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How DSOs Can Improve the Quantity and Quality of Patients with Amol Nirgudkar
Hear from Amol Nirgudkar, the CEO of Patient Prism, on how dental service organizations (DSOs) can improve the quality and quantity of patients using technology
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See video transcript
Alec Goldman (00:00.618)
Welcome to How I Grew My Practice, a 15 minute podcast sponsored by NexHealth. My name's Alec Goldman. I lead content here at NexHealth. Being joined today by Amol Nirgudkar, the CEO of Patient Prism. He's here to talk to us about how DSOs are leveraging AI to keep their practice schedules. Amol. Welcome. It's a pleasure to have you here today.
Amol Nirgudkar (00:27.225)
Thank you, Alec, very much. I appreciate being on your podcast.
Alec Goldman (00:30.914)
Cool. To get started, if you don't mind, just tell us and share with us a little bit about yourself. Give us some of your history, what's going on in Patient Prism.
Amol Nirgudkar (00:40.361)
Well, I accidentally started in this business. I ran a CPA firm in the dental and healthcare space for over 15, 16 years, doing all sorts of stuff from taxes to consulting to mergers and acquisitions. And during that period of time, I fell in love with dentistry and, and how dentists ran their practices. So I focused a lot of my CPA firm on improving dental practice revenues or expenses and stuff like that.
Amol Nirgudkar (01:09.109)
Like eight years ago, I started a marketing company to help dentists acquire the right kind of patients. This was just a fun project. And that fun project led me to understand that, okay, well here are the challenges for practice growth. And we were one of those companies who went to dental offices and said, hey, what kind of patients would you like to see? And then we delivered those patients via all sorts of, I don't know.
Amol Nirgudkar (01:35.273)
all the stuff that SEO was just coming about and video marketing and all that stuff. And one of the things we realized during that process that no matter how good we were and effective we were in driving leads or patient phone calls into the dental offices, if those offices didn't have the ability to close that deal on the phone, which means schedule an appointment, all that marketing dollars were going to waste. So Patient Prism was born out of that need to
Amol Nirgudkar (02:04.773)
get more patients to schedule appointments. And so we said, I asked a simple question at the time, I was not this technologically savvy as I am today running AI company for many years. I asked my co-founder and they could we teach Alexa how to understand dentistry. And he's like, sure. I mean, he's very nonchalant. He's like, sure. Like, what do you mean? Sure. And lo and behold, we utilize something that powers Alexa, powers Siri, powers all these devices.
Amol Nirgudkar (02:35.17)
which is the division of AI called natural language processing, which teaches machines how to understand human language. And we leveraged that technology, started building a product that would allow dental practices to understand who's not booking, why are they not booking, and what they could do about it. So that's the birth of Patient Prism.
Alec Goldman (02:57.386)
Very cool. I mean, before jumping into, I'm sure all the new technology that you guys are working on at Patient Prism in the thoughts that you have there, it might be a silly question, but what are some of the key goals for DSOs in 2023? And are those changing year over year from what you've seen in the past?
Amol Nirgudkar (03:16.213)
Well, some are changing, primarily because the dynamics of the dental market changed post-pandemic, right? But for the most part, everybody has the same goals. The industry is maturing and it kind of started 20 years ago, accelerated in the last decade, and then kind of is now in its third 3.0 phase of growth. Right? 3.0 is that there was a first set of DSOs that came about.
Amol Nirgudkar (03:42.445)
they became very big like Heartland and PDS and Aspen. They've built amazing businesses. The next 2.0 was right before the pandemic where there was a lot of emerging groups starting to form, to aggregate practices and hopefully create the next Heartland or the PDS or whatever it was. And it's great. Many of them in the pandemic, their business models were tested to see if they were doing, they were in it for the right reason. Do they, are they really providing support services to
Amol Nirgudkar (04:11.385)
to their members. And then the 3.0 version really evolved after the pandemic where now everybody's honing on to what the business model needs to be. But, and I think there is some amazing activity going on with emerging groups that are trying to figure out how to leverage various things to improve the patient experience. And those are kind of, I think there is a lot of thought put into patient experience now.
Amol Nirgudkar (04:40.317)
and the patient journey. But if you were to ask me, what are the top goals that DSOs have today? One is, I think the number one goal I don't think anybody would disagree with me is same store growth, right? Same store organic growth. Everybody wants to do that because that's what all the investors want, right? I mean, at the end of the day, it's not because, it shows you how the health of the practice is. You want to have good same store growth. At the same time, you want to have good margins, right? In the same time, you cannot have growth.
Amol Nirgudkar (05:09.965)
that comes at a very high cost. You wanna have good operating margins and good EBITDA margins, because those matter. You want, hopefully, double-digit same-store growth. Hopefully, you want double-digit EBITDA margins. And that's the goal that people have. In the spirit of having better margins, in 2023, the big thing that I'm hearing from the DSOs is how do we cut costs? Because, obviously, as we know, we're in a very...
Amol Nirgudkar (05:37.181)
a rate hiking environment, inflation is out there, and the Federal Reserve has basically doubled interest rates over the last year, which is the fastest it's ever done it in the history. So all of a sudden, if you were paying 7% on your debt, all of a sudden you're paying 11%. So that's squeezing margins, not EBITDA margins, because EBITDA is added back, but squeezing cash. So there's less cash. So they're figuring out how to meet budget by reducing costs. So growth is number one. Reducing cost is number three.
Amol Nirgudkar (06:07.309)
Capacity is number three. And number two, reducing cost is number two. Improving capacity. How do we see more patients within the constrained environment that we have, right? It's not that easy to just go out there and expand capacity, right? Patient demands always been high. And then despite only 50% of patients actually calling a dental office, so we have a huge, huge opportunity in dentistry to get more people in the mix. But how do we increase capacity, right?
Amol Nirgudkar (06:37.017)
How do we increase capacity to see more patients within the constraints that we have is a huge concern right now, because days booked out is a huge factor currently in DSOs, dental practices. I mean, sometimes new patients have to wait 100 days to get a new appointment. 100 days is not acceptable. Well, they're not gonna show up, right? We're gonna have lots of no-shows and cancellations because nobody wants to wait.
Amol Nirgudkar (07:04.429)
Today, in today's world, in Instagram, Snapchat, TikTok world, nobody has the patience to wait three months to see a dentist. If they want something, they want it now. They want the dopamine now, right? They want all the chemicals now, and exciting chemicals. So capacity is important, you know, and they're sort of thinking about how to creatively think about adding more capacity. Recruitment and retention is a huge deal. It's been...
Amol Nirgudkar (07:33.257)
there for a long time, but there's a bunch of in the hygiene, for example, the hygiene area, many hygienists retired during the pandemic. They don't want to come back. So there is a shortage of doctors and hygienists, but there's also shortage of assistants. There's also a shortage of front office. So overall, we are, we are in a shortage environment and the ADA says we're going to be in that environment till I think 2026 or 27. So, so recruiting the right people.
Amol Nirgudkar (08:02.345)
on the bus and retaining them is a very big goal for DSOs. And I think the fifth thing that I would say, it's kind of my thought into this process is, I think DSOs are struggling, have struggled. As they grow in size and number and people and all the things that grow with an organization that has more and more practices, they're-
Amol Nirgudkar (08:30.221)
they are struggling or they're aspiring to convert information they have into insight. And they wanna convert that insight into foresight so that they have a more predictable way of growing. And what do I mean by that? Information means the stuff that you have in your electronic health records, in all your systems that you have. Information is data. For the longest time, we've had many of these, there's many,
Amol Nirgudkar (09:00.333)
There has been a focus over the last 10 years on, oh, key performance indicators, what are they like? We need to look at those things. But what happens is as you grow the organization, you almost quadruple, quintuple the amount of information that you have to process. And that's just information, right? Information is, it tells you what happened, you know? And insight is idea of why did it happen, right?
