The Group Dentistry Now Show: The Voice Of The DSO Industry

Victoria Johnson, Chief Growth Officer of RCM Solutions at SupportDDS and Carey Lasher, Chief Operating Officer at Independence Dental Services discuss:

Understanding onshore/nearshore/offshore
How Independence Dental Services leverages outsourcing solutions
RCM and the three options for DSOs
Determining insourcing vs. outsourcing
Much more

To find out more about SupportDDS visit – https://supportdds.com/ To schedule a discovery call visit – https://supportdds.com/time To find out more about Independence Dental Services visit – https://independencedso.com/

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Full Transcript:

Bill Neumann:

Welcome everyone to the Group Dentistry Now show. I’m Bill Neumann, and as always, thanks for listening in or you may be watching us on YouTube, however you consume this podcast. We certainly appreciate it. Without an audience, we wouldn’t have great guests like the next two guests we have on. We are going to be talking about outsourcing. We’re going to talk a little bit about, I think. Victoria might talk a little bit about RCM, which seems to be the topic in the DSO industry of 2023. My guess is it’ll continue into 2024 as well. But welcome Victoria Johnson of SupportDDS to the Group Dentistry Now Show. And we also have Carey Lasher of Independence Dental Services. Thank you both for being here.

Victoria Johnson:

Thank you for having us.

Bill Neumann:

So I am going to let you do your intro since you know yourselves better than I do. But Victoria Johnson is the Chief Growth Officer for RCM Solutions at SupportDDS, and Carey Lasher is the Chief Operating Officer at Independence Dental Services. So I will let you, Victoria, start with your introduction. A little bit about your background if you don’t mind. Maybe you can tell us also a little bit about SupportDDS and then we’ll let Carey do the same.

Victoria Johnson:

All right, thank you. So I am Victoria Johnson, the Chief Growth Officer of RCM Solutions for SupportDDS. A little bit about myself, I am, or I have been in the dental industry for 13 years. I have been in multiple progressive leadership roles in mid and large size DSOs, lots of operations experience as well as end-to-end revenue cycle support. I work for SupportDDS where we provide outsourcing or what we like to call insourcing team members.

Bill Neumann:

Thanks, Victoria. Carey, you’re up.

Carey Lasher:

All righty, thank you. So I started my career in the dental industry about 25 years ago as a dental hygienist clinically. I made my way working through various areas of a dental office, everything with the exception of a dentist to opening de novo offices to multi-site operations, then business consulting throughout the years. Then I moved into a sales and operational management role for a larger DSO. You may have heard of them. ClearChoice. I focused on different regions within ClearChoice, mostly on the east coast of the United States.

From there, I left ClearChoice and started my consulting business or growing my consulting business, HighWater Partners where I had a couple of large DSO clients and a couple of large suppliers as clients. And that’s how I met the individuals from Independence Dental Service. So we’re new at DSO, and I shouldn’t say newer, we’ve been around for a couple of years now, but we started December 31st, 2020, and now we are at 50 plus locations and we’re geographically agnostic or East Coast to West Coast, and we’re mostly GP focused. So with that, hopefully in the future we have a lot more practices to grow and that’s our goal.

Bill Neumann:

Thanks, Carey. Yeah, and actually I remember Independence was in 2021, an Emerging Groups to Watch award winner. I remember a couple of the team coming to San Francisco where you received an award, so that’s great. So you started in late 2020 and won the award in ’21, and so you’re up to 50 locations. And we’re going to find out how you leverage SupportDDS and Victoria and what her team do. Victoria, could you talk a little bit about SupportDDS as we start to get into the Q and A part of this podcast? Tell us about what SupportDDS does. I know you have locations right now in, I guess you’re based in Texas, but you have a location in Zimbabwe and also one that you recently opened not too long ago in Costa Rica.

Victoria Johnson:

Yes, so our headquarters in Zimbabwe where we have a large facility with over 800 team members there. So we are providing dental support to all of the practices in US and also actually in the UK, we recently expanded there. The Costa Rica office is, we saw a market and a need for Spanish speaking support in the US, so we have expanded to that market and opened that office at the beginning of the year, I believe. So yeah, so I like to say anything that’s not patient-facing, we are providing support to dental practices all across the US and the UK.

Bill Neumann:

And you said something important there that the HQ is actually in Zimbabwe, correct?

