Sage Dental COO Discusses Ensuring Company-Wide Communication and Operations Consistency

DSOPro: Tell us how you got involved in dentistry and became the COO of Sage Dental.

I have been in dentistry for 30 plus years. I held a variety of positions within the dental office. I was hired as an office manager by a small group of offices which then became part of a much larger DSO, so I quickly went from managing an office to managing a market. I spent about 24 years with my previous DSO. During that time, I managed a market in the Mid-Atlantic (Virginia, Maryland, and Pennsylvania), advanced to Vice President of the East overseeing multiple markets on the east coast, then was promoted to the Regional Vice President of Central. At that time, the central region was in Texas and had 125 offices in San Antonio, Austin, Houston, and the DFW area. I worked for that DSO for a very long time and really loved it—managing people, offices, and doctors while honing my skills as a leader.

I consider my experience there as a period of significant professional growth, taking on more responsibilities and being promoted from within. I enjoy learning and embracing new challenges, as I believe knowledge is power. It’s exciting when you have new challenges, problems to solve, and new opportunities. I then received an opportunity with Sage Dental. They had 59 offices when I started. Today we’re at 127 offices, more than doubling in size.

So, for the second half of my career, 5 years ago I became the COO for Sage Dental. Now, instead of growing my career path, I’m helping grow the company. It’s like the other side of the coin. It’s a unique opportunity and I truly love the team I work with. I’m really excited for the things to come and what we’ve already accomplished.

DSOPro: 2019 led into a rough time, being right before the pandemic.

I know! Working for a year with a new company and then having Covid hit is really “make it or break it” time. We handled Covid very well, and I’m proud of what we accomplished. Coming out of Covid, we were in a great position and have since grown substantially.

DSOPro: What does your role as COO entail?

My role is primarily field based. My team, the Directors of Market Operations (DMO) and Regional Vice Presidents and I run the day-to-day in the offices. The Director of Administrative L&D as well as the acquisitions and integrations teams also report to me. We handle the operations piece for all the de novos and acquisitions. The integrations team helps set up the de novo and get it ready to open and, if it’s an acquisition, they help through the first 3 months or so until we convert the office onto our practice management system. They work with the DMO to help integrate that office, then it’s handed off to one of my DMOs to manage the office. Each DMO oversees a group of offices, usually around 10.

DSOPro: How do you ensure effective communication and collaboration across departments?

I have regular status calls with my team. If it’s a new DMO, we’ll have a weekly call and go through their market office by office, doctor by doctor, issue by issue. If they have been working with me for a while and they’re seasoned, then we’ll do statuses every other week. Another thing we do to ensure effective communication between the operations team and the entire company is to have a forecast call every Tuesday. The DMOs forecast the current month’s revenue and highlight wins and opportunities each week. We’re always very focused on that week-to-week.

The entire senior leadership team is on the call, and the DMOs report any risks in their market as well as successes they’ve had. If they significantly overperformed the plan, the DMO will highlight the action that led to the overperformance. All the other DMOs are on the call, so we share best practices.

They also note if there are any risks to them hitting plan and if they need additional resources from the support center.

We are diligent about having those calls and implementing action plans as a result. We also discuss recruiting needs, which is a key function to driving results. Talent Acquisition will speak to where we are in the hiring process for doctor and hygiene openings.

DSOPro: How many DMOs and how many total people are in the company now?

We have 15 DMOs and 1,500 staff members.

DSOPro: What are some of the biggest operations challenges you face and how do you address them?

One of our biggest challenges when we first decided to grow was that the senior leadership team was relatively new, and the company hadn’t experienced growth for a few years. So, when we first started to add offices, we had to get the right people in the right positions. We held multiple meetings and established a checklist to determine the cadence of when tasks needed to be completed. We’d open a de novo and then look back at the whole process and ask, okay, what did we do well? What do we need to do better? What do we need to add to our checklist to make sure it’s done the next time? Over time, that whole process became much more efficient.

We also hired a project manager, Amanda Leone, who leads these meetings. She initially started working with just the acquisitions and de novos and now has moved into enterprise-wide projects. She involves the appropriate people and keeps the initiatives on task. In the beginning there was definitely a learning curve, though now it is a much smoother process.

DSOPro: How do you motivate and retain top talent within the operations team?

I am very fortunate to have an excellent team to work with. I manage people the way I would want to be managed. Each of my DMOs treat the business like it’s their own. We don’t have a top-down approach where the corporate office says, “Okay, we want every market to do aligners, so get your doctors on board and let’s really push this huge initiative.” It wouldn’t work in every area. Some doctors might want to do it, others may not. The DMOs will identify and execute on initiatives that will drive patient care in their market. I allow the DMO the fun part of the job, which is to problem solve and strategize how they plan to grow their market next year.

We let each DMO be strategic and run their own business while keeping consistency amongst the offices. All the offices are essentially run the same way—the Sage way. We offer specialties in most of the offices, and there are certain things we want to do consistently, but we allow them to be very strategic in planning and putting together their budget for next year, as well as executing on it. I think that keeps the DMOs engaged and makes them feel like they’re operating a business. I’ve seen great results from this collaborative approach. We’ll talk things through and share ideas so that if something’s working well in one area, we can try it in another.

You’re very motivated when you have to speak to your business and how you’re performing every week. We celebrate when things are good. We motivate each other when we need that little extra push.

When I first started with Sage, there were only seven DMOs. Most of the recent hires have been referrals from existing DMOs, which is a huge compliment to the company and to the leadership.

DSOPro: What key performance indicators do you focus on to measure operational success?

KPIs are extremely important to us. The main three we focus on are Doctor Days, revenue per patient visit, and patient visits. These are our three key metrics.

All three must balance out to drive productivity. Each metric will lead you down a path of questions to answer in order to drive that metric.

DSOPro: Is there anything you want to add about the art of balancing priorities in the COO role?

We do that all the time! Every day we have to pivot our priorities. Emergencies pop up and need to be addressed immediately. I think that as an operator, the first priority is always “today and tomorrow.” But you must balance your time working on the “now,” while being strategic for the future. You can’t work in the present all the time, and you can’t just be strategic, you have to balance those out. Good operators do that intuitively.

DSOPro: How do you stay updated with industry trends and incorporate them into your operations?

There are always articles to read and events you can attend. Our Chief Dental Officer, Dr. Cindy Roark, stays well informed on industry trends and new and exciting developments. Dentistry is constantly evolving, and we want to be on the cutting edge. She’s the one who introduced 3D printers and various types of AI into our offices. She keeps us informed about innovative products that will be coming in the future. Clinically, I would say she is the innovator within our company.

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About April Cole

Joining Sage Dental in April 2019, April Cole has over 30 years of dental experience and strong operational and clinical knowledge. Before Sage, she was the Vice President of Operations: East for Smile Brands before being promoted to Regional Vice President: Central for Smile Brands. April’s strengths are P&L management, problem-solving, improving operational efficiencies, and building a solid team with excellent company culture.

Sage Dental

Sage Dental Group of Florida, PLLC, and Sage Dental Group of Georgia, PLLC have provided dental care to over one million patients through its broad practice network, which offers general, specialty, and cosmetic dental care, including restorative, prosthodontic, endodontic, oral surgery, periodontics, pediatric, and orthodontic treatment. Sage Dental participates in most dental plans and offers payment and financing options. Sage Dental Management, LLC, is a leading dental service organization based in Boca Raton, Florida, that provides comprehensive non-clinical business and administrative support services to over 120 affiliated Sage Dental practices in Florida, Georgia, and Tennessee.