SPG with Dave Salciccioli

Welcome back to the SPG podcast. I'm your host, Alex Sharp. And with me today is someone that I have been wanting to get on this podcast for a long time. I feel like my intro to all of these is pretty similar where I talk about how it's a special episode and all these episodes are special. But this person is the first non dentist on the show. I believe fact checkers will have to go back and fact check me on that. But I'm pretty sure this is the first time we've

had a non dentist on the SPG pod. And with me today is Mr. Dave Sousch acholi. Dave, how's it going man? I am doing great. I'm happy to join this morning. Hopefully the first non doctor on the pod will see. I think I think you are with with that intro, you better be. So Dave, Dave and I go back pretty far in in SPG time anyway. And the story with Dave and and how he came to be at

SPG, I think is one that's that's worth focusing on on the SPG pod. Because Dave and I first had our paths cross at Dykama, a big DSO conference back in 2023, where I saw Dave on stage, he was posting a panel. And I listened to what Dave was talking about the subject matter. And I thought, okay, this guy's sharp is a tack. And I have I filed that away in my brain. And then the next year, I was at a different event. And Dave was at the same event, same venue, different event. And

I saw Dave sitting in a coffee shop, like working on his laptop. And I said, okay, I'm gonna be creepy. And I'm just gonna go talk to him because I remember him from the panel from last year. And I just want to get his perspective on stuff and make a connection. And we ended up sitting there and trading war stories for about two hours, like the the events were happening, the there were other speakers, there were other things happening. But we ended up just sharing notes and looking at

his Monday board. And and we we connected at that time. And it was it was pretty obvious to me that Dave was a special talent. He he had come to dentistry in a very interesting way that we'll get into. But it was at that moment that I realized that man, SPG would be way better off. If if Dave joins us, than if Dave never joined us. So Dave with with that intro, I'd love to hear because again, I would consider you to have a non traditional dental background. Some people start in dentistry, and

that's all they know, they eat, sleep and breathe it. But you had a different path to dentistry. So tell me, how did you come to dentistry in the first place? Yeah, it's a great question. I I'll start though by saying I think I remembered it differently. I think I was the creepy one who was like, Hey, you're Alex, right? Can we talk about SPG? So that's how I remembered it. So you know, who who's to know what story is? Whatever you want to tell yourself,

Dave, whatever you want to do yourself. Yeah. So, Alex, I'll go way back. That, you know, being apart, being in the business world of DSOs was never in my estimation, you know, when I was going through college and thinking about a career. So, and I think that's probably, you know, that's true for many. Certainly those who are dentists are like, you know, a lot of them have a lot of clarity. This is where I want to go. This is how I see my future. But I'll go all

the way back in that I grew up a pastor's kid in the church. And so that's that was like what I had in my vision was I was going to be a pastor. My dad was a pastor. So I actually went to school in Seattle. And that's what I went to school for was biblical theology. Met my now wife and she was a teaching major. And so kind of shifted my, my thinking to, well, what if I, what if we went into teaching? What kind of do the, the dual teaching thing will have summers off with our kids, maybe

we'll teach overseas or whatever it is, right? So that was kind of like the next iteration of our vision. So got married before I finished college, we came back to Bend, Oregon, where I now live and we were sort of like, all right, what are we, what are we going to do now? This is, you know, pre kids. And my aunt, who was a principal out at a neighboring school district, had this job and she was like, Hey, I think you'd be great at it. I hadn't done any teaching credentials

yet or anything like that. So it was actually a grant funded position under Obama had this initiative called 21st century schools. And so it was a grant funded position where essentially, I was creating a lot of programs for, for kids who needed additional remediation or for, for Spanish families who needed parenting classes or school based health centers. So it was like, we were kind of trying to help, you know, some folks within the community, but by using this

school as kind of a central hub for it. So kind of a cool model. So through that, I really enjoyed the school context. And so I went back and got a master's in teaching. And then I taught in the public system for five years, taught middle school high school a little bit, did a lot of coaching, did everything I could to try to make ends meet, realized that 11 year old boys are the worst thing on the planet. Sorry for any of you who have them, I'll have one of those two too. But yeah,

middle school boys are rough. And more than that, my dad had transitioned out of pastoring into starting a coaching company. And he still operates. It's called Coach Well, and really moved into this one on one executive coaching space. And so at the time, one of the offerings that he had was, he was doing a lot of like CEO mastermind events, which had a lot of like teaching and

facilitation and kind of curriculum design components. And I was trying to find additional ways to sort of make ends meet as a, you know, we had had our first kid at that point, my daughter Scout, who's now 10. And we were, so I was just looking for anything that I couldn't to kind of make those ends meet. So I asked him if I could help both facilitate and design the weekends and the curriculum around these events. And so we did a couple of them with his CEO clients, really, really fun.

