The Group Dentistry Now Show: The Voice of the DSO Industry – Episode 31

Dr. Blair Brown of Mortenson Dental Partners joins the podcast to discuss how his DSO has been managing practices and navigating challenges throughout the ongoing pandemic. He talks about his concerns and the impact his DSO had on how he managed his practice, team and patient base during the crisis. If you are a solo practitioner trying to cope with the challenges of COVID-19, or if you want to understand the benefits of joining a DSO, this podcast is for you!

Dr. Blair Brown was born in Lethbridge, Alberta, Canada. He received his Bachelor of Science degree in Chemistry from Brigham Young University before moving to Louisville to attend the University of Louisville School of Dentistry. Dr. Brown has been with Mortenson Family Dental, a member of Mortenson Dental Partners, since he graduated from dental school in 2009. He and his wife, Laura, have five children: Cami, Noah, Ali, Ryan and Lily. When not seeing patients, Dr. Brown enjoys playing with his children, camping, fishing, cooking, barbeque smoking and watching movies.

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FULL TRANSCRIPT

Bill Neumann:

I’d like to welcome everyone to the Group Dentistry Now show. I am Bill Neumann, and we always have interesting guests today. This is a little bit different because we are typically talking to CEOs of DSOs or we’re talking about to vendors that sell product through the DSO. But this is actually great because we’re talking to a clinician that got in relatively early at a DSO. We can talk a little bit about his experience, why he chose to work at a DSO, what the benefits are, really how it’s helped during the COVID crisis, what he’s seeing in his locality with other clinicians.

Bill Neumann:

So without further ado, I’d like to introduce Dr. Blair Brown. I’ll give you a little bit of his background. So Dr. Brown was born … He’s actually a Canuck, so he was born in Lethbridge, Alberta, Canada. He received his bachelor of science degree in chemistry from Brigham Young University and then moved to Louisville, Kentucky to attend the University of Louisville School of Dentistry. Dr. Brown as been with Mortenson Family Dental, a member of Mortenson Dental Partners, and we’ll talk a little bit about that, since he graduated from dental school in 2009.

Bill Neumann:

He and his wife Laura have five children, [Kami 00:01:44], Noah, Allie, Ryan and Lily. When not seeing patients, Dr. Brown enjoys playing with his children, camping, fishing, cooking, barbecue smoking. That’s big in Louisville, and watching movies. Right now, I guess, you’re also enjoying some homeschooling with the children.

Dr. Blair Brown:

Yeah, the kids popped in a little earlier before we started recording, but they’re doing homeschooling right now. So all five of them are at home.

Bill Neumann:

There you go. So if you hear anything in the background, you know it’s the kids studying.

Dr. Blair Brown:

That’s right.

Bill Neumann:

So welcome, Dr. Brown, appreciate having you here.

Dr. Blair Brown:

Happy to be here.

Bill Neumann:

So tell us a little bit about Mortenson Family Dental and then Mortenson Dental Partners and maybe the difference between the two.

Dr. Blair Brown:

Sure. So as you mentioned in the bio there, I graduated from the University of Louisville in 2009, kind of during my junior year I had looked around at job opportunities, things like that. I knew some of the Mortensons already. One of the Mortensons was one of my classmates, Mark Mortenson, and his uncle was Wayne Mortenson, who had started the company. So they were on my radar, but I really didn’t have plans to necessarily join the group. At that time it was just Mortenson Family Dental. It was pretty much regional to Louisville and parts of Indiana, where we had multiple practices. It’s obviously grown since then to other regions. But I was looking to join a DSO or some sort of group. I could see the writing on the wall was towards group dentistry. So between my third and fourth year, we do an externship where you go out and you’re placed with a dentist, and you work for about four or five weeks and then go back to the school to kind of give you an experience of what it’s like to practice dentistry outside of the school setting.

Dr. Blair Brown:

So I purposely chose to work at a group in town. It wasn’t the Mortenson group, but it was a group setting. The dentist who mentored me really strongly advised me to consider that as a job opportunity. He had been in private practice for quite a few years and had struggled. I mean, he never was bankrupt or anything like that, but had struggled to be really financially successful. Then he decided to join this other group, and he said it was the best decision he ever made. So that kind of furthered my idea that group dentistry might be something I’m interested in.

Dr. Blair Brown:

I came out of school with huge student loan debt, as a lot of newer grads, and it’s even worse now. It’s about double what I came out with [crosstalk 00:03:56]

Bill Neumann:

Yeah.

Dr. Blair Brown:

To go out and buy a practice … I also graduated right after the huge 2008 economic downturn, so the idea of borrowing money to buy a home, borrowing money to buy a practice, and all of these things when my skill set and experience was zero seemed daunting. So I wanted to join a group. I kind of was hesitant to approach the Mortensons because I knew them personally. I didn’t want them to think they had to give me a job because we knew each other and I went to school with his nephew. So I started looking outside of Louisville, and we really liked Louisville. My wife’s from Kentucky. Her family lives nearby. So she said, “Well, we should consider it. You need to talk to the Mortensons.”