Victoria Johnson:

Correct.

Bill Neumann:

Okay. You’re based in Texas?

Victoria Johnson:

I am based in Texas, yes.

Bill Neumann:

[inaudible 00:05:43] Get that straightened out. Okay, so while we’re on the confusion of geographics, let’s talk a little bit about onshore, nearshore. And offshore. So onshore, nearshore, offshore, can you explain the differences?

Victoria Johnson:

Yeah, so onshore would be considered outsourcing with team members within the United States and within our country. Nearshore, we’re looking at people that are outsourcing to Mexico, Central America. And then offshore we refer to as places like we are in Africa, Zimbabwe, India, some people are in the Philippines. So yeah, we think that with the model that we have, we’ve really kind of broken a code here with being able to provide English speaking team members to support practices as well as a conflict I think that some of our clients have had in the past is time zones. So our team members work our time, US time zones, Eastern, Standard, Central, Pacific. So yeah, that’s the difference with onshore, nearshore, and offshore.

Bill Neumann:

Carey, how does Independence leverage SupportDDS? It sounds like they can do a lot of different things for DSOs, whether it’s at the practice level or whether it’s actually at the support level of the organization. Can you talk a little bit about your relationship and how you’ve leveraged their talent?

Carey Lasher:

Absolutely. Within DSO, there’s lots of different departments, lots of different opportunities. And how our DSO operates, we’re decentralized but trying to centralize a lot of our functions. We allow extreme clinical autonomy, but when it comes to an administrative portion of it, we really sometimes need that support. And so we do have the challenges of lack of staffing at a lot of centers and a lot of lack of knowledgeable staffing at centers. So with the right outsourcing, SupportDDS, we were able to centralize many of our processes and the functions. We were able to standardize some of our processes like our treasury management, some of our accounting processes where we needed. We keep in mind, of course budgets and cost always, but there’s different demands, there’s different needs of the business and finding the right people to fill those roles are really important. And we found specifically with this group, there were so many knowledgeable people that could help us rapidly grow our DSO.

We needed that scalability. Of course, growing in a short period of time, scalability was a big factor for us. And so we needed that. The team members that were able to do it, we needed an outsource group that understood our needs, that can meet our needs. And we’ve been nothing but happy with everything that SupportDDS has been able to provide for us. Specifically, I know some centers, we use them for administrative functions, some are for insurance functions, that whole RCM portion of that, and now we’re actually, I don’t want to steal Victoria’s thunder or anyone’s thunder here, but we are looking at using them for a full RCM department.

Bill Neumann:

Well, that’s a great lead into what Victoria and her team does. So let’s talk a little bit about what SupportDDS does on the RCM side of things.

Victoria Johnson:

Absolutely. So we noticed there was a gap in the market, and really I joined SupportDDS about three months ago. Like I mentioned before, I came from the DSO side. All of my experience comes from being on the DSO side and sitting in the RCM leadership position, I just realized there’s all of these great automated solutions that are out there, but there’s not a true end-to-end solution. Basically, you have to go and you have to partner with a solution for each different task in the RCM. So at the end of the day, you’re having to manage five, six different relationships in order to completely fulfill RCM. So what we are doing, and when I joined SupportDDS, the goal was to say, okay, how can we be the people or the group that provides this true end-to-end solution while leveraging all the great AI that’s out there and all of these other automated tools that are developing within the RCM space.

So we came up after speaking with tons of emerging groups, solo practices, large DSOs, we noticed there’s a different need across the board and we put them into three categories. So the first is those groups or DSOs that really have their SOPs and best practices in place. They know what they’re doing and they just simply are lacking the labor resources to do it. So for them, it’s basically, we’ve got team members for you, we’ll hand them to you and you can train them your systems your way. And then the second category we have are those that have best practices, for some things, they may not have them for all. And they’re really looking for advice to kind of piece together best practices across the board, but also those that don’t have time to train team members.

A lot of the RCM departments are shorthanded. They’re dealing with a day-to-Day, and a lot of people just don’t have time to train 10, 15 new team members. So what we do is we’ll meet with them, go over best practices, they’ll share what they have, we share what we have, we collaborate and come up with how we want to move forward, and then we train the team members and take on that burden so that the DSO or the client doesn’t have to do that and we get the team ready for them. Then the third category are those groups that really just do not have any best practices in place. They really are like, “We know we need help, we don’t know what we’re doing. Can you please help us?” So we share our best practices with them and then we also train the team members and provide them full support. So we have an auditor, they’re assigned an auditor, a trainer, and I like to call it the plug and play solution for them.

