← Becker’s Healthcare Podcast
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- [00:01]
A
Hello, this is Ariana Portolatten with the Becker's Dental and DSO Review podcast. I'm thrilled to be joined today by Ian McNichol, the CEO at Icon Dental Partners. Ian, thank you so much for being here today. It's great to have you.
- [00:12]
B
Yeah, thanks for having me. Excited to join you.
- [00:14]
A
Great. To start us off, can you introduce yourself for our listeners and tell us a little bit about your background?
- [00:20]
B
Yeah, I'd be happy to. My background's a little different. I didn't start in the dental industry. I actually began my career as a mechanical engineer. So I worked in the high tech industry for about 10 years and semiconductor manufacturing, pretty interesting stuff. But I kind of felt like I wanted to be an entrepreneur. So towards the end of that, I, I got an MBA from University of Washington, and about 20 years ago I quit my job and decided I'm just going to become an entrepreneur. And I've been building companies for the last 20 years and so got into the dental industry about 15 years ago. Originally co founded a dental marketing agency called WIO Media. And that company had done really well. And it's kind of still plugging along just fine. But about five years ago, I decided to get into the group space and so partnered up with one of my former clients, Dr. Jeremy Dixon, who's been in the group space for about 20 years himself. And yeah, we started kind of doing some DSO type consulting work for a few years. And then after a few years of that, we decided to build our own group. And so that's kind of how Icon got its start. Icon's a pretty unique group, but it's been a ton of fun. So that's kind of how I got into the group space.
- [01:35]
A
Very nice. It's always super interesting to hear from executives and even practitioners who sometimes have started off in other industries. What attracted you initially to the DSO field?
- [01:48]
B
Well, I like building companies and running companies. I like solving problems. I think that's probably the engineer brain in me. Um, but really it was the consulting with Jeremy. You know, I kind of started consulting with him originally just like, oh, I'm going to learn more about these, these groups. And this is back in 2018, you know, seven years ago when we started consulting together. And after a few years of that, you know, I just got to learning a lot more about the group space. And it's like, man, this is really interesting. I like dental, I like building companies. This just makes a lot of sense. And, you know, we spent a fair amount of time, you know, analyzing some of the weaknesses in a lot of the current DSO models. And so we spent a lot of time carefully thinking how do we change the model to address a lot of the shortcomings and then more of the corporate model. And so our partnership model is really much better for the doctors. And so, yeah, I just felt like, you know, we wanted to build a better mousetrap and I think we've done that. So, yeah, it was kind of a challenge that needed to be solved and so we set about to do it.
- [02:47]
A
Great. And I always like to ask this question when I speak to people who come from other backgrounds, but is there anything that you take from your experience in mechanical engineering into your work today, leading a dso?
- [03:00]
B
Oh, absolutely, yeah. I mean, obviously it's a very different world, you know, but the, the ability to kind of look at a situation and try to understand what are the different, you know, variables that are that are causing a problem here and how do we kind of break it down, you know, systematically and just figure out how do we solve this? And it's, you know, engineering is, we teach a lot of kaizen back in the day and that's become more popular in the business world now. But it's essentially a continuous improvement process. And so that philosophy applies to any kind of, whether it's a technical issue, a science issue or a people issue. It's the same kind of mindset. And so, you know, when you're, when you're running a dental group like I do, it's people, right? I mean, yes, processes of course matter, but it's really about the people. And so making sure that you're building the culture the right way and solving all these kind of challenges, technically and remote workforces and all kinds of things that we have nowadays with zoom and stuff like that, it's been a ton of fun. It just continues to challenge the problem solving side of my brain that I enjoy. So, yeah, it's been a lot of fun.
- [04:08]
A
Great to hear. Next question here. What are some of the biggest issues you're following in the dental industry this year?
- [04:16]
B
Yeah, there's been some pretty interesting stuff happening for sure. I think something that just was out of the blue that nobody saw coming was this. Delta Dental of Wisconsin acquisition of Cherry Tree Dental. That was pretty shocking. I'm still shocked about that. I'm really curious to see how that plays out in the courts and so forth, if that's allowed to stand. I think there's a fundamental conflict with an insurance company owning a dental group. I don't think that's great for Dentistry, but that's super interesting. I didn't see that coming. Also the current administration, you know, with the Medicaid cuts, that's, you know, a bit concerning and so we'll see how that plays out. The last thing we want to do is, is cut health care to low income people. I think that's the wrong way we should be going. So that's got me a little, you know, concerned checking that out. You know, staffing shortages is continuing to be a problem. It has been since COVID Obviously Covid made it worse. It's something, you know, we, we are always focusing on and struggling with, you know, in some of our practices. So that's, that's an issue. And then the other big issue that's not really an issue, but an opportunity I guess would be just this proliferation of all the new AI tools and services rolling out. It's just, it's just at a breakneck speed. It's kind of crazy how many new things are coming out and a lot of them are not well developed yet because AI is still in its infancy. But I mean, three to five years from now, I think the amount of things we can do with AI in this industry is going to be mind blowing.
- [05:45]
A
Okay, and some of the things you just mentioned might play into your next answer here. But I was curious to know what are you most excited about when it comes to dentistry right now and what makes you nervous about dentistry?
