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August 2022--Nilesh Rajadhyax is the group president of Great Expressions Dental Centers, a DSO with 272 locations in nine states. At the 9th Dykema Definitive DSO conference, held in Denver in July of 2022, Patient Prism’s co-founder and CEO, Amol Nirgudkar, interviewed Rajadhyax to learn about Great Expressions approach to thriving in the post-pandemic world.



Focusing on staffing and acquisition

“We’re going through some of the same challenges that everyone in the industry is facing,” says Rajadhyax. “We are facing a lot of labor challenges. So, one of our big focus areas has been to keep our offices staffed and to maximize team members’ efforts to help our doctors do what they do best and love, which is dentistry. The other focus area has been affiliations. We've been talking to a lot of small, mid-size, and large groups to see where we have synergies and where we have common guidelines and paths. We are looking for opportunities to try to bring them into the fold so we can grow together.”


Excelling in efficiency

Nirgudkar inquires, “What does Great Expressions provide a potential group or a single office that will make them more efficient?”

“We are really good with the practice management system, the backend data, the analytics, and the insights that come out of it, so we are able to show each office where they have areas of growth opportunity and help them build from there,” says Rajadhyax. “The other areas we contribute to efficiency are better pricing and payer rates, one-on-one coaching sessions with our clinical partners, and continuing education, so they grow clinically.”

Mentoring affiliated doctors

“Is there a mentorship program in place or do you pair senior doctors with junior doctors?” asks Nirgudkar.

Great Expressions has a clinical onboarding program for newly affiliated doctors. The regional clinical partner is a senior doctor with expertise in a range of proficiencies and different dental specialties. The next step is to run the new doctors through educational programs that match their developmental needs and interests.

“There is an advanced mentorship program that matches doctors with a mentor, according to where each doctor wants to grow,” says Rajadhyax. “And we have training programs in case presentation and schedule building, where we try to get the whole office together because dentistry's a team sport.”

Focusing on team retention

Great expressions conducted surveys to find the reasons people are leaving dental positions. They found that money isn’t the only reason. Sometimes it’s a mix of things—big and small, including benefits and clinical education.

Rajadhyax reports that they are acting on the data collected, as well as telling their doctors about the importance of keeping their teams together. "This is a critical piece of dentistry being a team sport. You must keep the team together," he says. “Have we solved it? No, but we are getting better.”

Increasing the availability of immediate appointments

To meet demand, they are attempting to provide as many immediate appointments as they can and see emergency patients on the same day.

Addressing the challenge of no shows

“The no-show rate really dipped in March and then it climbed back up,” says Rajadhyax. “Appointment confirmation has become a higher goal again but there is only so much we can ask our practice teams to do. We are relying on digital reminders, but in select cases, especially specialty cases that require more preparation, we are making outbound calls.”

Relying on referrals

New patients come to Great Expressions locations through word of mouth and advertising campaigns. “We rely more on referrals,” says Rajadhyax. “But the advantage I think we have is that we offer multi-specialty dentistry, and our mission is to serve the community's needs. And that's why we take pretty much all payers. We are across the board, whether it's Medicaid, managed care plans, or PPO. So, for us, it's more about reaching out to the community. Because we take care of everyone including children and we have specialists from pedodontics to oral surgery, we are the one place the community can go to solve all their oral healthcare needs.”

From consulting to managing a DSO

“How does your consulting background with technology and healthcare companies, help you run a dental support organization?” asks Nirgudkar.

“I think the key thing that you learn in consulting is to diagnose a problem and root causes, then put a structure around it, and prioritize it for implementation and impact,” says Rajadhyax. “It's not rocket science, but at the same time consulting gives you a little bit more insight into whether you should focus on something and drop some other balls because you can only juggle three or four balls at a time.”

“You're right. I think structure is important,” says Nirgudkar. “Processes are important, and a lot of times in the DSO world, it becomes difficult to prioritize when you're acquiring groups or dental offices that have different systems.”

“The other thing I think consulting has given me is the ability to bring in best practices from other industries,” says Rajadhyax. “The dental industry has certain things it does well, but there are other industries that are doing some things we can copy and see if they work. Because of my background, we are trying some different things.”

"Because we take care of everyone including children and we have specialists from pedodontics to oral surgery, we are the one place the community can go to solve all their oral healthcare needs,” says Nilesh Rajadhyax, Group President of Great Expressions Dental Centers


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