Bill Neumann:

Have you found that there are more groups out there looking for help with RCM as the economy has changed in the past 12, 18 months?

Victoria Johnson:

Absolutely. I think we went through a period where we had a lot of emerging groups and DPOs and DSOs that were going through lots of acquisitions. They grew from five to 15 within a short period of time. And then with the economy, it was, okay, let’s slow down, let’s focus on same store growth, organic growth, and let’s really start to focus on building the infrastructure. And I think as people began to peel the layers off of that onion, they’re realizing, wow, on paper it looks like we’re doing fantastic. But out of the 10 offices, they have, maybe four are doing all the heavy weight while the other six have lots of opportunity. So we’re noticing a lot of interest in that. DSOs and smaller groups are finding that there’s no standardization, no centralization, and really starting to focus on that. So in turn, that’s really made us a lot busier.

Bill Neumann:

Questions for Carey and Victoria, please feel free to give your input on this, but we all see issues with the labor pool still. I think it started pre-COVID even, and of course that exacerbated it for sure, and then a lot of people didn’t come back into the workforce, so we’re still challenged there. At the same time, labor costs have risen. So you’ve got some really interesting dynamics. How are you or how is Independence dealing with that, Carey?

Carey Lasher:

Oh, that’s such a [inaudible 00:14:15] question. Yeah, it’s a work in progress, but one of the biggest things is outsourcing. I mean, we really have looked to outsource it to help fill that role. One of the reasons for that is it’s reliable, and so we don’t have the high turn rate, the staff turnover as quickly. I guess the way to put it with SupportDDS, we can hire one individual that can train other individuals to fill the role, so we always have someone there in place. We never have that lag time or loss of knowledge. We never have that gap in whatever function or job duty that’s happening at that time. So they always are there to help in that way. It also helps keep our costs down, and I shouldn’t say much down, but more like it helps level it out so we’re not having to always fight with the next region or the next area. So-and-so pays this, therefore I should get this. And everyone seems to be asking for raises right now or bonuses or leaving a job to find another job that pays more.

So I think all DSOs are really struggling and I would not just say DSOs, but I’d say in general a lot of dental offices are struggling to help get the right people in place and outsourcing can’t help with the dental assistant or the dentist or any of the providers, but it definitely can help with a lot of the other functions in an office.

Bill Neumann:

And again, Victoria, are you seeing an increase in demand just because of, again, the lack of people in the market right now that have skills on the support side, whether it’s admin, and Carey mentioned a lot of it RCM, accounting, go down the list.

Victoria Johnson:

Absolutely. I think the labor shortage and finding team members, but then also worried about retaining the ones they have and making sure that they’re not getting overwhelmed and how to better support those team members so that they can focus on what we’re here for, patient care. I think the other thing that we’re hearing a lot is really, how can I help my team members? We are short staffed and what support can you guys provide so that they aren’t so overwhelmed?

Bill Neumann:

I’m curious, Carey, if you’re seeing this rise in need for bilingual team members, have you seen that at certain practices?

Carey Lasher:

Yeah, I think that’s very regionally centric. We’re going to see that more… Really, again, just depends on where you are. I think having the outsourcing of the bilingual is going to be important, especially from my perspective, one of the things is helping mine the pipelines at these centers, helping them work with any of the billing or the insurance submissions, helping if they need to contact a patient one-on-one. It really depends on what you’re using the outsourcing for, but it is a need that’s out there that isn’t met at this point. So I was happy to hear from Victoria and JW and their team that they were outsourcing to Costa Rica.

Bill Neumann:

And in fact, JW’s in Costa Rica right now, so that’s why he couldn’t be on the podcast. But obviously Victoria, your team’s done your research, there’s a need for it. You’ve opened up the Costa Rica location.

Victoria Johnson:

Yeah. So I actually was just speaking with a client earlier who specifically wanted Costa Rica and she’s a smaller group, about seven or eight practices, and they are looking for bilingual team members to call on from an RCM’s perspective, to call on patient collections, to contact patients, and they’re in a geographical area where they have a ton of Spanish speaking patients. So we’re seeing that. And then like Carey said, just mining the pipeline. A lot of direct or of first impressions and answering phone calls, we’re seeing a lot of need for that.

