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The Benefits of Multispecialty Group Practices and AADGP Membership
A conversation with Brent Barta, DDS, President Elect of the AADGP, about his experience owning a multispecialty group practice and how the AADGP can help others build theirs.
DSOPro: Tell us about your group practice experience.
I am the founder and primary owner of a group practice in Indianapolis, IN. We have one multispecialty location and three general practice locations. We’re built around a multispecialty concept of comprehensive care and provide specialty care at the large campus as well as at our general practices.
After graduating from Indiana University in 1984, I started in a traditional solo practice setting and grew that fairly rapidly. In 2006, some of my colleagues and I who were working in the same building thought it would be cool to collaborate and create a true multispecialty group practice. So, we built out and remodeled our facility to accommodate that and launched the practice as such in 2007 with 31 operatories. We’re coming up on 14-15 years of functioning under the multispecialty concept.
We added several individual GP practices over time, starting with one. We saw how we could support that practice with specialty care and decided to add additional GP practices with the same concept in mind—we help them manage the practice and support them with the specialty care that they typically wouldn’t get as a solo practitioner.
We’re at about 120 staff, which includes full- and part-time people, clinical and nonclinical.
DSOPro: Why start a group practice?
In my private practice I could see that with specialists in house we could provide a higher level of care. There were other dentists in the initial facility, and an oral surgeon who was my best friend. Talking with him and another periodontist I knew, we decided to try out the concept. Our idea was based on the clinical care of patients rather than it being some sort of grand business design.
The periodontist sold his practice to come practice with me. Unfortunately, our oral surgeon friend passed away just before we opened the facility, so we recruited another oral surgeon. While I am substantially the sole owner of the practice, I do have a minority partner who practices with us.
DSOPro: What is the history of AADGP?
The American Academy of Dental Group Practice (AADGP) was established in 1974 so we’re coming up on our 50th anniversary! It was well established before I even knew it was an organization. It was created by folks who had group practices and saw that there weren’t a lot of resources for people practicing in that model. They wanted to create their own academy to network and share ideas about growing group practices. They had a little more focus on running a good business than many dentists had at the time. Dentists were considered professionals and I don’t think they were allowed to advertise in some states in 1974.
The founders were very progressive thinkers, and the group has tried to remain that way—looking to the future of what is coming in dentistry with a particular eye on the business of running a group practice. Often the practitioners who attend an AADGP meeting or event are considering forming a group in the near future and are looking for resources, to network, and to learn more about what it means to run a group practice.
DSOPro: Tell us about membership benefits and upcoming changes to the organization.
We are currently rebranding and creating a different membership value proposition. Until recently, the organization existed primarily as an annual meeting. We usually hold a large 2.5 to 3-day meeting in February. We’d also create some publications throughout the year, reporting statistics from various groups who want to share information from their practices. But 90% of what we did was host the annual meeting. These included educational sessions, speakers, panel discussions, and round table discussions focused on the business of dentistry with time to meet and interact with our industry partners and vendors. We don’t generally offer clinical education. We’re more about how to grow, develop, and run a group practice with a heavy focus on the business end.
We now see the need to have more than one meeting per year. We have offered some online education, podcasts, lunch and learns, and we’re going to do more this year. We hope by next year to launch a mentorship program so that groups of similar sizes and stages of development can meet throughout the year to share their experiences, their numbers, and work together in a collaborative environment. We plan to launch that at our 2023 meeting.
And we will have a more elaborate, better website and technology platform later this year so we can house and provide easier access for members to get CE courses in a more user-friendly way.
DSOPro: Discuss the importance of vendor and industry support.
Those people are integral to the success of our group. Suppliers and vendors of all types, whether it’s dental supplies, equipment, software, accounting services, or other service partners, all are super important to running a group practice. We have vendor support for our annual meetings and some of our educational materials.
They not only provide the tangible items we need to run our practices, but they are also great sources of information about what’s going on in the industry. They have their hands in practices across the country and internationally, so they provide a wealth of information for us as group practice owners. It’s super important not only for financial support and mutually beneficial financial arrangements but to be able to share information with the vendor and the service providers in a very open forum. They learn from us, we learn from them, and hopefully everybody is better for it.
DSOPro: What emerging technologies are important to group practices?
Procurement platforms are being developed that allow groups to run their inventory control and monitor their costs more efficiently. AI is a big topic right now for diagnosis of x-rays and other things. Using AI in call monitoring is also huge. The ability to run AI on your computer system, whether it’s your telephone or diagnostic systems like CAT scans and radiographs, is very impactful.
We did a podcast last year with five of the current leaders of AI technology. It was cool to have competing companies on one podcast. The exchange was interesting, finding out and understanding what each company is working on and where they’re heading.
DSOPro: How important is compliance and record keeping for group practices?
The bigger you are the more important it is to have the infrastructure and the platform available to ensure compliance. For solo practitioners, I imagine a lot of that kind of flies under the radar if you will. You get bigger, you have more practitioners, more staff, it becomes more important that you can monitor and scale up that process to accommodate a large group. That is critical to really growing a practice beyond a couple of locations—you’ve got to have those things in place.