Amol Nirgudkar (09:28.137)
Inside is also a crystallization of this amount of information and then converting it to this amount of information. So I just want to know what happened, why did it happen? Not what happened, but why did it happen? What could have prevented something from happening? A bad thing. If something good happened, then why did that happen? Can we replicate that everywhere else? So that's what I mean by converting data or information or hindsight, hindsight what happened in the past.
Amol Nirgudkar (09:56.461)
to insight of why, what could have been done, and that insight, and crystallizing data information into insight, and then getting that insight and creating some foresight, which is, what could we do next time? Or what could we do to prevent something from happening? For example, what could we, how could we, okay, we had five cancellations. How do we fill that up? Right, we have five cancellations.
Amol Nirgudkar (10:24.121)
Now all of a sudden we have gaps in the schedule tomorrow. What do we do? So understanding we had five cancellations is important. That's hindsight, right? Why did those cancellations happen? That's insight. And the ASOs want to know that. And what could we do to fix that? That's foresight. And as long as they evolve as an industry from taking information, converting that in insight, and getting foresight, I think
Amol Nirgudkar (10:53.281)
That's going to be a goal, I believe, of all DSOs going forward.
Alec Goldman (10:58.126)
Cool. Yeah, I mean, I guess my question to you is, how is technology enabling, I mean, you have five different goals, specifically on growth and reducing costs, but even as far as helping folks develop that foresight and being predictive. So I guess my question to you here is, how's technology impacting the DSO space to achieve a handful of those goals?
Amol Nirgudkar (11:24.301)
Well, in terms of growth, right, the first way technology is helping is figuring out how to properly market to the right patients. Because at the end of the day, if you want to grow your business, there's multiple ways of, multiple levers of growth. You absolutely need new patients. And so there's marketing technology right now that is utilized by marketing folks in understanding.
Amol Nirgudkar (11:51.853)
what the demographic of people around the people want. So there is technology being used in marketing, whether it's bidding for AdWords, whether it's paid campaigns, digital campaigns across even Instagram and TikTok and social media. So technology is being used for patient acquisition. And not just patient acquisition, the smart guys are doing it for the right kind of patient acquisition, which means are the right people calling.
Amol Nirgudkar (12:20.045)
Right, so that technology is being used, hold on a second, the right technology is being used in getting the right patients and marketing to the right people and getting all those objectives done. Technology is being used in our context, for example, to make sure all those people who are calling are actually booking an appointment and understanding those kind of conversations and making sure that every patient is moving forward in their journey. So that when they call,
Amol Nirgudkar (12:46.521)
The first, our only obligation is to make sure that we convert, we call that conversion optimization. Technically the term was invented by Google and they call conversion optimization something different. I'll talk about it later. But so our patients, are the right people coming in? Technology is used to do that. Are they booking? Technology is used to do that. Technology is also used right now in terms of diagnosing the patient and getting them to accept treatment. So that's a huge.
Amol Nirgudkar (13:14.913)
role of technologies that's playing more so than ever before. Technologies also used in collections and revenue cycle management. Are we collecting? There's robotic process automation being used to look at claims and verification and eligibility. Technology is being used to look at claims and cleaning up the claims, validating all the data before they're submitted to the insurance company so that we get a better acceptance rate.
Amol Nirgudkar (13:43.597)
So there's a lot of technology being used, and I think that's a big growth area for the DSO and the dental world is how do we make a very inherently inefficient process of submitting to insurance and collecting back from insurance? How do we make that a little more simpler? And how do we make that less human-centric? That's the point of technology, right? And the point of technology is not to replace a human, it's to allow a human to be more
Amol Nirgudkar (14:13.165)
so they can do things that they wanna do, which is most likely spend time with the patient, right? And earn their trust and give them great customer service. The point of a human is not to stay on the insurance company for two hours waiting on hold to verify a customer. We should let technology do that because how much value does it add to anybody in the ecosystem when we're on the phone for two hours just waiting?
Amol Nirgudkar (14:44.006)
to verify patient information. So that is a big part where technology is helping in revenue cycle. And I think the big thing that I believe technology is helping is to really first, I think enhance the patient journey from the time they start. And the most important thing as we know in dentistry is that okay, you wanna acquire new patients, wonderful. That's important.
Amol Nirgudkar (15:11.201)
But at the end of the day, and that's what in marketing speak, that's top of the funnel, right? We're acquiring patients coming in. But what do you want to do once they come in? You want to make sure that they are moving forward, they're accepting your diagnosis, they're accepting your treatment. And then the most important thing for you to do is they are nurtured so that they are retained, right? Because you don't want to acquire all these patients on the left side of the funnel, let's say it's on the left.
Amol Nirgudkar (15:40.193)
and they're moving through the stuff, they come in for one visit, and they just don't come back. So apparently the statistics are out there, but the bottom of the funnel leak, which means the patients who are leaving, actively leaving the practice on a monthly basis, it's anywhere between 25 to 30 new patients are leaving the practice. So what happens is, what's the point, you know, when you have a leaky bucket, you know?
Amol Nirgudkar (16:09.417)
All you do is spend more money on marketing, get more people in, but then people are falling off that. So the big thought process is how do we get customers that are already customers of ours, to come in to get the treatment that we have presented them, to come in for their routine visits for hygiene every six months, for their hygiene maintenance every three months. And how do we get them into those sequences where...
Amol Nirgudkar (16:38.025)
We can use technology to activate them to take the next step for their own oral health. So somebody has postponed a crown for like six months. How do we activate them in the way they want to be activated? Well, a lot of people want to be activated over text, right? But how do we create technologies that are going to nurture the patient in the way a 2023 patient wants to be nurtured? Not in the way a 2019...
Amol Nirgudkar (17:05.673)
or a 2020 patient wants to be nurtured, or a 2010 patient wants to be nurtured. Yes, we want to send them reminders and all that stuff. That's great, but I think technology is going to need to help. And I think it's helping. Part of what you guys are doing over there at NexHealth is also, is where we are thinking about what the patient wants today. The convenience they want, right? They want to do online appointment. They want to be able to...
Amol Nirgudkar (17:33.465)
chat with somebody. They want to be able to quickly figure out. And as long as we can deliver that to them through technology. So that's it. In the area of nurturing and automation is where I think technology is going to really shine in the next few years in the DSO world, in the overall dental world. I think it's going to help us really grow this industry from where it is today to almost five to six times its size.
Alec Goldman (18:02.09)
Yeah, agreed. Amol, if you don't mind, so there's lots of technology that has been out there within regards to bidding on Google keywords and leveraging technology like HubSpot and all these different market automation tools. Can you share a little bit on the newer technology or perhaps new AI technology that is really enabling growth for DSOs?
Amol Nirgudkar (18:27.061)
Well, I mean, I'll start with my own because it starts at the front of the funnel, right? One of the big things that we've done is used a combination of AI, natural language processing, neural networks, deep learning. Even to an extent, what GPT has done over the past few months. We don't necessarily use that.
Alec Goldman (18:31.534)
Sure. Yeah.
Amol Nirgudkar (18:56.425)
specific technology, but the thought process that went in training a language model, we did it in-house. But the idea was to be able to understand a patient conversation in real time on the phone. Because remember, as I said at the beginning of the podcast, that there's lots of patients who are calling the dental office or the DSO based on these marketing leads and marketing campaigns.
Amol Nirgudkar (19:25.889)
but only maybe 55 to 60% of them are actually booking an appointment. And that was a big waste of marketing money, right? Because you spend the money to drive the lead in and you're not able to book. And as a result, these practices were not growing as much as they should have grown. So what AI, what Patient Prism does currently is, is first it evaluates, you know, are the right patients calling, number one, right? Are the right patients calling?
Amol Nirgudkar (19:57.081)
the right amount, at the right cost. So you want, okay, I'm an implant dentist, I want to see more implant calls coming into my profile, right? Because I have hired a marketing company or I have a marketing director that wants me to drive more implant leads into my office. And that's their job, right? And so I want, I go back to my marketing days and say, hey, I was held accountable for driving the right type of growth. Not any growth, the right type of growth.