Bill Neumann:

Carey, do you determine what is insourced and what’s outsourced or is it based on need? Were there certain things that you really shied away from and maybe you’re outsourcing now that you never thought you would? I know that’s about 10 questions there in one.

Carey Lasher:

No, you hit the nail on the head right there. It depends on need. And for us, for our perspective, it was scalability. So potentially how we looked at it two years ago may not be the way we’re looking at it now. So we have to be able to pivot. And if we’re having staffing issues or if we’re having assistance issue, we have a policy or procedure that’s not getting met or we have a protocol that we’re trying to implement for some reason, we’ve looked internally within ourselves to make for sure it’s a reasonable protocol. Sometimes just the staffing, finding the right people. If it’s initiatives that we want launched, sometimes it’s finding the right people to hold them accountable and helping us centralize and organize our information. But we have to make for sure we have enough people in place, not just throwing bodies at a problem, but actually been very prescriptive, been very intentional who we hire in that place.

And so I’d have to say specifically with SupportDDS, we are able to interview and place the people that we think best fit for that role. So they’ll bring us, recently we were hiring for a procurement coordinator role and they brought to us who they thought would fit in that role. So they prescreen them for us and then we’re able to finally say yes. So it’s not just that you have to deal with whoever they give you, you do have a say in it. Which helps with one, our reliability, our trustworthiness on the work that’s getting done. And then two, we don’t have that drop in projects. We don’t have that always chasing someone looking for the work that they’re putting in there. They’ve worked effectively on our time zones that we need to, which is important. It’s extremely important. We’ve worked with previous outsourced companies in different regions of the world and there’s a huge lag time between potentially when we need a deadline met and when they could actually achieve the deadline. So it’s very important as far as the timeline and the knowledge of the staff.

Bill Neumann:

I think the time zone piece is important. My interaction with the team in Zimbabwe has been incredible. I feel like they don’t sleep. So when I reach out, whether it’s East Coast or early in the morning or late at night here, I get almost an instantaneous response. So it’s something that I was really surprised. I’m not sure how they do it, but it’s pretty incredible.

Carey Lasher:

Yeah. I’d like to add too, the time zones help with us meeting our timelines and our deadlines, but one of our first things that we made a slight… I would say in the beginning of forming a DSO, you’re trying to figure out how to fix things. You’re trying to figure out how to centralize these problems and which problems do you prioritize first? And initially we were throwing software at the issue. We have this software program that can help us with this problem and this solution. And ultimately we learned that wasn’t the case, that we needed the right people in place and we needed the historic knowledge of DSO support staff. And with the SupportDDS, specifically Victoria and different other members of the team, they have that historic DSO knowledge that can help a lot of forming mid-size DSOs really achieve their goals and achieve their targets and get the right people in place.

Bill Neumann:

Well, I think that’s an interesting point. And specifically to Victoria’s role and RCM, there’s a lot of softwares out there now that have come out in the past couple of years, and I’m sure they’re all great, but you’re really combining technology with people at SupportDDS. And Victoria, how is that being received?

Victoria Johnson:

Great. So yeah, when I was in my previous position, there’s so much software and different automated solutions and AI coming at you, being thrown at you at all directions. So it’s really figuring out what the best solution for your DSO is and leveraging that. But I think one thing to note too is while these are all fantastic solutions, none of them are 100% yet. I do think in time that we’ll have solutions that give us 100% of what we’re looking for, but a lot of them give us about 70 to 80% of the information that the teams or the practices truly need to succeed. And what we’re doing is picking up that extra 20 to 30% and applying a team member or a human aspect to that.

Bill Neumann:

Well, I’d like to get a little specific here, and either one of you can answer this, but our audience is vast, so we have a lot of large DSOs and then we also have a lot of emerging groups, so all different teams, all different stages of scaling. And when we break it down at the role level, maybe we look at the practice level and then we look at the positions at the support level. Can we talk a little bit about how SupportDDS can fill those roles? Again, at the dental office, we know they can’t be assistants and they can’t be hygienists or dentists, so we know that’s out. But what roles at the practice level do you think SupportDDS can come in and sell?

Victoria Johnson:

Sure. I can tell you-

Carey Lasher:

At the-

Victoria Johnson:

Go ahead.