Jackson Hole, Laguna B, we did one in Scottsdale. And so over a period of like, I think it was about a year, I did three of these events. And I would just tell, I would be like, Oh, I'm, I gotta take my PTO. And I would go do these events for my dad. And it was a really, really fun experience. So that was kind of like my first entrance into like out of teaching and into the business world. So long winding path, hopefully that's not too long winded Alex to kind of describe that. And then I

can do the second part. Yeah, that was perfect. And I think it's interesting, the parallels between teaching and leadership. Because when you think about it, if you're teaching in a typical classroom setting, be it public or private schools, you still have the captive audience that you're trying to

relay a message to. And I think that that skill set, that knowledge base and even going further back into the pastoral activities, you're leading a congregation, you're imparting a message, you're trying to drive some type of recognition or grasping of material that didn't exist before you had the conversation or before you taught the lessons. And so I think all of those things are pretty interrelated. So to me, it may not be as big a jump as you think it is just from my perspective

outside looking in. And the part that I'm that I want to hear more about is I know that in the course of working with your dad in that environment, in the CEO development leadership environment, that's where you started having some dentists as clients. And I think that was the first foray into dentistry, or at least into your recognition of dentistry as a viable career path,

if I'm remembering right. Yeah, yeah, you've got it. And I would say, you know, it was really kind of two core pieces that I when I think about like the teaching and the ministry route for me that I bring into my current day, like you said, one of them is the ministry route for me because I was primarily like interested in like youth ministry and some more of that is like definitely, you know, you guys will get a sense that like a heart for service and for serving people. Like, that's a core

part that I would sort of claim as part of who I am. And I think that that impacted me in that way, certainly working with kids and, you know, underserved communities on that first role. But then what the teaching aspect do big things that come out of that. One of the things that you learn a lot is, you know, backwards design. And so what are the standards you're trying to teach somebody? And then you basically design your entire year day by day by day to make sure

that you're hitting those teaching standards, right? And so you can, you can see now working with me a little bit Alex, like that, that's how I think about everything. Everything is begin with the end in mind. Where are we trying to head? What's the ideal future vision? What's the ideal state of this process or this company? And then we backwards design all the steps to get there. And so that was like a huge component, I think that teaching brought in for me. I'm in addition to

refining my skills of presenting information, engaging people, all those sorts of things. But those two pieces are really key for me. So transitioning over, I did those three events and I was like, okay, I'm sold that I don't want to teach anymore. How do I make a transition? And so I left teaching. I came on with him in a kind of a business development role, I guess you could say.

And started doing some initial coaching with clients. But it was more like I was developing, I was looking for more companies to do consulting and coaching with. And so one of the first contracts that we actually landed into was a two event teaching contract or facilitation contract with the DEO, dental entrepreneurs organization. And so member group of a lot of doctors who are trying to build an emerging group, they might have one or

two practices or some of them had three. But like, what is that next step in terms of building it, their own DSO regionally. And so spoken an event in Philadelphia and one in Portland, kind of like 2018-19. And that's where I really got thrust into the the DSO world. That first event in Philadelphia, actually, there were some like the four guys who started guardian dental partners, they were just disparate guys there. And they were meeting at tables. And I met a

lot of them, like their whole DSO was hatched at that event, essentially. And there were a bunch of other kind of stories that came out of some of those DBO events. But that's where I kind of got my first thrust into this DSO space and learning about dentistry as a business. So at the time, I was also starting to transition out of like doing Biz Dev. I was like, I was like, oh, I actually want to work within companies. I want to learn this. I really like to tackle sort

of the next challenge or learn the next thing. And so I got embedded also with Kukko and Kbar Knives, which is a they're a family owned company out of New York, amazing family, the Stitt family. And so that was kind of one of my dad's legacy clients. And so he I got embedded there, spent a lot of time doing manager like leadership development,

doing a lot of process mapping and change leadership there for them. So I spent about a couple of years there, well, in addition to getting more deeply involved in DSO space. To kind of wrap up that journey, I ended up with that client who I met at that Philadelphia event his name is Dr. Jimmy Gardner. If he said his name, you wouldn't be able to know what his name is as his Southern accent is so thick. But just an incredible guy in Northern Alabama,

he had three practices at the time. And he said, you know, he had enough self awareness, which, you know, not a lot of doctors do at this point to say, you're doing I'm the doctor. I need somebody to run the organization. I know where my best value is. I'm good at leadership and inspiring, but I'm not a systems guy. I'm not a process guy. And I really want somebody to take that on. And so he asked if I would come on as a fractional executive

to help him do that. And so over the next three and a half ish four years, we went from three practices to 10 and formed a regional DSO. And that's what I've just recently exited out of to be able to join SPG. So that's the, how long do we take 12 minute answer to get us from, you know, childhood to this moment? Well, see, I love that you went into that level of depth. Usually it's me yammering. And the listenership appreciates the change of pace.

Okay, so I'd have to ask several follow up questions here, but I'll pick the one that seems the most pressing. What was the hardest part of leading the charge as a fractional executive in that group in Alabama? Because a lot of your time with that group was either during COVID or immediately after COVID when the notion of remote work was just coming to fruition and really just

coming into fog. So how did you from Bend, Oregon, do so much leadership development and and so and leave your imprint so clearly on that group in Alabama from a continent away? Yeah. Yeah, it's such a great question because I have so many lessons that I've learned there. And you know, if I think I told you this when we were first talking about this role, Alex, like if if this role had come up four years ago, I would have been like, no, like I'm not.