Amol Nirgudkar (20:24.309)
And the right type of growth is the most profitable growth. And what's the most profitable is those high value new patients, right? They drive a lot of high growth, right? So if you're an implant dentist, if you see, you know, if you place four implants a month versus 10 implants a month, the profitability is just outstanding because after your fixed costs have met, I mean, almost 70% of that implant production is profit. So what we do is we understand the conversation to understand did the right patients call
Amol Nirgudkar (20:54.325)
and did they book an appointment? And number two is in the right amount of the right cost, but did they book an appointment? So technology helps from our perspective to figure out is marketing effective and is your front office effective in getting those people in the door? And if we're not booking them, then the AI also helps in understanding that do you have capacity concerns, operations concerns, training concerns, and so forth. The second part where technology is affecting a lot
Amol Nirgudkar (21:24.617)
is technologies and computer vision. So the other aspect of AI is, one is natural language processing, what it looks at, looks at language and stuff. But the second aspect is AI that looks at vision, looks at radiographs, right? It was done in medicine for a long time before it came into dental, but there's companies out there right now, like PORL, that are looking at radiographs.
Amol Nirgudkar (21:52.405)
and trying to standardize diagnosis. What they have seen across the board is that there is a huge variance in how treatments are diagnosed. The same dentist will diagnose a treatment plan worth $100, and another dentist for the same treatment plan will diagnose $1,000. And so there is a huge opportunity for the dental industry to take advantage of
Amol Nirgudkar (22:21.869)
these models, these computer vision models, that are looking very deeply inside the X-ray to see things that sometimes a human eye may not see. It doesn't mean that the dentists are bad at reading X-rays, that's not the point. The point is, the ability for AI to see things that normally humans don't see is what AI is, right? In our context, it's the same thing. It's that you didn't notice that pattern, or you didn't notice it quickly enough.
Amol Nirgudkar (22:50.793)
If you had all the time in the world, you could see an x-ray for like 15 minutes. Great. Maybe you could see everything, but there's no time. You want to understand why. So you want to understand that. And then it's also a matter of patient trust in that world, right? Because sometimes patients don't trust the dentist that, oh, are you just doing it because you want to buy that next Mercedes or whatever it is, a nice car outside. Are you telling me the right thing? So now...
Amol Nirgudkar (23:19.657)
It's helping earn patient trust because now the diagnosis is right in front. Like, oh, you have bone loss of 30%. If you don't take care of this crown right now, your bone loss can be 50% and you could lose the tooth. So now it's no longer opinion. It's just math. And so you can't argue with math. And now 2 plus 2 is always 4. And now you see 30% bone loss, 50% bone loss.
Amol Nirgudkar (23:47.669)
or you see that your restoration for your crown needs to be replaced, there is a mathematical formula that the computer vision system is going to give you that makes you feel that, oh, I can trust this. This is not just the doctor telling me, it looks like I need to do this, or I need a root canal, whatever it is. So that's where AI is helping a lot. I think, and then the third thing I said earlier, AI is actually working, which is not
Amol Nirgudkar (24:16.441)
through the AI yet, but it's helping understand claims and making sure that the revenue cycle management process where we are filing the right claims and AI is helping in making sure that our claim process is complete, we're attaching all the things, or it's figuring out that, hey, maybe you're not attaching everything to get paid, right? You can, for example, get paid for a...
Amol Nirgudkar (24:45.673)
a panoramic X-ray and a white wing at the same time. So AI is thinking through some of these things, the mistakes humans could make, and getting us to be better at getting insurance processing done. Robotic process automation is not AI, it's just a matter of training a robot to do human things, but that's helping as well. But I think AI is gonna be introduced in some of these things, and it is already been to kind of help optimize collections.
Amol Nirgudkar (25:15.085)
So I think those are three things. I think acquire new patients of the right kind, diagnose them better and get more case acceptance, and help you collect more money. Those are three ways I think AI is helping DSOs and dental practices right now.
Alec Goldman (25:28.586)
Amol, do you see that this is widely being adopted at DSO specifically, but dental practices and for those who have not adopted it, I guess, where do you learn to find out more and get perhaps as caught up to speed as yourself?
Amol Nirgudkar (25:45.909)
It's not widely adopted. Any new technology, there's early adopters and those guys are, we're in the early adoption phase right now. We're not nowhere close to being a mature marketer. As the AI goes, I think the advent of chat GPT is going to accelerate people's attention towards AI. Not that chat GPT is the answer for everything. I mean, it's just not, right? There's limitations for generative AI and everything else, but...
Alec Goldman (25:50.574)
That's right.
Amol Nirgudkar (26:14.305)
What ChatGPT has done very, very quickly since last October when it was launched, it has shown focus. It's shining a focus on AI and what it can do. So I think we're still in a very early adoption stage. Do you think, is there 10% adoption of AI? No, I don't think there's even 10% adoption, maybe 5%. But I think we're gonna have an exponential curve over the next few years, driven by...
Amol Nirgudkar (26:43.445)
all the advances in AI that have not necessarily related to dentistry, but they're just overall and overall acceptability of AI and all that stuff. So I think the next five to 10, five years are going to be incredibly amazing for technology, for AI to really take, to become a utility. At some point it's going to become a utility, right? It's nowhere close to it today, but at some point people will say, we have to know this.
Amol Nirgudkar (27:12.161)
We have to have this, it's like you have to have a power on, you have to have air conditioning or heat during the winter. You have to have AI, because without that, we can't run our practices. We don't wanna run the old school practices. So the transformation of that, typewriters took a little while, right? When word processors came, it took a little bit. Computers as well in the 70s and the 80s, they took a little while to kind of get there.
Amol Nirgudkar (27:39.625)
Industrial Revolution. The machine took a little while to do the stuff that the humans used to do. But it's not if, it's just when. And my prediction is that I think it's going to happen a lot faster over the next five years. And people who actually adopt this early, the early adopters are going to win. The early adopters of technology are going to absolutely are going to win.
Amol Nirgudkar (28:08.237)
have an outsized, in five years from now, you adopt technology, yes, you will grow at 4%. But you do it today, right? You are going to have a unfair competitive advantage. It happens every time, right? Anybody who does something new, takes a risk, adopts technology that's gonna change their practices. And it's an informationally inefficient world, right? People who know, they adopt.
Amol Nirgudkar (28:34.473)
So early adopters have a distinct advantage in growing faster, being more profitable, making more money. And I absolutely, I'm seeing that already. If you adopt technology earlier, you adopt marketing automation, you adopt AI, you adopt some of the new tools, you are going to grow faster than people who are not.
Alec Goldman (28:59.23)
Yeah. And on top of that, I mean, it just feels like the introduction of all of this AI that has happened in GBT and all these tools and the colliding of the issue of kind of like labor shortage in the dental market have hit at the same point. So the question that dentists or practices really have to ask is how am I going to get the work done? Are you going to continue to really spend hours and hours looking to backfill roles or hire people?
Alec Goldman (29:27.046)
or other small efficiencies that you can gain by looking into AI for those three topics that you kind of provided and laid out on growth and diagnosis and also the collections piece, right? Those are so many tireless hours of just repetition over and over and over. So figuring out, hey, is there a new technology that I could be using, whether it's Patient Prism or NexHealth, or, you know, I'm sure there's tons of tools specifically around collections that I think.
Alec Goldman (29:55.254)
practices are going to greatly benefit from not even just from a growth perspective, but really just from a labor and cost perspective as well.
Amol Nirgudkar (30:02.541)
You have to create time, right? Time is the more scarce commodity, right? And if you are getting your humans doing things, it also doesn't do great for retaining people, right? As I said, you look right now, the ADA survey said, 39% of front office people in dentistry are looking for new jobs. 39%, why? And actually, it's anywhere between 20 and 40%.
Alec Goldman (30:06.658)
That's right.