Dr. Blair Brown:

So I reached out to the director of HR, just inquired, and they said, “We’re not hiring right now,” and I said, “Okay, that’s fine.” He told Dr. Wayne, and then Dr. Wayne personally called me and then interviewed me. He said, “I don’t want you to think that this is a charity job or a pity job or anything like that. I’ve been following” … I was surprised to know how much Wayne knew about me, actually, in dental school, because I didn’t know him all that well. But he said, “We’d love to have you. I think you’d be a great fit.”

Dr. Blair Brown:

So we made the decision to stay in Louisville and join Mortenson Family Dental, which at the time was the entire company. Since then we’ve expanded into other regions in an effort to allow other regions to maintain the goodwill and name recognition that they’ve built up over the years, we created the Mortenson Dental Partners, which is the larger group now that Mortenson Family Dental is a part of. So our local offices are all branded Mortenson Family Dental or our specialty practices are branded accordingly. But the other regions, for example, in Utah, we have Stonehaven now, that was something developed by the Toblers, and it had been there for quite a while. We didn’t want to lose the goodwill and the name recognition. So when they joined the group, they maintained Stonehaven Dental as their practice, and that’s what it still is, but it’s part of a larger DSO, which is now Mortenson Dental Partners. So that’s been around for five or six years.

Dr. Blair Brown:

So now it’s a larger group that can go into multiple locations, and we can welcome other groups in, in the future, that don’t have to completely give up what they’ve built over their years for their local recognition and their goodwill for their patients, because they can just get folded into the greater whole of Mortenson Dental Partners. So it’s worked out really well for the expansion model, and I think it centers around the idea that we’re asking people to join our group to help get managed and all the wonderful benefits that come with a large DSO like we have, without completely giving up their autonomy and the things that they’ve built over the years.

Dr. Blair Brown:

So that’s how we got where we are. I’ve seen that. I served on the board of directors for three years, from 2012 to 2015, during when a lot of that transition happened into the regional markets. It was really interesting to see Dr. Wayne’s vision and the other executive leaders to do that. I feel that’s mirrored at the local level, where even though I practice for a large group, I still feel like my local office that I work at … I’m the only dentist at my location. I still consider that my practice. I have a large degree of autonomy of how I treat patients and what I do, the materials and supplies that I use. But I have the support of the larger group to help me with management decisions, hiring, HR, things like that.

Bill Neumann:

That’s great. So you really have been there from the earlier times. It makes sense to have that local branding and the market where the patients still know the brand and also just gives you opportunity to really be tied to the community as well.

Dr. Blair Brown:

That’s right, exactly.

Bill Neumann:

Well, good. So let’s talk a little bit about … And I hate to do this. I’ve been doing this since the middle of March, but we’ll have to talk a little bit about COVID. One day hopefully we can talk about it in past tense, but right now-

Dr. Blair Brown:

That’s right.

Bill Neumann:

Being part of a DSO, obviously, and being in the dental industry has been a huge challenge during COVID. We, all of a sudden, ran into this timeframe from March until … It depends on where you are in the country, that there was essential dentistry and non-essential dentistry. So that was certainly a challenge, and to figure out, well, what’s essential, what’s not essential. A lot of times it varied. So talk a little bit about you personally and how working at a DSO really was a benefit to you during the COVID crisis.

Dr. Blair Brown:

The number-one thing for me personally … And this wasn’t true for every practice in our region, but we had to close down some of our practices because we knew the patient flow would drop quite a bit. So they chose about one in three practices in our region to stay open to see emergency patients during the shutdown. I was fortunate to be one of the practices chosen to stay open, so I’ve never closed. In fact, a lot of patients keep coming in. “How did you manage when you were closed down?” I said, well, we never closed down. We saw emergency patients the whole time.

Dr. Blair Brown:

The way they made that selection was, one, geographical. They also took in the skill set of each provider, who could do the most type of emergency dentistry in a short amount of time, and then risk factors. I didn’t fall into any of the risk factor boxes, age wise or medical history wise. I don’t think anyone wanted to get sick, but the idea was we don’t want people out there that are at high risk. So I wasn’t in the highest category. Also willingness. I was willing, and I told the executive team early on I’m willing to work. I want to see emergency patients. I want to make sure people are taken care of.

Dr. Blair Brown:

So they allowed me to stay open, where, if I was a solo practitioner … And I know this because I have a lot of friends from dental school that they closed down. They didn’t have the resources to be able to drop their revenue that much and still pay their employees. But we were able to do that by selectively choosing which offices stayed open, and so that was really nice.

Dr. Blair Brown:

Then during the whole thing … This was a really big deal. When it first started, no one knew what this was. No one knew how it was going to affect us. No one knew what the protocols should be. So I would get emails from the board of dentistry, from the governor’s office, all these things because I’m on their list of health care providers. Excuse me there. Then to try to sort through all that let along all the stimulus packages and all the other benefits the government was trying to roll out. It was overwhelming to try to read through that knowing, well, don’t go to work today and do something that you’re not supposed to do. Then someone from the health department shows up and shuts you down. So right from the get-go, our leadership team, they were going through this and reading it and making sure and making phone calls to the board, getting confirmation. Dr. Schuler, our regional president, I mean, he was on top of it. He was calling the board. He was calling everybody to make sure, okay, let’s get some clarification on this. What does this mean? What do we need to do?