I'm not your best pick for that role. But but the last four years of experience in this really challenging environment, like you said, sort of tail end of COVID or right through it, post COVID, all this, all the challenges there really helped prepare me for for what I can do now and what I believe I can can do in terms of having strengths to be able to lean into SPG. So a couple lessons,

I would say, you know, first of all, you have to, there's a it's a it's a small community. And when I say like, mall, southern community, like, I didn't understand what that meant coming from the west, right? I'm like, you know, like there's, yeah, like there's another there's another community called Redmond, which is like 15 minutes away. I would consider that part of Bend, right? Like, I have no problem driving there. I know people from there, but like, in northern Alabama, it's

like literally people don't cross the river. Like we don't talk to those people across the river in muscle shoals. And we're here 10 minutes away. I'm like, field in McCoy stuff, right? Oh, yeah, wild. And each little township has its own governor and its own school system. I mean, it's still very much that way where it was. So I had to really, the biggest hurdle I think to face initially was just like, who's this outsider, right?

Who's this guy from Oregon? What's he gonna do? And he gonna come in and just fire us all? Are they gonna change everything? And so the skill set there that I think really helped is, I've always been naturally good at connecting with people. But I think I really had to grow that side in terms of like, how do you connect with people to build trust? Everything moves at the speed of trust. And so if people can't trust you, then you can't implement any more changes.

You can't help leverage their skill sets towards a better future vision of the organization. And so I really had to overcome that first barrier of like, who's this outsider? What is he gonna do? And how do I build trust quickly with people to be able to do that? And so that really refined sort of how I think about building relationships and how important relationships are to being able to do really, really positive work together. Because consultants in the space always get a bad

rap. They're like, come in, tell you everything that you're doing wrong. Come in as the Axeman and Ax people, because the founder doesn't want to do it. And then we move forward. But that wasn't the approach that I wanted to take. And certainly one that I didn't have to take because I took a much more relational build trust, build goodwill with them first, and then bring them in as part of the change rather than me just sort of forcing it upon them. So that's one lesson I think that I

would highlight. And the forcing change thing only works in specific settings. And what I mean by that is when you want to superimpose your own playbook over an existing company, the company almost has to have a certain level of scale, a certain level of development already having already having happened. And then you have to be the type of company that is

poised to receive that super imposition of that structure, if that makes sense. And so like in dentistry, I think about the traditional DSO model of like, we're gonna buy a bunch of practices, we're gonna put them under one umbrella, we're gonna retrofit our best practices over those existing ways of operating. And it that type of thinking doesn't really work in a de novo model, especially a practice that's a younger company that's a younger de novo model like SPG, where we

have pretty unique, uncommon way of doing stuff. And we're still very much discovering the best way of operating, which I think is, I don't want to put words in your mouth, but I think that's one thing that attracted you to the company is the fact that there's still so much development yet to do, and so much yet to discover about what's the best thing to do in a given day, month, and year. And that leads me to my next question, which is, in the course of our conversations,

from Q1 of 2024 on through Q2, Q3, what made you choose to come to SPG? What about the inflection point that you reached in your career made you think, you know what, this is the right

company for me to choose to work with at the right time? Yeah. Yeah, so what's December 16? So I think officially to start my third full week with SPG, we did some initial work in November, obviously, getting to know individuals, which goes back to that lesson that I learned with with Jimmy as well as like, start slow, build relationship, get to understand and have empathy for where people are, what are

their greatest strengths, what are their challenges? So that's some of the work that we did in November, and I know it's not super pertinent, but I was just for the listeners, I had asked Alex and Matt and founders, hey, this is all I want to do in November. I want to have as much one-on-one conversation as I can to really understand people's perspective on the company and their own unique place where they sit on the bus. And I think it's made for a really, really positive start.

And so I just, that was one of the lessons, I think, kind of linking those to your first question, that I've really learned in terms of, if you're going to come in and implement change, it's all about having those one-on-one relationships to be able to leverage those towards the future. So

thank you for allowing me to do that. So yeah, coming in third week. So if I think back, you know, when I, my experience with the DSO space and to broaden it just a little bit alongside working with Dr. Jimmy Gardner, you know, learned a lot in terms of acquisition and de novo builds, building out the DSO structure, you know, we went through all of those changes together. And, but I also got to consult with some other, like other startup groups and got exposed to

some even broader scale within the industry. And so there's a couple of things that I think attracted me to SPG. One I would say is as DSOs grow, there becomes a larger gap between the clinical side and the business side of dentistry. And so having dentist founders is a value for

any DSO. I think that, you know, if you go back 20 years and I've been able to like kind of hear retrospective on the DSO industry, I wasn't around 20 years ago, but you know, those first iterations were very, they were finance guys coming in saying, how do I squeeze the blood out of the turnip of this? And I'm going to create and they created very adversarial relationships with their doctors. And unfortunately, some of that has sort of carried over right in terms of

now that people think about DSOs, what does that look like? But what where I love where the industry has shifted is to say, you know, actually, how do we create an incredible experience for our doctors? How do we make this the kind of dentistry they've always wanted to do? How do we provide financial opportunities for them that they wouldn't be able to have otherwise? How do we help them be part of a community where when they're struggling, they can learn from

other dentists? How do they get that mentorship? Because as you and I know, Alex, the kind of the kind of skill set of dentists coming straight out of dental school is, I mean, it's as wide as it's the biggest gap you could ever imagine. You know, some are coming out never having placed a ground at all. And some are coming out having done 100, right? And so you have this

massive gap. And so I just heard from you specifically, because I had talked mostly from you, but you know, and then had some time with the other founders, we want this to be an incredible place for a dentist to do the kind of dentistry they want, to have an incredible financial outcome for themselves as they grow with us, right? And to do it the right way with

