Epic4 Specialty Partners aims to reshape the DSO landscape: Q&A

After laying the groundwork for a solid foundation and team, Scottsbluff, Neb.-based Epic4 Specialty Partners is ready to leap into action for growth in 2025.

The DSO, founded in 2022, prides itself on its dedication to quality care, collaboration and support for dentists through its unique partnership model. Another factor that sets Epic4 apart from competitors is that more than 40% of the company's founding doctors are women. 

CEO Sami Webb, DDS, spoke with Becker's to discuss the company's mission and upcoming goals for growth in the industry.

Editor's note: Responses were lightly edited for length and clarity.

Question: What inspired the launch of Epic4?

Dr. Sami Webb: There are 18 founder doctors in our company, and we originated out of the Schulman Study Group, where we had been friends and colleagues for 20 years and have been collaborating, sharing information daily, looking at cases together [and] sharing best practices. So we've been doing this for a long time together. At some point, we realized the landscape of our industry was changing and we knew that we needed to do something different, and that's when we came together. Some of us had been looking at other models prior to that, but none of the models made sense to us. We evaluated different groups, we looked at some of the positives and some of the negatives, and we decided that we wanted to create our own organization and do it better. So, we spent about a year just creating the vision, working on the foundation, setting our goals, and we merged all of our practices together. There were 18 founder doctors with 53 locations across 13 states, and we merged them all on the same day. I can't say for sure, but I'd have to think it's one of the largest mergers on a single day in this industry.

After we merged, we spent the next year formalizing systems [and] growing our team. We have some of the best practices in the country, and we're now up to 17 states and 60 locations. This group of doctor founders truly believes in what they're doing. They're very passionate about it, and really want to do it right. We didn't feel like going fast was the right way. We really took our time to make this a quality company that's sustainable, and now we're ready to kind of announce who we are to the nation. We're proud of what we have built, and I think we're doing it right.

Q: What wasn't working with other DSO models?

SW: For me, it was the associate piece of all these organizations. All the organizations offered partnership to these associates, but they would have to buy into the company, and we're talking about new grads out of school who are coming out with $600,000 or more in student debt. They're asked to get a loan for equity that a traditional bank won't lend. They go into more debt with no guarantees. It just wasn't resonating for me, and I feel that a lot of the companies are struggling right now [because of] the revolving door of doctors going in and out, and that is not great for patient care. It's not what our belief system is. We believe very strongly in providing great clinical care and customer service, and a revolving door of doctors will not be sustainable in this industry. Our company set out to do that differently, and I think that's one of our largest differentiators, that associate piece. 

We don't like to use the word associate. We call them associate partner doctors. And the reason we do that is because every doctor that joins Epic4 is a partner. [When doctors] come on board with Epic4, they gain immediate partnership into Epic4 and they are gifted stock in the company that they don't pay for. They don't take any debt on, and that is what our company has decided to do so that we can gain the best doctors, we can provide the best care for our patients, and so that those of us who have worked our entire lives to build the practices we have — when it comes time to exit, we know our legacy lives on and that we're taking care of patients in the right way, and we believe that comes from having quality doctors at the chair.

Q: How else does Epic4's model differ from other DSOs?

SM: I think another way is that we truly are a specialty partner organization, and it's that partnership word that matters. I think many of the DSOs are very corporate driven. They're all about the numbers. They're about control, and that's not who we are. We truly are looking for great partners. We want them to maintain their autonomy and their practices. We want them to be who they are. We want to be there for mentorship, support, provide the back-end services and help them be better, but we in no way want to control them. We want to partner with them, come alongside them. That's the difference, and that's why we are called Epic4 Specialty Partners, because of that partnership. That autonomy piece is very important. We don't want to change what makes people great. Every practice is different. Every area of the country is different, and we are looking to partner with the best practices [and] the best doctors who fit our cultural system, and we just want to help them be better and take away those administrative duties.

Q: How would you describe your company's growth and evolution in 2024?

SM: We have been very slow and methodical about this. We're very intentional and very selective in the practices we look to take on. A lot of the larger companies are struggling financially because they're just buying practices. They're overpaying, they're not buying quality practices [and] they're not taking on quality doctors. We are being very intentional and selective of who we bring into Epic4, and that is another differentiator. We want to be sustainable, and we want to weather the financial storms. We have taken on some great partners in 2024, and we could have taken on more, but we didn't feel like some of these were the right fit for us. 

Merging 53 practices in one day was a feat in itself, and it was a huge lift that I'm not sure a lot of people anticipated or saw coming. That includes our legal team, our accounting teams [and] all those advisors that we have. We have all systems in place. We're running very smoothly. We're very proud of what we created. The headquarters is right here in Scottsbluff, Nebraska, and I will say that we're very proud to be located in Nebraska. We don't have a lot of people in suits running this company. These are some great local people. We're in the bread basket of America. It's about work ethic, integrity and — we call them the "diamonds in the bluff" because we're in Scotts Bluff, Nebraska, but we truly have some amazing diamonds here. I have seen them get to work at 6 a.m. [and] leave at 9 p.m. They are invested. This administrative team loves this company. They are invested as much as any doctor in this company. They want to see us succeed. I can't speak enough to our team here and to all of our advisors. 

Q: What kind of things do you look for in a partner?

SM: We're really looking for partners who believe in clinical excellence, providing great customer service, who have a desire to leave that legacy behind, who have been involved in their community, who take pride in their work [and] they're not just looking to sell their practice and get out. We want partners who want to grow their practices. It's okay if they are toward the end of their career, but we need to have a doctor there to sustain that practice, so we're looking for longevity. That growth piece is important. 

Q: What can we expect to see from Epic4 in 2025?

SM: We're ready to get our name out there [and] tell people who Epic is. As we were working hard behind the scenes getting the company set up, it was a little bit of a down year [for the industry,] so it was a great time for us to be working in the background. Now as that economy is coming back — and I do project that 2025 will be a large acquisition year — I just see us growing and growing. 

I think another point to add is that we are not private equity-backed like a lot of other companies. We did not want that. We are a very low-debt company. We have a strong cash flow. We have access to bank financing, and that is going to help us grow and keep our debt down, so that our partners gain on that equity in the future. We did not want to bring in a private equity partner to control us at the beginning. We wanted to set this company up the way we felt it should be, keeping patients at the top of that list and providing great clinical care. All of the founding doctors in this company took no cash up front. They put their practices in, all equity. We put all of our chips on the table ... that speaks volumes because we believe in ourselves and what we're doing and we're betting on ourselves.

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