The Group Dentistry Now Show: The Voice Of The DSO Industry – Episode 42

Frank Quinn of Align Technology provides his perspective on the DSO market, key trends in teledentistry and virtual care, how to better engage patients, digital dentistry and Align Technology’s clinical education opportunities. If you want to unlock more opportunities for great patient care and better outcomes using innovative digitized tools, this podcast is for you!

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.

The Group Dentistry Now Show: The Voice of the DSO Industry has listeners across North & South America, Africa, Australia, Europe, and Asia. If you like our show, tell a friend or a colleague.

Choose your favorite listening app below and subscribe today so you don’t miss an episode! Full transcript is also provided below.

Full Transcript:

Bill Neumann:

I’d like to welcome everyone to the Group Dentistry Now Show, I’m Bill Neumann. I always say we’re happy to have my next guest here, but I really am. It was interesting, off camera we were talking a little bit about how we first met and I believe it was in Las Vegas at the DSO summit that Align had. It was probably two years back maybe. It certainly wasn’t this year because it was virtual. But we’re going to talk about that and the virtual meeting that you had, and some other virtual events that you have coming up. Then hopefully there’ll be some live events in 2021, we’ll cross our fingers that that’ll happen. But we have Frank Quinn from Align technology, so first off, thanks for being here, Frank.

Frank Quinn:

Thanks for having me, Bill. Good to see you.

Bill Neumann:

Yeah. Good to see you as well. I’ll go into Frank’s background a little bit here. He’s been with Align since 2013. In November of 2019, Frank was appointed to the role of vice president and general manager US at Align Technology. So tell you a little bit about this new position, relatively new position that he has. Frank’s responsible for driving continued growth and profitability for the United States, overseeing US sales, marketing, DSO, commercial excellence and functional leaders supporting the US commercial organization. That’s a mouthful. It sounds like a big responsibility.

Bill Neumann:

Like I mentioned before, he joined Align in 2013 as the director of special markets, so came right into Align in special markets and university. Was promoted several times to different positions, including senior sales director of special markets and iTero, vice president of special markets, business development and education, and most recently as the vice president of marketing for the Americas. As a respected member of the industry, Frank also serves as a board member of the America’s Association of Orthodontic Foundation, AAOF, we love our acronyms in the dental industry, and the American Academy of Clear Aligners, the AACA. So again, thanks Frank for being here, and maybe a little bit of your background at Align, specifically in the DSO market. Then talk a little bit about, maybe, what does Align special markets look like?

Frank Quinn:

Yeah. Great. Thanks for the lengthy intro. I forgot I did all those things, Bill, so thanks for reminding me. But no, I mean, I was lucky enough to get to Align seven and a half years ago. It was an interesting time for dental service organizations and special markets. As consolidation continues to happen today, it was doing the same thing back then. At Align, we really didn’t recognize dental service organizations per se, it was a much more retail, private practice focused business. So I was lucky enough to come in to Align and build out a business unit that was specifically designed for the complex world of dental service organizations, from two to five practices all the way up to the biggest of the big. And so it was quite a task and, really, it’s been outstanding for Align to be fully engaged in the special markets channel.

Bill Neumann:

So what was it like back in 2013 when you came in? I mean, was there a special markets division or did you kind of spearhead that? What did it look like?

Frank Quinn:

Yeah, there was not an official division. It was two of us as a matter of fact, just sitting there with a whiteboard and a lot of knowledge from the industry. I had been a small business owner and sold my company to Henry Schein, and been there for four years, really learned special markets quite a bit in that world. Then said, “Hey, it’s a little different here at Align, and we’d like to make sure that we have a world-class relationship with our customers.” So we started with a whiteboard and really designed what we wanted this to be like from a partnership perspective. So it’s kind of ironic that we sit here today. I think we have maybe over 50 dedicated people, specifically for dental service organization partnerships and relationships. So from a whiteboard with two to where we are today, it’s pretty exciting.

Bill Neumann:

In seven years.

Frank Quinn:

In seven years. Yeah.

