N.com, or you can email myself or Josh, it’s just josh@oragen.com and drdayne@oragen.com. We’d love to connect with you, and even if you just want to visit more about what we’ve talked about. I’ve seen Josh walk people through spreadsheets that never sold their practice practice to us, but ended up making changes that were very, very beneficial to them.

Bill Neumann:

Well, that’s great, and we’ll drop those email addresses and also your website information in the show notes. Darci, if any listeners want to find out more about Planmeca or they want to contact you directly, how do they do so?

Darci Wingard:

Yes, they can go to our website Planmeca.com or email marketing@planmecausa.com. And they want to learn more, there’s a lot of information online or they want to request a demo, we can have an imaging specialist visit any of the locations and doing an office demo.

Bill Neumann:

That is great. And with that, I think this has been an incredible podcast. I’ve learned a lot. I’m sure the listeners have as well. Thanks, Josh, Dr. Jensen and Darci for being a part of the Group Dentistry Now Podcast today. Certainly appreciate your time and thanks everybody for listening in. Until next time, I’m Bill Neumann.