Vince Dilley, Founder & CEO of Platinum Dental Services, takes us on his DSO start-up journey. Vince is one of the best storytellers, bar none, in the dental industry. If you want to learn a great deal about dental entrepreneurship and be inspired in your own personal journey towards fulfillment and success, this podcast is for you!
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Full Transcript:
Bill Neumann:
I’d like to welcome everyone to The Group Dentistry Now Show. I’m Bill Neumann. I got to admit this guy I met, gosh, I think it’s been about a year. Vince you can tell me if I’m right. I think we met in Orlando at the ADSO Partnering for Growth Summit. So maybe a little over a year ago, but it feels like about three lifetimes with COVID. But we have Vince Dilley who is the CEO and founder of Platinum Dental Services. So thanks for being here today.
Vince Dilley:
Yeah. Thanks for having me Bill. I appreciate it.
Bill Neumann:
Yeah, good stuff. So we’re going to go through… I normally do introductions and I read off the person that I’m interviewing’s bio, but if you follow Vince on LinkedIn, he really can weave a story pretty well. So I would not be able to do his bio justice. So he has the honest of actually going through his story because he’s done such a good job on LinkedIn. So Vince why don’t you give us a little bit of your background, how you got into the dental industry. You were not a dentist, take us through your story because it’s a fascinating one.
Vince Dilley:
Sure. Yeah. So I got into the industry kind of, I guess, backwards way, if you will. I think the kind of life cycle for most DSOs is acquire a few locations, get to a point where you’ve got a centralize some services and then figure out how to put together a platform for scale.
Vince Dilley:
I got into dentistry in 2010, I bought a company called Platinum Recall that does patient reactivations for dental offices, which by the way, during COVID we were turning clients away because so many people were trying to call and get reactivation services for the six month downturn from the closure. But anyway, I bought that company in 2010 and at the time I didn’t know the DSO space existed in fact came about to acquire our first dental office two years later in 2012 and the whole strategy going into it was to kind of find practices that were maybe mismanaged a little bit, but had a long operating history and then plug them into the reactivation business and then try to get new patients coming through the door on the front end and burn the candle at both ends and get more people walking through the practice, that was kind of the strategy.
Vince Dilley:
So I bought my first office in 2012 had no idea what I was doing. And six months in, I was like, this is crazy. This is a much harder business than I thought. I realized I wasn’t selling popsicles or I wasn’t running a lemonade stand by any means. So anyway, I got it six months into it I was struggling. Anyway after about nine to 12 months, kind of got the hang of things. And anyway, I went about finding these dental offices that were struggling and wanted to kind of reactivate the patient base and buy them cheap and grow them and create equity that way. So that’s largely been the strategy for the last eight years. Over the last couple of years, we started buying a little bit healthier offices. I mean, we acquired some offices in the early days that were only doing $150,000 a year in revenue.
Vince Dilley:
I mean, there were open one day a week and we kind of coined them dumpster fires because that’s pretty much what they were. We bought them and we lost a lot of money trying to grow them. We burned cash as we grew them, but then over time as we grew them, obviously they became healthy practices and those practices are now multimillion offices. So that’s kind of been the strategy and the approach. And so we’ve done I think 28 transactions with 22 locations and continue to add a few each year.
Bill Neumann:
Nice. And you are in Utah and Colorado?
Vince Dilley:
Correct?
Bill Neumann:
Sounds good. Are they all GP? Do you have any specialty? What does that look like?
Vince Dilley:
Yeah, that’s a really good question. So things evolved a lot over those years when we first started buying them, the first office we had had just four chairs as we got into it. In fact, I was probably about five years in. And I had a friend of mine. We do a lot of charitable work. We go to Haiti a few times a year. I met a periodontist in Haiti who called me maybe six months after our trip and said, “Hey, do you need a periodontist?” And I said, “I have no idea if I need a periodontist. Why don’t you come on board and let me know.” And since then, since about 2017 or so we started doing an integrated specialty model. So just three years ago our average practice had I think five and a half six chairs in it.
