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Women Leaders in DSOs: Leaning Into Empathy

Amol Nirgudkar, CEO of Patient Prism, interviews Gina Bruzzichesi, who is the chief operating officer of The Aspen Group (TAG)—the newly branded parent company of Aspen Dental. “Managing the operations of a large DSO with hundreds of locations is a huge responsibility,” says Nirgudkar who is eager to know how she does it so well.

 

Managing 965 Locations

“How do you manage an organization from an operation standpoint when you're at 965 locations? How do you keep a pulse on everything that's going on as a leader in an organization that large?” asks Nirgudkar. 

“You don't always get great night's sleep because you're constantly thinking about how you can continuously improve and how you can continuously bring value,” says Bruzzichesi. “But my background has not always been in operations. I started as a lawyer, an employment lawyer, who went into human resources, who went into a customer experience role. And that's all about people. I think that if you continuously focus on the fact that this is about changing patient lives and bringing access to care to patients who have not had that access before, and if you're doing it with people who see the vision and are acting as one, it’s possible. We have a concept at Aspen where we are Aspen One. We all work together for the common purpose of bringing access to care, changing more lives, and bringing smiles to more people's faces.

“It’s all about focusing on that first and then the rest comes naturally. But I will say too, that as a leader, my expectation for the leaders that work with me is that they're going to continuously develop their people. They're going to be invested in making them better leaders. And if that happens, then you will naturally have an organization that's holding each other accountable, and joint accountability is really important.”

Because Apsen’s regional managers have 6 to 10 locations, they can’t be in one location more than twice a month.

Bruzzichesi asks two questions of her direct reports. The first is:

  • Are your teams doing what you want them to do when you are not looking?

If they can’t say yes to that question, there is work to do. The second question is:

  • If you had your best leader in the location that is performing the worst, what would happen in that location?

 

“Nine times out of 10, they look at me and say it probably wouldn't be their worst location anymore,” says Bruzzichesi. “And if that's the case, then you have the wrong leader leading that location. You have to keep reminding yourself that strong leadership is the key to success.”

Empowering Teams

Nirgudkar asks Buzzichesi how Aspen deals with employees making mistakes.

She thinks it's important to empower people to not just follow rules but to do the right thing for the team and for the patients. 

“We have this general framework, but we want to give people freedom within it. And as long as they are working in that direction toward that goal, then you're going to get the right results. They're not always going to be the same results, and they're not always going to be the same means to the end, but that's okay,” she says.

When mistakes occur, she does what she calls “Monday morning quarterbacking.” She takes them aside and says, “Let's think about that. What could you have done differently? What resources could you have asked for that would've changed the result? What people could have you contacted or how could you have managed your own team to hold them better accountable? If we do that, we learn from mistakes and the expectations is that we won’t make the same mistake again.”

If someone is repeating mistakes, that is a problem says Bruzzichesi. “It’s okay to move people into different roles but that should not be the norm.

Nirgudkar reflects on this and asks, “What advice do you have and how do you get the right people in the right seats? A lot of DSOs struggle with this.”

 

Promoting from Within and Hiring from Outside

Bruzzichesi has observed that best-in-class, high performing teams are made up of both people who have organically grown with the organization and people who bring in diverse thought from the outside. 

“I think you need a good balance of both in order to have that perfect cocktail of operational excellence,” she says. 

An example she gives is that of an open hygienist manager position. Just because a hygienist has ten years of experience at Aspen doesn’t mean the hygienists will have management skills. She reminds her regional managers and would-be managers from within that the skills for being a great manager are very different than the skills for doing the clinical job. She says, “Let’s talk about what those great skills are that will make someone successful as a manager and let's really be honest with ourselves.”

“Developing people to perform at their highest level and optimally using them is the name of the game,” says Nirgudkar. “But you don't want to put your talented people in a role where they won’t excel.”

