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Stephen E. Thorne IV, CEO & Founder of Pacific Dental Services, discusses COVID-19’s impact on the entire dental industry, how teledentistry can be used as a solution during the crisis, and PDS’ new grassroots campaign to keep dental emergencies out of the hospital ER. This social media initiative is for both solo and group practitioners and their teams.
Our podcast series brings you dental support 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.
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Pacific Dental Services, led by its CEO & Founder, Stephen Thorne, has started an initiative for all dentists throughout the country, not just PDS supported dentists. Please help with this grassroots campaign today! Here are some vital #DentalER numbers:
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FULL TRANSCRIPT
Bill Neumann:
I’d like to welcome everybody back to the Group Dentistry Now Show, I’m Bill Neumann and actually for the second time we have Steve Thorne from Pacific Dental Services on the show. He was the first guest we actually ever had and times are a little bit different. We’re going to get into that right now. But for those of you that don’t know who Steve is, and I’m sure most of you do, but for those who don’t and also who don’t know who PDS is, I’ll do a little introduction. Steven Thorne is the CEO and founder of PDS, Pacific Dental Services. They are a leading dental support organization and they were founded way back when in 1994, in Irvine, California. PDS provides business support services to over 800 dental practices in over 22 States. And actually I think you hit 800, December 31st of last year and it was like 11 or 12 practices you guys opened in one day, which was crazy.
Stephen Thorne:
Yeah, I think we hit 804 was the final number on that day, yes.
Bill Neumann:
You rolled over 800.
Stephen Thorne:
We went over 800 that day.
Bill Neumann:
Okay. Yeah, that was incredible. I mean, not just to hit the 800 but that open so many in one day.
Stephen Thorne:
Right.
Bill Neumann:
A little bit background on Steve. Steve actually began working in the dental field in 1989 he actually was helping his dad out, who’s a dentist and really made that practice very, very successful. Helped his dad out for a couple more years and then he went out on his own and founded PDS. Great to have you back on the show. I know circumstances are just super unique and once in a lifetime we hope, so we’ll address that for sure with the Covid-19 crisis. But first of all, we’ll talk a little bit about this grassroots movement that you have started and PDS is really fueling. I know that Kim Larson here at Group Dentistry Now saw some of the work that you’ve been doing with the grassroots movement on Instagram, and then I’m more of a LinkedIn guy, so I saw a lot of it yesterday and today on LinkedIn. Let’s talk a little bit about that grassroots movement that you have going on.
Stephen Thorne:
Yeah, well the central idea behind this grassroots movement, first off, thanks for having me.
Bill Neumann:
Sure.
Stephen Thorne:
It is unprecedented times to say the least, I think that word has been overused, but it is truly unprecedented and I just pray that none of us ever, ever have to experience anything like this again in dentistry. It’s been horrible what has happened to the whole dental profession right now. We started to kick off this social media campaign. I wanted to do a grassroots effort to get all dentists involved in helping be part of the solution to this crisis we’re in, not be brushed aside like so many governmental agencies have tried to do, and we support dentists who serve just a vital role in keeping patients out of emergency rooms. I read a statistic every 14 seconds in America, a patient goes to an emergency room with oral health payment and most of these emergency rooms, they don’t know how to help patients with oral pain.
Stephen Thorne:
My best friend is an ER physician. He has been for 25 years and he doesn’t want these people coming into the ER, he wants them to go to the dental office, so a grassroots campaign to help keep people that need our care, these emergency and essential dental services, help them get to the dentist, dental offices and not the ER.
Bill Neumann:
That makes a ton of sense. I’m sure there’s a lot of confusion out there from the patient perspective. Are the dental practices open? Are they not? Am I allowed to go there? There might be some, if I’ve got pain, they may just go think the hospital’s my only choice.