Dr. Blair Brown:

Then that was then passed on us as providers. I don’t want to say I didn’t pay attention to those emails, but I knew that I didn’t have to completely understand everything that I was reading to the T, because I was going to get an update. In the beginning, it was literally the next day … An email would come out the next day. We’d get some sort of email communication, and then at least once a week, and in the beginning sometimes twice a week we’d have a Zoom call or a group call like we’re doing with updates. Dr. Schuler would say, “Okay, everyone, this is what has come down. This is what it means. This is how we’re going to change the protocols.”

Dr. Blair Brown:

So, I mean, the amount of support that that gave to me was phenomenal. I really couldn’t imagine on my own trying to deal with that, and I guarantee, if I had been a solo practitioner, I would have to close down, let alone the personal protective equipment, all of the other supplies that were extra that we needed that as an individual I could not have possibly gone out and acquired.

Dr. Blair Brown:

We have full-time people whose only job during the shutdown was to go around and find PPE for the whole group. Economies of scale being what they are, if you need to buy only 100 masks, you might not have the ability to get that. Whereas if you’re going and buying thousands of masks, then you can buy in large qualities and have those distributed to the office that needed it. They also were able to take PPE and other supplies from offices that were temporarily furloughed. So we’re able to shift our resources even locally, things we already had. So they went into all the practices and said, okay, who’s got what? This practice is closed down for a few weeks. Let’s use that over here. So there was a huge amount of support and just maximizing the resources of the group to make sure we were able to keep seeing patients. So, I mean, without a doubt, there was no way I could have stayed open had I not been part of the group. I don’t know many private practices or any personally that actually did stay open during that time, because it just wasn’t financially or logistically feasible to do it, where I felt very supported.

Bill Neumann:

So let’s talk a little bit about the team. We were talking a little bit about how they supported you as a clinician, but what about the rest of the team? I mean, there’s all sorts of interesting dynamics right now with clinical staff, not the dentist necessarily but the hygienist and the assistants, and then of course the office managers, the non-clinical staff. During the crisis, what was the communication like? For maybe the practices that were furloughed, what was going on over there? If you can talk a little bit about that. Then for your office that was open during the shutdown, talk a little bit about your staff. Did you have any that were a little apprehensive to come in?

Dr. Blair Brown:

We didn’t. But I know that there were others who did, and everyone was given the choice. For example, if one of my dental assistants had been, “I don’t want to work. I’m worried about this. I’m high risk,” then they gave the opportunity to those from furloughed offices to fill that position. That didn’t happen in my office, but I know it did happen in other offices, where no one was ever told they had to work during it, and I really appreciated that upfront. They gave everybody that option. If you don’t feel comfortable, if you’re high risk, if you have high risk people at home, then by all means let us know, and we’ll make sure you’re taken care of.

Dr. Blair Brown:

As far as communication goes, I mentioned we had group meetings and Zoom calls and things like that, and so did each position. So they didn’t do it as frequently as they did for the … The doctors were at least once a week, but they had periodic calls where everyone would get together, all the dental assistants, all the practice managers, all the hygienists, to give them updates.

Dr. Blair Brown:

My hygienists … Even though we stayed open, hygiene was off the books. You couldn’t do it. So they were furloughed. So not only did the company do meetings with them, but we tried to do … Our office, just as a little group, we reached out to hygienists and made sure they were … How’s everything going? Are you losing your mind yet? How are you keeping yourself busy? Those types of things, just to make sure there was that feeling that you were still part of the group.

Dr. Blair Brown:

One of the beautiful things that I think the company did is they gave an extra two weeks of paid time off to the people, because in the beginning we didn’t know how long the shutdown was going to last. In Louisville, the heavy restrictions lasted, I think, about five weeks, end of March through till about May the 10th or so. We started bringing offices back online. We didn’t bring them all back at once, but we phased them in as it went along. So that extra two weeks that they were able to use plus the benefits that came from the government helped a lot of people financially, where we didn’t have to lay people off. We didn’t have to terminate the position. They were able to be furloughed and just stay home and use those benefits as they chose to. Some people didn’t use them, and they saved them up to be able to use them later in the year. But a lot of people did because, financially, if they weren’t working, then that was a challenge.

Dr. Blair Brown:

For my office, we were able to have daily updates from our … At the beginning of the day, we have a morning meeting. We can say, okay, this is what’s the new protocol for today. That’s what we need to do, that type of thing. So those who were working got that all the time. Then those who were furloughed, they got, at least once a week, some sort of an update, whether it was a video call or an email or something to tell them how things were going, when it was expected to change, and just updates like that.