clinical mentorship, with a lot of development. And so I think that any DSO that's trying to grow that doesn't have a really strong clinical component, which many of them don't, are going to struggle because we have to close the gap between the clinical side and the business side and make sure that those two things are aligned in a really, really strong way. So that's, I think for me, that's a big deal, because I didn't see that. I haven't seen that

across the spectrum in terms of DSOs. And that's a great point, because I've spent a lot of time this past year, year and a half networking in the space, hearing about how other companies operate, what are the strengths, what are the pain points? And it's really hard to overcome what you just said, because you can't fake what you just said when it's a dentist found founder led dentist led company. There are certain blind spots that you just don't have that you would have in other

companies that aren't dentist led or founder led. And we're not perfect, obviously. But there are certain things that I feel like are hardwired into our DNA as a result of having dentist founders and being run and operated by, by dentist founders. So that's, that's a key point. And I think that that is more of an attractant for people than even I realize sometimes because people, people

join us because they know that we're built by dentists for dentists. And one of my common things that I say on recruitment calls or throughout, you know, just talking to dentists that we get to work with is that we wanted to build the company that we wished we would have had to employ us out of school. Because most of us had to ping pong around to crappy associate jobs where, you know, things weren't done fairly or we experienced multiple pain points that plague new grads

historically out of school. And we wanted to solve for as many of those as possible. And so to your point earlier, you talked about wanting to crystallize in your brain, what the end goal is and then build systems and processes to get you there. Yeah, that's what we started out with is wanting to engineer the best type of

dentistry, the best position for people to thrive in. And it just so happens that it's this really compelling style of dentistry that hasn't been made ubiquitous in the marketplace.

When we say that we wouldn't democratize the fixed arch, there's several layers to that. But on the most visceral, I guess, easily understandable layer of that is we want to increase access in the US to this type of dentistry beyond just the major metros and beyond the really, really challenging price point that this type of dentistry tends to be offered at. And so doing this style of dentistry with really surgically inclined, highly trained GP dentists

is a fresh perspective. It's something that hasn't been done, really, in all reality. So what excites you about building a company like this that's going in a fresh new direction?

And I'll say as a quick plug, whenever we talk to new dentists that are looking at joining the company or specifically at the intro to all on four course that you attended a month and a half ago, talking to those dentists that love surgery that want to really dial in their focus on surgery fixed, it's really, really hard to be excellent and multiple things.

And you saw that in the GP realm. You saw that when I tried to be the jack of all trades, you end up being the master of none, you're beholden to insurance contracts, you're just trying to keep all these different plates spinning. Whereas sometimes there's a lot of liberation to be had in putting on blinders and just saying, this is what I want to do.

This is what I want to focus on. This is how the patients can be the recipients of the most amount of value for what they pay us is by just nitching out and being relentlessly focused about being the best denture and implant DSO in the country. That's our goal. And so what speaks to you about that mission rather than jettling and trying to be all things to all people in the GP realm? Yeah, it's a great question. To your point, we had a doctor in the Alabama group that

wanted to do this type of dentistry. Amazing, surgically inclined, places tons of implants, very skilled. But within the traditional GP model, there's just no way to do it at the same scale that we're trying to do it now. You can try to carve out three, four hours for surgery on a Friday or whatever. But it's all the other systems related to it too. And it's also the confidence coming with like, if I'm doing a couple of arches every couple months, how do I

really build the confidence around this particular procedure? And so I saw the struggle there with he wanted to move in that direction. But you're also checking three rows of hygiene and you're doing everything else on top of it. So now I will say that we were able to get him to do a lot of that because being a part of a group can help because you can refer out the other root canals or other things. And so he definitely have to do more of that type of dentistry than he wanted

to, but or then he would normally be able to. But being able to do this type of dentistry, it really takes a hyper focus on this model. And so a couple of things that I think attracted me

to the space, I love, done a lot of insurance negotiation, worked in that space. I have very strong opinions about that we can have another whole podcast on about what insurance has essentially created for providers in terms of we take on all the credit risk as a business, we take it on all the responsibility of being collecting money and it puts us in a weird place. Right. So I understand it from the access side, but I definitely think that when I look out at the

future, there's a couple sort of converging streams I got me excited about SPG. One is lots and lots of dentists are trying to move away from insurance dependency, reducing insurance dependency as much as they possibly can. And I think patients are starting to really understand that in many ways, insurance is not what's best for them either. And so I think there's going to be a lot that happens in the next five, 10 years. That's a huge, you know, rural Caribbean cruise

ship that you can't turn around very easily. But I think we'll start to see some of that in the future when we look way out. I also think I love this, you know, when I look at the transformations when somebody goes from, you know, I get to see them now more, which is awesome, you know, where they get, you know, full double arch. And hearing their experience with it, being able to have their confidence back, being able to eat things that they haven't eaten in years, like,

that's an incredible mission to be able to rally around. And so I'm excited, you know, that's something that I can get behind 100%. Right. And I think our teams and our doctors can as well. No, obviously that treatment's not for everybody. And it's other things that we can do in the practices as well. But that's, it's such an incredible life changing procedure. It's a little bit different than, you know, I'm doing pro fees all day, right? It's a little bit different focus

there. We can talk about oral health in general, but it's such an incredible procedure. So I think, yeah, I think a couple of things led me to SPG, but I like the mission that you guys are on and loved hearing about that. And I think the last thing I would say is the company, like you said, is early enough that, you know, I've used this analogy before, it's like wet concrete, right? We

we know that the model works. You guys have proven from proof of concept from all your hustle over the past couple of years that this model works that we can have incredible outcomes for patients that doctors can really thrive in this model. But now it's time to, you know, kind of put some additional fingerprints on it. And you guys have been open to what are the systems and processes that we really need to be building and thinking about to get us from, you know, 38 to 68 to 98.

