Pittsburgh-based North American Dental Group is making several investments in technology, staffing and patient care this year to support its network and drive success.
CEO Paul Reda recently spoke with Becker's to discuss the company's goals for this year, plans for network growth and his thoughts on the current DSO field.
Editor's note: These responses were lightly edited for length and clarity.
Question: What are some of the top goals for your company this year?
Paul Reda: The top goal for our company is to engage and retain our top talent. That is imperative in the current space between our hygienists, our providers, our dental assistants [and] even our office managers. We're trying to give them the tools to be successful in their roles. We're trying to give them the support. We want them to feel valued. We're part of a team, and then we want them to work for each other. All of those roles are critical to the ecosystem of a practice, so that is a huge focus for us. Turnover is expensive. Our patients don't like turnover. They want to come and see a familiar face. So, that's something we want to focus on.
We also want to focus on growth via expansion and joint ventures. Joint ventures are really imperative to keep our doctors engaged throughout their career life cycle. They're kind of told through dental school that you go to dental school and you buy a practice. That landscape has shifted. More and more dentists are coming out of dental school and going to DSOs, but we want to keep them here. Three years is great, but I'd rather them stay here and build a career here, and we have those opportunities. Some other DSOs that are well known are built off JV models, so it's common in the industry. We'll also look to grow strategically in the smaller DSOs. We're just about over 230 practices. We think we can absorb 40-50 practice groups as well, so we think there's opportunity.
Also, I'd like to be in a place where we have density in our current geographic presence. I wouldn't be interested in one practice in Idaho, for example. We have 60 in Ohio. That's an interesting market for us. Unless we get density, I don't want to enter a new market.
Q: How have staffing challenges evolved since the pandemic? How is your DSO working to support team members?
PR: I think it ebbs and flows. Hygienists have been difficult to find in many markets. About 10% left the workforce during COVID, and another 15% are expected to retire over the next five years. We are not replacing the hygienists at that rate, so that will become a challenge. We have invested heavily in our hygiene team. We have a great VP of hygiene. We have hygiene coaches who spend their time mentoring younger hygienists across the organization. We started offering ancillary products, like Perio Protect [and] Curodont, which are great for our patients.
I hope to begin saliva testing as well, and that tails into mouth-body health as well and that connection, which I think is really important. So, we're going to start doing saliva testing, but really building a hygiene community. Our hygienists are really engaged, and they want to be part of it.
We've implemented a fully supported — and by support, I mean NADG bears the cost — [continuing education] curriculum. We hired a new doctor onboarding specialist who, when a new doctor joins us, will go to our doctor infusion program, which is indoctrination, basic education, CE, how to work at North America Dental Group, and then we give them an 18-month curriculum they need to follow. It's endodontics courses, restorative, implant surgery, etc. We [also] have a 12-module office manager training, which is really meant to develop their skills, because we truly believe a strong office manager with a strong provider are the keys to success.
Q: What technology investments will you be making this year?
PR: We'll have CBCTs in all of our practices by the end of this year, and we're not financing, we're paying for them. We put SprintRay printers in many of our practices. We went with the first 50 Midas [printers] to put in our practices to do same-day crowns because we really think printing is a way to go for both temporary and permanent [crowns], surgical guides, night guards, etc. So, we're making a lot of those capital investments so that we have the latest technology. We're now buying new scanners. We've had scanners for years, but we're adding scanner capacity because of items like Perio Protect and same-day crowns.
Q: What are you looking for in a practice partner?
PR: Quality of care is imperative. That's number one, and sometimes I think it might get forgotten in this industry, but you have to do what's right for the patient. If you do what's right for a patient, everything else follows suit. We want quality of care, a good reputation and someone who's open and willing to use new technology and growth. Also, we want a provider who is willing to take on an associate and mentor that provider. It's about being part of the community. Ultimately, it's what is best for our patient, and then what is best for our team and our providers. If this is not good for the patients, that's not something we want to participate in. So, that's kind of the logic and what we look for in practice.
Q: What is your perception of the current DSO field?
PR: It's going to be an interesting year in 2025. I think there are too many DSOs. I think there needs to be further consolidation there. A lot of them are not really fully integrated platforms. They're just a bunch of doctors or groups together. North American Dental Group is fully integrated on one [practice management] system. We have a fully integrated billing team [and] centralized resources. We will look to add smaller groups into us. I think there has to be some consolidation. There were too many that were put together in 2018, 2019 [and] 2020, and their debt load is just unsustainable. So, once that debt needs to be refinanced, I think that's going to cause some interesting consolidations in the industry, which I think needs to happen ... Once you start getting below the top four or five [DSOs], I think there's going to [be] a lot of change, especially once you get to the ones that are between 20 and 80 practices.
Q: What are some of the other trends you are following this year?
PR: [Artificial intelligence] is very popular, and you hear it everywhere now. I think it's a great support tool in dentistry. The reason we put Overjet at all of our practices is it helps us build trust with our patients. You always do the right thing no matter what. It's not always easy, and it's not always cheap, but you do the right thing. By having Overjet, [patients] can see their teeth. It's right there on a big screen in front of them, and that starts an easy conversation with the provider to build trust. Ultimately, people choose their dentist based on, do you take my insurance, and do I trust you? We want to really establish that trust. We're really trying to build that trust and use that technology.
We're also investing heavily in cybersecurity. We're doing penetration testing. We have outside companies doing testing. We have an internal team now for it, so that has been a significant increase in our [profit and loss statement], but it's also necessary in the world we live in. People are always trying to get after patient data, so we have to be careful with that.