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In this audio-only episode, Bill Becknell, CEO of Mortenson Dental Partners and Eric Tobler, DMD, National Director of Clinical Affairs of Mortenson Dental Partners and Regional President of Stonehaven Dental, join the show to discuss how their DSO is addressing the Covid-19 (Coronavirus Disease 2019) pandemic.
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To find out more about Mortenson Dental Partners’ Coronavirus Response Plan click HERE.
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FULL TRANSCRIPT
Kim Larson:
I’m Kim Larson. Bill Neumann and I are talking about Coronavirus disease 2019, also known as COVID-19 today. COVID-19 concerns are sweeping the world since it spread so easily from person to person and is now considered a pandemic. This rapidly evolving situation is challenging everyone, including the DSO industry. We are speaking today to two leaders from Mortenson Dental Partners about how they are responding to this public health emergency.
Bill Becknell is the CEO of Mortenson Dental Partners, a 140-plus practice dental support organization based in Louisville, Kentucky. Bill joined Mortenson Dental Partners in 2014 and served as the chief strategic officer and president of dental teams before becoming CEO. He is the first non-clinician to serve on the board of directors.
Dr. Eric Tobler is the national director of clinical affairs, serves on the board of directors for Mortenson Dental Partners and is the regional president of Stonehaven Dental. He has been practicing dentistry with his family at Stonehaven Dental in Utah since 2007.
Welcome to the show. Let’s jump right into this, guys. Bill, Dr. Eric, obviously, there’s a lot of activity in the media around COVID-19. Can you tell us what you’re seeing and what plans you have in place to address?
Bill Becknell:
Yeah, absolutely, Kim, and thanks for inviting us to the call. We’re honored to be here. It’s a pretty interesting and quickly evolving situation. From our perspective at Mortenson Dental Partners, we know we’re in the early stages of the outbreak here. We are seeing cases in nearly all of the geographies that we serve, but we are not experiencing any cases in our patient base or team members as of yet, which we are very happy about, but we are fearful that it’s just a matter of time.
Bill Becknell:
We did spend some time reviewing some industry data that came out of Cleveland Research by Jamie Clow, and some of the statistics quoted in this research were pretty staggering. First, dental visits dropped nearly to zero for the term of 30 to 45 days. Elective procedures in healthcare were down 85 to 90%, and just significant disruption in the way of life for everyone for 30, 60 days during the outbreak, and so, armed with that information, we’ve got pretty busy in terms of preparing for our company and even saw some more data today that said, “Dramatic declines in patient visits are beginning to occur in Washington and California over the last seven to 14 days,” so very few offices have closed yet, but a few of those have.
Bill Becknell:
We’ve seen directly some impacts here around supply in terms of personal protective equipment, lots of questions from our team members and patients. We are tracking our appointments and cancellation trends. There’s no major factor as of yet in the regions that we are in, but we’re expecting that to change, and we’re starting to see more cancellations probably next week and increasing no-shows for appointments. We are also thinking that team member availability is on the horizon. We have had schools closed in the regions that we serve. Also, we know that it’s going to impact a lot of our team members’ abilities to get to work, so the situation has escalated really quickly this week. We really recognize we’re going to have to be ready to respond with a real possibility it could worsen in our communities over the coming next 30 to 60 days.
Bill Neumann:
Yeah, it’s amazing how quickly this is escalating, and the plans that you have in place right now might change drastically, so talk about the first steps you took as part of the planning process.
Bill Becknell:
Yeah, so, Bill, first off, we really thought about our priorities here, exactly what do we want to do, what do we want to preserve. The first thing we thought of is our safety of our team, our patients and the communities. I think, as an organization, we have 800,000 patient encounters per year, and, obviously, the commitment to those and their safety is paramount for us, and then also we began to consider that, as this unfolds in 30 to 60 days from now, we want to make sure our organization exits this event just as healthy as we entered, and so we began to think a lot about organizational continuity. We established a COVID-19 response team really to create some plans around this with those three main points, specifically team member and patient safety and communication and business continuity.
Bill Neumann:
Dr. Eric, this next question is for you. Let’s take each of those points that Bill just brought up one by one. Tell us about some of the work you’ve done on behalf of the team members.
Dr. Eric Tobler:
Yeah, so, initially, what we looked at is we recognized that this was going to become an issue really a few weeks ago, and so, starting two weeks ago, as a clinical director, I was able to send out an email to communicate with our team members about what we were seeing and what we expected may come down the line, really starting with some of those PPE shortages and other things that we anticipated, but, quickly, we realized that that email communication wasn’t going to be enough, so we started developing… in conjunction with that response team, we developed a number of resources and protocols to really help address the issues that our team members were going to have, and then we developed an internal webpage as well, so the webpage itself basically houses now all of our resources, so some of the one… more impactful pieces has been the frequently-asked-questions section, a team member exposure policies, so, specifically, the team will know… knows exactly what to do if there is an exposure, if they’re having symptoms or they notice any of those within their patients, so they have a very clear protocol there.