Dr. Blair Brown:

The weekly doctor call was really important, because, again, two-thirds of our providers were not working. So that was a forum for them to ask questions. How was the PPE working? What is it like to work in an N95 mask? For those of us who were working, we were on that call and able to say it’s not a lot of fun, but about a week after you do it, you start breathing again and not wanting to pass out, and that type of thing. So there was that type of communication between those working and those not working, so they could feel part of the group still.

Dr. Blair Brown:

So I really appreciate there was a lot of communication and a lot of trying to keep people updated with what we knew, because it was constantly changing. But every level, whether it was the dental assistant, the hygienist, the practice managers, our business associates, they all had some sort of individualized communication from time to time from the leadership team to update them, to tell them what to expect. Then right before we started bringing offices back online, we actually brought them into the office for a two-hour reorientation for those who had not been working, of, okay, this is what it looks like now to practice in this new setting, because they hadn’t been doing it. They were able to ask questions and get up to speed with what they needed to do. Largely, that information came from those practices that were already operating, the things we found out, the things that they had changed, that type of thing.

Bill Neumann:

It’s great insight. I’ll point this out. A lot of people that are listening or watching this podcast may have seen it, but early on in March we did a podcast with Mortenson. You all as a DSO had been really close to the ground in China following what was happening there way back when in January and had put in contingency plans as far back as January and February just in case. Unfortunately, it came to the United States. But it was really interesting to have that conversation and then listen to that podcast now. Other groups, other, certainly solos, didn’t necessarily have the insight to take a look and be in communication with people and Europe and in China to see, really, how it was affecting them.

Bill Neumann:

So we talked about you as a clinician, and we talked about the team. Let’s talk about the patients. So what was it like? How did Mortenson handle patient communication during the shutdown? You talked a little bit about some practices being shut down and almost any emergency being funneled into your practice. How did that all work?

Dr. Blair Brown:

So we have lots of different methods to communicate with our patients. Phone calls are the primary way we try to alert patients. I mean, our schedule is typically booked out three or four weeks at least, so when it’s shut down we had to go through that list. All the practices, whether they stayed open or not, had to go through every patient and call them, in addition to emails and text messages, to tell them, look, if this is non emergency care, we’re not able to see you. So we were about four weeks ahead of the schedule because the hygiene patients are scheduled at six months … four weeks ahead of the schedule to make sure they were alerted that, look, we’re probably going to have to reschedule, that type of thing. We didn’t go the full … because we didn’t know how long it was going to last. So about four weeks rolling ahead, we continue to call patients and get them pushed back or just take them off the schedule and say, we’ll reach out to you when that shuts down.

Dr. Blair Brown:

So that’s how it worked for our patients. We had a lot of our business associates and our practice managers just going through the schedules at all the offices, alerting people. A lot of people already knew just because of the news and things like that. I mean, they’d heard that the governor was shutting down non-essential care, so a lot of them were already on board with that. They actually responded really well to it. They weren’t upset. They understood completely.

Dr. Blair Brown:

Once we were working though, what would happen is, if people called in to any one of our offices, as you said, they were funneled to whatever the closest Mortenson office was. The interesting thing was, when I was seeing emergency patients for those five weeks, probably four-fifths out of the patients I saw were not Mortenson patients. They were patients from other groups in town or other practices in town that were not open. I’ve told this to a few patients since I’ve been back.

Dr. Blair Brown:

The dentist isn’t everybody’s favorite place to be. We get told all the time, I’m scared of the dentist. This isn’t my favorite place to be. I’ve never felt more appreciated as a provider than during the shutdown. Everyone who came through the doors … I mean, they had to be in pain or they didn’t come through the doors. So these are people who, if they couldn’t come see us, they weren’t going to be seen, because an emergency room … They do their best, but they’re not able to deal with dental emergencies very well, other than here’s some pain medicine and antibiotics. See you later, type of thing. So everyone who came through the doors, our patients, other patients, were so grateful, and I think there was a general sense in the country of gratitude for health care workers, more than we’ve seen in the past, because of the risk we put ourselves at being exposed to this virus potentially.

Dr. Blair Brown:

So they were incredible. I mean, I felt like a king walking around the office. Everyone was like, oh, thank you so much for seeing us. We don’t care how long we have to wait. We’re happy that you’re here. Thank you so much for being open, that type of thing. So our central patient services was then able to funnel those people from whatever number that they happened to reach, individual practices or our central number, to funnel them to an office that was open during hours that worked for them. So that was just seamless. I didn’t have to worry about that at all. My schedule was chock full every single day that I was open with patients.

Dr. Blair Brown:

It tended to go one day I would see all limited exams. I’m diagnosing all of these things. Then the next day I was doing treatment. It seemed to alternate that way because my schedule would fill up so quickly that one day I would just be diagnosing, and the care we could do that day, we would do it. But generally speaking, one day was diagnosing. The next day was heavily involved in emergency treatment and back and forth, back and forth, as the time allowed. I think it worked very well.