 

Goals Alignment Across the DSO

Nirgudkar continues, “The question I have next for you is about aligning the operational-financial goals of the organization with the clinicians’ goals, because clinicians aspire to be good clinicians. They want to perform at the highest clinical level. And sometimes in DOS, corporate managers are focused on revenue, P&Ls, and EBITDA. How do you marry that?”

“From the very beginning, we make sure that our dentists have the appropriate opportunity and exposure to business leadership classes,” says Bruzzichesi. “They become comfortable with holding people accountable, managing performance, and helping their office have a great culture. We also never stray far from our purpose of delivering care to patients. We come back to the question: How do we give access to care to more people who deserve it and need it? And how do we do it with team members that are empowered and excited about doing it? If you keep bringing it back to that, I think you're always going to find success.”

Aspen recently created a team of experts under Dr. Judge’s leadership to create business cases that help clinicians understand why business metrics matter and why Aspen is investing in educating all its dentists on implant treatment and aligner orthodontics.

“We want to help them deliver that standard of care,” says Bruzzichesi. “But not every clinician will respond to the why in the same way. “We realize that our doctors are all different, so we need to help them understand differently. And we take that individualized approach.”

Aspen has brought several high performing dentists and owners together, and they now report to Dr. Arwinda Judge, Aspen’s Chief Clinical Officer, in creating those business cases. “They understand it from the clinician side and are successful,” says Bruzzichesi. “And we have somebody who is helping them through the first year of their career after they graduate. We have somebody else who is helping them after that first year. And it's helping them connect the dots and see what they need to do.

 

Offer Something Different

Nirgudkar prompts Bruzzichesi to talk about being a woman COO in a very large DSO. “As a woman in leadership, what lessons have you brought to the table that have added more color, more diversity of thought as well as more robust strategy to how you execute on business objectives?”

“First of all, you have to embrace the fact that you offer something different,” says Bruzzicheso. “Women are a little different. As I grew in my career, I was in a highly male-dominated industry. I was typically the only female sitting in the boardroom. I was the first and only female to run operations in a very heavily male-dominated world. Early in my career, I would often try to emulate the men around me. And I sometimes failed miserably because I was trying to be them, and I naturally wasn't them. I recognized that and I started to embrace who I was, and I am a woman. I'm a single mom. I have two wonderful girls. Maybe I am a little bit more empathetic than a man. I'm probably a little bit more emotional than a man. I probably lead with my heart more than most. And I started to say to myself that's okay. That's who I am. And I have to lean into that and then help those around me feel comfortable with that too, so that they too can come out of their shell and let their best self shine.”

Nirgudkar closes the interview by asking, “How do you lean into that and still be firm and respected?”

Bruzzichesi answers, “It's about empathy. It's about compassion. It's about teaching, and coaching, and helping people grow and all of that, but it's about setting expectations. And expectations are that we are going to perform. We're going to perform well. If you need help, you're going to ask. It's all about doing the right thing for our patients and for our clinicians and for our team members. And if people are doing that, then I don't need to be firm with them. They're doing the right thing. But if they're not doing that, if they're not meeting the expectations, then it's easy to say, ‘We talked about this. This isn't working. It's not the right fit.’”

“You can lead with compassion, you can lead with your heart, and you can still be firm and still be respected because you're holding people accountable to do what's right for the patients,” says Amol Nirgudkar. “And that's what counts the most,” says Gina Bruzzichesi

About Gina Bruzzichesi

Gina Bruzzichesi joined Aspen Dental (www.teamtag.com) from Clear, an industry-leading touchless biometric security and identity verification platform -- owned and operated by Alclear, LLC -- which leverages biometric data to allow people to bypass document checkers at security checkpoints at airports and sports stadiums by using fingerprints and/or iris identification. Prior to Clear, Gina served as SVP of Global Operations at WeWork, a real estate company that designs and builds physical and virtual shared workspaces. While at WeWork, Gina led the organization through a transformation that positioned it for future growth. Before that, Gina held positions of increasing responsibility and leadership during a 16-year career with Avis Budget Group. Gina has a Juris Doctor degree from Seton Hall University School of Law and a bachelor’s degree in sociology from Villanova University.

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