The Group Dentistry Now Show: The Voice Of The DSO Industry – Episode 59

Josh Muir, Director of DSO and Special Markets, joins Bill Neumann on the Group Dentistry Now Show for his second appearance. Josh discusses how RecallMax has assisted dental groups during the pandemic and how the organization has helped dental groups pivot during the new normal. He also talks implementation and operational change within a DSO setting. Finally, Josh talks about big changes and the growth of RecallMax. RecallMax is also the title sponsor of the DSO Leadership Summit! If you want to learn how to be a stronger DSO, this podcast is for you!

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Full Transcript:

Bill Neumann:

I’d like to welcome everybody to the Group Dentistry Now show. I’m Bill Neumann, and we’ve been cranking out a lot of podcasts recently, and happy to have our next guest on here from RecallMax. Actually, this is Josh’s second time he’s been on the Group Dentistry Now show. So welcome back, Josh Muir from RecallMax.

Josh Muir:

Thanks, Bill. Glad to be on the podcast again with you as usual.

Bill Neumann:

Yeah. This’ll be our second time and we actually did another podcast with the DSO Leadership Summit. I think it was a Facebook live together not too long ago.

Josh Muir:

Yeah, that’s right. A lot of fun.

Bill Neumann:

So we’re getting pretty good at this.

Josh Muir:

We are old pros.

Bill Neumann:

Yeah, there you go. So Josh is the director of DSO and strategic markets with RecallMax. I’d like to give Josh a little bit a time to just talk a little bit about his background and then also a little bit about RecallMax for the folks that don’t know Josh and also may not know RecallMax. So take it away, Josh.

Josh Muir:

Awesome. Thanks, Bill. Well I’ve spent the better part of the last decade really in practice management and development for a number of medical verticals. In the last five years, I’ve been with RecallMax as their director for DSO and strategic markets. And my whole focus is really working with groups and helping them understand the value of what we bring to them. At the end of the day, I like to say that for the last 10, 15 years, my whole goal and ambition working with medical practices is to put butts in chairs and helping them understand how valuable the patient is and really putting initiatives in place to help them fill their chairs and their operatories. That’s why I’m with RecallMax. I eat, sleep, breathe, live, and love what we do here. So I’m happy to be sharing and hopefully can help bring some new things to light for the dental space. And we’ll get into it, I’m sure.

Bill Neumann:

Yeah, that sounds good. Talk a little bit about the company.

Josh Muir:

For sure. RecallMax was really born out of a consultancy. We’ve been in the dental consulting space for about 30 years. And over a decade ago, Ron Barsotti, our founder had this idea of, “Hey, let’s really take what we were doing from a manual perspective and helping practices learn how to really effectively grow organically through hygiene optimization.”

Josh Muir:

We were doing a lot of things manually. We said we need to create a platform that allows practices to automate some of these really manual tasks and create really phenomenal workflows and processes. And that’s how RecallMax was born. We focused heavily on the Canadian market during the infancy of our platform and we now have about 25% of the market share in Canada. Around one in four patients that receive a digital message is coming from our platform. That’s really something that we’re proud of. Now, we’re focused heavily on helping build this into the US market and take what we’ve done here and duplicate it down in the US.

Bill Neumann:

That sounds great. And it sounds like you’re also building the platform as well.

Josh Muir:

Absolutely.

Bill Neumann:

Good. So last time we spoke, and we actually did have Ron with you, I think on that podcast. That was right around the end of May, I think. Things have changed quite a bit in a year. Thank goodness. And in a good way. The time we spoke in May, I think it was really about restarting practices, right? These practices that have been closed down for four weeks to two months. So that was really the focus of the conversation there. So let’s talk a little bit about last year and then what have the challenges been for RecallMax and also some of your customers?

Josh Muir:

Yeah, good. I think if any of us reflect back over the last year, I think the challenges that we saw from an organizational perspective were the same as the challenges people were seeing from a personal perspective. We all had to learn how to do things much differently. We’ve all become Zoom experts on a personal and on a corporate level. I think it was just really learning how to adapt to the limitations of not being able to travel, not being able to be one-on-one in person.