Amol Nirgudkar (30:32.465)
is all the people who are looking to change jobs. And some of them are moving away from the industry. So what we have to do is we have to make their jobs easier. We have to give them the tools that'll allow them to do things that make them more fulfilled and not like stay on the phone for two hours, right? And make them more efficient. And you want the next generation of kids who are coming into the workforce, and I call them kids now, I cannot believe that, are looking...
Amol Nirgudkar (30:59.993)
to grow, they're looking to make money, but they're also looking to do cool things and to adopt things where they can really take their God-given gifts and deploy them at the highest level. Whether you're a dentist, you wanna perform at the highest level, but even if you are a front office person, you want to perform at the highest level, right? And you don't wanna feel that you're in an environment where it's a dead end, where there's no learning happening.
Amol Nirgudkar (31:30.493)
So absolutely, is technology an option today? No, it's not. But we've got, in order for us to even retain our people and inspire them and continuously motivate them to perform at the highest levels, we have to support them with technology that'll allow them to do better things than just the stuff, the mundane routine stuff that all healthcare practices have done for the last 20, 25, 30, 40 years.
Amol Nirgudkar (31:58.741)
And that's really, so it's an imperative. It's not an option. Not everybody's gonna get that imperative in 2023. The guys who do understand that it's an imperative are going to benefit handsomely because there are people that are gonna reward them. The team members are gonna reward them with loyalty. Like, man, I like that my company's investing in technology, I'm learning a lot. I'm getting to upgrade my skills. They're giving me opportunities to talk to patients and do other things that...
Amol Nirgudkar (32:28.197)
I really love? I don't necessarily love, you know, doing mundane stuff. It's not. It's boring. It's like, it's not food for my soul or my mind.
Alec Goldman (32:40.054)
That's right. Amol, we're coming out. I mean, we're, I've been really enjoying the conversation. You're extremely wise in all the AI stuff here. But I want to make sure you got any last thoughts in before we close out for this conversation.
Amol Nirgudkar (32:55.249)
Yeah, I mean, I think if I was a DSO today, right, I have multiple priorities. And I'm technically a vendor in the space and you go to a DSO show, there's 500 people, right? How do you choose technology? How do you choose what to adopt? Given that there is a lot of noise out there. Oh, you need this for that, this for that, this for that. You need...
Amol Nirgudkar (33:24.981)
Apparently you need 19 other technologies right now to run your DSO. And there that that's a frustration, right? So how do you choose technology that's going to help you grow the business and not be, you know, not be so suffocating to your team members, right? So one of the things that I talk to people about is that first and foremost, you have to pick technology that makes life easier, not harder. That makes the
Amol Nirgudkar (33:54.625)
people, your team members. If you're gonna give them another thing to do, and it's gonna burden them with more tasks to do, then first of all, it's not gonna be adopted. People are not gonna use it, right? So you have to figure out what technology are out there that are helping you consolidate things into a smaller amount of solutions. You cannot do one solution for everything. It's just not out there, right? But instead of 19 solutions, can you use 10?
Amol Nirgudkar (34:21.897)
Are there technologies that allow you to consolidate the tech stack that are gonna help you so that you can focus on things, right? You also wanna focus on technologies that are gonna give you insight and foresight, not just hindsight. So that are gonna give you things to do, not just loads and loads and loads of KPIs. Nobody cares about them. The more KPIs you see, the more blind you get to all the information and then you ignore everything. So...
Amol Nirgudkar (34:49.517)
Who's gonna give you what technology is gonna give you the insight and force out in the tools to act upon. If somebody canceled, I wanna fill that cancellation. If somebody didn't book, I wanna rebook them. If somebody didn't accept treatment, I wanna diagnose them better. I want the time is important. People don't have time and we wanna be able to save time. And so we want technologies that are gonna give us more time and that are gonna help us develop insight.
Amol Nirgudkar (35:19.277)
First, we wanna consolidate the stack into a smaller stack so that we can focus on using those things, otherwise not focusing on anything. Second, we wanna be able to give them insight and foresight and give them the tools, just the right tools to help them do their jobs better. The third thing is that many DSOs struggle with. It's easy to, technology is easy to buy, but it's not easy to operationalize, right?
Amol Nirgudkar (35:47.253)
So you need to figure out who, not how, right? The famous Dan Sullivan quote. Who, not how? Like, how are we gonna empower leadership within the organization for change management? How are we going to adopt technology where people actually buy into the idea that hey, this is gonna help? Who? The most important person to help in dental business is the patient, right? That's the most important person we're trying to help here. We're trying to get them to better health.
Amol Nirgudkar (36:14.749)
And as long as all of us strive very hard to get that patient in the door and get them to their optimal oral health and overall health, we're all winning. We don't have to worry about EBITDAs and valuations and none of that stuff. What matters is are we empowering the society to become healthier? And so how do we operationalize that? Happens through leadership. Happens through the concept of who, not how. Who do we empower? Who do we make the champion of that person?
Amol Nirgudkar (36:43.497)
in the organization that can take the bull by its horns, convince people that this is the right thing, get the change management happening at the DSO level. And there is some good thinking around that. We have failed many, many times, Alec, over the last seven years in figuring out the change management piece. And we very, very, very much have focused our last two years in thinking like, hey, we're dealing with people. This is a people business. And this, you can't just...
Amol Nirgudkar (37:09.965)
fly by night, oh, I got this fancy AI, nobody cares. What people care about is their problems. And then we have to solve their problems. We have to get the team members to understand that this is solving their problem. This is reducing the amount of work that they don't like to do. And operationalizing this is big. If you can't operationalize any of this stuff, no matter how cool it is, you can, you know.
Amol Nirgudkar (37:37.473)
build the next bot that's gonna do dentistry on it. Nobody cares about that. People care about their problems. People care about their teams. People care about their retention. People care about their own jobs. And we have to make sure, as technology companies in this space, we have to make sure we help these DSOs and dental practices adopt this in a way that it's going to make an impact and it's not going to create more aversion to like, oh my God.
Amol Nirgudkar (38:06.937)
another thing to do, right? So that's, I think, are my last thoughts really is, is we gotta empower people to be leaders, and we gotta figure out how that leadership process is gonna work in the organization so that we can adopt this technology in a way that it's going to empower everybody to be their best selves, improve the patient experience, grow your practice, top line and bottom line, and really help you.
Amol Nirgudkar (38:34.593)
do your most important job is to serve your patients and to get them to the best health possible. And if we have done that as dentistry, then we have all won, regardless of our EBITDA or regardless of the valuation that we're gonna eventually be at.
Welcome to How I Grew My Practice, a 15 minute podcast sponsored by NexHealth. My name's Alec Goldman. I lead content here at NexHealth. Being joined today by Amol Nirgudkar, the CEO of Patient Prism. He's here to talk to us about how DSOs are leveraging AI to keep their practice schedules. Amol. Welcome. It's a pleasure to have you here today.
Amol Nirgudkar (00:27.225)
Thank you, Alec, very much. I appreciate being on your podcast.
Alec Goldman (00:30.914)
Cool. To get started, if you don't mind, just tell us and share with us a little bit about yourself. Give us some of your history, what's going on in Patient Prism.
Amol Nirgudkar (00:40.361)
Well, I accidentally started in this business. I ran a CPA firm in the dental and healthcare space for over 15, 16 years, doing all sorts of stuff from taxes to consulting to mergers and acquisitions. And during that period of time, I fell in love with dentistry and, and how dentists ran their practices. So I focused a lot of my CPA firm on improving dental practice revenues or expenses and stuff like that.
Amol Nirgudkar (01:09.109)
Like eight years ago, I started a marketing company to help dentists acquire the right kind of patients. This was just a fun project. And that fun project led me to understand that, okay, well here are the challenges for practice growth. And we were one of those companies who went to dental offices and said, hey, what kind of patients would you like to see? And then we delivered those patients via all sorts of, I don't know.