Carey Lasher:

Go ahead, Victoria.

Victoria Johnson:

Go for it.

Carey Lasher:

Lead the way. I can tell you at the practice level, we use them as assistants, like your executive assistant, scheduling things. We use them for call centers. We use them for billing personnel. We use them for insurance verification. We use them for understanding some of the software that we early on purchased to help solve an issue. At the DSO level, we use them, and I know you asked for a center level, but DSO perspective, we use them as like GL managers and AP managers, our AR managers, our payroll team and support team and managers. So gosh, anything that you can think of, I would say if you have a pain point within your centers or you have a pain point within the DSO and you’re like, “I don’t even know how to fix this or who to call to fix it.” You know what? I would encourage you to call these guys. They’re pretty incredible. But I’ll start with that. And Victoria, what were you going to share?

Victoria Johnson:

Yeah, you nailed it, Carey. Everything you said we were able to fulfill. I always say anything that doesn’t require patient facing, a drill in the mouth, we can help support at the practice level. From the DSO side, AP, finance, HR, IT, marketing, sales, sales, RCM obviously, scheduling, any operation support, call center, overflow calls, all of that we have teams ready to go for it.

Bill Neumann:

So again, I mentioned earlier that we have a pretty vast audience. Again, all different. So if we look at maybe some practices that are just growing into being a DSO, so somebody, doctor owned, doctor led, they start to scale up, maybe they’ve never outsourced anything before. So can we talk a little bit about, there’s going to be some apprehension I would guess. So maybe Carey, could you talk a little bit about your first experiences with outsourcing and maybe any way to alleviate that? Because I’m sure there are a lot of people thinking, “Well, I really don’t want to do that.” But you may have to and actually it may be a much better solution than spending a lot of time trying to find somebody that is in the states that just isn’t available.

Carey Lasher:

Yes. I think when you say outsourcing, sometimes people think of the phone trees from the credit card company and you get the never ending loop of the same person that’s answering the question over and over. And it’s more task oriented and not so much the critical thinking or solution oriented outsourcing. And I’d have to say all of us are victim of that, or not really victim, but we all fall victim to that thought process. But that’s not what we have, not currently, at least with the SupportDDS. I was introduced to them originally by one of our partner doctors who uses them at a center level as a personal assistant or an executive assistant from afar. And we had experienced, at the time we were using a different outsourced company and I thought, this is not going to be any different. We just need to hire everyone in the US. We need to overcome these issues.

We’re having big communication issues, which was leading to frustrations from the enterprise level down to the center levels and anyone that was communicating with our first outsource team. And then when I talked to our partner at her location, she was just raved about them. I said, “Okay, I’ll meet JW.” And so once I met JW and he introduced the concept to me, I was like, “Okay, I’ll listen a little bit more when they speak the Queen’s English.” Which matters to a lot of our centers and understanding and the clarity and the communication. And so I said, “We’ll start with one, we’ll start with one person.” And so we started with the one person and he just was absolutely amazing. And from there we added a couple more and then a couple more and a couple more.

And now I’m really not for sure how many we’re up to, but we have whole departments that are just SupportDDS BS. So I would say as you go into it, of course there’s going to be some skepticism, as there should be, but I think once you dip your toe in and you realize how beneficial they could be, and once you trust the process and you trust that you can select who is going to be your outsource, you’re not just stuck with someone. They don’t just say, “Here.” They do take the time to ask your needs. They do take the time to find out exactly what you want. We put together job descriptions of exactly what we’re looking for. And again, so far I can’t say enough good things about how relieved that I’ve been, it’s night and day between our previous outsource company to this outsource company. It’s just that you can’t compare them.

Victoria Johnson:

Do you mind if I add to that, Bill?

Bill Neumann:

Absolutely. Go for it.

Victoria Johnson:

Coming from, I was previously actually on the client side and worked on building a centralized RCM team at my previous DSO. And I think what really sets SupportDDS apart from a lot of the other outsourcing companies is that SupportDDS isn’t transactional based. It’s relationship. You get a team member and it’s all about how successful you incorporate them into your team. Do you have morning huddles with them? Do you celebrate birthdays, anniversaries, just like you would a team member in the practice? When they feel valued, I mean, the sky’s the limit with them and you will get so much more out of them in that relationship than you will from a transactional based model. So I think that’s really important to bring up because a lot of our clients that are really successful with outsourcing, it is because of how much effort and energy they put into building that relationship and creating that success for their team member.

