By Carolyn Mauterer, D.D.S., CDA Vice President
From the Winter 2019 Journal of the Colorado Dental Association
In 2017, I made a major leap of faith and sold my beloved private practice to a DSO. The events leading up to this decision were too many to list, but the two biggest factors were my incredibly high stress level and the dental industry trends. I kept my finger on the pulse of the dental industry since attending an ADA panel discussion about work model types back in 2013. That panel discussion really opened my eyes to the possibilities beyond private practice. Two years ago, after studying the trends carefully and after hundreds of conversations with dentists, vendors and dental service providers, I realized how fast the DSO work model was growing. I decided to take a leap and start talking to corporations. Finding a company that jived with my practice mission, vision and methods took me about a year.
The reason why it took me so long to find the right match was because I was scared. I was really afraid that my relationships with my patients and staff might be affected by giving up some of my decision-making to a corporate entity. I worked my entire career and built my practice from scratch, one human relationship at a time. After 13 years of practice growth, I knew that 99% of my success was because of my incredible staff. I didn’t want to change who I was and how I treated my staff and patients. I felt a lot of pressure to find the right fit because I wanted to be happy enough to finish out my (hopefully long) career in my same practice.
Eventually I found the right company for my practice. I had to take a leap of faith that my CEO was the man he was promising to be. Now that I am immersed in the culture of the company, I am relieved to say that the mission, vision and practice methods they teach are the same I have lived by since graduating.
After selling my practice, I immediately emailed my CDA president and executive director to let them know. I wanted to disclose the new working relationship and make sure there was no conflict of interest in continuing to serve on the CDA Executive Committee. I was relieved to hear that our awesome prez and ED were enthusiastic to have the perspective of a DSO doc serving the CDA in the boardroom.
The phrase “corporate dentistry” and “DSO” is often said with a bit of a masseter flex in some circles of organized dentistry. I want to open a dialogue and change the culture when it comes to embracing work model diversity.
My experience as a DSO doc this past year has not changed my practice philosophy. In fact, it has reinforced my oath that I pledged at dental school graduation. My patient always comes first above all else and my DSO wants me to do everything I can to create a lifelong relationship with my patients. They allow me the flexibility I need to help each patient meet their individual oral health goals. It feels good to come to work; I’m happy there.
Don’t get me wrong though. The transition was not all butterflies and rainbows. Change is very difficult and emotional work and I lost some beloved staff members in the beginning. There was a shift of dental software, job duties, and a ton of new faces wandering through our hallways. It was all very tough on my staff. The only real change that my patients noticed, however, was the personnel change. We had a major change of staff at the front desk and added an offsite call center. My long-term patients were a little thrown off when their calls were answered by new members of our team. Luckily, there was very little change in my back-office staff members and once my patients saw some familiar faces, their anxieties were lessened. Change is scary but we did not face any challenges I wasn’t expecting. The staff mainly just wanted to feel that they were still a special and valued member of the team. With new management on board, our main goal was to re-establish that comfort level for our staff.
One of the unexpected perks of working for a DSO is the comfort level and support I now feel because I can lean on my corporate management team. I used to feel that everyone leaned on me for support. Those moments when I really connected with my co-workers and patients were the best part of my day but as we grew bigger and bigger, I started to feel weary. There just wasn’t enough of me to go around. I needed help and support so I could maintain my love for that very intense work of connecting with other humans. This became crystal clear to me when I had a rather difficult day last November.
On this particular day, I was running our large group practice alone because my partner docs were out. It was a busy day and I knew I had a really difficult appointment at the end of my day. With all the other challenging aspects of the schedule, my easy 1:30 p.m. flipper delivery patient was barely on my radar…until she was right in the center.
After her flipper delivery was complete, I remember I could hear some raised voices at the front desk. I couldn’t tell what the words were, but the tone and the volume were enough to know something was happening up there. As I finished up my hygiene check, I heard the words, “I need to get Dr. Mauterer right now.” I immediately changed course to find my patient coordinator. She filled me in that the news of the flipper cost had caused an intense interaction that ended with my patient shouting to everyone in the reception area that she was going to go to her car to kill herself.
I went out to her car immediately and discovered she had found a knife and hurt herself. Once I activated 911 all I could do was keep pressure on her physical wounds and listen to her stories of all her emotional wounds. I had known this patient for many years and had never realized all the trauma she had endured and how close to her heart she kept it all.
Once the paramedics had taken her to the hospital I walked back inside, washed my shaky bloody hands and attempted to finish out my schedule. Over the next few hours, my office manager (who had taken the day off) rushed into the office and gave me a hug and made sure we were all OK. Then my regional manager rushed over from 20+ miles north and my HR director did the same from 20+ miles south. It meant so much to me that my DSO management team dropped everything and came racing over to check on us. It was such a comfort to know I was working with people who cared so much about us and about our patient.
I later thanked my CEO for creating a company that puts the human experience first. When I relayed this story as an example, his first words were concern for our patient and an offer to help her. From a man in his powerful position, so far removed from day-to-day patient care, one might mistakenly assume that patient care is a means to an end for him. However, he showed me with his actions and words that he considers our lifelong relationships with our patients to be the entire corporation’s top mission. He is the son-of-a-dentist, after all. His dad served his patients with integrity throughout his career and volunteered in his state’s local ADA component society for many years. He taught his son very well.
Changing over from private practice to a DSO was a scary leap of faith into an unknown realm. What I have discovered on the other side is that it is entirely possible to be part of a large company that places its highest priorities in that tiny moment when you truly connect with another person.
I know there are many DSOs like mine that are approaching patient care in the right way. I will continue to share my experience with anyone who is curious and I look forward to hearing some of your stories. Afterall, isn’t storytelling how we form our deepest connections with each other?