Amol Nirgudkar (01:35.273)
all the stuff that SEO was just coming about and video marketing and all that stuff. And one of the things we realized during that process that no matter how good we were and effective we were in driving leads or patient phone calls into the dental offices, if those offices didn't have the ability to close that deal on the phone, which means schedule an appointment, all that marketing dollars were going to waste. So Patient Prism was born out of that need to
Amol Nirgudkar (02:04.773)
get more patients to schedule appointments. And so we said, I asked a simple question at the time, I was not this technologically savvy as I am today running AI company for many years. I asked my co-founder and they could we teach Alexa how to understand dentistry. And he's like, sure. I mean, he's very nonchalant. He's like, sure. Like, what do you mean? Sure. And lo and behold, we utilize something that powers Alexa, powers Siri, powers all these devices.
Amol Nirgudkar (02:35.17)
which is the division of AI called natural language processing, which teaches machines how to understand human language. And we leveraged that technology, started building a product that would allow dental practices to understand who's not booking, why are they not booking, and what they could do about it. So that's the birth of Patient Prism.
Alec Goldman (02:57.386)
Very cool. I mean, before jumping into, I'm sure all the new technology that you guys are working on at Patient Prism in the thoughts that you have there, it might be a silly question, but what are some of the key goals for DSOs in 2023? And are those changing year over year from what you've seen in the past?
Amol Nirgudkar (03:16.213)
Well, some are changing, primarily because the dynamics of the dental market changed post-pandemic, right? But for the most part, everybody has the same goals. The industry is maturing and it kind of started 20 years ago, accelerated in the last decade, and then kind of is now in its third 3.0 phase of growth. Right? 3.0 is that there was a first set of DSOs that came about.
Amol Nirgudkar (03:42.445)
they became very big like Heartland and PDS and Aspen. They've built amazing businesses. The next 2.0 was right before the pandemic where there was a lot of emerging groups starting to form, to aggregate practices and hopefully create the next Heartland or the PDS or whatever it was. And it's great. Many of them in the pandemic, their business models were tested to see if they were doing, they were in it for the right reason. Do they, are they really providing support services to
Amol Nirgudkar (04:11.385)
to their members. And then the 3.0 version really evolved after the pandemic where now everybody's honing on to what the business model needs to be. But, and I think there is some amazing activity going on with emerging groups that are trying to figure out how to leverage various things to improve the patient experience. And those are kind of, I think there is a lot of thought put into patient experience now.
Amol Nirgudkar (04:40.317)
and the patient journey. But if you were to ask me, what are the top goals that DSOs have today? One is, I think the number one goal I don't think anybody would disagree with me is same store growth, right? Same store organic growth. Everybody wants to do that because that's what all the investors want, right? I mean, at the end of the day, it's not because, it shows you how the health of the practice is. You want to have good same store growth. At the same time, you want to have good margins, right? In the same time, you cannot have growth.
Amol Nirgudkar (05:09.965)
that comes at a very high cost. You wanna have good operating margins and good EBITDA margins, because those matter. You want, hopefully, double-digit same-store growth. Hopefully, you want double-digit EBITDA margins. And that's the goal that people have. In the spirit of having better margins, in 2023, the big thing that I'm hearing from the DSOs is how do we cut costs? Because, obviously, as we know, we're in a very...
Amol Nirgudkar (05:37.181)
a rate hiking environment, inflation is out there, and the Federal Reserve has basically doubled interest rates over the last year, which is the fastest it's ever done it in the history. So all of a sudden, if you were paying 7% on your debt, all of a sudden you're paying 11%. So that's squeezing margins, not EBITDA margins, because EBITDA is added back, but squeezing cash. So there's less cash. So they're figuring out how to meet budget by reducing costs. So growth is number one. Reducing cost is number three.
Amol Nirgudkar (06:07.309)
Capacity is number three. And number two, reducing cost is number two. Improving capacity. How do we see more patients within the constrained environment that we have, right? It's not that easy to just go out there and expand capacity, right? Patient demands always been high. And then despite only 50% of patients actually calling a dental office, so we have a huge, huge opportunity in dentistry to get more people in the mix. But how do we increase capacity, right?
Amol Nirgudkar (06:37.017)
How do we increase capacity to see more patients within the constraints that we have is a huge concern right now, because days booked out is a huge factor currently in DSOs, dental practices. I mean, sometimes new patients have to wait 100 days to get a new appointment. 100 days is not acceptable. Well, they're not gonna show up, right? We're gonna have lots of no-shows and cancellations because nobody wants to wait.
Amol Nirgudkar (07:04.429)
Today, in today's world, in Instagram, Snapchat, TikTok world, nobody has the patience to wait three months to see a dentist. If they want something, they want it now. They want the dopamine now, right? They want all the chemicals now, and exciting chemicals. So capacity is important, you know, and they're sort of thinking about how to creatively think about adding more capacity. Recruitment and retention is a huge deal. It's been...
Amol Nirgudkar (07:33.257)
there for a long time, but there's a bunch of in the hygiene, for example, the hygiene area, many hygienists retired during the pandemic. They don't want to come back. So there is a shortage of doctors and hygienists, but there's also shortage of assistants. There's also a shortage of front office. So overall, we are, we are in a shortage environment and the ADA says we're going to be in that environment till I think 2026 or 27. So, so recruiting the right people.
Amol Nirgudkar (08:02.345)
on the bus and retaining them is a very big goal for DSOs. And I think the fifth thing that I would say, it's kind of my thought into this process is, I think DSOs are struggling, have struggled. As they grow in size and number and people and all the things that grow with an organization that has more and more practices, they're-
Amol Nirgudkar (08:30.221)
they are struggling or they're aspiring to convert information they have into insight. And they wanna convert that insight into foresight so that they have a more predictable way of growing. And what do I mean by that? Information means the stuff that you have in your electronic health records, in all your systems that you have. Information is data. For the longest time, we've had many of these, there's many,
Amol Nirgudkar (09:00.333)
There has been a focus over the last 10 years on, oh, key performance indicators, what are they like? We need to look at those things. But what happens is as you grow the organization, you almost quadruple, quintuple the amount of information that you have to process. And that's just information, right? Information is, it tells you what happened, you know? And insight is idea of why did it happen, right?
Amol Nirgudkar (09:28.137)
Inside is also a crystallization of this amount of information and then converting it to this amount of information. So I just want to know what happened, why did it happen? Not what happened, but why did it happen? What could have prevented something from happening? A bad thing. If something good happened, then why did that happen? Can we replicate that everywhere else? So that's what I mean by converting data or information or hindsight, hindsight what happened in the past.
Amol Nirgudkar (09:56.461)
to insight of why, what could have been done, and that insight, and crystallizing data information into insight, and then getting that insight and creating some foresight, which is, what could we do next time? Or what could we do to prevent something from happening? For example, what could we, how could we, okay, we had five cancellations. How do we fill that up? Right, we have five cancellations.
Amol Nirgudkar (10:24.121)
Now all of a sudden we have gaps in the schedule tomorrow. What do we do? So understanding we had five cancellations is important. That's hindsight, right? Why did those cancellations happen? That's insight. And the ASOs want to know that. And what could we do to fix that? That's foresight. And as long as they evolve as an industry from taking information, converting that in insight, and getting foresight, I think
Amol Nirgudkar (10:53.281)
That's going to be a goal, I believe, of all DSOs going forward.
Alec Goldman (10:58.126)
Cool. Yeah, I mean, I guess my question to you is, how is technology enabling, I mean, you have five different goals, specifically on growth and reducing costs, but even as far as helping folks develop that foresight and being predictive. So I guess my question to you here is, how's technology impacting the DSO space to achieve a handful of those goals?
Amol Nirgudkar (11:24.301)
Well, in terms of growth, right, the first way technology is helping is figuring out how to properly market to the right patients. Because at the end of the day, if you want to grow your business, there's multiple ways of, multiple levers of growth. You absolutely need new patients. And so there's marketing technology right now that is utilized by marketing folks in understanding.