Like what are those things that allow us to be built to scale? And those were really exciting conversations for me and part of what what led me into this too is, you know, I love that the clinical side to my point number one, that that you've got clinical, a strong clinical side of

the organization. You I love the mission of democratizing the full arch. But also I love the willingness and the change readiness that you found just presented in like, no, we want to we want to continue to grow, we want to see things advanced, we want to build new systems so that we can scale. And so that's what gets me excited because I wouldn't join an organization where it was like, Hey, this is your, you know, kind of plug you in. This is this is your role, like,

we're not going to change anything, just kind of do the same thing day over day. That's, you know, I'm much more like I want to see things advance and continuously improve. And so that feeling that that core value was actually lived out every day. And now seeing that that in action really wanted me to inspire me to want to join the group as well. So I think it's those three things that are exciting. Well, it helps when we're democratizing implant dentistry rather than trying to democratize

the interproximal filling, right? It's a lot fun to do this scope and scale of dentistry for people. Because for me, a pain point in dentistry, just being completely open and honest, has been the resistance that the average dental patient feels to just being there in the first place. Because in a dental office, it's just so adversarial and so negative in general in most cases, because people are there, nothing personal, but I hate the dentist. Like if I had a nickel for

every time I heard that in my career, oh, yeah, yeah, it'll be be retired. But it's a different angle of approach when you're rendering a service that patients seek you out for. Because when you're in the GP realm, when you're in the traditional practice where you're doing trophies and crowns and fillings and root canals and single extractions and stuff, patients feel like you're

highlighting needs that they don't necessarily identify with. It's subtle, but it's true. And so when you're doing the normal garden variety, insurance participation, PPO practice, yeah, you can do this type of dentistry, but it's an uphill battle, because you're having to highlight the need, build the value, get the patient over the finish line. So it's really hard to do

any more than like two orches a month. If you're lucky, like that's the point that I got to, it was like one to two orches a month, and it's hard to be excellent at anything doing it once or twice a month. Because when it's here, the joke that we talked about at the Central Team retreat was like we're not having to necessarily go out and rope people into coming into our

practices because they self-identify. They don't always self-identify perfectly correctly, but we have a lot of people that come in knowing that their credentials are knowing that they have a terminal dentition or knowing that what they currently have isn't meaning their needs aesthetically or functionally. Therefore, they know that doing implants or dentures is the right way

to go. So that's a subtle but important distinction when we're thinking about our model, because patients are self-selecting in, rather than us having to scour an existing patient base for opportunities to do the care that we provide. Another question I have for you, Dave, is you obviously identified SPG as a great company to align with, to join, to maximize your own impact in your career. You've joined us, and like you said, effectively two weeks ago now, you joined us as the VP of

Operations at SPG. In your time being with us part-time in November and then full-time to this point in December, what has that role meant to you? How do you see you being able to influence the company through that role as VP of Ops? Great time, take a drink of my coffee. So basically whatever Matt Greeno tells me to do, no, I'm just kidding. But Matt G and I have had a great partnership. I so appreciate his institutional knowledge on everything that's happened, the nuances of the

business. So I think just to the side point in the first couple of weeks, it's just been a lot of drinking from a fire hose and really learning how does the organization operate currently and nuances around the industry. Because again, it's very different than general. In some ways, I love the challenge of it's a real business that we actually have to put time into sales and marketing. GP is very different. And I'm not throwing shade at the GP model.

It's such a good way to put it. I'll shut up, but that's such a good way to characterize because it's like a fake business because you don't have to worry about recruiting people to come and receive your care. Like they just happened because you're marketing through insurance participation. So people don't think that insurance participation is a marketing expense because you have that deep, deep insurance discount that you pay through the nose for,

whether you realize or not. And so you're kind of cheating. You're playing the game on easy mode. That's such a good option. I'll shut up now. No, it's totally different. And I mean, we can go down that tangent for just a second. One of the ways that I helped our org feel better about how much we are being undercut by insurance was I just characterized it as marketing spend. And then we just built it into the cost per acquisition of patient, right? Because that's

essentially what it's doing for us. It's you're an in-network provider, but it made us feel better when it was like, hey, we're getting 43% of the amount of ground. So what's that gap between that and our UCR? That's essentially marketing spend. That's how we have to think about it. You cry when you look at it. Yeah. Yeah. But it helps to soften it a little bit. But that essentially is what you're paying for in many ways, right? You're paying for

that. That's your marketing spend because you don't really have to do a whole lot otherwise. I mean, obviously be involved in the community and do SEO work, but it's not to the same scale of general market awareness that we have to do within this space and driving people to understand the benefit of of arch and the other treatments that we can do, right? So I think it's a good distinction. I like the challenge of that, though. I think it really operates like a true business