Josh Muir:

Our customers were struggling as well because we weren’t in office as often. That personal interaction was taken away, and we had to adapt really quickly to that. We had to implement new technologies to help us communicate more effectively with each other on a corporate level and with our customers. So there was a lot that that had to happen, but I think we’ve all adapted well. I mean, hey, I’ve seen you’ve been traveling. It’s nice that the world’s opening up a little bit again, but I think those restrictions may come back into place and we’re prepared. We’ve implemented those processes to allow us to engage our client base a little more effectively.

Bill Neumann:

Yeah. I think that’s a great point. I mean, certainly, I don’t think anybody wants that to happen, but I think there’s the word prepared, right? We need to be prepared for whatever it is that may happen next, and be able to communicate with our patients in ways that you may have been able to in the past, but you may have not needed to necessarily in the past. Now, it’s not a want, right? It’s a requirement. It’s something that I think from a patient perspective, it’s an expectation, right? Patient being a customer expecting to be communicated to that way digitally, being reminded that way. They’re used to that outside of a dental practice. So why not expect that in a dental practice. More of a retail environment almost if you kind of look at it that way.

Josh Muir:

Yeah, for sure. I mean, if you consider some of the things that we’ve done to enhance the experience really resonate with that, Bill. Our virtual waiting room as an example. This is one of those pieces where, I mean, conceptually, it’s so simple. You get to a practice. You get a text message when you arrive. It says, “Thanks for your appointments today.” When you arrive at the practice, reply with X or whatever the reply is.

Josh Muir:

Then immediately the practice gets an alert that that patient’s arrived. It limits the amount of phone calls they have to place. It creates this digital experience for the patient as well, because they’re apprehensive. They’re nervous. They don’t want to walk into a waiting room full of people. And this is one of those tools that we’ve enhanced our platform with. It really speaks to the time we’re living in right now.

Josh Muir:

I think it’s those pieces that we’ve put in place that help accommodate some of the challenges that the patient base is feeling right now, or the concerns that the patient base is feeling right now. And that really is where we’re winning and our clients are winning, is being able to provide those tools to create a more seamless, smooth, digital experience for the patient.

Bill Neumann:

It’s a shame the pandemic really is the reason that we have this seamless, from digital to the chair almost. I know my personal experience was I never liked to wait in a dental practice whether it was during COVID or before COVID. I mean if there was one good thing that’s come out of this, I think there’s that realization that patients don’t want to be in a dental practice waiting. So here’s a question for you. COVID hits, and again we had some of this discussion last year, but talk about RecallMax pivot.

Bill Neumann:

So what were some of the needs of the customer, the practitioners, the DSOs? What were they looking for from you? And then how did RecallMax adjusts to really create that platform and the changes in the platform to accommodate?

Josh Muir:

Yeah. I think a few of the changes that we made from a platform perspective, I alluded to the first is a virtual waiting room. I think some of the other pieces that really helped groups came from the perspective of providing that digital experience, but also helping the practices reduce the workload. A lot of practices were plagued with staff shortages. I mean, there’s no surprise. We’re all in the media. We all read the newspaper. There are staffing shortages across the country.

Josh Muir:

And if we can provide relief for the folks that are working in the practice, that they may be down one or two bodies, things like digital form integration, whether or not having a hand forms, they’re not having to manually enter things into the PMS. Digital form integration was a huge modification for us because it provides, again, another relief point for the administrative team of the practice. Online scheduling, being able to provide the ability for patients to select their own appointments and schedule themselves online.

Josh Muir:

Now, those are the kind of the techie advancements that we pivoted to. But I would say this. There’s really one thing that we did not pivot from, and I think it was intentional, and I believe that this needs to be a common theme for most practices and most groups moving forward. That’s the importance of recall management from a personal engagement perspective. Because again, you’re dealing with a patient base that, look, overdue, late past, your patients are increasing at a rapid pace because now we’re trying to play catch up with all the patients that weren’t coming in last year. And it’s hard to stay on top of that.