Vince Dilley:
Our average office now has 11 chairs in it. So we’ve grown a lot internally that way and expanding facilities or moving facilities. So we’re a general dentistry with integrated specialty, a traveling specialty model, obviously tough to do that in four chairs, as you cannibalize your specialty with your general dentistry. So we’ve had to pay for a lot of tenant improvements and expansion projects so that we can facilitate our integrated specialty model, but we believe that’s where the industry is going, the convenience and everything that it lends itself to for the patient experiences is kind of our strategy. There is a general dentistry with integrated specialty.
Bill Neumann:
Great. So let’s talk a little bit the startup phase. So you talked a little bit about you buying your first practice and in six months and going, what the heck did I do. But over time you learn the business and then you were able to find practices that you wanted to acquire. Have you done any de novos or have they been all acquisitions?
Vince Dilley:
Mostly acquisitions. We did our first de novo last year. We did it in October, interestingly enough just six months before the pandemic hit. So it’s been a little bit longer of a runway cycle than we expected. We were hoping to kind of be up and be profitable within the first six to 12 months. We weren’t, we’re not. But gaining traction and gaining ground after COVID which feels good. So our future we see as being a lot more de novo than what our past has been. That saying we’ll probably still do both. We’ll do new acquisitions and we’ve really liked folding in practices, buying a practice and folding it in with another location. That’s been great for us as well.
Bill Neumann:
So as you’re doing this and you’re still in startup mode and you kind of cranked through that first location and you’re looking for a number two and three, I mean, did you get to a point where all of a sudden there was that law of diminishing returns where you got to maybe three or four locations and you almost felt like you were taking a step backward. And then when did you start to actually build out the DSO? This is really a two-part or maybe I’m sure it’s all connected, but when did you start to really build out the support structure? So there’s the legal side of it, but then there’s actually building out the systems and making sure that across your different locations, you actually were talking to each other and you’re using shared services.
Vince Dilley:
Yeah. That’s a good question. Again, we kind of entered the DSO space in a unique way in that we had a call center before we were at a dental office.
Bill Neumann:
Right. You had that already.
Vince Dilley:
Yeah. So for that usually the call center is a big cost structure, right? I mean, it’s just a new cost to a DSO that they’re not used to paying for. They’ve got to decide whether or not they want to pay for it and whether it’s going to give the appropriate ROI or not. Our call center was a profit center for us. We had clients that we were serving with a profit margin. And so we were able to implement at least that basis of support services from day one. Again, we would see about a 10% increase in new patients day one without spending any additional marketing dollars, just by capturing the phone calls between the hours of 5:00 PM and 9:00 PM.
Vince Dilley:
So when the office goes home, that those calls were rolling over the call center and capturing those calls, we would see an immediate lift in new patients. And so for us, again, it’s a little bit of a non-traditional way into the DSO. And so from there, we just started bolting on additional support services. So a natural one is going to be HR as you integrate your HR functions, right. And paying everybody, I think we’re at maybe three or four offices and we have three or four different payrolls going at one time, and it was like, oh, this is crazy. We got to bring these up. And then frankly that’s when I discovered the whole DSO space. I think I had maybe three locations before I even knew the DSO space existed. Right. And I think that was where we were truly coming into form as a DSO and supporting doctors in a way that was there were real valuable support services that would benefit them.
Vince Dilley:
Yeah. I think the services just go building, I mean, you always want more than what you can pay for. I think if you’re a foot to the gas pedal type entrepreneur, you always want more than what you can afford. There’s a different route for everybody. Some people come in really hyper funded with a private equity group and others bootstrap it the way we have. So we haven’t taken a dollar of dilutive capital up until this point. And so for us looking back, we’re super glad we did that at the time. Man, it was rough, it was stressful. Looking at the bank account every two weeks, making sure that you got enough for payroll and live in that way on the bottom line is definitely a different pathway. And looking back, we wouldn’t do it any different, but in the moment it’s definitely a gut check.
Bill Neumann:
I’m sure at this point, and probably, well, before this, you’ve had private equity come to you and probably try and sweep you off your feet, so to speak, but you’ve been able to hold back your 22 locations. Going back to the beginning what about… So it was, you were buying practices. What was your first big hire would you say? What was the important hire that really kind of helped you or you were stuck and you needed to fill a position. What did you go to And how did that work out?