Bill Neumann:

Yeah. So you obviously have many more responsibilities now than just managing a DSO, but what do you see as far as the landscape of DSOs? We can look at it historically if you want, and maybe even I’m going to have to go way back because you’ve been in the dental industry for a while, certainly pre-Align. You said you were at Schein for a while, you had a small business that you sold to Schein. Give us a little bit of your perspective on things. I mean, I saw things, in 2003, I had no idea. I mean, DSO didn’t even exist as a term until relatively recently, so I guess it was dental group practice. But let’s talk a little bit about that.

Frank Quinn:

Yeah. That’s a great point. The term DSO is front and center in dentistry today, and that’s because of the consolidation that’s taken place over the years. You’ve been involved in it as well. It’s interesting because not one is the same. Regardless of size or leadership culture, they all run just a little bit different, which is something that takes time to learn and is exciting. But you still see this continued consolidation, depends on what you read and pay attention to, it’s anywhere from, let’s say 12% to 20%, depending on how you define a group or dental service organization. It really accounts for even more of that when you talk about the production that takes place. So what that really tells us is that they, when done properly, create a lot of efficiency in their system, depending on their design.

Frank Quinn:

It’s an ever-growing part of dentistry, including orthodontist, every specialty. So I think it was exciting ten years ago, seven years ago, five, and it still is today. What I believe is really happening at an accelerated pace over the last couple of years is the adoption of digital ecosystems and platforms into the dental service organization. We may have seen this in the past when they adopted centralized practice management systems or digital radiography and imaging systems. But what you’re really seeing now is the adoption of a full digital platform, which includes all the way to the edge, in the patient chair, with scanners that are directly connected into high value platforms, such as the Align digital platform. And they really get the opportunity to create efficiency because of the size and scale that they have. I think that’s where you see this next big growth opportunity for DSOs specifically. I think there’s a lot of great opportunity that lies within those gold mines of practice and patient databases and these large consolidated businesses.

Bill Neumann:

Yeah. I mean, that really ties right into something else I wanted to talk to you a little bit about. You mentioned the changes that have occurred, but you’re right, it’s still the platforms all seem to be relatively unique. I mean, you have some that mimic others, but you have, I don’t know what the number is, I mean, it’s probably… I don’t know if it’s infinite, but as far as DSO business models go, there are quite a few, whether it’s size or specialty, or de novo versus acquisition, or a combination of the two, the type of insurance that they take. As far as resources go, when you, as a special markets team, start to work with these groups, I mean, you probably have different types of resources based upon the models that they have. Let’s talk a little bit about those resources that you build out.

Frank Quinn:

Yeah. That was one of the key parts of how we started this whole special markets at Align group. We knew that the requirements were a little different, right? When you think of dental service organizations, you live in this world, they have more of a corporate entity, right? The centralized billing, the marketing, human resource, chief clinical officers, it runs the gamut. So what we really did was design our dedicated resources to match and marry up to the dental service organization. Like I said, they’re all a little bit different, but there are some really key things that really drive the relationship.

Frank Quinn:

One is clinical education. It is a pillar for every relationship that includes a doctor and a clinician. So we invest heavily in our clinical education platform that is customized and unique for each one of our partners. They each have a different nuance to it, right? In some you find mixed dentists and orthodontists and clinical leaders and mentors. So we really designed very specific plans, programs, and applied resources for those doctors around clinical education.

Frank Quinn:

The second piece is really around marketing. Obviously, the brand Invisalign, it’s the most recognized brand in orthodontics. We invest a ton of money, over a billion dollars over the history of our business, to create that brand awareness. And really, that is to drive patients, potential patients, into practices looking for Invisalign. In the relationship with dental service organizations, they have their own marketing organizations. So we have an opportunity to partner together, and then again, marry up their brand with ours and their unique strategies on how they’re driving awareness and patient and new patient flow into their practices, and furthermore, into the existing patient database, right? Leveraging the Align digital platform and the ability to scan every patient, let’s say, with an iTero scanner and leverage the Invisalign brand, co-branded with these partners and practices, which is an important part of the relationship.