Stephen Thorne:
Right. And think about how good dentists have been over the last, I’ve been in this 32 years, in the last 30 years, how great dentists have been in that personal protective equipment area in keeping patients safe. There was a little bit of a scare back in the early nineties for those that were in, back then around the AIDS crisis. But dentists jumped in quick and when it turned, when all that fell through, if we remember, most of that was a couple of weird things happened, they weren’t actually transmissions within the dental offices. Dentists have always done a great job on protecting themselves, and their team members, and patients. And so we can do this as an industry and help these patients out. There are so many that need care right now, and this isn’t a PDS thing too. This isn’t for self promotion. This is a public service for all of dentists, and all of dentistry to go after.
Bill Neumann:
Yeah, you’re right. I mean the clinicians that PDS supports are in it, as well as solo practitioners and dentists that are supported by other DSO’s everybody’s really in the same predicament, if you will, what’s an emergency service? Or is it an essential dental service? There’s confusion there and it’s state by state. And then again back to the patients. The patients have no idea if the dental practices are open or not and if they’re allowed to go, so it becomes very confusing. And what you don’t want is you don’t want them going to the ER where there are Covid patients and there’s this chance that they may get infected.
Stephen Thorne:
Right, exactly. We can do things at the dental office that, I know we’re doing at Pacific Dental, but I know a lot of groups are doing this too. This isn’t privy to us. Is there having patients wait in the car and then they can escort the patients directly by a staff member that’s fully protected directly to the operatory that’s fully sterilized. Practice just incredibly safe techniques. I can say right now in our organization, as of today, I am not aware of one single transmission within the office of Covid-19 or any of our support centers, because we just really stepped up and I think most groups have. Now we do have team members that have Covid-19.They’ve all received them through family members or traveling and things like that.
Bill Neumann:
Right.
Stephen Thorne:
We can really help these patients out.
Bill Neumann:
We talked about this not being a PDS thing strictly.
Stephen Thorne:
Right.
Bill Neumann:
If there are other dentists in the country that want to join this movement, how do they get involved?
Stephen Thorne:
Okay. What we’re asking them to do, we’re asking dentists to ask a team members or somebody to take a quick video of them, 10 seconds to 30 second video of them at their practice, and then maybe get a little creative with social media and letting patients know that they’re available and there to serve them, and speak to their community about how much they are ready to help include the hashtag DentalER, that’s one. hashtag Covid19 and you can do your associations too hashtag CDADentist, hashtag CDA, hashtag ADA and I would appreciate it, so I know about the movement. You could hashtag me or tag me at Steve Thorne PDS. That would be really nice to see that. We’re already getting traction from my biggest competitors right now. We’re all in this, like you said, we are all in this together.
Stephen Thorne:
It is state by state but generally speaking, every state is limiting the care for every dentist in America to either emergency only, or emergency and urgent, and essential care.
Bill Neumann:
Okay, that’s good to know and I hope this picks up some steam. I mean it really everybody including the patients have a vested interest in this movement.
Stephen Thorne:
They do. And what we’re seeing is as we get in front of the people that are making the decisions and they understand the important role dentists play in helping solve this crisis. We’ve seen mandates put out, but then changed quickly if we can get in front of the right people, whether it’s the governor or the governor’s people or the dental boards to allow. When you think about it, if a patient goes to an ER for oral pain, let’s say they have a blown up tooth or something, they’re going to go there, that physician or nurse practitioner is going to have to use all the PPE to serve that patient there. And yes, they probably run a higher risk there in the ER, and most of the time that physician or nurse practitioner is going to then send them to a dental office.
Bill Neumann:
Right.
Stephen Thorne:
We’re actually double using the PPE by following some of these mandates, I think mostly unintended consequences of these mandates.
Bill Neumann:
Sure.
Stephen Thorne:
That governors and others have put out there.
Bill Neumann:
Yeah, that’s a great point. I mean, obviously the docs there in the ER, or the nurse practitioners, or the physician’s assistants aren’t qualified to do dentistry, so they ease the pain and then they send them off to. And we know what there’s the shortage of the N95 masks and all really PPA is incredible right now.
Stephen Thorne:
Yeah, there is, I’d like to comment on that. There is a little, I think misinformation about the lack of some of this personal protective equipment out there.
Bill Neumann:
Let’s talk about that.