- [06:00]
B
I think what I'm most excited about would be the AI stuff. We are piloting four, four different AI technologies right now across icon, across our platform. And it's really interesting. The AI, it can relieve pain points both at the practice level and the platform level. And so we're looking at things to help with revenue cycle management and marketing and AI receptionist type services and insurance verification and eligibility checks and all. Just a lot of stuff that is not the sexy part of running a practice that the team members don't typically love to do. I think to the degree that these AI companies can continue to solve those problems, it's going to really help the practices and the platforms out quite a bit. Our philosophy is we're not trying to make them more productive so we can let people go back. We purposely structure our company so we have no control over the practice staffing, which gives the doctors that full control, you know, full autonomy at the staffing and clinical decision making and all that. What we want to do is let's take burden off of the team members shoulders, you know, so they can spend more time on patient care. Or doing recall or do, you know, having people do things that the technology can't do. Right. Let the tech do what the tech can do and let people focus on things that people are better at. And so I'm really excited to see how AI continues to solve some of the pain points, but also just making us all a lot more productive and ultimately more profitable. That's. That's a pretty cool thing that I think I'm excited about. I think probably most people would share that viewpoint, but with the AI coming on board nervous, I think the stuff that makes me the most nervous would be the economy a little bit. And related to that, like I said, the Medicaid cuts and just what happens with those types of things with insurance reimbursements going down constantly, those are not great things for the industry. Staffing, I think, just continues to be a bugger. I think associate doctors, getting them on board and training them up, that's a big thing. Just hygienists to a large degree continues to be a challenge. I think it would be great if the country can open more dental schools and more hygiene schools and more assisting schools. That will be super helpful. Those are the things that I guess would make me a little bit nervous that I'm keeping an eye on.
- [08:19]
A
Yeah, definitely. That's something I've heard from other dental leaders recently, is just there's no shortage of necessarily people who want to be hygienists or dentists, but maybe we're not producing as many as far as like the dental assisting and dental hygiene schools and then the dental schools overall. Is there anything that ICON is doing differently this year to help attract more hygienists and dentists?
- [08:47]
B
Yeah, that's a great question. I mean, it's something that I think every group is always noodling on and struggling with and testing things, you know. So, you know, our team, we've done a pretty good job of, you know, finding good candidates in. In general. But it's interesting as we look across the platform, you know, we. We have. Most of our practices are doing really well financially. They're growing. Their EBITDA's up, margin improvement, great stuff. The practices that are struggling are flat or down in revenue production, EBITDA and so forth. It's almost always been tied to shorting of associate doctor left, haven't been able to replace them. Hygienist left, haven't been able to replace them. When we look across our platform, the practices that are down or struggling a bit, it's almost always related to staffing and so, yeah, I mean, creative things that we've done to try to solve that problem. We have a pretty strong HR team. We call people and culture as hr. But yeah, I mean, you know, a lot of the typical stuff, right? Social media groups, reaching out, you know, personal people's personal networks. There's lots of different, I guess, strategies that we all use to try to get in front of doctors and stuff like that and hygienists, but I don't know that we've figured out anything new or innovative. We're just trying to execute really well on kind of a tried and true plan. So.
- [10:10]
A
All right, and last question here. What will the most effective healthcare leaders need to be successful in the next two to three years?
- [10:19]
B
I don't think that that really changes much, honestly, from past to future, it's really focusing on people and culture. I think that's always the secret sauce in any company. It doesn't really matter what kind of company you have. If you can do a good job on onboarding the right people that fit your culture and then making sure you're doing things to maintain the culture, definitely process matters and having good management systems matter and all these things are super important. But if I had to rank them, you know, if you don't get the culture right, it's going to make everything else more challenging. We just came off of an executive retreat this week and we had, you know, our, our directors, VPs and C suite all together for the week, and it was just an awesome experience. We try to do it once a quarter and it's just, it's, it's a really critical ingredient because, you know, with most companies now, we have remote workforces. And if you stay fully remote and don't ever really get to connect with your coworkers and colleagues, it really makes it tough because inevitably every company is going to have struggles and challenges. And if you don't have that personal relationship with your co workers, it really makes it more challenging to navigate that stuff. So to me, I'm always focused on how is the team doing? Culture, communication. Do we have any problem spots? Let's resolve them. That is probably the biggest thing I focus on. But beyond that, certainly the process optimization stuff. And again, that's my engineer brain seeping in there, here and there. But we have a lot of things that we're doing to project, manage effectively, to drive goal setting and driving towards those results. This is nothing new that anybody listening to this podcast probably doesn't realize. It's really about the execution. How do you develop and maintain a great culture, and how do you effectively optimize the practices? One of the things that I know has become a lot more prevalent on people's minds over the last few years due to Covid is organic growth at the practice level. Investors and people are generally wanting to see, hey, it's great that you can go out and do acquisitions, but can you actually grow those practices once you've acquired them? And that's another huge thing that I think we're focusing on is our ability to execute on the growth. But it gets back to the people in the culture. If you can maintain a great culture, you're more likely to retain your doctors and hygienists and be better at recruiting doctors and hygienists. And so if that's our biggest challenge with, with EBITDA right now, then fixing it is, to a large degree, recruiting. Yes. But culture is as important as well. So it all kind of ties back to people at the end of the day, one way or another.
- [12:57]
A
Very true. Some great thoughts from you there. So thank you for sharing that. That is all I have for you today. Ian, thank you so much for joining us. It's been a pleasure speaking with you and I look forward to connecting with you again in the future.
- [13:07]
B
Thanks. I appreciate it.
- [13:08]
A
Enjoy the rest of your day. Bye. Bye.
- [13:10]
B
Bye.