Vince Dilley:
So I remember I was in Sunnyvale, California, visiting a friend of mine, a smart guy, a business guy, and I was staying at his house. And I remember going to sleep that night. And I just had the worst stomach ache because of, I didn’t know if we’re going to make payroll and all the stresses of the business going on things. And it was 2014, maybe two years into it. And anyway, I had been talking to this friend for a long time about my business and what I was doing. And he was a product manager for a big tech firm out there in Silicon Valley. And anyway, shortly after that trip, he reached out and said, “Hey, we would you be interested in me coming on board?” And in hindsight I was just super, super lucky, right?
Vince Dilley:
Because his skill set was finance, had an MBA with an emphasis in finance. And I brought him on as our CFO and actually for the first year I had him in operations. I was in operations and frankly, the partnership was kind of a disaster upfront because I didn’t know where he fit. I didn’t know where I fit. And it was just kind of a real rough go. And then he settled into finance and that was the luckiest best move I ever made because he came on board, he vested 10% of the business. So he’s an owner, he’s my partner in the business. And at the time, frankly, it was worth it to me at the time, just to have somebody to commiserate with, right.
Vince Dilley:
Just a sounding board, somebody I could talk to. Now in hindsight look at how sophisticated our financial operations are for the size of DSO we are, that’s all him. To me bar none the best hire I ever made was bringing him on as a partner. That being said, I’ve had incredible doctor partners who are just amazing and have led on the clinical front as well. So hard to say the one eclipses the other. But I do think that getting strong and firm financial operations early on in your DSO is very, very valuable. You can certainly outsource a lot of that, but I do think that for us that was a game changer for us today, right? All the groundwork that he laid the last five years have allowed us to sprint and scales still bootstrapping, not taking any growth capital. I think that’s a pretty unique spot to be in at this stage in the game.
Bill Neumann:
Yeah. Absolutely. So Dr. Partners. You look at a lot of these practices, at least initially you were a dumpster fires. So did you have in some cases where the docs were just done, they wanted to kind of dump that practice and move on to something else? Or did you have some that stayed? What does that all look like? And do you have some doctor partners that have helped mentor other doctors as you’ve brought other practices on?
Vince Dilley:
Yeah, I think there’s a reason that groups and people aren’t lining up to buy dumpster fires, right. It’s not super easy and it’s a lot of work to turn them around. And oftentimes the doctor’s the issue, right? I mean, can’t be the issue. And so I think that’s where for sure getting the right doctor on board and making sure that they can turn that corner and change what they’ve done. All the doctors want a different outcome of success. Although they’ve got to stop and look at why the practice hasn’t been successful. And so for us, that was the big thing was identifying, is this the doctor partner who’s going to stay on board with us or not. And in many cases it was, and in a couple of cases it wasn’t, that was just fine. But I do think that most of the doctors given the type of practice that we look for are at least disenchanted with running the business, right? At least some of them are just done.
Vince Dilley:
But I had a partner who partnered with us a year ago and a little bit, 18 months ago now, but he told me, he says, “I’m going to take a break from dentistry. I’m going to be gone for six, 12 months and that’s it, after we transitioned this thing.” And he says, “I might come back. I might not.” I said, “Okay, that’s fine. Let’s give it six months.” Well, six months into it, he wasn’t doing his own hygiene anymore. His practice went from $400,000 a year, I guess, not six months, about a year into it, six months he had decided to stay on, but about a year into it, his practice was doing 1.4 million a year up from about I think $450,000 a year.
Vince Dilley:
And he came back and he says, I have loved dentistry so much. I haven’t enjoyed it as much. I’ve never made as much money. And so for that particular doctor, that’s what I live off of to see a doctor who’s practiced for 20 years and has just totally been kind of disenchanted is the best word I can use, I guess, with his industry and his business. To me that gets me excited. So we certainly have those success stories. And then we have stories where I had to go to the dock six months in and just say, hey, man, you can’t say the F word in front of patients, sorry, like, that’s not going to work. You can’t throw instruments at your dental assistant. I’m sorry, it’s not going to work. Right. So you get a mixed bag, you get a mixed bag. There’s definitely a more predictable outcome I would say with those higher performing offices, as it pertains to a partnership and the doctor leadership.
Bill Neumann:
Excellent. All right. So you are at 22 locations currently. We were talking about this before we started to record. And so right now, well, so let’s why don’t we start talking about COVID so early March, everything kind of shuts down, pandemic. We don’t know what’s going to happen. Take the audience through the steps that you took to shut everything down essential versus non-essential care, communication with the patients, with the staff, and then kind of take us through the summer and where you are now.