Amol Nirgudkar (11:51.853)
what the demographic of people around the people want. So there is technology being used in marketing, whether it's bidding for AdWords, whether it's paid campaigns, digital campaigns across even Instagram and TikTok and social media. So technology is being used for patient acquisition. And not just patient acquisition, the smart guys are doing it for the right kind of patient acquisition, which means are the right people calling.
Amol Nirgudkar (12:20.045)
Right, so that technology is being used, hold on a second, the right technology is being used in getting the right patients and marketing to the right people and getting all those objectives done. Technology is being used in our context, for example, to make sure all those people who are calling are actually booking an appointment and understanding those kind of conversations and making sure that every patient is moving forward in their journey. So that when they call,
Amol Nirgudkar (12:46.521)
The first, our only obligation is to make sure that we convert, we call that conversion optimization. Technically the term was invented by Google and they call conversion optimization something different. I'll talk about it later. But so our patients, are the right people coming in? Technology is used to do that. Are they booking? Technology is used to do that. Technology is also used right now in terms of diagnosing the patient and getting them to accept treatment. So that's a huge.
Amol Nirgudkar (13:14.913)
role of technologies that's playing more so than ever before. Technologies also used in collections and revenue cycle management. Are we collecting? There's robotic process automation being used to look at claims and verification and eligibility. Technology is being used to look at claims and cleaning up the claims, validating all the data before they're submitted to the insurance company so that we get a better acceptance rate.
Amol Nirgudkar (13:43.597)
So there's a lot of technology being used, and I think that's a big growth area for the DSO and the dental world is how do we make a very inherently inefficient process of submitting to insurance and collecting back from insurance? How do we make that a little more simpler? And how do we make that less human-centric? That's the point of technology, right? And the point of technology is not to replace a human, it's to allow a human to be more
Amol Nirgudkar (14:13.165)
so they can do things that they wanna do, which is most likely spend time with the patient, right? And earn their trust and give them great customer service. The point of a human is not to stay on the insurance company for two hours waiting on hold to verify a customer. We should let technology do that because how much value does it add to anybody in the ecosystem when we're on the phone for two hours just waiting?
Amol Nirgudkar (14:44.006)
to verify patient information. So that is a big part where technology is helping in revenue cycle. And I think the big thing that I believe technology is helping is to really first, I think enhance the patient journey from the time they start. And the most important thing as we know in dentistry is that okay, you wanna acquire new patients, wonderful. That's important.
Amol Nirgudkar (15:11.201)
But at the end of the day, and that's what in marketing speak, that's top of the funnel, right? We're acquiring patients coming in. But what do you want to do once they come in? You want to make sure that they are moving forward, they're accepting your diagnosis, they're accepting your treatment. And then the most important thing for you to do is they are nurtured so that they are retained, right? Because you don't want to acquire all these patients on the left side of the funnel, let's say it's on the left.
Amol Nirgudkar (15:40.193)
and they're moving through the stuff, they come in for one visit, and they just don't come back. So apparently the statistics are out there, but the bottom of the funnel leak, which means the patients who are leaving, actively leaving the practice on a monthly basis, it's anywhere between 25 to 30 new patients are leaving the practice. So what happens is, what's the point, you know, when you have a leaky bucket, you know?
Amol Nirgudkar (16:09.417)
All you do is spend more money on marketing, get more people in, but then people are falling off that. So the big thought process is how do we get customers that are already customers of ours, to come in to get the treatment that we have presented them, to come in for their routine visits for hygiene every six months, for their hygiene maintenance every three months. And how do we get them into those sequences where...
Amol Nirgudkar (16:38.025)
We can use technology to activate them to take the next step for their own oral health. So somebody has postponed a crown for like six months. How do we activate them in the way they want to be activated? Well, a lot of people want to be activated over text, right? But how do we create technologies that are going to nurture the patient in the way a 2023 patient wants to be nurtured? Not in the way a 2019...
Amol Nirgudkar (17:05.673)
or a 2020 patient wants to be nurtured, or a 2010 patient wants to be nurtured. Yes, we want to send them reminders and all that stuff. That's great, but I think technology is going to need to help. And I think it's helping. Part of what you guys are doing over there at NexHealth is also, is where we are thinking about what the patient wants today. The convenience they want, right? They want to do online appointment. They want to be able to...
Amol Nirgudkar (17:33.465)
chat with somebody. They want to be able to quickly figure out. And as long as we can deliver that to them through technology. So that's it. In the area of nurturing and automation is where I think technology is going to really shine in the next few years in the DSO world, in the overall dental world. I think it's going to help us really grow this industry from where it is today to almost five to six times its size.
Alec Goldman (18:02.09)
Yeah, agreed. Amol, if you don't mind, so there's lots of technology that has been out there within regards to bidding on Google keywords and leveraging technology like HubSpot and all these different market automation tools. Can you share a little bit on the newer technology or perhaps new AI technology that is really enabling growth for DSOs?
Amol Nirgudkar (18:27.061)
Well, I mean, I'll start with my own because it starts at the front of the funnel, right? One of the big things that we've done is used a combination of AI, natural language processing, neural networks, deep learning. Even to an extent, what GPT has done over the past few months. We don't necessarily use that.
Alec Goldman (18:31.534)
Sure. Yeah.
Amol Nirgudkar (18:56.425)
specific technology, but the thought process that went in training a language model, we did it in-house. But the idea was to be able to understand a patient conversation in real time on the phone. Because remember, as I said at the beginning of the podcast, that there's lots of patients who are calling the dental office or the DSO based on these marketing leads and marketing campaigns.
Amol Nirgudkar (19:25.889)
but only maybe 55 to 60% of them are actually booking an appointment. And that was a big waste of marketing money, right? Because you spend the money to drive the lead in and you're not able to book. And as a result, these practices were not growing as much as they should have grown. So what AI, what Patient Prism does currently is, is first it evaluates, you know, are the right patients calling, number one, right? Are the right patients calling?
Amol Nirgudkar (19:57.081)
the right amount, at the right cost. So you want, okay, I'm an implant dentist, I want to see more implant calls coming into my profile, right? Because I have hired a marketing company or I have a marketing director that wants me to drive more implant leads into my office. And that's their job, right? And so I want, I go back to my marketing days and say, hey, I was held accountable for driving the right type of growth. Not any growth, the right type of growth.
Amol Nirgudkar (20:24.309)
And the right type of growth is the most profitable growth. And what's the most profitable is those high value new patients, right? They drive a lot of high growth, right? So if you're an implant dentist, if you see, you know, if you place four implants a month versus 10 implants a month, the profitability is just outstanding because after your fixed costs have met, I mean, almost 70% of that implant production is profit. So what we do is we understand the conversation to understand did the right patients call
Amol Nirgudkar (20:54.325)
and did they book an appointment? And number two is in the right amount of the right cost, but did they book an appointment? So technology helps from our perspective to figure out is marketing effective and is your front office effective in getting those people in the door? And if we're not booking them, then the AI also helps in understanding that do you have capacity concerns, operations concerns, training concerns, and so forth. The second part where technology is affecting a lot
Amol Nirgudkar (21:24.617)
is technologies and computer vision. So the other aspect of AI is, one is natural language processing, what it looks at, looks at language and stuff. But the second aspect is AI that looks at vision, looks at radiographs, right? It was done in medicine for a long time before it came into dental, but there's companies out there right now, like PORL, that are looking at radiographs.
Amol Nirgudkar (21:52.405)
and trying to standardize diagnosis. What they have seen across the board is that there is a huge variance in how treatments are diagnosed. The same dentist will diagnose a treatment plan worth $100, and another dentist for the same treatment plan will diagnose $1,000. And so there is a huge opportunity for the dental industry to take advantage of
Amol Nirgudkar (22:21.869)
these models, these computer vision models, that are looking very deeply inside the X-ray to see things that sometimes a human eye may not see. It doesn't mean that the dentists are bad at reading X-rays, that's not the point. The point is, the ability for AI to see things that normally humans don't see is what AI is, right? In our context, it's the same thing. It's that you didn't notice that pattern, or you didn't notice it quickly enough.