Bill Neumann:

That’s great to know, Victoria.

Carey Lasher:

I was going to say… Sorry, Bill. I was going to add she’s spot on. We treat the outsourced people as employees of Independence. So we don’t treat them as a secondary or a service, they are our employees as far as we’re concerned and maybe that’s what makes us successful with the service.

Bill Neumann:

Well, that’s also nice because you talked about perception of outsourcing and I don’t think a lot of people have that perception that the people that are truly treated as employees, so that’s great to know. Something we didn’t mention earlier is SupportDDS does a lot of charitable work and gives a lot of profits back to charity and donations. Can you talk a little bit about that, Victoria?

Victoria Johnson:

Yeah, so our mission is to transform the lives of our team members while making a global impact. So providing jobs to the people of Zimbabwe, ultimately our goal is to provide 20,000 jobs to people there, and we donate 51% of our profits to ministry work across the globe. So building orphanages and being highly involved in a lot of ministry work.

Bill Neumann:

As we start to wrap this up, I’m curious, this is kind of the crystal ball question I have at the end of the podcast, so predictions on the future. So maybe we can look at some predictions. With the tight labor market, I think outsourcing is going to continue to be something that is going to be leveraged. And again, when I say outsourcing, it’s not what SupportDDS does. You’re really providing employees that just aren’t on shore. So talk a little bit about what, you’ve obviously scaled up. You’ve opened in Costa Rica, so you know that you’ve got the bilingual, Spanish speaking. What do you see as the future for SupportDDS and the services that you offer?

Victoria Johnson:

I think we’re just going to continue to grow and grow and grow. I mean, we have a ton of interest even just on the RCM solution side. Right now, we’re nearing, approaching our 900th team member. We support over 1,700 dental practices, and I don’t see it slowing down anytime soon.

Bill Neumann:

Carey, how about I ask you this question about Independence. You said you’re going to grow and add more practices. Can you be any more specific?

Victoria Johnson:

That’s why we’re going to keep growing.

Carey Lasher:

I can’t give you specifics on how we’re going to grow and add practices, but I can’t be specific in the fact that when we do add on those practices, that our plan in the future is to have SupportDDS to help us with those policies, the processes, and make them for sure that our integration is smooth with those future offices.

Bill Neumann:

And are most of the practices that you add when you add them, are they acquisitions?

Carey Lasher:

Yes, it is all acquisitions at this point.

Bill Neumann:

Okay. And you said not tied to any geographic area specifically. So you’re East, West Coast, you’re pretty much everywhere.

Carey Lasher:

Yeah, we’re pretty much everywhere. We have a stronger concentration in Florida, Texas, and California right now, but we’re in several different states, I’m going to say 14 states at this point.

Bill Neumann:

As we wrap things up, since we’re on the subject, Carey, if there’s somebody out there that might be interested in partnering with Independence or just finding out more about the organization, how can they reach out to you or give us how they can find more information on Independence?

Carey Lasher:

A couple different ways. We have our website, independencedso.com. They can also reach out our chief growth officer, Dave Thoni. His email address is David D-A-V-I-D @independencedso.com. Or you can reach out to me if you have questions. And it’s carey@Independence.com. And my name’s spelled a little bit different there. It’s C-A-R-E-Y. So we’re very much willing to have conversations with anyone about outsourcing or about joining a DSO.

Bill Neumann:

Thanks, Carey. And Victoria, if anyone wants to find out more about SupportDDS, whether it’s RCM or all the other great solutions that you offer there, how can they find out more?

Victoria Johnson:

Visit supportdds.com. If you want to learn more about our mission, supportdds.com/the51 and then my contact information is my full name, victoria.johnson@supportdds.com.

Bill Neumann:

Great. Well, thank you Carey Lasher and thank you Victoria Johnson for joining us today. By the way, you don’t have to memorize the email addresses or the URLs, we’ll have them in the show notes, so you’ll be able to just click on those and reach out to Victoria or Carey. But we appreciate everybody spending time with us today. Great conversation. I personally learned quite a bit and I am sure the audience, you’re going to be getting some emails, that’s my guess. So until next time, this is the Group Dentistry Now Show, and I’m Bill Neumann. Thanks for joining us.