Frank Quinn:

Then there are all, a whole series of other resources that are very specific to the relationship, including your own dedicated business development specialist and manager that will manage that relationship and needs specifically for the dental service organization.

Bill Neumann:

Let’s talk a little bit about… It’s interesting, and I think part of the interest is due to COVID. I hate to talk about COVID, but you have to bring it up. So we’re going to talk a little bit about it. But tele dentistry, all of a sudden became the hot thing when COVID hit. It was around before and people didn’t… I say people, providers didn’t, and DSOs, maybe knew what it was, didn’t necessarily know how it applied to them. And I really think virtual care and tele dentistry came into its own during COVID. I’m just wondering, from your perspective, what is Align offering? And then what kind of adoption are you seeing? As things open back up, are the providers going back to their old ways or are they really embracing it? And what about patients?

Frank Quinn:

Yeah. Great question too. Yeah, it kind of forced the issue, right? You go through this lockdown, office closures. You think back, it was only just a few months ago that we were living this. We accelerated the launch of a couple of key products around tele dentistry and our virtual care platform, because we quickly identify the challenge with having business continuity as practices were closing, and then continuity in patient care. So we launched two very unique things called virtual appointments, which was a way for the clinician, the doctor, the staff to, in a HIPAA compliant way, connect virtually with patients that were interested in treatment. We still had treatment taking place, ironically.

Frank Quinn:

Then we also launched virtual care, which is, while in treatment, how do you stay connected? You could see it coming a mile away, that virtual and tele dentistry was really taking a foothold, especially when you can combine them in end to end digital platforms, that it’s not like some one-off, I’m having to take different, unique software packages and try and put them into my workflow. You knew that this was coming, and then we were lucky enough to have this already in our development and in our plans that we launched it rather quickly. It was a very interesting way for doctors and patients to stay connected, while treatment… It delivers convenience, which we know consumers of all types are very interested in. Then it provides a level of confidence while they’re in treatment to say, “Yeah, I am progressing.”

Frank Quinn:

It was unique because Invisalign, very different than wires and brackets, where if you couldn’t get into a practice, this is from doctors, not from me, that the patient couldn’t progress in their treatment. With Invisalign, just we’ll get on virtual care, we’ll take a look and you switch your aligners, and you’re still actually progressing treatment, or holding your treatment in place until I can get my practice back open and see you in the practice to ensure that we’re progressing the way we had originally designed it in the treatment plan.

Frank Quinn:

So these were really important tools that were added to the platform and the adoption has been fantastic. We really haven’t seen any drop in any of it now that practices are back open, we’ve seen further adoption and utilization. And we’ve actually launched some newer revs and versions of that software with direct doctor feedback. So it’s really been an interesting time in dentistry, let alone dental service organizations.

Bill Neumann:

I guess the fortunate thing was you already had it in development when COVID hit so you were able to launch it rather quickly.

Frank Quinn:

Yeah. We were a little ahead of schedule. We begged for some forgiveness on maybe some of the subtle things that weren’t perfect, but it really served a purpose. During that time, we were so immersed with our customers that the feedback was fast and furious. Being in an agile environment here at Align, and an innovator, we just quickly iterated and addressed and provided better features and benefits from the packages.

Bill Neumann:

So tagging onto that a little bit here, let’s talk a little bit about engagement, from a dentist’s perspective, with their patients. What are you seeing that works? What are the opportunities? Maybe some of it could be with virtual care and tele dentistry. But that’s one of those things is, there still may be some apprehension with certain patients because of COVID. I’m sure dentists are trying to make sure that they get the patients in if they’re willing to and get that comfort level up. So let’s talk a little bit about that. What are you seeing?

