Hiring has become more competitive in the oral surgery field as more DSOs enter the market, according to Jason Auerbach, DDS.
Dr. Auerbach is the co-CEO of Hackensack, N.J.-based Max Surgical Specialty Management. The oral surgery-focused management services organization launched in September and supports 16 offices and 25 surgeons in New Jersey.
Dr. Auerbach recently spoke with Becker's to discuss the MSO's goals for 2024, the trends he is following and the challenges facing DSOs today.
Editor's note: Responses were lightly edited for length and clarity.
Question: What are your organization's top priorities for 2024?
Dr. Jason Auerbach: There are two different groupings that I put our priorities into. One is to identify and differentiate ourselves from other oral surgery platforms out there. We are very focused on the qualitative stuff in terms of how our surgeons who we're both recruiting and currently working with feel that they are part of the experience and they're actually being part of the experience. There's a lot of talk in terms of marketing and rhetoric out there about what these platforms do for their doctors, both from a recruiting standpoint and from a retention standpoint, but we are really trying to differentiate ourselves among the platforms out there. At the same time, we are very focused on extending our footprint beyond New Jersey. Within the next 60 days, we are scheduled to close on eight new locations in four new states that will bring us well beyond where we currently are practicing and expand our footprint by about 40% in [a] very short period of time.
Q: What are some strategies in place to expand and grow your footprint?
JA: We're investing a lot into the patient experience. Riverside Oral Surgery was founded and its initial success was predicated on what I called the optimal patient experience each and every time. And we are looking to scale that patient experience, which obviously is, I don't want to say challenging, but it is definitely something that you have to put a lot of thought into because every practice you partner with has a different culture and trying to bring to light why that patient experience stands out and how that enables each of the practices to grow in their own right is a very important and somewhat challenging thing to do, but it's something that we're very focused on. We've been very lucky that the partner practices we are working with are receptive to change. They want to understand what it is that is so special about what we're doing and they want to implement it. I will say, though, on the other side of that is the people we are partnering with always have something they do better. So we're able to bring these practices together and actually use best practices among all of the partner practices. That's definitely something we are very fortunate for because the people we're with are really exceptional. They're all market leaders, very focused on doing the right thing by their patients, very focused on the culture of their offices, the outward-facing stuff and all of that.
We are thinking about doing a de novo [office] in an area that we know is the desirable place to be basically right in our backyard. The board just approved a complete renovation in an existing practice, basically committing a great deal financially and support-wise to the vision ... I feel very strongly about the fact that our financial partners have been people who, when they say they're going to do something, have done something and consistently time in and time out, what they've always done is supported the vision that they originally got behind. They are not at all obstructionists or anything like that. What they have done in terms of supporting the vision and supporting what we're trying to accomplish has been exemplary. I'm very thankful every day that we made the decision to go with these specific financial partners.
Q: What are the biggest challenges facing DSOs today?
JA: I think we see a continuation of what we saw last year. Difficulty in terms of recruiting, difficulty in terms of retaining support teams. People are perceiving that they're looking to improve their situation financially, and in that way, they're looking to potentially see other opportunities that are out there. With more and more general dentistry and multispecialty DSOs in the space of oral surgery, there is competition for people who know what they're doing, which have by and large been assistants and administrative people, who have worked in oral surgery offices [and] understand the nuance that is oral and maxillofacial surgery. So competing for labor and competing for doctors and recruiting.
A lot of people talk about percentages and things like that, but they don't really understand young surgeons coming out of residency. You have to understand [who you're affiliating with.] The people you are affiliating with are the people who you're going to go to work with day in and day out. It is not to put anyone else down. Everybody is doing a great job, but I know that working at a Max office, you're going to get the support that you're told you're going to get. I know that you're going to be busy, you're going to get to collaborate with other surgeons. You're going to be educated in a real way. You're going to have camaraderie with oral and maxillofacial surgeons who can guide you through your career. So there's a ton of the intangible out there that we try to highlight, and we still are very competitive in terms of the way we pay, but there are these intangible qualities of Max that we focus on that we think really differentiate the experience of being at Max, both as a support person and as a surgeon.
Q: Many DSO execs are expecting slower growth amid a challenging economy. What are your thoughts on this?
JA: Well, we always think about the macroeconomics of where we are, but we also think about industry-specific economics and that's definitely what's going on. Fortunately, we're in a good position in terms of our debt. There's not a lot of debt where we are. A lot of people who did a lot of this work in the years leading up to increased interest rates and tighter debt markets are having a little bit more trouble now because of the fact that there was already existing debt on their books. We basically started at the end of 2022 and because of that, we were there when interest rates were already rising. We're very disciplined in what we do. We're in a very good, very strong position financially to go out and find practices and partner with the ones that make sense for us. Inflation is clearly coming under control and there's talk of interest rate cuts in 2024, and as such, I think we're going to be in a better financial situation than we were in 2023.
Q: What are the top trends you are following now?
JA: A lot to do with the patient experience and the technology associated with providing optimal care. For us, we've invested a ton into honing that experience in terms of human capital and financial capital. We've invested a ton in our office locations and our facilities, there's been a ton of capital expenditure to bring [up] our offices that maybe weren't up to speed. We reinvested a ton of capital in technology. All of our offices have cone beam technology, intraoral scanners and 3D printing, and our relationships with vendors are strong, so our implant position is very strong as well. So materials, technology and patient experience.
Q: What is your proudest accomplishment of 2023?
JA: My personal proudest accomplishment was becoming co-CEO actually, which is funny for me because I'm not much of an organizational type of guy. Not that I'm disorganized, but I've not ever been in an organization of this kind. I have a very founder-esque mentality, entrepreneurial. But to be able to hone my leadership skills and bring them to a place where I can actually hold a leadership position that is defined in such a way is something I feel is showing a lot of evolution of me as a human being. The thing I feel most proud of about Max is really that we've been able to come together as doctors and really change the game. There's a lot of talk about what we're doing. We are at a crossroads here where there are a ton of players in the space and we are really redefining the way DSOs are seen in the oral and maxillofacial surgery space. We're doing that because we care a lot about our doctors. We're putting them first. We care a lot about our staff. We're putting them first as well. It's really about the human beings in the organization. I think the fact that time and time again we are actually living our word is something that I'm very proud of at an organizational level.