Vince Dilley:
Yeah. So credit to you guys Group Dentistry Now other groups that I’m affiliated with and partnered with really honestly were just a huge, huge asset during that time. We were on a phone call with the ADSO. I know with some of the CEOs over in Europe a few weeks leading up to kind of the closure. And just to hear the CEOs of some of those dental groups over there, like tell their story. I remember we were talking to, I think it was one of the CEOs or a dentist at one of the groups in Italy.
Bill Neumann:
Colosseum, I think. Yeah.
Vince Dilley:
Yeah. That was just crazy. He just said I took my last box of PPE down to the local hospital because they called me and said, this guy’s going to lose his leg if we don’t get this PPE. So he took his last box down there and closed his office. I remember getting off that phone call just thinking what’s about to happen. I had no idea what was like about to happen in the United States. And so again, super grateful to be a part of that organization because we went back and we started putting together kind of a furlough plan and just figure out, okay, how do we Batten down the hatches, knowing that we don’t have these coffers of deep capital to draw on, right. And maybe private equity group funded groups don’t either, but at least they have that fail safe. Right?
Vince Dilley:
We don’t, it’s like live or die by the bottom line. So for us, it became about being there for our team after COVID. And so that’s what we announced to the company. We said, hey, our job is to make sure that you have a job when this is all over. So we’re going to go down to doing emergency dentistry only shortly after that phone call came out, all of the mandates to do emergency dentistry only, but we had already decided to furlough everybody, got most of our team members to the front of the lines, from an unemployment perspective to get access to some type of financial aid. And we just batten down the hatches. We kept a team of about 20 people on board mostly HR function kind of call center, what was left of revenue cycle management.
Vince Dilley:
And that was about it. And then through that time it was just eight hours a day, 10 hours a day of just back-to-back Zoom meetings with the ADSO, with governing agencies trying to figure out what this thing was going to look like. And long story short it was just living in this reality of new information on a minute by minute basis. And we secured the PPE that we needed. That was a big part of it. We have an amazing head of purchasing that was able to secure the K 95 masks for us. And anyway, it was just frankly chaos for the first little bit. And then the biggest thing I took away from that though, was communication throughout the organization is that people didn’t know.
Vince Dilley:
And it’s better to know bad news than to not know news at all. And I think that that’s what we really took away from that was constant communication. So I did at least one email to the entire company every day, letting them know of all the steps we were taking to secure the future of the company, the future of their jobs. And as we came out of that we still didn’t know if we made the right decision or the wrong decision or what have you, but come May 1st when we opened back up, thankfully the demand had built up so much that we came through like many DSS did and had our best month ever in June, our best month ever in July. And we’re on track to have our best month ever in November.
Vince Dilley:
So we feel good about that. But the thing I really took away was just leadership in a crisis comes down to being decisive and making sure that you’re making a decision, right. That even the wrong decision is better than no decision at all. I think just when it comes to leadership and projecting out to the rest of the company that we’re going somewhere, right, that this is the direction we’re going. And in hindsight, I’m really glad that we did, the furlough saved us hundreds of thousands of dollars and secured capital that we greatly needed to be able to come back from the shutdown.
Bill Neumann:
Yeah, it’s amazing that I think the dental industry is in as good a shape as it is in general. I think there was some predictions early on that this was going to be a lot uglier than it has been. I think a lot of it has to do with being a DSO and having the support of some of these organizations that you mentioned and some of the funding from the government with the PPP and getting some things I think that were pretty essential to keeping things going. But you wonder how some of the GPs, solo practitioners managed and that’s kind of one of those questions I wanted to ask you as far as you start to look at practices to acquire now what is the landscape look like? Are there more dentists that are out there, solo practitioners, maybe seeking shelter with a DSO, so to speak. What are you finding? And then what’s your activity look like? Are you back looking for practices to acquire?