within the dental space, which is exciting. Okay. So a couple of things that I think about in the first couple of weeks. So essentially, as I think about the role as it's developing for me, I'm a support for everything that's happening in the operation space. But really where I want to be able to put a lot of emphasis is what is the relationship between doctors and practice level

and central team? And I want to help make those processes, those communications, that leadership from between those two practices as effective, as seamless, and as enjoyable as possible. Because we, the RM's who are now my team or part of my team, we exist to serve the doctors and our team members at the practice level, right? So that you can serve the patients as you engage them in this process. So it's that value stream that I think we need to be, that I'm really excited

about, that I want to be focused on. So how do we identify where the breakdown in communication is between the practice level and the RM's and central team, they're, they're, you know, an extension and make those processes as effective, as seamless, and as enjoyable as possible. Because if we can do that, then we can scale to a greater level, then we can have greater impact, then we can democratize the full arch more. And so that's what I'm really hyper focused on right now,

is, you know, being in support of sort of operations on the whole. But also, I really want to see, especially with a remote company, how do we do that really, really well in a digital environment to where our practices and doctors feel supported, their roles are clear, they're being placed in the best possible position from a training and development standpoint to just do incredible their job, right? So that we can maximize the amount of time that we're focused on our patients,

more patients doing the treatment that we know is, is life-changing for them. So that's kind of how I think about the role as it's developing. What speaks to you about that, that hokey visual that I developed where it's like the old Conestoga

wagon wheel, where it's SPG leadership, and then we have the central team as like the tire. And then we have the different spokes of the SPG central team, all orienting inwardly towards the core of the SPG doctors, because what you just described is what I've tried to encapsulate with that image, where we want our aspirational aim is to truly do exactly what you said, which is build such a robust central support infrastructure to where the value for the SPG docs is just

unassailable. And I think we're way closer to that than we ever have been. We have a lot of room for improvement, but our inclination and our orientation to me is in the right place, because that's truly what I wake up and endeavor to do every single day is to build a company worthy of our SPG docs. And I think we've gotten better as a unit in soliciting feedback and demonstrably visibly weaving that feedback into the changes that we've made. And you know, you being here is

honestly a part of that. But what do you see as being some of the things at SPG that you're excited about that we're already doing that you think is already a strength or a superpower, that you want to be sure that we amplify, because whenever whenever you make changes in a company, this is even this is even obvious at a single site, because I saw this firsthand when I bought my first practice and I saw that there was a readiness and a thirst for changes, because some people

wanted to keep the approach the same, but then other people saw immediate room for improvement, but you don't want to cut off your nose despite your face just to say we're making changes. So what are some of those things that you're like, Hey, these are some of the core elements of SPG that need to not only persist, but really be amplified and be given more of a front row seat,

more of a spotlight going into the future? Yeah, it's a it's a great question. To your point, your first question sort of around, you know, the you call it hokey, but maybe that's just

because it looks like a wagon wheel. But I think the visual is I think it's effective. Again, you know, sort of augmenting that the way that I've always thought about it as sort of the inverted or sharp pyramid, right, which is like, we know we're the smallest triangle there, and we exist to serve and support the the as a central team, the practice level, right, positions, as we're looking at, you know, those those front office roles, DAs, and then those are in support of the, you know,

the doctors and the doctors are supporting our ultimate goal, which is supporting patients in receiving treatment and being excited about the treatment they've received. So that's sort of another like sort of visual that I like to use, but but we have to live into that. There are so many DSOs again out there that it's like, you know, if you're a doctor with an idea, so you wouldn't

know you wouldn't be able to call the founder have any communication with the founder. I mean, the and the founder probably sits, you know, somewhere in an investment, you know, bank in New York or whatever it might be, right. So I think I think we, you know, keeping that connection and keeping that sense of we exist and to serve and support at all those layers, I think is really, really key. So so yeah, a couple of things that I think are are really exciting about what SPG

already has, and I'm excited to continue to lean into and amplify. I think the like to my first point, the clinical side of it, the the coaching, the mentorship, and not just coaching on the clinical side, right, we need that in terms of like, Hey, is this what's the candidacy for this patient? You know, let me look at the scans and act on and gets the borehole ideas on it, right, that's great. But also with like Derek's role in terms of like coaching, like, what does it mean

to wield influence effectively within the practice as a doctor with an SPG? Like, that's not easy. What do I own versus not own? And how do I be a really positive presence? Because I know they're looking up to me, but gosh, I'm like younger than everybody in my practice, right? There's a lot of nuances around what it means to be a really effective leader as a doctor within a practice.

And so I think I'm so happy that we're leaning into that piece. And I think still solving that equation and equipping our doctors to be incredible leaders as they grow in their own career. And as individuals, I'm super excited about that. And I love that that you guys have put emphasis on that and hired around that that particular sort of vertical that we want to bring to our practices. Yeah, directionally, we've definitely seen that that is a just a definite

benefit to leaning into. And again, are we perfect at having implemented that knowledge and that insight across the board everywhere? No, but that's one of the things that I'm most excited about for 2025. And in the same breath, when we were at the central team retreat, what was that 10 days ago? Ish? Yeah, nine days ago, we, you and I rolled out three big buckets, three, three large buckets that

can be translated and applied at every level of the company. And I think that those three buckets are really important for us to come back to time and time again, because we're going to, we already

introduced those on the doctor call, we introduced those to the central team. And if you don't mind, tell me about why we want to focus on those three buckets, because the three buckets in plain speak and plain English are number one, making sure that we are metrics driven, KPI driven, communicating well, and that we're adopting a philosophy around which we can unify in our efforts.