Dr. Blair Brown:

Another advantage was, if we did see a patient, for example, as I mentioned … The two other offices closest to me closed down, so I agreed to take their call. So any of their patients that came in, I would see them. I was able to reach out to their dentis on the phone because I know them personally. I was able to get into their charts through our computer system to see, okay, well, what’s the last thing this patient had done? What do their x-rays look like six months ago? Now for patients outside of our group, obviously, I wasn’t able to do that. But for those who came in that were from other practices, that centralized support and IT system that we have allowed me to get into their individual charts, talk to their individual provider, even though they were furloughed, to make sure we took good care of them. That happened on quite a few occasions where I had to consult with their dentist saying, hey, this is what’s happened. I can slap a quick fix on it, or do you want me to take care of this permanently while they’re here so that you don’t have to worry about it when you get back? “Oh, yeah, go ahead. Do that. That sounds great. Thank you.” It gave the patient peace of mind knowing that I had personally spoken to their dentist [crosstalk 00:23:06]

Bill Neumann:

Right.

Dr. Blair Brown:

So that was a huge advantage. Quite a few patients who were really apprehensive about going somewhere different … They’d seen their dentist for 10, 15 years. It was good for them to know that I personally called them on the phone and said, hey, this is what’s happening. This is what we’re going to do. They said, yeah, go ahead. Give him the green light. We had a lot of patients who that just made them feel really good about the fact that we consulted together, and the group was what allowed us to do that.

Bill Neumann:

So you mentioned that some of the Mortenson practices were temporarily shut down, and everything was funneled through you. But you also talked about this. We talked about this before we started to record, that there were plenty of docs that were not part of Mortenson that also were shut down completely, and some that still are.

Dr. Blair Brown:

Still are, yeah.

Bill Neumann:

Is that correct?

Dr. Blair Brown:

That’s correct.

Bill Neumann:

This is a little off topic, but I really want to make sure I don’t forget to ask this. So I don’t know if we’re coming out of COVID. I’m not going to say that because I don’t want to jinx anything. But certainly the new normal, whatever you want to call it, mostly everything’s opening back up. But there are still practices in the local area, anyway, that have no reopened. You’re getting some of those patients that are now in need of whether it’s just hygiene or whether they have emergency care that are reaching out because their doc has not opened back up. You said even in some cases they’re calling and there’s nobody answering the phones.

Dr. Blair Brown:

That’s right. I had a patient this week that said, “I keep waiting for them to open up their doors. They haven’t opened their doors, so I drive by this office, and so I thought I’d come in here and see you guys, because at least you’re open.” They had no ill will towards them. They completely understood, but they needed care still. I had a few cases I’ve taken over in the middle of quite advanced treatment that were trying to call my dentist. Well, they’re not open. So we’ve had to take over and, obviously, complete it the best we can. Everyone’s been very understanding because it’s not like it’s a localized situation – it’s everybody going through this together.

Dr. Blair Brown:

But we’ve had quite a few patients come over, not because they were dissatisfied, not because they didn’t like their dentist, but they’re just not open. I mean, we’re five months, six months into this, and so by any stretch of the imagination, they can’t just keep waiting for routine care, or even urgent care because they need someone to take care of them. I can’t speak for other practices, but I know I’ve gotten a lot of patients in the last few months coming in just because, we’ve waited as long as we can. I guess we’re going to come over here now. We’re obviously happy to receive them.

Bill Neumann:

A lot of speculation about, once this is all said and done, how many practices won’t reopen. But it certainly sounds like there are some that might not, at least in your local area. I can’t imagine that’s not across the country at some point. It kind of gets back to the point of this whole podcast, the support of a DSO and being able to procure the PPE and things like that and having the management behind you and being able to handle the phone calls and emergent versus non-essential care, so a really interesting phenomenon that’s occurring.

Bill Neumann:

So a couple other things. During when the dental restrictions were in place, was there one big concern that you personally had? How was Mortenson able to handle that? I know you probably had a lot. But was there anything that really stood out?

Dr. Blair Brown:

So me personally, I don’t know. Just the way my brain works, I was never really afraid of getting sick or things like that. To me, being in health care, we take standard precautions. So it wasn’t that. It was more, with the ever changing restrictions and do this, don’t do that, how do you communicate that to patients, to staff members who may be afraid of that? Most of them were, and who don’t necessarily have as much understanding about how the body works and viruses and that type of thing. But there was a lot of fear. There was a lot of, what’s going to happen? This is really scary? Do we want to come and get treatment done? As far as patients go and the staff members, are we going to catch this?

Dr. Blair Brown:

Then, also, are we doing the best things to make them feel better? So there’s all this fear. There’s all this uncertainty. Let’s make sure we have the right protocols in place for them to feel comfortable. I was worried. Are we going to be doing enough? Are we going to do the right things? Are we going to be doing the things the governor’s office wants us to do? That was where I was worried about, again, trying to treat all these patients while trying to interpret and roll with this type of thing. That was my biggest concern was, one, we’d have patients scared out of their minds, two, their employees, and, three, we don’t want to do something wrong that could then get us in trouble because we did something that was not according to protocol. So that was my biggest fear.