Stephen Thorne:
But we’re not, and those masks were N95 and equivalent masks, right. But we’re actually not finding that if the people listening search out there across the United States, there are groups out there that have them and it may not be the Henry Schein’s or Patterson’s of the world, but there are other groups out there that have availability right now.
Bill Neumann:
Okay.
Stephen Thorne:
Okay.
Bill Neumann:
That’s good. It’s good that you’re finding that.
Stephen Thorne:
Yes.
Bill Neumann:
Well good, so tell us a little bit specifically with PDS supported dentists, how they’re not just helping out with this grassroots movement, but what are they doing in their communities right now?
Stephen Thorne:
Well they are getting out in to the communities in a big way actually visiting emergency room, urgent cares, making phone calls to all the leaders at these hospitals too, and getting the word and getting referrals. One of the neat things we did was to start teledentistry too, so patients can access, make an appointment online and access a dentist via teledentistry. And then if the dentist does need to see them physically they can make those arrangements if the patient is comfortable to come in. I think there’s a couple things going on too right. There’s patients that are nervous to come into the dental office also that need to, we need to assure them that we are safe a place for them to visit.
Bill Neumann:
Let’s talk a little bit more about that because that was actually one of the next questions I had.
Stephen Thorne:
Okay.
Bill Neumann:
Let’s talk about teledentistry a little bit. That’s I know a big announcement that you have. You kind of already let the cat out of the bag with teledentistry. Let’s talk about that because I think it’s been out there for a while, but I think there’s been some roadblocks from the standpoint of some of it’s just acceptance, right? I’m from either whether it’s the clinician or whether it’s the patient, but then state by state there’s such a variation. What can you do when you can’t do. Well now all of a sudden it’s needed and I think the States tend to be a little bit more accepting of this and even some of the insurance providers.
Stephen Thorne:
Yeah, I think there’s… I don’t know all the details on it. I’m not the expert there, but they have I think loosened most of the rules and regulations around it and the carers have really stepped up as I understand it, to reimburse the dentists for this. And obviously you can’t do a root canal through teledentistry, right?
Bill Neumann:
Right.
Stephen Thorne:
But many dentists can help their patients out with different areas and then they can do an assessment screening on the video, on their phone, on their tablet. And then if the patient does need to get in, we can help them get in. One other thing we’re trying to do, what PDS is doing, and I think a lot of my peers are doing the same thing, is helping patients with their out of pocket expenses in a big, big way. Roughly across the nation, 40% of all dentistry is paid out of pocket from patients, about 60% from carriers, right?
Bill Neumann:
Right.
Stephen Thorne:
And so we can really help patients out by postponing their out of pocket costs, not waving. I’m not saying that at all. We are not waiving any co-payments, violating any of the insurance contracts, but many dentists can push out those patients payments for two, three, four months and help those patients out.
Bill Neumann:
That makes a lot of sense. I mean, I think the jobless claims were 3 million or somewhere. It went from virtually the lowest jobless claims in history to the highest in the space of a month.
Stephen Thorne:
Yeah. They were over, I think it was 3.2 million. I think we’re going expect much bigger numbers. Another area for, I think all dentists in this movement would be to encourage patients once some of these bans are lifted. And I sure hope it’s soon, and they can get in the dentist while they have their benefits, get in and use their dental benefits while they can. Right now the insurance company, because people haven’t been going in to the dentist, right? The insurance companies do have the funds to pay for the services, but patients aren’t coming in. I don’t know when the bans will be lifted. I don’t think any of us know, but when they do, as an industry, we want to be jumping on that.
Bill Neumann:
Yeah, yeah. That makes a lot of sense. And again, just unique times where we’ve never experienced anything like this.
Stephen Thorne:
No, we haven’t.
Bill Neumann:
Let’s jump back a little bit.
Stephen Thorne:
Okay.
Bill Neumann:
I’ve got a question here and you’ve talked about this, in fact, the podcast a year ago you talked about this, but you’ve been talking about this for quite a while and it’s really that whole body health connection.
Stephen Thorne:
Right.
