What makes DSO executive recruitment like major league baseball?

DSOPro: Tell us about your background and transitioning to the dental industry.

I began my career recruiting baseball players for the Arizona Diamondbacks. That’s where I started understanding putting teams together and that you are not just looking at individual needs. You have to project into the future how people will develop and what their ceiling is. Obviously, with a baseball team it’s more physical ability, but they also must form a good team, have a good culture, and blend together. I really enjoyed that part of the job.

Baseball was fun and involved a lot of travel, but when my wife and I started a family, I needed to make a change. I joined Patterson Dental as a sales rep in Albuquerque in 2007, where I worked for about 11 years. That’s how I got into the dental side of things. In 2016, I transferred to the Austin, Texas, branch. I was doing well as a sales rep but then, I like to joke, I got “demoted” to branch manager with all its headaches. 

However, that reignited my love for putting teams together. When I look back on the baseball experience, I had learned how certain people can bring different skill sets into a group. That’s what led me into the recruiting world again. It resonates internally with me. So, I started this company, Fidler and Associates, focusing on the executive search side. It’s been a good run here, too. 

DSOPro: Describe your process for recruiting as well as finding what DSOs are looking for.

We play both sides of the coin. I have a mantra that I live by: “somewhere in the middle.” This job fits into that as well. We are always expanding our network on the candidate side. Most of our network is built by referrals, making phone calls, and meeting folks at events. The other side is when we are officially hired by a group looking for a chief operating officer, director of operations, VP of marketing, etc.

At that point, we’ll start networking with people we know. In the beginning we’re learning about the group and what the culture, roles, and responsibilities are. Then, we start talking to potential candidates. We identify those whose background matches and introduce them to the client.

We also look for candidates from different ends of the spectrum, like who may have hit the ceiling of opportunity, or is newer in their career path and wants to work their way up. We often introduce a variety of candidates to the client and let them figure out what’s best. That’s when the magic really happens—when they talk. Hopefully, they pick up on things from candidates they didn’t think of targeting ahead of time. There’s usually a little bit of learning on both sides and they end up redefining the role, refining what they feel the best fit would be, and deciding who will check all the boxes for them.

DSOPro: Are there guidelines on when to hire executives and which to hire first in a group practice?

If only somebody could create an algorithm to figure that out! There’s such a difference in group structures and sizes and how they grow organically. There is no magic formula to say, “Once we have six offices, we need a director of operations or a regional manager.” 

We work with groups with two or three locations and a doctor who doesn’t want to deal with the operational side, so it’s the right time for them. We’ve also worked with groups that have grown to 15 or 16 offices without having a director of operations because the doctors/owners have done a good job of managing that side and enjoy it. Now maybe they want to hire an HR or financial person. It is our job to listen to what their needs are and plug in the talent that fits.

DSOPro: When is the ideal time to search for a candidate?

We tell doctors about six months before they want to hire someone. Depending on the aggressiveness of the search or whether they are in dire need to fill a position, it could take a few weeks to six months to find the right person.

A lot of factors go into matching a candidate with an opening—obviously personality, background, and experience—but it can also be dictated by, salary, education, geography, and the size of the market area. There are a lot of ancillaries to consider that impact how fast the search goes and how picky we need to be with the types of candidates. 

DSOPro: What are the most difficult positions to fill right now?

Obviously, the higher up you get in larger companies, in terms of C-level titles, there are fewer candidates available with the right experience level. I look at it as a triangle: at the top are the large groups with the C-level positions; as you move down the sides, there are a lot of regional managers. The candidate pool depends on the level of the hire.

We focus on regional managers through C-level positions. This ranges within different departments from marketing, to IT, financial, or operational positions. We know the business well enough and have a good network on that level. 

DSOPro: Is having a clinical background important? And from what other industries can you pull talent? 

We can decide once we learn about the role. If a DSO is really struggling in certain areas and needs some expertise from within dental, then that’s where we start. If things are running well, the group is growing, and they’re looking for some fresh perspective, then we reach outside the profession.

We can pull candidates from surgery centers, dermatology, chiropractic, optometry, veterinary, hospitals, or other areas of healthcare that have multi-location experience. They’re basically structured similarly to most DSOs. We feel like we can recruit outside dental, especially if it’s on the financial side. It depends on what’s needed. We’ve pulled people from wine companies and other specialty services or logistics for procurement and those sorts of positions. We can get creative and have a variety of ways to approach the search for different types of backgrounds.

