Effingham, Ill.-based Heartland Dental added 424 practices in 38 states last year, expanding its network to support more than 2,300 doctors in more than 1,550 offices.
The DSO plans to continue its growth by adding 107 practices in 2022 and anticipates 100 percent growth in practices built from the ground up in 2022.
Becker's spoke with Heartland Dental President and CEO Pat Bauer on the DSO's growth, the largest trends in the industry and the biggest challenges facing dental practices.
Editor's note: Responses have been lightly edited for style and clarity.
Question: How will Heartland Dental's growth in 2021 drive the trajectory in 2022?
Pat Bauer: 2021 was challenging, not as challenging as 2020, but we still had challenges because of COVID-19 and all of the different things we're dealing with. It was a really great year from a growth perspective. Our patient visits are up. It's always a struggle to find hygienists and dental assistants and team members, but our turnover has been pretty stable so we're pretty positive about that. The trajectory for 2022 is set up very well because our flywheels are back, so our growth looks really good for 2022.
What we do really well is affiliations and de novos, so what we'll concentrate mostly on is that. Our core business is about supporting dentists. Whatever we do, it basically comes down to our culture. Our goal is to have 5,000 supported dentists by 2025. We think our culture is best for supporting doctors because it's about the doctor leading their practices and how do you make sure that they're leading their practices. We're really good at that. Our strength is in supporting them and the services, not only in the back office, but also helping them with any practice concerns. That relationship with the doctor is the most important relationship I have. There's a lot of people who say, "Well, gosh, we should be doing some more cool things." Well, if it adds value to our doctors, then I'm all for it, but if it's not gonna add value or if it wrecks that cultural part of our relationship, then it doesn't work.
Q: What are the top three issues your team is focusing on going into 2022?
PB: Inflation is going to be an issue, so we're all dealing with that. How do you put the right fees for our services [and] at the same time you have everybody else wanting more increases, so that's always a battle. There's nothing new, except this year we know that there's a lot more pressure and we've been pretty good at supporting our doctors with the suppliers that we have. So we're pretty fortunate, but it's going to be pressure all the time. Interest rates are going to be a struggle as we grow, because then you have more interest that you have to be taking care of, but we don't think that will affect us in 2022 as much as maybe the years after that.
Staffing is always an issue. We don't have very high turnover, so our retention is pretty high. We are not only growing our base offices, the offices that we've had for three-plus years, but we're also adding so many practices. So making sure we can staff them properly and put the right team in place, it's always a challenge. Our relationships with dental schools, those hygiene schools, are crucial [to] how we make sure we can hire people. We have a great recruiting team that works their tail off to make sure we have the right people for our support offices.
Q: What are the biggest trends you have identified in the industry?
PB: Artificial intelligence is pretty much going to change the industry. I don't know how long it'll take, but the stuff we're seeing and testing is pretty game-changing for consistency in care. For our doctors, it's about supporting them so they can do the best dentistry in the communities they serve. So having that consistency is amazing. I think it's going to change the industry dramatically in a positive way. Invisalign — there's so many competitors now. There's so many things that are changing from that perspective, but it's all focused on patient care and how our dentists can help. Marketing — how to contact patients — that's all changing and it has been changing over the few years. Also, healthcare. How do you integrate healthcare and dental? We've been talking about it for about 35 years. When will it happen? We don't think it'll be in 2022. There will be massive changes, that's for sure. I don't even know if it'll be in the next two to three years, but we know we have to be aware of what's going on in the external environment.
Q: What are some opportunities for growth in the DSO field?
PB: Implants are growing. So that's something you have to be fully aware of. It's one of the fastest-growing products we do, too. Invisalign [is] still growing. So those are product growth opportunities, but it still comes down to supporting dentists and helping them take care of their patients. Being a solo practitioner isn't easier, it's harder. When you have PPOs who don't increase their fees every year, you get increases from your supplier and you don't get fee increases from the payer, that's a disaster for most solo practitioners; plus, all the people want more money. How do you fight that battle? That's where we come in to help support them so they can keep doing what they're doing and not have to worry about things like that. That's the growth opportunity.