Dr. Blair Brown:

Again, we’ve kind of mentioned that a little bit with the updates, but a specific example, we reached out to the governor’s office and the board of dentistry with all of their restrictions and said, okay, here’s a list. Can we do this? Can we not do this? So they actually sent to the providers a cheat sheet, if you will, and, of course, it always says use your clinical judgment. The individual provider needs to make the final call. But it said, here’s some examples of things you could do. Here’s some things you shouldn’t probably do based on what we understand.

Dr. Blair Brown:

So that was on my desk very early on. So when a phone call would come in or a patient would come in and say, well, is this something that falls within the criteria or not? That changed as we got more clarifications. So, at first, we were very strictly, if you are not dying in pain, you did not walk through the door, because we didn’t want to be spreading this virus or doing things we shouldn’t be doing. Then as we got clarification, that was updated, and so that’s changed and updated until we knew … There was always this reassurance for me that things are okay. We know what we’re doing. We’re doing best practices. This is the most current guidelines.

Dr. Blair Brown:

Another example, when they first came in, they were telling everybody … And this was pretty much nationwide, I think, at least in our group. Everybody needs to be rinsing with 1% hydrogen peroxide solution before you do anything, so that was protocol. We’re doing that. Then after a few weeks, they’re like, actually, the research is now showing that that’s probably not necessarily. So they said, stop doing it. We stopped doing it. So things like that that, on my own, there’s no way I would have been able to look that up and see … At least, I didn’t want to take the time to do that type of thing every night. So they were constantly updating. So I felt very comfortable communicating to patients that, look, what we know is this. These are the proper protocols. We’re doing everything the governor’s asking us to do because of that support system behind us. It was good for the patients, but also for the employees and the team members to know we’re doing everything that’s the most current. As I mentioned before, if they did feel uncomfortable, we’ll find somebody else that’s willing to work, and you don’t have to.

Dr. Blair Brown:

So I think being part of the group, the support led right into that idea of I didn’t need to worry about that as much now. Individual people still were really scared, and we had to reassure them and give them as much information as we could, yes, we’re taking precautions, and, yes, this is important that you’re here because you’re swollen and you’re in pain. If we don’t do something about this, then you’re going to be in a much worse position. So that individual we had to work through things on an individual basis. But as a whole it was nice to know here’s the protocols. This is what you need to do. We’ve been talking with the governor’s office. We’ve been talking with the board of dentistry, and we are up to date with the current recommendations. So if you implement this, you know you’re doing what you’re supposed to do.

Bill Neumann:

Excellent. So we have a lot of solo practitioners, whether they own a practice or whether maybe they’re relatively new out of dental school, don’t own a practice, but are toying with the idea of either working for a DSO or affiliating, selling their practice to a DSO. What questions should they be asking? What should they expect? Because you didn’t have a practice, but you kind of probably had some of the same thoughts. You’ve heard some things that might not have been necessarily positive about DSOs when you were in dental school. So tell us a little bit about your thought process back then and then maybe just now that you’re on the other side, now 11 years in, what that experience is like. Because I think that we get a lot of folks that come to us that are, again clinicians that are kicking around the idea but don’t necessarily even know where to start, what questions to ask, what to look for.

Dr. Blair Brown:

That’s a great question, and I think it is the crux of why not only I came to Mortenson Family Dental and now Mortenson Dental Partners, but why I’ve stayed, because I heard the same things. Don’t work for the groups. They’ll take advantage of you. Without naming names, I hd a job offer from another group right out of the dental school, before I had chosen to join Mortenson Family Dental. Then I talked to … Before I joined … As I mentioned, I knew a lot of the Mortensons already. I talked to some and they said, this is great. They don’t step on my toes. They don’t interfere too much. That being said, as you mentioned, I’ve never had my own individual solo practitioner practice. So I was able to seamlessly come into the group, and this was just how it was. So I kind of fell in, and I’ve never felt micromanaged. I’ve never felt they said, this month you need to do this many crowns. This month you need to do this many root canals. That has never happened, and if it ever did happen, I would leave. But I know it won’t because of the way that the group is set up. But that does happen in other groups.

Dr. Blair Brown:

So I would say to them the devil is in the details. You need to find out not only what they tell you, but speak to their practitioners. Speak to them privately. Go out to lunch. Go out to dinner with them and say, hey, what’s the deal? Is this … And I’ve had those conversations with other people joining our group, where the executive team said, hey, call Dr. Brown. Go out to lunch with him. Ask him. I’ll tell them candidly the pros, the cons, all of those things and let them decide. But it is the devils in the details. Not all group dentistry is created equally. One of our slogans at Mortenson Dental Partners is that we’re the next generation of private practice. I really believe that. I really believe that we’re much more of a group that works together for the collective whole than we are an ownership company that employs dentists. I really feel that strongly. So I know there’s probably other groups like us out there. I can’t speak to them. I know Mortenson Dental Partners tries their best to do that, to give the autonomy where the autonomy …

Dr. Blair Brown:

Now that being said, there’s still … I can use the dental materials I want, but there is a select things that we have special deals with, certain companies we have deals with that says, if you order this, you’re going to get a select discount. It behooves me to use products that are a little less expensive, but if I don’t like that product or I have another product that I want, I can still order that. They’re not going to come in and say, you can’t order that.