DSOPro: Are group practices under additional scrutiny as a larger business?
In concept they are not under any different scrutiny than an individual practice. But are you a bigger target, or is there a greater chance because of the number of people and the number of locations that an incident might occur? Yes, absolutely. And one incident can spread across an organization if it’s serious enough. I think the large groups and DSOs have a great concern about those situations. They understand they just can’t afford to have problems of that nature.
DSOPro: Does the AADGP have DSO members as well as group practices?
We are interested in all people who are interested in group practice. We welcome any group to join as a member. We’re pretty agnostic about the structure of the groups. We traditionally focused on group practices because we were established at a time when a DSO wasn’t even a thing. But a DSO is a form of a group practice inherently. Whether a group or DSO is large or small, you are a valued member of the AAGDP regardless of your structure or business model. We can all work with each other.
DSOPro: What types of programs does the AADGP offer at annual meetings?
We did the 2021 meeting virtually. We were one of the last national meetings to occur in 2020 before everything shut down, and we got shut out of our 2022 meeting by omicron. What we were planning to offer at the 2022 meeting was very diverse. Our theme was “Establish, Grow, & Exit” or the “Evolution of a Group Practice.” We had educational tracts that support the new group, the developing group, and then the more mature group whose owners might be looking to exit or sell.
Some topics were related to the best practices for setting up a practice, covering a lot of systems and accounting courses. For growth, we were offering information about best practices for procurement, AI, clinical support, and legal—how to avoid making the mistakes others have made in the legal area. For practice sales or exiting we had information on valuation of groups, and how you build a group that has value should you want to liquidate, sell, or transition your practice. Like the things that buyers or other groups are looking at, the types of structures that impart value to your group, such as the practical day-to-day nuts and bolts of accounting. Also, how you may be developing a group that from a business standpoint has true inherent value. Whether you want to sell or not, you want to be building something that is founded on solid principles and is a strong business model.
We’ve typically had about 500 groups represented at annual meetings. We have a goal to expand to 2,000 groups in the next 5 years. The group practice and DSO model is exploding, there’s a lot of hunger for information, and we would like to be able to provide that. We’re more focused on smaller emerging groups because they are the ones who most need assistance, networking, and information.
DSOPro: Are new dental school grads looking more toward careers with group practices?
The American Dental Association recently published an industry-wide paper that spoke to the changing trends of the new graduate. It was quite clear that it’s rare for a new graduate to go into their own practice or even join a solo practice setting. A predominant number are going into group practice or a DSO setting. We see a really high opportunity for the AADGP to meet those needs.
DSOPro: Any advice for practitioners thinking about starting or joining a group practice or DSO?
We’re a privately owned practice, and I had a young person here last week who is concerned about joining a true DSO that may have some private funding. There is nothing inherently good or bad about either of those concepts. But you have to understand the culture and the focus of what a DSO or group practice is doing, and that takes a little time. You have to get into the practice and get a feel for that. Are they patient-centric? Are they treating the staff well? Are they treating the practitioners well? In every setting you can imagine, you’ll find good and bad. In my opinion, people looking for their next career move must do some research.
For someone interested in starting a group or DSO, one thing I see today is a tendency to think it is a way to get rich quick. If that’s what you think, you will probably be sadly mistaken. It is a lot of work to form and run a group or DSO. It’s either work you’re going to do or work you’re going to have to employ somebody to do. It also requires a very solid business background to do it well.
DSOPro: Does the DSO or group practice model attract people to the profession who just want to do dentistry and not worry about running a business?
That’s where there is a lot of opportunity with these developing concepts. If it’s done right, it actually benefits everybody—the patients, staff, dentists, and the organization. It should be a totally win-win arrangement. You’re not going to buy four or five practices and then make millions of dollars without doing it extraordinarily well.
DSOPro: Any final words?
I would like to emphasize that AADGP is a non-biased organization in the sense that we’re here for the membership, and we are a not-for-profit organization. We’re not selling anything to anybody. We hope that that gives people some confidence in coming to meetings and joining the Academy. We’re purely an educational and networking organization. And you truly are a member of a group when you join and attend our meetings. We’re not trying to influence or sell, and we’re open to all business models.
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About Dr. Brent Barta
A practicing dentist for over 30 years, Brent Barta, DDS, founded West 10th Dental Group, a multispecialty practice, in 2007. WTDG has grown to a 15-doctor practice with specialty providers in periodontics, oral surgery, pediatrics, endodontics, and orthodontics. Dr. Barta and his dental group operate from the fundamental principle that group practice is a better way to provide dental care.
Dr. Barta has been an AADGP member since 2005, and a Board member since 2012. He is the current President Elect of the Academy.
About the AADGP
The AADGP is a true impartial Academy dedicated to providing its members with an environment that encourages collaboration, engagement, and the pursuit of Best Practices for Dental Group Practices. You do not have to build your practice alone!