Josh Muir:

It’s not capacity doubled over the last year. If anything, we’re limited from a capacity perspective. So now we’re playing catch up with patients. It’s really important for us to stay on top of engagement. One of the things that our whole platform focuses on is automating tasks at the practice level, but then really emphasizing personal engagement. Giving them clear, specific lists of who they need to engage, how often they need to engage them and giving them the ability to see in quick order, “Hey, these are the 10, 15 patients I need to tap into today.”

Josh Muir:

THen on the corporate side and the enterprise level at the oversight level, giving the leadership visibility to what that engagement is looking like, “Hey, are we moving the needle forward? Are we engaging our patient base? Are we seeing a decline in the number of patients that are doing late? Are we increasing the number of patients we’re pre-appointing?” Giving them the visibility points to say, “Hey, yeah. We’re moving the needle forward.”

Josh Muir:

While introducing new technology, we also don’t want to deviate from the real important topic of engagement, patient engagement, because it’s more important than ever right now.

Bill Neumann:

I love to drill down a little bit more on this patient engagement. So talk to me about what that means, and then what’s effective? So what are you seeing that’s really working well?

Josh Muir:

So for all of those technology lovers watching this, I may ruffle some feathers, but I’m okay with that. There’s a message that’s continuously pumped out into the marketplace and that’s set it and forget it. Automation is the only way to go. Fully automate your practice. Fully automate communication. And while that has its place, we know based on our analytics that it’s not true all the time. We did a case study of a group, 37 practices, and we monitored previous years, messaging results versus engagement results.

Josh Muir:

Patients that were messaged about their due and late status, requested or booked an appointment 5% of the time. Patients that were personally engaged, meaning someone picked up the phone to the practice level and called in this particular group, 41% of those patients scheduled an appointment. That’s a huge difference, right?

Bill Neumann:

Yeah.

Josh Muir:

It just goes to show that automating things isn’t going to work in this environment all the time. It’ll work some of the time, but it’s not going to work all the time. Patients want to hear from the practice. They want to hear that protocols are being met at the practice of it. They want to hear that what measures you’re taking to ensure they’re safe. They want to hear from you. We know. We can validate it through our data. We know every time we do these case studies with DSOs, it turns out the same every time. Automation versus engagement, engagement will get you a seven to eight times improvement on booking, overdoing, late patients versus the automated piece. So it’s super important that groups understand this.

Bill Neumann:

Yeah. Super. Good to know. Makes sense, right? I most likely am going to reply to somebody. Chances are if they actually call you, Sally that you know who’s been at the practice for a while. So that’s good. Good stuff. So let’s talk a little bit about just your overall observations of the market. Since you sit in Canada, it’d be interesting to kind of get your perspective on Canada versus the US. It’s kind of a real general question, but what are you seeing out there with your customers in the market as a whole?

Josh Muir:

Yeah, it’s interesting. So I always like to say, there’s really not a difference between Canada and the US. It’s just 10 times bigger in the US. So they have 10 times the issues or 10 times the rewards or benefits, whatever you want to say. The challenges in the market or us is helping practices understand that you still need to work on the operations of your practices. There’s still this opportunity for us to bring in new technology, to streamline our operations, to institute new protocols and new procedures, and the important than ever, we’re noticing that consolidation and acquisition has rapidly increased over the last year.

Josh Muir:

In my mind, I was thinking, gee, we must be hitting a plateau in the M&A space in dental because it’s relatively consolidated. But when you really look at it, it’s not all that consolidated. I think the pandemic brought the perfect opportunity for groups and DSOs to snap up practices quickly. Now, what we’re seeing is instead of focusing on instituting standardized procedures and processes across their group, they’re focused heavily on the acquisition space, rightfully so.

Josh Muir:

I guess my caution to the group space is that it’s not acquisition or organic growth internally, it’s both. You can still grow your group by acquiring new practices. Patient acquisition is still important. It always will be. But it’s equally important to focus on the operations of your group. Especially coming out of a pandemic when we’re seeing those numbers increase, or the opportunity in doing patients is increasing and increasing, it’s more important now than ever to put those processes in place to help overcome some of those challenges.