Dr. Blair Brown:

Now they are going to say, you need to run your practice. You can’t have your costs out of control. They’re going to give you advice on revenue. They’re going to give you advice on production, on people costs, all of those things. Every month they’re going to review that with you and say, look, here’s where you have some opportunities to improve. But they’re not going to come and tell me how I have to improve that. They’re just going to say, look, we want to take care of the patients. Here’s an area you could improve on. So there have been some people who have worked for us that don’t want to be told anything. But, to me, why am I in a group if I’m not going to listen to people who know a lot more about those types of business things than I do? So I never take it as them trying to control me. They’re trying to say, we want to be successful. We want you to be successful. Here’s some advice on how that can be.

Dr. Blair Brown:

I really feel that it is the next generation of private practice in the sense that, in my individual office, there are lots of similarities with all the other groups, branding and things like that. But my patients come to me, and they still feel like they’re seeing Dr. Brown. I moved locations three years ago to my current location from another group in a different part of town, and I had quite a few patients who followed me over because they liked Dr. Brown. They had nothing against the other dentist at the other practice, but they had been seeing me for eight years, and they wanted to follow me, and they were allowed to do that. They came over to my practice, because we were just a few miles down the road, and I still see those patients.

Dr. Blair Brown:

So there’s very much that feeling of this is my office, but it’s supported by the greater whole. I don’t think that that’s true of all of the groups out there. So really looking into those details about, one, how much autonomy do you have clinically. I feel that providers should have all the autonomy clinically, as long as they’re practicing within the standards of care, obviously. There’s always oversight if you start doing things that you’re not supposed to be doing. The group’s going to come in and say, hey, we need to have a conversation. But if you’re practicing within the normal scope of standard practices, then they’re not going to say anything. They want you to take care of your patients, so I provide a lot of advanced type of dental care, but other people don’t. They don’t feel comfortable doing sedation dentistry or implant dentistry. They’re not forced to do that. They can do what they feel comfortable with. But if they want to do that, they have the support of the group to say, well, let’s get you the continuing education you need. Let’s get you the equipment that you need to do those procedures.

Dr. Blair Brown:

So it’s a huge benefit, and I personally have loved it in the sense that I feel the support, but I don’t feel micromanaged. I’ve never felt that, clinically, they’re stepping in and saying, you have to do this, you have to do that or else. I know people who have worked for other groups that they have been told that. You’re not doing enough crowns. You need to do more crowns. You’re not doing enough this. You need to do more that. To me, that’s not a good thing when we start making decisions based on just numbers, not on what a patient actually needs.

Dr. Blair Brown:

So the last thing I would advise people who are looking at DSOs and groups is, what’s your opportunity to have ownership in the company? Because the tradeoff with having them provide a practice for me and the equipment is, obviously, they need to have some sort of return on investment. So they’re going to reward the people who have spent the money, the owners of the company, to invest in this location. So if you’re never given an opportunity to buy into the practice or to buy into the group, then I feel like, financially, you’re never going to achieve the same level that you could have as a solo practitioner. It doesn’t mean you would have as a solo practitioner, but that you could have through that ownership option.

Dr. Blair Brown:

So Mortenson Dental Partners … And before it was at Mortenson Family Dental. After my first year, I qualified to be able to buy into the company, and so I did. I’ve continued to do that every time there’s been a capital call. I’ll put money in to continue to buy more ownership. Then we have our employee stock option plan, which is like our retirement plan, that everyone from my assistants to my business associates to my practice manager, they’re all given each year a certain amount put into this retirement account, which is ownership in the company. Actually, the single number-one largest owner of our entire group are the employees – they own the most percentage of the company. So it really is not only the dentists, but also the people working for us. I think that’s very rare. I don’t even know if there are any other DSOs that offer that, without question, you’re going to become an owner. Then in addition, for our providers, the dentists, if they want to, they can buy stock, whether in the whole or in their local region as one of the partners.

Dr. Blair Brown:

So ownership and then autonomy. To me, those are the two biggest things you need to look for in a DSO or a group. Because if you don’t have those two, you’re not going to be happy for very long. If you’re not happy, you’re going to leave. But there are groups out there like ours that don’t do that. Their goal is to bring you on, make you part of the team and give you a long-term career.

Bill Neumann:

So autonomy and ownership.

Dr. Blair Brown:

Amen, that’s it, autonomy and ownership.

Bill Neumann:

To your point about ESOP, I think you are one of the few. There may be a couple others out there.

Dr. Blair Brown:

We all get ESOP, dentists and everybody alike. Whether you invest or not, that’s just given to you at the end of the year [crosstalk 00:38:56]

Bill Neumann:

That’s excellent.

