As I attend conferences and webinars and view YouTube videos on DSOs, most of the focus is on operationalizing the enterprise. The mission is to build an infrastructure that can power the enterpriser to scale, increase leverage in transactions, and increase profit margins. With the focus overwhelmingly on operations (processes, procedures, structures, IT, SOPs, KPIs) DSOs overlook a vital element of success — experience.
Many DSOs believe that younger dentists can deliver more for less. By being “lean,” DSOs can create competitive advantages that boost profits, increase market share, and keep both patients and shareholders happy.
To do this, many DSOs focus on hiring the best and brightest students, recruiting the most intelligent and polished graduates from the nation’s top dental schools and residencies, or stealing the best young dentists from their competitors. But with fewer than 8,000 new dentists available per year, the competition for recruiting these dentists is hot and heavy.
The Value of Older Workers
The influx of younger dentists can lead to a workforce that is smart and technically competent, but it doesn’t bring the experience level that is just as important — maybe even more important — for success. Jean-Paul Sartre said it best: “The more sand that has escaped from the hourglass of our life, the clearer we see through it.”
Many DSOs fail to appreciate and understand the value of older dentists. Many even seek to weed out the most veteran dentists to bring down the median age of their workforce. After all, the younger a company is, the smarter and more competitive it will be — right?
DSOs that value the wisdom older dentists bring to the table, realize that older dentists can often generate better patient relations, better staff relations, bring a wealth of clinical experience, and provide greater emotional stability to the culture.
Biggest Sector of Dentists
Older dentists represent the largest group of dentists currently in dental practice in the U.S. According to the ADA, among the 198,517 dentists working in dentistry in 2017, 16.3 percent were under age 35, 23.3 percent were between ages 35 and 44, 21.2 percent were between ages 45 and 54, 23.5 percent were between ages 55 and 64, and 15.9 percent were over age 65. That means that 67.71 percent of practicing dentists are over the age of 45.
So what are all these older dentists doing? Most of these older dentists are in solo private practice. The asset value of solo practice is shrinking rapidly. The personal incomes of these older dentists is shrinking. The difficulty of sustaining a solo practice is increasing. On the other hand, the level of experience and clinical competencies is tremendous. Consider older dentists may be are a far better workforce than rookie dentists. Maybe DSOs are recruiting in the wrong place?
Today, most DSOs resist buying solo practices, given the high cost, along with the poor adaptive capacity of older practices to be modernized and re-enculturated. Besides, older dentists want more money to do dentistry. But maybe DSOs should consider the downstream benefits of adding older dentists to their workforce. And maybe figuring an “earn-out” strategy to pay for their practice might be a viable strategy. With an earn-out, older dentists could work, at least in part, for paying for some of the cost of the practice.
My claim is that resisting bringing older dentists onboard simply because of an expense viewpoint might be setting yourself up for failure because such a move could lead to a future leadership vacuum — with both patients and staff. And that could be costly. Sure, leadership might be available at your resource center, but leadership is a local phenomenon.
To succeed, DSOs need the kind of knowledge and experience veteran dentists bring. Without these things, younger, less experienced dentists won’t know how to effectively manage through a patient or staff crisis when it happens. Older dentists, however, have already been there and done that, and they are more likely to be able to guide the practice through troubled waters.
Let’s Talk about Work Ethic
And then there’s the work ethic of younger workers. Everyone is talking about how millennials have a false sense of unearned entitlement. A generation of children who have been pampered by “helicopter parents” are now finally arriving in the workforce — and the consequences are often devastating for many companies.
Younger people demand higher wages but want to work fewer hours. They bristle at the idea of having to travel to different offices. Contrast this with the generation of older dentists who are preparing for retirement. Mature workers bring a different approach to their jobs. They are accustomed to taking their jobs seriously and feeling a type of responsibility and loyalty to their patients and staff that many younger workers lack.
Plus, older workers don’t have the same type of financial commitments that younger workers have. Rather than having student loans or hefty mortgages to pay off, their kids often have already graduated and their houses and cars are paid off — so they may not need to earn nearly as much.
What Older Workers Want
For older workers, job satisfaction often has less to do with compensation and more to do with feeling as if what they are doing is meaningful. When veteran dentists believe they are contributing to the health of the patients and overall success of the company, they often report higher job satisfaction.
Many older dentists enjoy the social relationships they have at work. Going to their job means seeing the people they like and admire, which also makes them more productive and well-adjusted.
DSOs that can recognize the value of older dentists and who take steps to both recruit and engage these veteran dentists — dentists who have the knowledge and experience clinically and are experienced with patient relations — provide a competitive advantage.
DSOs would do well to bring in older dentists to their workforce, given it would enhance local leadership, generate better clinical outcomes, deliver greater patient satisfaction and mentorship for younger dentists. It might cost more on the front end, but the ROI on the back end would be significant.
As Bob Bennett is quoted as saying: “Those who improve with age embrace the power of personal growth and personal achievement and begin to replace youth with wisdom, innocence with understanding, and lack of purpose with self-actualization.”
From a culture, leadership, patient satisfaction, clinical acumen, mentoring, and eldering point of few, adding older dentists to the provider mix should be considered.