Amol Nirgudkar (22:50.793)
If you had all the time in the world, you could see an x-ray for like 15 minutes. Great. Maybe you could see everything, but there's no time. You want to understand why. So you want to understand that. And then it's also a matter of patient trust in that world, right? Because sometimes patients don't trust the dentist that, oh, are you just doing it because you want to buy that next Mercedes or whatever it is, a nice car outside. Are you telling me the right thing? So now...
Amol Nirgudkar (23:19.657)
It's helping earn patient trust because now the diagnosis is right in front. Like, oh, you have bone loss of 30%. If you don't take care of this crown right now, your bone loss can be 50% and you could lose the tooth. So now it's no longer opinion. It's just math. And so you can't argue with math. And now 2 plus 2 is always 4. And now you see 30% bone loss, 50% bone loss.
Amol Nirgudkar (23:47.669)
or you see that your restoration for your crown needs to be replaced, there is a mathematical formula that the computer vision system is going to give you that makes you feel that, oh, I can trust this. This is not just the doctor telling me, it looks like I need to do this, or I need a root canal, whatever it is. So that's where AI is helping a lot. I think, and then the third thing I said earlier, AI is actually working, which is not
Amol Nirgudkar (24:16.441)
through the AI yet, but it's helping understand claims and making sure that the revenue cycle management process where we are filing the right claims and AI is helping in making sure that our claim process is complete, we're attaching all the things, or it's figuring out that, hey, maybe you're not attaching everything to get paid, right? You can, for example, get paid for a...
Amol Nirgudkar (24:45.673)
a panoramic X-ray and a white wing at the same time. So AI is thinking through some of these things, the mistakes humans could make, and getting us to be better at getting insurance processing done. Robotic process automation is not AI, it's just a matter of training a robot to do human things, but that's helping as well. But I think AI is gonna be introduced in some of these things, and it is already been to kind of help optimize collections.
Amol Nirgudkar (25:15.085)
So I think those are three things. I think acquire new patients of the right kind, diagnose them better and get more case acceptance, and help you collect more money. Those are three ways I think AI is helping DSOs and dental practices right now.
Alec Goldman (25:28.586)
Amol, do you see that this is widely being adopted at DSO specifically, but dental practices and for those who have not adopted it, I guess, where do you learn to find out more and get perhaps as caught up to speed as yourself?
Amol Nirgudkar (25:45.909)
It's not widely adopted. Any new technology, there's early adopters and those guys are, we're in the early adoption phase right now. We're not nowhere close to being a mature marketer. As the AI goes, I think the advent of chat GPT is going to accelerate people's attention towards AI. Not that chat GPT is the answer for everything. I mean, it's just not, right? There's limitations for generative AI and everything else, but...
Alec Goldman (25:50.574)
That's right.
Amol Nirgudkar (26:14.305)
What ChatGPT has done very, very quickly since last October when it was launched, it has shown focus. It's shining a focus on AI and what it can do. So I think we're still in a very early adoption stage. Do you think, is there 10% adoption of AI? No, I don't think there's even 10% adoption, maybe 5%. But I think we're gonna have an exponential curve over the next few years, driven by...
Amol Nirgudkar (26:43.445)
all the advances in AI that have not necessarily related to dentistry, but they're just overall and overall acceptability of AI and all that stuff. So I think the next five to 10, five years are going to be incredibly amazing for technology, for AI to really take, to become a utility. At some point it's going to become a utility, right? It's nowhere close to it today, but at some point people will say, we have to know this.
Amol Nirgudkar (27:12.161)
We have to have this, it's like you have to have a power on, you have to have air conditioning or heat during the winter. You have to have AI, because without that, we can't run our practices. We don't wanna run the old school practices. So the transformation of that, typewriters took a little while, right? When word processors came, it took a little bit. Computers as well in the 70s and the 80s, they took a little while to kind of get there.
Amol Nirgudkar (27:39.625)
Industrial Revolution. The machine took a little while to do the stuff that the humans used to do. But it's not if, it's just when. And my prediction is that I think it's going to happen a lot faster over the next five years. And people who actually adopt this early, the early adopters are going to win. The early adopters of technology are going to absolutely are going to win.
Amol Nirgudkar (28:08.237)
have an outsized, in five years from now, you adopt technology, yes, you will grow at 4%. But you do it today, right? You are going to have a unfair competitive advantage. It happens every time, right? Anybody who does something new, takes a risk, adopts technology that's gonna change their practices. And it's an informationally inefficient world, right? People who know, they adopt.
Amol Nirgudkar (28:34.473)
So early adopters have a distinct advantage in growing faster, being more profitable, making more money. And I absolutely, I'm seeing that already. If you adopt technology earlier, you adopt marketing automation, you adopt AI, you adopt some of the new tools, you are going to grow faster than people who are not.
Alec Goldman (28:59.23)
Yeah. And on top of that, I mean, it just feels like the introduction of all of this AI that has happened in GBT and all these tools and the colliding of the issue of kind of like labor shortage in the dental market have hit at the same point. So the question that dentists or practices really have to ask is how am I going to get the work done? Are you going to continue to really spend hours and hours looking to backfill roles or hire people?
Alec Goldman (29:27.046)
or other small efficiencies that you can gain by looking into AI for those three topics that you kind of provided and laid out on growth and diagnosis and also the collections piece, right? Those are so many tireless hours of just repetition over and over and over. So figuring out, hey, is there a new technology that I could be using, whether it's Patient Prism or NexHealth, or, you know, I'm sure there's tons of tools specifically around collections that I think.
Alec Goldman (29:55.254)
practices are going to greatly benefit from not even just from a growth perspective, but really just from a labor and cost perspective as well.
Amol Nirgudkar (30:02.541)
You have to create time, right? Time is the more scarce commodity, right? And if you are getting your humans doing things, it also doesn't do great for retaining people, right? As I said, you look right now, the ADA survey said, 39% of front office people in dentistry are looking for new jobs. 39%, why? And actually, it's anywhere between 20 and 40%.
Alec Goldman (30:06.658)
That's right.
Amol Nirgudkar (30:32.465)
is all the people who are looking to change jobs. And some of them are moving away from the industry. So what we have to do is we have to make their jobs easier. We have to give them the tools that'll allow them to do things that make them more fulfilled and not like stay on the phone for two hours, right? And make them more efficient. And you want the next generation of kids who are coming into the workforce, and I call them kids now, I cannot believe that, are looking...
Amol Nirgudkar (30:59.993)
to grow, they're looking to make money, but they're also looking to do cool things and to adopt things where they can really take their God-given gifts and deploy them at the highest level. Whether you're a dentist, you wanna perform at the highest level, but even if you are a front office person, you want to perform at the highest level, right? And you don't wanna feel that you're in an environment where it's a dead end, where there's no learning happening.
Amol Nirgudkar (31:30.493)
So absolutely, is technology an option today? No, it's not. But we've got, in order for us to even retain our people and inspire them and continuously motivate them to perform at the highest levels, we have to support them with technology that'll allow them to do better things than just the stuff, the mundane routine stuff that all healthcare practices have done for the last 20, 25, 30, 40 years.
Amol Nirgudkar (31:58.741)
And that's really, so it's an imperative. It's not an option. Not everybody's gonna get that imperative in 2023. The guys who do understand that it's an imperative are going to benefit handsomely because there are people that are gonna reward them. The team members are gonna reward them with loyalty. Like, man, I like that my company's investing in technology, I'm learning a lot. I'm getting to upgrade my skills. They're giving me opportunities to talk to patients and do other things that...
Amol Nirgudkar (32:28.197)
I really love? I don't necessarily love, you know, doing mundane stuff. It's not. It's boring. It's like, it's not food for my soul or my mind.