Bucket number two is that we want to make sure that we're pouring into our people that every single person in our company at all levels has a development path and has something resembling a curriculum to grow alongside. And then number three is really getting clear on what success looks like operationally. What are the things to focus on? What are the the measurements that

we're applying? Those are the three buckets. So Dave, tell me about why those buckets make sense to you and what you're excited about when rolling those out and getting more clarity on each of those in 2025. Yeah, I'm glad that you kind of walked over those three. So I think, you know, with my conversations that I was able to have in November, and then confirmed in the first couple of weeks in terms of getting underneath the hood and seeing everything that's happening,

being a part of meetings. And, you know, also some of the feedback from the employee engagement survey as well. Like I think these three initiatives, well, they may not capture everything that we're trying to do as an organization, because there's a lot of initiatives and a lot of change happening.

And, you know, I'll pause for just a second before I kind of lean into all three of them, but, you know, just to read or read again, what I guess what I was impressed with the support retreat or central team retreat is like, this is a team that that is all wants to see the same objective happen, right? So in terms of like alignment around mission, you know, everybody's all in. I mean, so many people who have lots of good ideas, very well intentioned wanting to see things grow,

wanting to see things improve. And the level of like, you know, going back to my former Alabama group, the level of like, who's the outsider and like, is, we don't really have an appetite for change right now, we don't have a lot of change readiness. Like, that's what I faced with the Alabama group. They're like, who's this guy? And I don't want to change at all, because that might mean I lose my job or whatever it is, right? All the fears come up. None of that. I didn't feel any

of that with this team. Any of my conversations will together as a team. We've changed so much, whether people want to do or not. Like we've stamped all that out. So in that way, some of that work have already been done. It's great. Thank you. So I think just like, that's already feel a lot of alignment and a lot of like, change readiness around where we're headed. So, yeah. So I think, you know, these three, the real objective around them, right? For the first one,

we want to increase alignment and execution across the organization. And so a couple of like real specific pieces is I've implemented some tool sets from EOS, which is a book called Entrepreneurial Operating System. I bet if I looked on your back there somewhere, it's gonna be an orange book. It's it's around. I know. It's a double use. I have it alphabetized by author. So I have,

yeah, right there. There you go. Okay. There's the whole set of them. All of them. Yeah. So I mean, it can get really complex, but essentially it's a model for how you take vision and translate it into strategy and then how do you translate strategy into tactics? And then how do you have those the implementation of those tactical things that you do feedback to your strategy, your vision, which implement or affects your strategy, which in turn, you know,

it affects your tactics. So it's kind of that cycle that that I'm really excited for us to be able to bring in. And we've already started some initial work on that in terms of how do we get hyper clear and communicate in a really clear way? What are we focused on for the next three months?

What are the initiatives that are happening? What are the actions? And what I hope to be able to do is to make sure that we communicate those ahead of time effectively so that our key stakeholders, doctors and others included would be able to say, awesome, like this is where we're headed this quarter. This is what the team is focused on. Here's the kind of things that we can expect. And so just increasing that sort of alignment and execution using US, I think will be a big piece

of this year. Anything you want to speak to there? Yeah, I can agree more. I think that's going to be a great starting point just to re-examine what's working about our communication flow because every company, you solicit feedback. And in some way, part of that feedback is going to be communication needs to improve. And there's a lot of layers to that piece of feedback. Like is it the quality of communication, the frequency of communication, what's contained within the communication is the

information, the right information at the right level. So all of those things, I think we can pretty immediately start to work on to improve. Because again, that's an example of something that's way better going into 2025 than it was going into 2024. We've improved, but it's still not where we want it to be. It's still not completely meeting our needs. I'm excited about that. The second one you already mentioned, which is around growing the team. And so some of the initial

thoughts around how do we use Paylocity for reviews? How do we build a really great system to help develop people and coach them into their highest level of performance? What kinds of training do we need for various roles? And how can we sequence that in a way, whether it's micro training, let's learning, or it's going to a key location to learn. So lots and lots of things there. But as we've seen with the doctor side, and we also need it for the rest of the individuals within

the practice is the higher the capacity of everybody within the practices. It's sort of a rising tide floats all boats. And so we want to make sure that from a leadership, acumen standpoint, people are equipped to be their best selves in that way, in addition to the technical skill set that's needed to complete the job. And so you can't have a practice without an incredible doctor, you can't have a practice without an incredible support team. We need both

of those. And so I think we've put a lot of initial thinking into what does that look like for 2025 and not going really lean into sort of bringing up and engaging people in a growth process, you know, over the next year. And that leads to bucket number three to me because you guys have operational excellence. You can't have consistency across the org if you don't don't first pour into and develop

your people because like it or not, dentistry is a service business. Every single dollar that we collected our practices comes from a service either being rendered or expected to be rendered. This is this is not a transactional type of business that we're in. This is not where we sell widgets. We don't ship stuff from a warehouse. Every single thing that we do requires people to do

it. Therefore, it stands to reason that the more developed and engaged and bought in, our people are the better that we perform and all of our practices because the phrase that I've used recently has been barbell. You see it across our company where historically we have some practices that thrive month over month. They've they figured it out. They work well together.