Bill Neumann:
Oral health, so let’s talk about that. The critical role and we already touched on it a little bit with the Covid-19 crisis, but talk about that critical role with dental, health dentistry and how it relates to overall health care.
Stephen Thorne:
Yeah. Absolutely. The science I think is getting more and more crystal clear. In some cases it is crystal clear that certain of the bacteria, the bad bacteria we call it in our mouths are causal to so many chronic inflammatory diseases, diabetes, cardiovascular disease, Alzheimer’s the new one, a couple studies came out. And then the data by the carriers looking at the sick, cost savings is clear. When patients get proper oral health, it helps reduce the overall cost of their care in any given year. Definitely a cause and effect relationship. And I think right now it’s even more important because look who’s at the most risk of Covid-19, those with chronic diseases.
Bill Neumann:
Right.
Stephen Thorne:
And if we can help those patients out and keep those harmful bacteria from getting into the bloodstream and causing more problems. We might be able to help people from I think they’re moving from light symptoms, to moderate symptoms, to severe is kind of what I’ve seen in the news, right?
Bill Neumann:
Yep.
Stephen Thorne:
Keeping people from moving down that path to severe symptoms. Dentists can just… man, they can just play such an important role in that right now.
Bill Neumann:
Yeah. And you can see as it’s not just age-related too, because there are people that are much younger and the mortality rate if you have pre-existing conditions, whether it’s anything having to do with the lungs. There’s a lot of different variables, but you’re seeing people that are passing away from the Covid-19 that aren’t what you would think of the older people, right? It’s not just the elderly.
Stephen Thorne:
It’s not just the elderly. You’re exactly right. And we call it the mouth-body connection. And there are actually DNA tests that you can get to see how responsive your body is or lack of response to these chronic ailments.
Bill Neumann:
Interesting.
Stephen Thorne:
As that progresses and that science progresses we’ll know that in advance, whether your 19 years old or 90 years old, because you could be 19 years old if you have some of the DNA that causes you to be susceptible or highly susceptible to these inflammatory diseases, you sure as heck better be visiting the dentist a lot to help keep that inflammation down in your body and you may be more susceptible to Covid-19 then a 90 year old.
Bill Neumann:
Absolutely.
Stephen Thorne:
Yeah.
Bill Neumann:
Yeah, so super important to keep that in mind and as more research is done, I think we’re just going to find that. I think it’s already accepted now. I think a year or two ago there wasn’t that acceptance. There was still a little skepticism, maybe not so much from the dental side, but maybe for more of the medical side and now I think there’s a realization with some of the studies that have been done that hey, this is real. I mean that the mouth is connected to and influences really that whole health.
Stephen Thorne:
There was a great study, if you can find it online, and I can send it to you if you want. There’s a Blue Cross Blue Shield of Hawaii did a great study. The medical side that did the study and looking at a diabetic population and who received good oral health care and I think it was over a three or four year period, don’t quote me on that. But I do have this study and the amount of savings to those people and how much healthier they got. They’re kind of equating the savings in dollars to help the ER. Meaning they didn’t have to go to the hospital as much and things like that, so it’s a really powerful study.
Bill Neumann:
Yeah, that’d be great to see. I made a note, I’m going to check it out after this.
Stephen Thorne:
Okay.
Bill Neumann:
One last question here. Obviously PDS as a DSO, actually you were a group practice when you started, right? Because DSO didn’t exist but the terminology way back when in 94. But you’ve been a thought leader in the industry for decades, so what do you think? How do you see PDS? Once we get over the hump of Covid-19.
Stephen Thorne:
Right.
Bill Neumann:
Whether it’s next week or two months from now or three months from now. What do things look like moving forward?
Stephen Thorne:
That’s a great, great question. And that’s probably the question I get asked the most right now. Let’s frame this up a little bit. Last year estimates are, the dental profession in the United States did about $142 billion in services. The last few years, I think five years Marko Vujicic, Chief Economist & Vice President, Health Policy Institute, had some real good data with pretty good growth rate in dentistry. Some of the best since the early two thousands before the last financial crisis. Estimates are this year at the low end, the industry is going to do 51 billion, at the high end, most optimistic at about 90 billion. It should have done 150 plus billion, so-
Bill Neumann:
Staggering numbers.