Frank Quinn:

Yeah, big kudos to the practices out there and dental service organizations that rebounded quickly. New protocols, just different capacity, workflows, really challenging, right? And kudos to many of you out there who have figured this out. I’d say the big thing is it’s a digital world, right? And that is, I think, the bottom line to all of this, is that, really, digital became the answer. And that when you think of, obviously, the efficiencies, those are all there. I think we all know that when you properly implement and adopt digital into your practices, into your business, especially large scaling business like dental service organizations, it lends itself to really being agile and pivoting quickly to address those needs. Patient fear, all of those things, I think those are continual challenges, they’ve always been in dentistry. But when you present a digital option to a patient, for scanning, and virtual care, virtual appointment options, it really does help alleviate the capacity challenges of a practice. Then when you also have a great solution like Invisalign as an option for a patient, it allows them to continue and progress with transforming their smile and changing their lives.

Frank Quinn:

It’s been really quite a journey with dental service organizations that have adopted the Align digital platform. There was a tsunami of patient care that had to come in post opening. That was a frenetic pace, getting patients in that needed treatment. Then when we slide into this, maybe, new normal, you’re really finding the utilization of these digital tools like iTero, and these virtual platforms and tools on our platform have really escalated. So that’s really what we’re seeing from our perspective, and really don’t expect that to change anytime soon, regardless of what happens in a wave two and all the things that are going on. I think it’s been a long time, but the new normal is here and it’s digital.

Bill Neumann:

Right. Yeah. And I think, whether you were comfortable with it before or not, from a patient perspective, from a provider perspective, you got comfortable pretty quickly.

Frank Quinn:

Yeah. Had to.

Bill Neumann:

Yeah. Let’s talk a little bit about some of the new products and technologies. You talked about launching the tele dentistry and the virtual care platform, but it sounds like there’s different iterations of this. What have you launched recently and what can you tell us about that’s in the works?

Frank Quinn:

Yeah, always a dangerous question there, right?

Bill Neumann:

Yeah.

Frank Quinn:

I think at our core Align is a technology innovator. That’s how we built our business over a quarter century, and really pride ourselves on that. And so some of the most recent launches beyond what I just talked about, our ClinCheck Pro 6.0, really creating something that our customers have been asking for, a really device agnostic ClinCheck tool. Web based so you can use it on Apple, Android, Microsoft. We’ve really opened up the platform for simple use and web-based use, which was something that’s been in development for a long time. We’ve gotten outstanding feedback from our customers. And really putting more detailed, 3D controls in the doctor’s hand, real time, with that web-based application.

Frank Quinn:

The other thing that we’ve been highly focused on over the last decade, I should say, is really around creating predictability and outcomes from the treatment plan, the 3D treatment plan. When you’ve treated over 8 million, maybe 9 million patients, you really have to leverage the experience and knowledge and put that into the hands of the doctor through these tools. We’ve added the 2D, 3D visualization to the portfolio as well, on certain products, where you can take that 3D treatment plan from ClinCheck and actually put it into the face. Through the Invisalign photo uploader portion of our platform, and take that rendering, which was always maybe on a screen, you can do it with a scan, showing the before and potential after with the outcome simulator on iTero, but you can actually drop that treatment plan into in-face visualization tool, right in ClinCheck. These are game changer type scenarios, right?

Frank Quinn:

We all know that seeing is believing. I mean, you think back all the way in the advent of intraoral cameras, we are so far past that. And that when patients actually get that digitized experience from their doctor or their hygienist, they’re really committed. It’s a great way for our customers, especially dental service organizations with a large patient database, to unlock so much opportunity for great patient care and outcomes by using these digitized tools.

Frank Quinn:

The other piece that I’ll share is, we commercialized, we got approval for the iTero 5D right in the middle of the lockdown and the pandemic. It was really an odd time to get the approval, which is something we’ve been really anticipating and so excited about. So this is really the first scanner that’s been introduced to the market that does full 3D intraoral impressions, full scanning, 2D color images, and then uses near infrared imaging, NIRI, within 60 seconds, all one loop around the mouth. It’s collecting all this massive amount of data that is just great diagnostic tools for the clinician themselves, but it is also a great tool for the patient as well. Because you’re seeing the structure and the enamel of the tooth without radiography, there’s no harmful radiation. And you’re really creating this moment and this energy, chair side, when you leverage technology like this.