Bill Neumann:

Yeah. I totally concur there. As far as strategic initiatives, you already gave us a little bit of an idea there. I mean, is there anything that should be a priority or is there anything that you’ve seen with your customers that is like, “Hey, this is what a lot of our customers seem to be focused on and it’s working”? Where they should be focused on.

Josh Muir:

Yeah, it’s interesting. On the group in DSO side, one trend that I’m seeing consistently, especially in the mid-market space is to centralize some of the efforts to bring those patients back into the practices. Again, if you’ve got staffing shortages at your practice level, one of the greatest ways to overcome some of those challenges related to that patient base doing late growing and growing is to centralize it.

Josh Muir:

Our application allows for centralized services to be used within our app. A call center region can log into three, four, five, six, 10 different practices and be able to have visibility to all the opportunities in those practices through our toolbar. I think that is one trend that I am seeing come out more and more often.

Josh Muir:

I think it’s a good trend. I think it provides an opportunity for you to standardize, for you to create awareness around the opportunity, and then to really centralize that effort as a corporation to provide services. If you’re an affiliated group, you’re able to provide that from a service perspective to your affiliated practices. And that’s just one other benefit that a DSO has for its affiliated practices or a DPO might have for its affiliated practices.

Bill Neumann:

So that patient engagement that you talked about going from office manager at the practice level to either a call center or somebody at the DSO, the support center tasked with that to handle it for multiple sites.

Josh Muir:

Yeah, exactly. Particularly when the focus of that call center or the tasks of that call center are so focused on patient engagement, you’re able to really refine that and determine what scripting works well. How are we able to get those patients back in? If that’s your whole focus, you get really good at it really quickly. And we are seeing some pretty good successes out there in the mid-market space.

Bill Neumann:

This is interesting. This would be a relatively big change for some groups, right? Especially if they kind of did this decentralized model or at least when it comes to patient engagement or patient recall where it’s decentralized practice by practice kind of doing their own thing. So I’m doing probably better than others. So when you’re making something like this, this is a relatively big change, big operational change. Let’s talk a little bit about how DSO and emerging group handles something like that, and other operational changes, because it’s tough. It’s tough to get that buy-in at the practice level.

Bill Neumann:

Maybe Sally or Joe at the practice doesn’t want to give that up, because they’re really good at that. And maybe others want to give it up. So talk a little bit about that. Trying to try to make that change, how does a DSO do that?

Josh Muir:

Yeah, I think when DSOs can convey the value to the solo practice on what this will allow them to do more effectively, it goes a long way. I would say that it’s not a one or the other. It’s not a take it all away and give it to the centralized team, but it’s an offer as a support. And to paint the picture of, “Look, we know how challenging it is to work recall in the practice. We know that at any given day, you’re on the phone with insurance companies, you’re checking patients in and out. There’s a kid crying in the back room.”

Josh Muir:

Whatever the challenges are that they face at practice level, if they can convey value and the relief that centralizing some of these services would bring to the practice, it goes a long way. And again, it may not be for all practices. Some practices have the ability to really tap into the recall as some work it. But for other large multi-operatory practices, we haven’t heard of many of those large practices unwilling to give some of those tasks off to centralize services.

Josh Muir:

It’s a relief for them quite frankly. I think the biggest convincing that needs to be done is at the corporate level of those groups, that this is a valuable featured add-in to your offering. From a resource perspective, it’s not that difficult. We’ve seen groups that centralized, but they don’t centralize. They centralize from the perspective of they’ve got one individual that runs it at a corporate level, and then they’ve hired folks that pretty much stay at home moms working from home, working recall lists, downloading RecallMax under their home PC, and just being able to work from the comfort of their own home.

Josh Muir:

So there are a multitude of different ways you can work centralized services. It doesn’t necessarily have to be in a call center box environment. As long as you’re open to exploring the possibilities, I think it adds great value for them.

Bill Neumann:

Yeah, and that’s a great point. I think, especially after COVID there are some… I would say it’s probably a decent percentage of people that are very happy working from home now and don’t want to go back to the office for whatever reason, whether they’ve become comfortable or whether there’s some fear still because of COVID. Probably a combination of things. So that flexibility, and I think to your point about things that the support center can still monitor and pull reports and kind of … You see how people… So even though it’s centralized, your point is it’s decentralized because they’re working from home.

