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August 2021--Smile Brands is a dominant player in the dental space with over 700 affiliated dental practices across 30 states. At Dykema’s 2021 DSO conference, Patient Prism’s CEO, Amol Nirgudkar, asked Steve Bilt, co-founder, and CEO of Smile Brands, what lessons he has learned during the pandemic that have made Smile Brands a better company? “Movement happens on the local provider level,” said Bilt, and Smile Brands found more effective ways to make that movement happen through coaching its affiliates in more productive scheduling, constant leadership communication, and immersing its affiliated doctors in targeted online CE to take their skills to the next level in the areas of dentistry each most wanted to pursue.



A new outlook was born

The company’s outlook from the start of Phase 1 of the pandemic was to envision traversing a canyon to a new rim, rather than climbing back up a mountain to its top. 

“When the pandemic started, it would have been easy to say, ‘We tumbled off the mountain top, now we're at the base of the mountain, and we have got to climb back up,’” says Bilt. “But I wanted our company to have its eyes open and head clear to say, ‘Let's invent whatever new should be in this opportunity.’ So, we used the canyon metaphor instead, saying ‘Don’t go back to that rim. Climb to another one.’”


Appointment scheduling changed

“We’re scheduling smarter,” says Bilt.

Out of necessity, at the beginning of the pandemic, dentists triaged patients by acute need. When the patient arrived, they did everything they could for the patient in that one appointment. They intentionally boosted productivity in a single sitting. That experience carried dentists forward into a new model of scheduling. Rather than focus on the number of patients per day, the focus is now on optimizing each appointment. Patients come fewer times to complete treatment.

Smile Brands’ doctors’ production per hour is going up because they are scheduling 3-hour slots and patients arrive expecting same-day treatment. From the patient’s perspective, the procedure has more value due to the convenience and rapid problem solution.


Top leadership collaborated via teleconferencing  

Smile Brands has local operating units that make decisions in the best interest of their patients. Locally, team leaders are accountable. They have the control and influence says Bilt. “I spent a lot of time during the pandemic thinking about: Are we designed properly? Is this working? Is the clinical team and the operational team engaged properly? Do they have the right accountability?” 

Smile Brands has spent the pandemic doing a lot of video conferencing. Every week, its market operating unit leaders, have been conferencing with Bilt, in groups of 10. They sit down for “virtual coffee” and ask each other: What do you want to talk about? How are we doing with it? How should we adjust it? Are people understanding it? 

“And that's a huge part of our culture. It's that repetition of coming back again the next week and asking: What's holding us back? What are we doing well? We have been learning from each other and executing what we are learning as a constant process.” 

“Technology is our friend,” says Bilt. “It really opened up our ability to listen to more people regularly. “I'm a better listener now because I'm getting more input.” 


Priority was placed on growing its providers as clinicians

If providers are not making enough money “to pay the bills and pay off debt, they could love you and still have to leave,” says Bilt. “We try to focus on building cash and provider productivity, and then things tend to come into alignment if we do that.”

“I say when you take the paycheck as seriously as you take the P&L, the quid pro quo is that you're going to take the P&L as seriously as you take your paycheck,” says Bilt. “We’re partners, and we’re going to win together.”

“Stagnant productivity impacts the income of the individual provider,” says Bilt. Dentists care about that, and knowing the national averages makes it easy for the unit leaders to point out when a provider is delivering a lower level of productivity and a lower standard of care. “For example, we say, “’By the way, those big fillings you are doing fail at twice the rate of indirect restorations, so here’s how you get trained up for that—because indirect restorations are better dentistry and better for you.’”

When market unit leaders meet with their providers every month, they ask, “How are you doing against your goals? Are you clear on what those goals are?” If a provider wants to raise productivity and do implants, Smile Brands supports the provider in doing that with its implant CE program. If a doctor would prefer endo, Smile Brands has an endo CE program. 

Smile Designs ramped up its CE programs to weekly events during the pandemic, and this has been “one of the gifts of the pandemic,” says Bilt. Smile Brands also has in-person learning components in its CE programs.

“And that is taking them down a path that is more fulfilling for them,” says Nirgudkar. “Whether it's endo, ortho, whatever it might be, you give them a path to not only achieve greater financial independence but also professional fulfillment.”


Additional Bilt Insights

View the above video to hear more from Steve Bilt about his 2021 insights into:

  • The Smile Brands culture
  • Dental patient demand
  • Changes in dentistry
  • The dental labor shortage
  • DSO acquisition integration
  • DSO dentist compensation
  • DSO revenue cycle management
  • What lies ahead for DSO expansion


Additional Dykema & DSO Patient Prism Blogs:

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