Frank Quinn:

I said it before, seeing is believing. But then you start creating a scan once a year or every six month visit, and you start leveraging the tools like time-lapse that are in there as well, and you’re showing the change in soft and hard tissue to the patient over time. Then it’s their decision at that moment, right? So you’re providing this diagnostic visual tool with the iTero 5D, and you’re really allowing the patient to fully engage in their treatment and the health of their mouth, which can include any type of restorative work as well as pre-restorative orthodontics with Invisalign. So these have really been some game changer technology innovations that we’ve launched. We’ve seen just really exciting adoption, we’ve seen our doctors really out there on social media and Instagram, and really sharing their patient experience as well, which is always exciting to see on our side. So those are some-

Bill Neumann:

And that’s the way people are communicating now, for sure.

Frank Quinn:

Oh yeah.

Bill Neumann:

I mean, everything’s virtual and everybody seems to have more time on social media, or they’re spending more time on social media, so it’s good to see that. We already talked a little bit about digital dentistry overall, and that shift towards digital dentistry, and we think COVID really has amplified that, sped up that process of adoption. Let’s talk a little bit about, this is probably one of the tougher things to do virtually, is the education side of things, clinical education. There have been no live meetings. I mean, maybe there’ve been a couple of small clinical meetings hands-on, but for the majority, 99% of the dental meetings have all been virtual. Talk a little bit about what you’ve been doing since the pandemic started and then what you’ve got planned for the future. We mentioned it earlier, that’s where we met, we met at your special markets summit. So you just had a virtual one recently, correct?

Frank Quinn:

Yeah, we did. Team did a great job there. I think we had over 1200 attendees to that virtual summit.

Bill Neumann:

Wow.

Frank Quinn:

Which is just outstanding.

Bill Neumann:

That’s the benefit to virtual.

Frank Quinn:

It is the benefit, right? It allows people to choose. The platforms that we’re using, from a digital virtual education perspective, are very flexible, and that allows those in attendance to choose their path. Classically, when you have live meetings, you got to pick where you’re going to sit in a class and stay there, and you may have missed a session that you were really interested in. I think the way we’ve been launching virtual, it just creates a high level of availability and flexibility for those who come in, and so it allows that user to create their own experience.

Frank Quinn:

We’re doing it on our side, right? We’re doing everything we can to, to deliver this live, and we do a lot of this virtual live, with the cameras and the sets and all of those things, because we want to be connected to our customers. But it really is immersive. I’ve been quite impressed with the way our customers have engaged a lot of this content. We joke a little bit around virtual exhaustion, and sometimes you get Zoomed out or whatever that may be, but we haven’t had any challenges in doctors and staff and hygienists and you name it engaging with us on our virtual platform. That also all exists in the Align education tab on IDS. I mean, the content and the library that’s there is massive.

Frank Quinn:

And it really started years ago, right? We’ve had this whole mantra of, “Provide the customer what they want, when they want and where they want it.” So we’ve always been huge in our live learning events because we believe knee to knee, eye to eye is highly valuable, but we really have been making this transition to providing that virtual touch point. So when COVID hit and lockdowns hit, it wasn’t a frantic run around and figure out what we’re going to do, we just said, “Okay, we’re ready. Let’s get this into a virtual environment”, and stayed very connected with our customers throughout that whole period of time and continue to do so. When the time is right, we’ll get back to live. Obviously, we’re following CDC guidelines just like everyone else is, and we’re obviously excited to see everybody again. We’d love to see everybody again. But we’re being cautious and respectful and following those guidelines. Hopefully, in time, we’ll be standing in the same room again, Bill.

Bill Neumann:

Yeah, absolutely. We’ll make sure of that. Well, I think we’ll leave it on that note, that was kind of a great way to finish things off. We’ll see everybody live again soon.

Frank Quinn:

Yeah, exactly.

Bill Neumann:

Wonderful. Well, thanks again. We appreciate having Frank Quinn. I have to get your new title right, well, relatively new title, vice president and general manager at Align Technology. Until next time, I’m Bill Neumann, and thanks everybody for watching and listening to the Group Dentistry Now Show.

Frank Quinn:

Thanks, Bill.