Alec Goldman (32:40.054)
That's right. Amol, we're coming out. I mean, we're, I've been really enjoying the conversation. You're extremely wise in all the AI stuff here. But I want to make sure you got any last thoughts in before we close out for this conversation.
Amol Nirgudkar (32:55.249)
Yeah, I mean, I think if I was a DSO today, right, I have multiple priorities. And I'm technically a vendor in the space and you go to a DSO show, there's 500 people, right? How do you choose technology? How do you choose what to adopt? Given that there is a lot of noise out there. Oh, you need this for that, this for that, this for that. You need...
Amol Nirgudkar (33:24.981)
Apparently you need 19 other technologies right now to run your DSO. And there that that's a frustration, right? So how do you choose technology that's going to help you grow the business and not be, you know, not be so suffocating to your team members, right? So one of the things that I talk to people about is that first and foremost, you have to pick technology that makes life easier, not harder. That makes the
Amol Nirgudkar (33:54.625)
people, your team members. If you're gonna give them another thing to do, and it's gonna burden them with more tasks to do, then first of all, it's not gonna be adopted. People are not gonna use it, right? So you have to figure out what technology are out there that are helping you consolidate things into a smaller amount of solutions. You cannot do one solution for everything. It's just not out there, right? But instead of 19 solutions, can you use 10?
Amol Nirgudkar (34:21.897)
Are there technologies that allow you to consolidate the tech stack that are gonna help you so that you can focus on things, right? You also wanna focus on technologies that are gonna give you insight and foresight, not just hindsight. So that are gonna give you things to do, not just loads and loads and loads of KPIs. Nobody cares about them. The more KPIs you see, the more blind you get to all the information and then you ignore everything. So...
Amol Nirgudkar (34:49.517)
Who's gonna give you what technology is gonna give you the insight and force out in the tools to act upon. If somebody canceled, I wanna fill that cancellation. If somebody didn't book, I wanna rebook them. If somebody didn't accept treatment, I wanna diagnose them better. I want the time is important. People don't have time and we wanna be able to save time. And so we want technologies that are gonna give us more time and that are gonna help us develop insight.
Amol Nirgudkar (35:19.277)
First, we wanna consolidate the stack into a smaller stack so that we can focus on using those things, otherwise not focusing on anything. Second, we wanna be able to give them insight and foresight and give them the tools, just the right tools to help them do their jobs better. The third thing is that many DSOs struggle with. It's easy to, technology is easy to buy, but it's not easy to operationalize, right?
Amol Nirgudkar (35:47.253)
So you need to figure out who, not how, right? The famous Dan Sullivan quote. Who, not how? Like, how are we gonna empower leadership within the organization for change management? How are we going to adopt technology where people actually buy into the idea that hey, this is gonna help? Who? The most important person to help in dental business is the patient, right? That's the most important person we're trying to help here. We're trying to get them to better health.
Amol Nirgudkar (36:14.749)
And as long as all of us strive very hard to get that patient in the door and get them to their optimal oral health and overall health, we're all winning. We don't have to worry about EBITDAs and valuations and none of that stuff. What matters is are we empowering the society to become healthier? And so how do we operationalize that? Happens through leadership. Happens through the concept of who, not how. Who do we empower? Who do we make the champion of that person?
Amol Nirgudkar (36:43.497)
in the organization that can take the bull by its horns, convince people that this is the right thing, get the change management happening at the DSO level. And there is some good thinking around that. We have failed many, many times, Alec, over the last seven years in figuring out the change management piece. And we very, very, very much have focused our last two years in thinking like, hey, we're dealing with people. This is a people business. And this, you can't just...
Amol Nirgudkar (37:09.965)
fly by night, oh, I got this fancy AI, nobody cares. What people care about is their problems. And then we have to solve their problems. We have to get the team members to understand that this is solving their problem. This is reducing the amount of work that they don't like to do. And operationalizing this is big. If you can't operationalize any of this stuff, no matter how cool it is, you can, you know.
Amol Nirgudkar (37:37.473)
build the next bot that's gonna do dentistry on it. Nobody cares about that. People care about their problems. People care about their teams. People care about their retention. People care about their own jobs. And we have to make sure, as technology companies in this space, we have to make sure we help these DSOs and dental practices adopt this in a way that it's going to make an impact and it's not going to create more aversion to like, oh my God.
Amol Nirgudkar (38:06.937)
another thing to do, right? So that's, I think, are my last thoughts really is, is we gotta empower people to be leaders, and we gotta figure out how that leadership process is gonna work in the organization so that we can adopt this technology in a way that it's going to empower everybody to be their best selves, improve the patient experience, grow your practice, top line and bottom line, and really help you.
Amol Nirgudkar (38:34.593)
do your most important job is to serve your patients and to get them to the best health possible. And if we have done that as dentistry, then we have all won, regardless of our EBITDA or regardless of the valuation that we're gonna eventually be at.
The dental industry has undergone significant changes in recent years, especially in the wake of the COVID-19 pandemic. As the market matures, dental service organizations (DSOs) are constantly striving to achieve their goals and stay ahead of the competition. In this episode of How I Grew My Practice, we will explore the top strategies shared by Amol Nirgudkar, an industry expert and CEO of Patient Prism, and discuss how technology is enabling DSOs to achieve patient growth, reduce costs, improve capacity, recruit and retain staff, and gain valuable insights for future success.
Improving Practice Capacity
DSOs face the challenge of meeting patient demands within the constraints of their current capacity. With high patient expectations and limited availability, practices must find creative ways to increase capacity. Amol Nirgudkar highlights the importance of reducing wait times and days booked out, as patients today have little patience and prefer immediate access to dental services. By addressing this issue, DSOs can minimize no-shows and cancellations while enhancing the patient experience.
Prioritize Recruitment and Retention
“Recruitment and retention is a huge deal. There's a shortage of doctors and hygienists, but there's also a shortage of assistants and the front office. So recruiting the right people and retaining them is a very big goal for DSOs,” says Amol.
The industry is projected to experience a shortage until at least 2026 or 2027, with 39% of front office staff looking for new jobs, so it’s crucial for DSOs to attract and retain the right talent and leverage technology to make your staff’s job easier and more fulfilled.
Leveraging Technology for Growth and Efficiency
Technology plays a vital role in enabling DSOs to achieve their goals. Amol Nirgudkar highlights several ways technology can support growth, including targeted patient marketing, conversion optimization, and enhancing the patient journey.
“In terms of growth, the first way technology is helping is figuring out how to properly market to the right patients. Technology is being used to make sure all those people who are calling are actually booking an appointment and understanding those kind of conversations and making sure that every patient is moving forward in their journey," says Amol.
Advanced marketing technologies help identify the right patient demographics and optimize digital campaigns to attract the ideal patients. Additionally, technology streamlines revenue cycle management, collections, and insurance processes, reducing human-centric inefficiencies and improving cash flow.
The Importance of Data for DSOs
DSOs face the challenge of processing vast amounts of data and transforming it into actionable insights. Amol Nirgudkar emphasizes the importance of converting information into insight and foresight. DSOs must analyze data to understand why certain events occurred, identify preventable issues, and replicate successful outcomes. By leveraging technology and data analysis, DSOs can make more informed decisions, enhance operational efficiency, and achieve predictable growth.
Simply Having AI Technology Isn’t Enough
Amol emphasizes that simply having advanced AI technology is not enough. What matters more is how AI can address and solve real problems that people face. The focus should be on ensuring that team members understand how AI can effectively solve their problems and alleviate their workload.
Conclusion
As the dental industry evolves, dental service organizations must adapt and implement effective strategies to achieve their goals. Amol Nirgudkar's insights shed light on the top priorities for DSOs in 2023, including same-store organic growth, improving capacity, recruitment and retention, leveraging technology, and converting information into insight and foresight. By adopting these strategies and embracing technological advancements, DSOs can thrive in a competitive market and provide exceptional patient experiences.
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