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Systems Will Set You Free

Jacob Puhl - CEO

Jacob Puhl CEO/Partner of The DEO

How confident are you about the systems you have in place in your DSO? Your associate hiring and retention strategy? Are you just beginning to grow your DSO — or even a seasoned pro — but feel overwhelmed by these issues? Not surprising. Having worked with 100s of dentist-entrepreneurs, we’ve seen how daunting they can be.

Recently, I had the pleasure of talking with DEO Member Dr. Tarek Aly, who has conquered these issues. He is COO and Co-owner of OrthoDent Management and Modern Smiles (19+ locations). He shared how he has successfully led associate alliances and perfected systems management to grow his DSO.

Tarek’s success speaks for itself and his presentations at DEO Summits have been fan favorites. As a DEO Member, he is often called upon for his expertise.

Build alliances with Associates to ensure successful buy-in

During our conversation, Tarek really hit home the importance of creating alliances with the Associates you hire. If you have determined your DSO structure will include an ownership option, seeking Associates that have the qualities for the long term vision of your DSO is paramount.

If this is you, then you want to search for Associates who have the entrepreneur mentality…who want to grow… who see the clinic as a business… and most importantly as a vision greater than its clinical offerings.

Tarek notes a strength to come out of the pandemic is that dentists are facing it together. Everyone has dealt with the same issues: shutdown, loss of profit, safety, facing the common enemy and sometimes collaborator of regulators/ government etc. Dentists — no matter if they are Associates, owners, in the chair, or out of chair — are challenged by the same issues. It has caused a reevaluation of values and goals.

Thus, it’s prime time for hiring associates and determining if they are a good match for your dental group’s vision. Tarek suggests the following approaches:

  • Does the candidate have a growth mentality? Yes? Show them appreciation for seeking to be part of your dental group.
  • Ask them about their vision for their future.
  • Don’t be narrow-minded about the ownership structures your DSO offers. One size may not fit all.
  • Associates who have stake often perform better than those who don’t. Have a path (or multiple) to ownership.
  • Offer ownership at the local level and/or the DSO level. Both offer benefits to a growth-minded Associate.

Watch my conversation with Tarek here.

Use the science of systems to get through the dark tunnel

Most DSOs head into the “dark tunnel” between 3-5 locations. At this time there is a lot of struggle — executives need to be hired but the DSO can’t afford them yet, operations need to be centralized but funds aren’t available and/or it’s difficult to determine which operations would be best — call center? HR? Billing?

If your DSO is going to accelerate past 5 locations, successful systems must be set up. As is often noted by DEO Members “systems will set you free.”

Tarek likens running a business without systems to a pilot flying an airplane without reading the controls. He notes that the industries with the least amount of errors are aviation and construction. “When you enter a building you take for granted that it isn’t going to collapse. Construction has systems and checklists in place to ensure this. Why shouldn’t we pattern our businesses the same way?”

Approaching everything with a systems mindset is critical to getting out of the dark tunnel and beyond. Tarek recommends the following steps to employ the science of systems:

  1. Determine which Key Performance Indicators (KPIs) are most important for your business and start tracking them.
  2. The data from the KPIs will shed light on where your issues are. Create checklists for to improve those processes. Tarek recommends the book The Checklist Manifesto: How to Get Things Right by Atul Gawande to implement this step.
  3. Financials: with the KPIs in hand and checklists made, you can determine where to invest for the growth and maturing of your DSO.

For a more detailed explanation, I recommend you watch my conversation with Tarek. There’s even more there — we also discuss among other things how to structure a pitch to potential associates, the importance of placing culture first, getting out of the chair, hiring staff, and more.

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Jacob Puhl

Dentist Entrepreneur Organization

CEO / Partner