Dr. Eric Tobler:
We also have information on benefits for our team members, employee assistance programs and our telework policy. In that website, we also have regular updates that we’re putting there that is constantly changing, so supply and inventory updates, links to the CDC educational videos, all of those kinds of things we’re developing and putting out on a regular basis. We also have some incident reporting forms and then, finally, we have a box down to bottom. It’s kind of an Ask Dr. Tobler a question, and that’s been a great form of communication back and forth between our team members, so that’s been pretty great, and then, for the communications, we’ve really tried to focus on a few things. One of those is just emphasizing the importance of our standard protocols for disinfection and sterilization and just emphasize that, but then also talk about at the office level how to strengthen the disinfection as well, so, yeah, those are the initial things that we’ve kicked off.
Bill Neumann:
Okay, so that’s really how you address things from your team member perspective. Tell us a little bit about what Mortenson Dental Partners has been doing for the patients from a patient perspective.
Dr. Eric Tobler:
Right, so the patient communication has really come from a few different places, both from direct communications centrally from the company, but then the more important communications, of course, come from the office level, so, initially, we posted a statement on all of our external websites, and we sent an email to our patients to talk to them just a little bit more about what we’re seeing and what we’ve done proactively to help maintain their safety and the safety of our team members, of course, and then, prior to appointments, we’ve also sent out messages, confirmation messages like we would do normally, but also included some screening questions and asking patients who are exhibiting symptoms or who have traveled out of the country recently to push back their appointments for 14 days, and then, on the communication side at the office level, we have a counter display that really talks about those same things. If you had flu-like symptoms, coughing, shortness of breath, please delay your appointment.
Dr. Eric Tobler:
We have some pamphlets to just further inform them about what they can do to keep themselves, their families and our community safe, and then we’ve also been balancing openings in our schedule, trying to do what we can to take care of the patients today, because we don’t know what tomorrow looks like, so our practices have been trying to look creatively at how they can take care of patients as well as possible, especially patients with emergency situations, patients in pain. We’re really trying to do everything we can to take care of them today.
Bill Neumann:
This next question is really for Bill, so, Bill Becknell, with everything that’s going on right now and the fact that it’s changing day by day or, really, actually more than that, it’s hour by hour now, how do you ensure that continuity of your business? I mean, how do you ensure that things continue on in a reasonable manner?
Bill Becknell:
Bill, we are, as a leadership team, we are meeting every day to review the most recent events, the information that we’re getting in from the practices, the statistics from yesterday in terms of missed appointments and cancellations and then making plans and communicating that back out to our teams, as well as receiving the latest updates in from operations. That keeps us informed making decisions in a timely fashion and changing as this thing is changing rapidly, as you just mentioned.
Bill Becknell:
Each of our regional leadership teams, and we have six main regions out there, anywhere from 45 practices to 13 practices, and then each support function leader really is developing a contingency plan for various levels of impact. We broke this down into four levels of impact, and that is level one, we’re at a 100% of operations, we’re just being proactive in terms of education and communication. That really is where we are today as an organization. Then we said level two would be is operating at 75% of our normal operations, level three at 50, and level four at 25% and/or below, and so, for each of those levels, we’ve developed plans that we would execute as the business gets impacted.
Bill Becknell:
We’re optimistic and hopeful that obviously we never get past level one, but we want to be ready as the challenges come ahead. We’re looking at different ways to consolidate practices in terms of a major downturn so we can still deliver care for those that are seeking it and also manage the availability of employees that we have that are willing to and able to come to work. We’re starting to create work from home for call center insurance posting and those types of things to make sure we can continue to support our practices through this difficult time.
Kim Larson:
Bill, what advice would you give to others working on contingency plans?
Bill Becknell:
Kim, that’s a really good question. I think, first, you have to keep your priorities in mind and consider your organizational responsibilities to really the larger good, specifically the safety of our patients, team members and communities. As a significant provider of healthcare, we need to make sure that we’re in a good position to protect the individuals that we serve and then also protect our business. A time of crisis really requires an extreme decentralized management approach to be effective. Your organization needs to be nimble, so you need to make sure you communicate to the teams the priorities, give them the tools to get things done and stay out of their way because they will be needing to make decisions on the fly especially as this thing unfolds and ramps up, and don’t forget that everyone that you depend on is going through the same challenges. You need to think about how their unreliability can impact your business.
Bill Becknell:
Obviously, patients are going to be impacted, wanting to stay at home, wanting to not come in, not risk infection. Team members and providers are going to have kids that are no longer in school who require care at home and are unavailable to work. Our payers are going to have the same challenges that we are, so you can expect your revenue stream to slow down, and our suppliers are going to have the same difficulty filling orders and making sure that we get the necessary supplies in a timely fashion to take care of our business.