Vince Dilley:
Yeah, I believe so. I believe a lot of the trends that there were already existing in the dental space and the DSO space are only being accelerated by this. Right? So I think it’ll accelerate the percentage of dental graduates to go into DSS, which is already very high. I think it’ll accelerate consolidation in terms of deals and acquisitions. The answer is yes. What we’re finding is there are a lot of doctors who before COVID wouldn’t really consider an affiliation with the DSO who are now very open to it. We do have a couple of practices that we’re working with right now to close on in upcoming months. And so I definitely believe that a lot of those trends will continue. I think there’ll be a greater acceleration of medical and dental integration for sure.
Vince Dilley:
I’m reminded of our second practice. I was a year into running our first dental office. In fact it was one of my recall specialists as we called them, who called patients for our clients between the hours of 5:00 PM and 8:00 PM. She came to me, she says, “I’m an office manager by day and I just do this for extra money at night.” She says, “But my paycheck’s been bouncing. And I’d love for you to talk to my dentist.” And so I sat down with his doctor and from the time I first met him to the time we closed on the practice was like two weeks. And he was in a bad situation. I guess I’m coming back to, I think there’s more and more of these scenarios where it’ll lead to greater acquisition post COVID, but this guy he owed the bank $360,000.
Vince Dilley:
We called the bank, offered them $100,000 of which I didn’t have at the time, but I figured I could find 100 grand if they’d say yes. They said, “No, we need at least $150,000.” I said, “Okay, well nothing I can help you with.” And so they said, “Okay, well, we’re going to repo the office, repo war style.” They’re going to show up and take all the equipment. And I said, “Okay, well, let us know when you’re going to be there.” So I went to the landlord who he owed $40,000 in back rent to. And I said, “Look, you can get stand behind these guys and get nothing because this guy’s not going to declare bankruptcy, or you can lease the space to me and you’ll have a paying tenant and we’ll do some free dentistry for you to make up the past due balance.”
Vince Dilley:
Anyway, long story short, they came in, they repoed the equipment. I rented a U-Haul and I drove around. They came in on Friday and took all the equipment. I drove around buying equipment online, Craigslist and local classifieds websites. Bought a bunch of used dental equipment went in on Friday after they had laughed and spent from Friday to Monday putting back together this dental office. Doctor stayed onboard, secured everybody’s jobs. Everybody stayed on board. And I think all in, I was like $48,000 on that practice, that practice would do almost $3 million a year. And so I think those stories although in the moment it’s like I said, a gut check and I was like, man, what are we doing? Like, does this even seem rational?
Vince Dilley:
I guess in my mind, it seems rational at the time. I don’t know why we operate that way, but I think more and more of those scenarios are going to come about, right? This was six, seven years ago. Doctors are in that position. I think even more of those are going to be in those types of positions and it will lead to greater consolidation, a greater rate of consolidation.
Vince Dilley:
I think the difference is there’s not a lot of these DSOs, particularly private equity backed to DSOs. I mean, they’ve got a threshold of like a million bucks a year and they don’t even usually look at deals unless they’re a million dollars or more, which for us is a good thing, for us it’s a good thing. I think there will probably come the day where we might shift into that acquisition target. But right now if it’s doing $600,000 a year that’s like perfect for us because we can crank it up and get it doing a million and a half bucks pretty quick by introducing our specialists. So we’re very bullish, very positive on the acquisition market going forward.
Bill Neumann:
Are you bullish on employees, dental assistants, hygienists docs. What’s that look like?
Vince Dilley:
Great. Yeah. We are heavily investing in focused on our training platform. I think that we have to not only attract the right talent, but we have to get better at developing the right talent for that reason. I guess in short, no, I’m not. I think that wages are going to be continually increasing as a percentage. And so we’ve got to get more skilled labor. And so I think there’s an opportunity to do that by developing that labor. But it’s very, very competitive. We’re in Utah in Colorado. We’re definitely seeing market differences but generally we’re seeing a lift in those costs, for sure.
Bill Neumann:
Yeah. I mean, the reason I bring it up is with COVID I know that a lot of groups, I think a lot of practices are dealing with issues of getting employees back, depending on what state you’re in, you went on unemployment was paying you more than what you were making in a dental practice. You probably stayed on unemployment. So now that a lot of that’s out of the way. Yeah. I think there’s still probably some apprehension from some people because of COVID to come back. But it sounds like you have that figured out and investing in the people is the way to go, even though it may be expensive, but it’s more expensive to retrain and rehire.