Stephen Thorne:
Staggering numbers. Dentistry is in a massive tailspin and needs help and relief. I saw something come across from the ADA estimating about 50% of dental practices in America today are closed. Most practices that are open are operating at about a 80% decrease from what their normal is. They can’t sustain that for much longer with the staffing requirements and all the cost to maintain the practice. There’s some help in this latest bill that is going to help out dentists, okay. There’s a little bit there, but it’s not easy to get and their loans, and ramifications to it, and requirements on sick leave, and FMLA, and things like that to dentists. From what I’ve been told, and I’m not the expert on this by any stretch but it may not be quite as good as everybody thinks. And so dentistry needs help and there will be another stimulus package. I’ve been told stimulus number four, and dentistry needs to be involved in this and get some help or it’s going to be really hard on many, many dentists. Now we’re financially strong still, but the cash burn rate, we can’t keep up either.
Bill Neumann:
Fair.
Stephen Thorne:
And I don’t think anybody can frankly.
Bill Neumann:
Right.
Stephen Thorne:
Dentistry is going to be changed forever, it truly is. I think the requirements in the office from a sterilization and PPE standpoint will be changed forever. I think that the financial side of what we’re all dealing with is going to change so many things in the next couple of years in dentistry. It’s a tough time, we’re in a pandemic. We’re in a crisis. Now do I think we’ll come out of it? Absolutely, a year from now, my prayer is that we look back and go, that was the worst quarter we’ve ever had. Meaning the coming up quarter, I think Q2 will be the worst quarter, who knows, maybe in the history of dentistry and the year is going to be a bad year.
Bill Neumann:
Sure.
Stephen Thorne:
And I hope that this time next year, if we get to do another podcast that we look back and go, well that was a really bad quarter and a really bad year, and we never want to experience that again, but we’re back at it.
Bill Neumann:
Yeah.
Stephen Thorne:
That’s what I think we can hope for.
Bill Neumann:
Yeah, so we’ll do a third one, right. And it’ll be this time next year and hopefully we’ll have big smiles on our faces and hopefully as a country and actually globally, right? As an industry, we can learn from this. And you’re right, things are going to be done differently forever in dentistry and in hospitals. And I think will the handshake go away? Who knows. We’ve even heard-
Stephen Thorne:
Let’s talk about that, right.
Bill Neumann:
It’s going to be really challenging I think for the industry and in the country. I appreciate you giving some perspective on this.
Stephen Thorne:
Right.
Bill Neumann:
And also that grassroots movement. We’ll have some information on Group Dentistry Now so people can make sure they tag everything right hashtags and make sure they tag you as well, so you’re aware of what everybody’s doing and it’s not just PDS, it’s all clinics-
Stephen Thorne:
No, this is everybody. The hashtag DentalER capital E capital R, hashtag Covid19 and then you can hashtag in all the state associations and the ADA. I think somebody on my team spoke with the ADA and they’re supportive. We need every dentist in America getting behind this.
Bill Neumann:
Yep. Well we’re definitely behind it. Thanks Steve. I know you’ve got a lot going on, especially with the co… You have a lot going on anyway, but with this Covid crisis, it’s unimaginable. I appreciate taking the time, love the effort and yeah, we’ll talk on the other side of this and then we’ll have a lot more time to breathe.
Stephen Thorne:
Let’s do that. Thank you, Bill, very much. I wish everybody the best. It wish God watching out for each and every one of you during these times. It is challenging times. It is going to get tough, but we can start to see the light at the end of the tunnel. And so if we do the right things, make the right decisions, let’s stay optimistic, stay healthy and we’ll come out of this and we’re going to come out of this as a bigger, better, stronger industry.
Bill Neumann:
Yep. Agreed. Well, thanks again Steve, and thank you everybody for listening and watching the Group Dentistry Now Show.