Josh Muir:

Yeah. Exactly.

Bill Neumann:

Pretty interesting. So let’s talk a little bit about implementation of this change. So decentralized, and we’re going to, changing things up a little bit more, and working with RecallMax, more patient engagement, more patient communication. How easy is it to make that change if a DSO or a group is not doing it or not doing it well or doing it at the practice level? How do you make sure that this isn’t a heavy lift for the group?

Josh Muir:

Yeah, it’s really not. We get that question all the time like, “How taxing is this going to be on my operations team?” And it really isn’t. We have really perfected the art of implementation of RecallMax within a variety of different processes, either at the practice level or a centralized level. And we do all the heavy lifting.

Josh Muir:

That’s one myth that is out there that it takes a lot of operative manpower on the DSO side to implement a change like a RecallMax into their current workflow. And it really isn’t. First of all, in an implementation called discuss what the process is going to look like, how we’re going to support the team. We work independently from their operations team, with their IT team to do the installation, to do the implementation, to get everything teed up.

Josh Muir:

We make recommendations based on how they want to roll out either at the practice level or at an enterprise and a call center format level. And we’ve got the expertise. We’ve got a client success department that’s dedicated solely to ensuring that our platform is being levered. Not many software companies have an entire team dedicated to ensure that their software is being utilized by the client base.

Josh Muir:

Typically, when software is launched into a company, once the sale is done, you don’t really hear from that company. We go to the nth degree to make sure that our clients are leveraging the platform. Again, our whole belief is that engagement should be personal and should take priority over everything else. And we want to make sure that RecallMax becomes a living, breathing process within groups and practices. And because of that, we’ve built out an entire division of our organization to make sure that’s happening. We’ve got DSO implementation specialists, DSO support specialists that understand the dynamic of groups and DSOs and DPOs. And they’re able to offer insights and advice on what the best practices should be when setting up that internal infrastructure.

Josh Muir:

But at the end of the day, it doesn’t take a lot. You need one point person for an entire group. Depending on the size of the group, you may want two or three, but you will reap the benefits of bringing those individuals in to run it, because all it takes is picking up the phone and calling your patients that are overdoing late. And your group is organically growing 15 to 20% in their hygiene side overnight, because we know that engagement equals appointments. So there’s great value in the end. It doesn’t take a lot upfront to set up this process and it pretty much is just, “Hey, hire one person. See how it goes and then continue to scale up based on the success of that.”

Bill Neumann:

I think this is a really great point and I don’t want to go pass this and then move on to the next and last question also, which is going to be really interesting to talk about. We do surveys every year with procurement, clinical directors, people at DSOs, both large and small. I think to your point about there’s the product or the software. So what it does is super important, but I think equally important, and this is why I bring up the survey that we do is we ask on a scale of one to five, talk about what’s most important. Is it price? Is it, this? Is it that?

Bill Neumann:

Almost always, the service, whether it’s the onboarding, the implementation, the education is almost as important as the product itself, right? Because in the end, if you’ve got a great product, but you don’t know how to use it, or you use one-tenth of it, probably not going to use it too much, right? I think the education, the onboarding is super important. So something that you really consider, I think with just about anything that you’re out there, if you’re procurement, you’re a clinical director considering is what is the company going to do to support, to educate and to improve? And I think if you’ve got that combination, you’ve got a winner.

Josh Muir:

Listen, I couldn’t agree more. One of my favorite tools to gain perspective on how companies are growing is LinkedIn’s analytical tools on company growth. You can go into the company page and see the head count growth and the areas of the business that are growing. And if you’re ever looking to bring in technology, due to the research, is that organization growing as heavily on the support side as they are on the sales side?

Josh Muir:

And if you see sales is up here from a headcount perspective and support is stagnant, that could be challenging down the line. And I can say hand on my heart, we have invested just as heavily in growing our support side as our sales side. In fact, our support side tends to lean heavy on the growth before our sales, because we want to make sure that the processes are in place. The support mechanisms are in place. The client success mechanisms are in place before the sales come. And that really has always been there because we want to make sure that we’re meeting the demands of the growth of our business.