And on one side of the barbell, they they're just our consistent strong performers. And on the other side of the barbell for whatever reason, there's other practices that have struggled to get off the ground. They've they've struggled to launch. And so how do we democratize access to success just as we're democratizing access to the amazing care? And so that's why bucket number two matters in service of being consistently excellent across the org. Yeah. Yeah. I mean, I've said it before,

too. You just mentioned it like we are people working with people to work on people. And so it's the most people business out there, right? Because even the product itself is working with and on people. It's such a people intensive business. So to that point, I sort of think of it in three three ways. You know, we want to be able to create systems and processes that you know, borrowing market conditions, which we are affected to, right? Certainly.

To be able to have more consistent and more more consistent operations at all levels. So, you know, what are the systems and processes we have to refine to make sure that every practice, at least has the opportunity to be to have consistent growth and consistent operations month over month,

right? Big deal. How do we do that? How do we improve operations at the at the central team within how departments flow within how departments work together to make this the most cohesive service focused central team out there and leveraging a lot of technology to be able to stay lean and mean because you don't want this side, this apparatus of the DSO to just balloon as well, right? And so we have to keep that in check. So sort of central team operations, practice level operations.

But then there's the messy middle. What's happening in between those two, right? How does information flow back and forth? How does process flow back and forth? And so I really want to put emphasis in there as well. So in terms of like, how do we streamline operations between back and forth between those practices and the central team? And so I kind of think of it in those three three groups. Obviously, we've talked a lot about one of the technologies I've used a lot is

Monday.com. So you guys will get sick of hearing that. But I hope to prove to you. I hope to prove to you within the first couple of months of the new year, the value that it can have for us as a central team and as a practice level and really managing kind of that messy middle. So I think I think you guys will see that stay tuned put some trust in in that process. But I

think I think you'll see the value of it pretty quickly. And I think Monday will be a part of all three of these initiatives as sort of the engine that helps to drive a few different things that we're doing across those three areas. So Dave, I'm just so excited, more so than I can even communicate about all that we're going to be doing in 2025. And on behalf of the founders, on behalf of the central team, on behalf of our group of doctors, I just want to say officially,

welcome to SPG. Thank you for choosing us. And for for someone like you who had all the options in the world about about where to land and where to engage and where to provide value, you chose us. That's not lost on me. And I just want to really say thanks for the trust that you're putting in me and in us to help us further our progress towards our mission and in closing. What's your resolution for 2025? What's your what are your goals? Like do you have a fitness goal? Do you have anything

that you're going to put on the white board and say this is what I'm going to do in 2025? You do like 10 bar muscle ups uninterrupted? Oh my gosh, I don't know about bar muscle ups. My garage is a little low on my pull up bar. So my head might go through on a muscle up. I can certainly butterfly there. Yeah. So you know what I would say is for doctors who are listening. And I hope to have one on ones with each of you over time. So just reach out. David shared practices or

I'd love to love to grab some time with you. I've been able to meet a few of you. And obviously I spent a lot of time with the central team. But for any doc who wants to just discuss, get on the call and let me get to know you. I'd love that. So just email me. So resolutions, you know, when I think about goal setting and my my wife and I actually just got some time we took a weekend away and started to look at that. So we actually do.

We'll plan some family goals. And then we actually engage our kids and setting a few goals for their year. And so over the next couple of weeks when they hit Christmas break, we'll do like, hey, I was 2024. Like I look back with them. And you know, it's silly stuff like being able to swim underwater, right? And hold my breath. But like, we make a big deal of celebrating it. And they're all stoked on it. So they'll kind of set their own new goals, which is always fun. So three kids,

scout is 10, holdens eight, my son holding and then my daughter Lyla's four. And so we'll do that process with them, which is fun. But and then we kind of set some family goals and then individual goals. But for me, I think if I was to sort of have a word, and I think I said this in a call, but for me, I think 2025 is more about consistency over intensity. I've had a few very intense years of

like, go in heavy on this and travel a ton to Alabama and go here. And so now being able to really kind of settle into this role and for the rest of the org, like, I've pushed off all the other consulting and all the other things I've wound up all those things so that I can be hyper hyper

focused on this role and within SPG. And so I'm looking forward to like getting a little bit more focused on like, you say fitness like consistency day to day week to week in terms of fitness or in consistency in terms of connection with my kids and consistency and the best practices that I can do within my week and within within work here. So that's sort of where my head's at is like, I'm looking forward to that, having some, you know, being able to project forward what I'm doing for

the next year and then build some consistent rhythms that I think will be really, really helpful. So that's kind of where my head's at. I love that maximum consistency over intensity. That's such a great one, especially in our model, where we've seen high highs, low lows, it's hard to achieve

any kind of consistency in what the day feels like much less how the month goes. And so I think that consistency is going to be a great litmus test for effectiveness because the more consistent our performance is, the more implied mastery over the model, there is at a given location or for us or wide. So Dave, we're coming up on an hour. I know we each have a full day of meetings ahead of us. I just want to say thank you for for carving out the time to be with me on the SPG pod

and look forward to talking again soon. Yeah, thank you. Super fun. See you later.