Bill Becknell:
Obviously, you also need to think about cashflow. If the reports that we’re getting out of China are correct and we’re going to have a significant depression in visits for the next 15, 30, 45, 60 days, cashflow really is going to be paramount in preparing for this event, and probably the good news to that is embracing the equilibrium, and, in these events, it’s real quick and easy to get focused on one side of the equation or the other, specifically either the supply or demand. The reality through these types of events is usually both side of the equation is affected equally, and so, as your supply or resources goes down, also the demand from patients will likely go down with it, so these usually will work I believe in somewhat parity as these things change.
Bill Becknell:
Communication, Kim, is absolutely critical, specifically from an internal standpoint, that everyone knows and understands what is going on, what the most recent changes are and what we’re looking for from them so that we can execute effectively as an organization. It’s important to establish one version of the truth and really a reliable source for them to find that truth, and, as Dr. Eric articulated earlier, we’ve created a website to do that, as well as a daily email coming from Eric with all the latest and greatest around the Coronavirus. In short, in a time of crisis, really, the reality of it is, if we don’t rise to the occasion, then we fall to our highest level of planning, and so, as an organization, we’ve worked aggressively to make sure we have a good plan in place to get us through this.
Bill Neumann:
Dr. Eric, what would you say the response has been to the communications and plans that you’ve put in place so far?
Dr. Eric Tobler:
I’ll say this. I mean, Bill saying latest and greatest, that’s the first time that I’ve heard that the communication about Coronavirus from me has been the greatest, so I appreciate that. No. There’s really been a few things that I’ve seen, so, being the point of contact, I’ve been fortunate to really interact with team members who are hearing so much reporting both locally and nationally, and I’ve really heard a few things from them specifically about what we have going on in our practices. The first one is specific questions about what do I do in this situation or that and what does this mean for my pay, what does this mean for my team members, how are we going to deliver care, and I’ve been grateful for the group as a whole in general with those questions.
Dr. Eric Tobler:
We’ve already had the protocols in place, and it was really just a matter of validating the concerns of the individual team members and then referencing them to the protocols on the website I was talking about earlier and showing them, “This is where you can get your answers,” and… because, like anything, it’s sometimes hard to navigate and know exactly where to look for the information, so I’ve just been able to direct them in the right spots.
Dr. Eric Tobler:
The other half of the communication I have received from team members have actually been really fun. They just thanked myself and the rest of the team for our proactive approach, and they’ve said things like, “Considering all of the things that we’ve heard, it gives us a lot of confidence to see that you guys are taking this seriously and that we as a company are getting ahead of it.” I think that’s been the two main sources of communication that I’ve had from the team members up to this point, and, for me, it demonstrates the value for us as a DSO, the value we’re able to bring if we do things right.
Dr. Eric Tobler:
We can really help our clinicians stay focused on their patients and then provide to them directly the most current information that, as we said, is sometimes changing minute by minute, but we want to make sure that the information that we’re sharing throughout the company is scientifically based and supported by the best resources possible, but that’s been able to allow both our doctors and our teams to focus on the patient care while we as a company focus on building those contingency plans and protocols to help support them.
Bill Neumann:
This is great info, and I know we just really scratched the surface with your process and what you have in place right now. Would Mortenson Dental Partners be willing to share these insights to… As you know, we have a lot of emerging dental groups and larger dental groups and solo practitioners that listen to this podcast. I think that what you have in place right now is very forward-thinking, and my guess is that there are some groups struggling to find the process. Would you be willing to share your insights?
Bill Becknell:
Bill, we would be, and we’ve had some requests from some of the past attendees that are scaling up group dentistry conference, and we’ve already begun to share this, so, absolutely, we’d be willing to do that with your followers, and I really appreciate what you guys do in the profession to keep everybody up-to-date on the latest that’s going on in the group space, so I think it’s important to note we don’t want to really give any advice here for legal reasons, but we’re more than happy to share what we’re doing, and, please, whoever reviews the information needs to use it at their own review and modify it to what best suits their organization.
Bill Becknell:
I think we’ve aligned for a website to be developed that you can go to. It’s mortensondentalpartners.com/coronavirus, and you’ll be required to enter some information and sign off on a non-disclosure or, if you will, that hold harmless agreement, but we’re more than happy to share our information, and we really wish everyone the best of luck through this and want to make sure that we all come through this as healthy and productive as we can for our patients, our teams and our communities.
Kim Larson:
We’d like to thank Bill Becknell and Dr. Eric Tobler for joining us today and sharing so much about how Mortenson is responding to this pandemic. Your crisis management protocol is a great example for other dental groups and DSOs. The CDC actually recommends that everyone do their part to help respond to this emerging public health threat, and I think we did just that today, and we know the information shared today will help so many, so thank you again
Bill Becknell:
Kim, Bill, thank you so much for having us on the call.
Dr. Eric Tobler:
Yeah, thank you. It’s a pleasure to be here, and, as as you said, it’s changing so quickly.