Josh Muir:

So if you look at our head count growth, we’re pretty even Steven from a support and a sales side. And that’s a pat on our own back. I’m really proud of it. I think that we go to great levels to ensure support is there for our clients.

Bill Neumann:

That’s great. Support side is the delivery side. Sales side is the promise side. So if your support is actually ahead of the sales, it makes a ton of sense. I know a lot of companies don’t necessarily operate that way. I would venture to guess it’s probably unique.

Josh Muir:

I would agree 100%.

Bill Neumann:

So final question for you, and I know we’re going to have you on, in the not too distant future for a follow-up podcast, we’re going to be doing a series of these. And really, I always look forward to these conversations, whether they’re on a podcast or whether we’re just having a conversation via phone or Zoom, and hopefully in person at some point again soon.

Bill Neumann:

What are the plans for RecallMax? What’s going on? What are you… And any meetings you’re going to? What can you tell us? I know there’s some things you want to talk about. Maybe you want to talk about them on the next podcast. But give us a little bit of an idea of what’s going to be happening in the near future?

Josh Muir:

Yeah, very good. I mean, the world’s opening up again. At least in North America. So we’ll be live and in person and present. We’ll be at the Dykema DSO conference coming up in July. We’re going to be at the DSO Leadership Summit with you Bill and the fine folks at HR for health. We’re really excited to be presenting at that summit as well. Leading up to that, there’s a lot going on for us. We have grown significantly in the last year. We went through, I would say a significant financial event back in December. And we’re going to talk a little bit about that on our next podcast, because we’re really happy with the partnership that we now have with a large investment firm in Canada.

Josh Muir:

It’s given us the opportunity to expand in ways that this was not really possible previously. We have now since opened an office in Utah. I think we’re on employee 16 or 17 in about three months. So that’s pretty considerable growth in a matter of three months. Our focus is really to support the US market moving forward. Of course, to maintain our current client base in the Canadian market and continue our growth up here is important. It’s where our roots are established and we’ll continue to do that.

Josh Muir:

But really now our focus is the US growth and a little teaser of the potential of exploring other verticals that recall also speaks well into. So we’ve got really big ambitions for the near future. And I can’t wait. I’m not going to say anything else. We’re going to introduce some of our new team members on our next podcast, but we’re really excited about the growth and I think our clients should be too.

Bill Neumann:

Yeah. We’re excited for you as well, and always appreciate the opportunity to sprinkle… We’re just going to lead people on a little bit until the next podcast. We’re going to make sure we break anything important on the next podcast that weekend. I know that it’s going to be an exciting podcast. So you mentioned Dykema a meeting end of July. S you’re going to have some of your team there. I know you’ve got a couple events going on around the event. So folks can find out more about that on GDN and from Josh at RecallMax. And then the DSO leadership summit which will be early September, the 7th and 8th in San Fran. RecallMax is the lead sponsor there. So we appreciate that. And then of course the other meetings that hopefully we’ll all be in person going forward.

Josh Muir:

Yeah, absolutely. I mean, we’ve got team members in Florida right now at the… There’s a convention out in Florida. We were in Texas last week for the dental conference down in Dallas, I believe. So we’re out there in full force now. So we’re really happy to be finally talking to people, unmasked, face-to-face once again. And in person, not digitally.

Bill Neumann:

Right. It’s something that we’ve all needed for quite a while. So until next time, Josh, thank you very much. We will have Josh on and probably a couple other special guests from RecallMax on the next podcast. This will be a series we’ll be having these conversations throughout the year and next year. We’ll talk a little bit about RecallMax’s growth and what they’re doing in the US and beyond, and possibly in different verticals. So all sorts of good stuff.

Bill Neumann:

So again, Josh, thanks for being here. This is Josh Muir from RecallMax. He is the director of DSO and strategic markets. Until next time, thank you, everyone for listening, watching, whether it’s on YouTube or one of the many audio platforms that we’re on. Until next time. I’m Bill Neumann. Thanks, Josh.

Josh Muir:

Thanks, Bill.