Dr. Blair Brown:

I’ll tell you one thing, it’s not only great for retention, but it helps you feel like you’re a part of it. It’s not just me working at this office, but I have fractional ownership in the group, and so I have a vested interest in staying and also treating patients well so that we do well financially.

Bill Neumann:

It makes a lot of sense. So we have time for one last question, Dr. Brown. So let’s talk a little bit about, just in general, any experiences, anything else you want to share, whether it’s pandemic related, whether it’s not pandemic related. Then we’ll let you go, but this has been great.

Dr. Blair Brown:

The number-one thing, and my wife just … She posted my written interview that we did before on Facebook yesterday, and she put a little tag in there. I think it was really nice, this idea that, through the 11 years, there have been ups and downs and good years and bad years and that type of thing, just whatever it might be. I’ve always stuck with the group because, in the end, it’s the support. Is there an opportunity to be a solo practitioner and do very well financially? Yes, there is.

Dr. Blair Brown:

But then I think COVID … The one thing it’s really driven home more than anything else is that, when the sun’s shining, it’s easy to make hay for everyone. But when hard times come, solo practitioner, you’re on your own. That doesn’t mean you’ll sink, but it just means you’re on your own. So you have to do all those things yourself. This experience, as much as I haven’t liked COVID, my work experience has actually … And I kind of mentioned this earlier … been probably the most fulfilling time of my career, both from being able to see emergency patients and the gratitude that I felt as a health care worker, not just at the office.

Dr. Blair Brown:

I started wearing scrubs again because I was wearing business casual clothes, and we don’t want COVID all over that. So I went back to wearing scrubs, and most of our dentists did that when this started. So we can take them off at the practice, wash them there. You don’t have to bring anything home to your family. But I’ll go to work in my scrubs. If I stop by the gas station, “Oh, you’re a health care provider? This is free. Don’t worry about it. Your drink’s free,” that type of thing, just that general feeling of gratitude for health care workers.

Dr. Blair Brown:

But in addition to that, the gratitude I feel for the group to support me through this time. I was fortunate, and I realize not everyone is fortunate to be able to work. But I continued to have income this entire time. Not all of our providers did, and so they did face some financial hardships, but the company also gave them great advice of what they could do. I mean, they even did a little email about, hey, this is what you can with your 401(k). There’s a way you can take out a hardship loan and pay it back, information that any of us have access to. But I have no idea about any of that.

Bill Neumann:

It’s a maze for sure… on your own.

Dr. Blair Brown:

They came out with a whole financial assistance advice package that they emailed to everybody saying, here’s a few things you can do if you need help financially through this crisis. There’s a loan you can get. There’s this you can get. So just that feeling of support. There’s ups, there’s downs, like I said, to anything. But this experience has cemented in my mind the huge advantage of working for a group because of that support that you just wouldn’t get otherwise. So my wife had mentioned we’ve always been committed to the company, but we’re more committed now than we’ve ever been because of how we’ve seen … Regardless if we agree with how the world’s reacting to this or not, it’s happening. There’s lots of stuff going on. There’s people scared. But I’ve never felt at any point that my employment was at risk or that financially my family would be ruined by this because of being part of the group. I would not be sleeping as well at night, I think, if I was a solo practitioner during this.

Dr. Blair Brown:

This will pass, but there will be other crises. There will be other problems. There will be other changes. How will you weather each one? To me it just gives me peace of mind knowing they’ve got my back. We’ve got a great relationship working together. It just gives me a lot of peace of mind. That would be my one final thing to say is just, for those who are considering it, the devil’s in the details. Make sure you ask what type of group you’re joining. But it’s so comforting. I think back to what I mentioned earlier. When I was in dental school and I worked with this other group … And it was a great group. That dentis that had done it for 10 or 15 years on my own … And he did okay. But he just said, “My life is so much happier since I’ve given away all of that headache to let someone else manage for me. I just treat my patients now.” So this COVID crisis has really re-cemented that and recommitted me to being very happy where I’m at and being part of the group. So it’s a great thing, and other people should really consider it.

Bill Neumann:

Excellent. Well, that’s a great way to end this podcast. So thank you, Dr. Blair Brown, from Mortenson Family Dental, part of Mortenson Dental Partners. I think I got that right.

Dr. Blair Brown:

Yeah, that’s right.

Bill Neumann:

So thanks for your time. Really, I think we went through a lot in a short amount of time, whether it was COVID related, whether it’s just, hey, why should I consider a DSO. I mean, you talked about autonomy. You talked about equity, ownership, those types of things, getting rid of the headaches. But really nice to hear that things are going well, especially for Mortenson.

Dr. Blair Brown:

June and July were the busiest months of my career, my personal production, the two highest months of my entire career, because of the backlog that people … Whether they’re new patients or whether it’s our patients who weren’t able to be seen have to come back in. To me, that shows there’s confidence from our patients that we’re doing things right.

Bill Neumann:

Absolutely. Well, great stuff. So thanks again, Dr. Brown. Thank you, everyone, for watching and listening. I’m Bill Neumann from the Group Dentistry Now show. Until next time.