Vince Dilley:
Yeah. Well, we definitely don’t feel like we got to figure it out, that’s for sure. I think that’s where we’re realizing we lived on this luxury of what I felt was really good culture. Right. I felt like we had a good culture pre COVID and things. And so we had very high retention. COVID threw us for a ranch. We had a lot of people not come back, a lot more people not come back than what I expected. Some of that was self-driven that a couple of things, here’s another idea, silver lining for a lot of DSOs, smaller DSOs, was everybody cleaned house. Everybody kind of cut the fat. And so a lot of those bigger groups that ended up eliminating some of those higher paid positions created an opportunity for a smaller DSOs to pick up some really good, really talented people.
Vince Dilley:
If you made those moves and do it in a way that that was within your budget. Some of the people who joined the organization with us, I think would have been slightly outside of our range pre COVID, but given the circumstances created a more opportunity in the market. So I think it goes both ways. I think that for those who acted during that time, you were able to pick up some really talented high level experienced DSO people operators. And so we were able to pick up a couple of regional managers, COO joined the company. And so we feel like we’re better off than we were pre COVID.
Bill Neumann:
Great. Yeah. Well, that’s good news. I want to finish this podcast off with some questions about Platinum Dental Services and Vince Dilley as the CEO and founder giving back, you do some charitable work in Haiti. Let’s talk a little bit about that because it’s not just about creating this big DSO and it’s more than that, so.
Vince Dilley:
It is more than that. It’s a lot more than that. And I think that’s where I find myself surrounded by great leaders in this industry, in that regard. Philanthropy is actually my passion. I think at the end of this journey, I think that’s where I’ll spend a lot of my later years in life. I volunteered for a long time before I ever got into dental. And in the orphanages in Mexico, I loved going down there and I found this love for just visiting people and helping people, whether it was painting a playground or a school in Rosarito Mexico, or if it was going to Haiti. And I think we’ve built that in. I remember, I think it was nine or so months after we acquired our first office, we had this idea to do like a free dental day, which isn’t an uncommon idea in the DSO space.
Vince Dilley:
So many DSOs get back and independent practitioners give back, but we did that and I didn’t have money to pay people. So at first I was like, man, how am I going to pay all these people to come and do this free dental day? Right. And I was kind of burdening that myself. And I said you know what? I’m just going to ask everybody to see if they’re willing to donate their time. And you know what? It was amazing. Everybody in the office thought it was such a great idea. Everybody donated their time and now it’s become this thing where every year we donate our time, we have vendors who help donate supplies. We have local restaurants that donate the catering for everybody who shares their time. And so for me, that’s what it’s about.
Vince Dilley:
Right? As we exit a political season where we see the divisiveness throughout the country, what an opportunity, what an industry, we have to be a part of to be able to truly change people’s lives, to really be able to give back to them and help them in our own backyard. Nonetheless, we do go to Haiti a couple of times a year, unfortunately, because of COVID, we have not been able to go this year. We’ve done lots of work in Puerto Rico. I stepped out of the company for about a month and a half, almost two months when hurricane Maria hit Puerto Rico, I have a soft spot in my heart for that place. I lived there for two years on an ecclesiastical mission. And hurricane Maria hit them hard and we were able to raise 1.5 million or so, and take down solar power generators and solar powered lights to give to the people who wouldn’t have power for months on end.
Vince Dilley:
So we love that aspect, personally that’s my passion. I love that more than anything else that we do, but you got to run a profitable business and we believe that we can all do good for people so long as there’s a bottom line. One of our core values from Tony Shay, the founder of Zappos, which is to do more with less. And the basis of that core value is we have to be profitable and we have to run a profitable business. And if we do so we can help a lot of people. And if we don’t, then there’s fewer people we can help. And so that’s what we try to do.
Bill Neumann:
Yeah. Great way to finish off the podcast. I think we’ll leave it at that. So like to thank our guests, Vince Dilley, who is the CEO and founder of Platinum Dental Services. He has right now, 22 locations in Colorado and Utah. And sounds like you’re working on closing a couple of others before the year’s over.
Vince Dilley:
That’s right.
Bill Neumann:
Excellent. Well, again, thanks for your time. Great story. And until next time I am Bill Neumann, and this is The Group Dentistry Now Show. Thanks for listening.