DSOPro: What are executive candidates looking for in a new career?

Each role and candidate have different needs. For some, it’s salary. For others, it’s the title, level of responsibility, or they want to work their way up. Some people are more focused on a culture that fits or being valued more, or they want the ability to influence change. We learn what is most important to each candidate and then match that up with a role that can provide that for them.

It is a two-way street, though. The dental group needs to benefit from their experience and understand what the candidate’s going to bring to the role. It really is a puzzle to put the two pieces together.

DSOPro: What are the biggest shifts or trends you’re seeing in the market?

I would say it’s a candidate-driven market right now. Also, if there’s any blessing in the new work environment, it has evolved into more hybrid or remote types of roles. People are used to not being in the office every day now, which can result in a preference of working remotely or hybrid. 

It has made our process tougher because some groups do still have headquarters and central offices and some roles require going into the office. Candidates have become  more assertive or demanding if they want to work remotely or hybrid. If they have enough background or experience and can prove they have done very well working remotely it may work out for them. 

We are seeing a hybrid type of executive level where they travel into a main office for a week or two each month. Also, groups are expanding locally more rapidly. In the Austin area, for example, a group of just 10 or 15 offices makes it easier to have a centralized headquarters. But groups with 100 or 200 offices can be scattered throughout different geographies. If a C-level executive can maintain the culture, manage the team efficiently, and work with other executive team or board members while working remotely, more groups are open to that.

Also, when candidates are driving the market, salaries tend to go up. We’ve seen a rise in salaries over the last 12 months. It’s partly because DSOs want to find “A” players to join their teams. This relates to the concept of a soft ROI versus a hard ROI. Hard ROI is when a person can bring money to the bottom line and improve production or collections.

Soft ROI refers to whether they will be a good team member and add to the culture of the group, customer experience, and contribute things that aren’t directly tied to money but overall will help the business. 

If you can bring a candidate in who is going to improve the bottom line, then maybe you’re willing to pay more. I think candidates realize they can ask for more as well. So, there has been a shift as far as salary and expectations go.

As a candidate, it is important to know what you’re looking for because there are so many opportunities out there. My advice for the group side is to be open to different types of candidates. Be aware of what separates your group from other DSOs. And keep in mind that sometimes a fresh perspective from a different segment of healthcare with experience in efficiencies that run differently may be the best candidate. 

DSOPro: Is there a typical educational background candidates are expected to have?

That depends on the group. Some groups are looking for people who have an MBA or a certain type of background. Other groups just want people we call “GSDs”: those who Get Stuff Done. I usually use a different word than “stuff.” If they need someone more on the action level in the offices day-to-day to oversee things, background or schooling may not be that important. 

DSOPro: Is there a logical progression through the C level? 

The progression depends on the candidate and what’s important to them. Typically, people look for what they don’t have in their current role. They may feel underpaid, not like the culture fit, or see a lack of opportunity or inability to affect change. Or they leave a larger group and go where they get to make the decisions and have better potential for career growth. 

We may also point out things that may be part of the future of a role that are different than they are experiencing now. They might be trying to immediately solve a problem, but we often say, “Let’s also talk about being with this company for the next 5 to 10 years and what that can provide as well.” 

Another situation may be a DSO wants to fill a role for only two or three years and then we will plan an exit strategy or an acquisition. To us the main thing is being transparent with the candidate and the group about expectations and making the right match.

There’s just no blueprint for success. That’s what makes this so interesting. Each group and candidate are different. Finding out what’s important to them and making that match is where the magic happens. It can change the group’s projection, it can change the owners’ lives, it can change the candidates’ lives, and that’s the fun part of it.

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About Jon Fidler

Jon Fidler is the Founder and CEO of Fidler and Associates. He has a history of building teams by connecting talent with opportunity that started with working for the Arizona Diamondbacks major league baseball team in the scouting and player development departments. Jon was responsible for not only recognizing the physical talent of potential prospects, but also developing that talent into a championship caliber team. 

For the last 13 years, Jon has focused his skills specifically within the dental industry, placing successful executives through the country in DSOs, multi-location groups, manufacturers, distributors, and other dental-related organizations. 

Jon is a graduate of the University of Iowa and resides in Austin, Texas.  

About Fidler and Associates

Fidler and Associates is a nationwide dental-specific advisory and recruiting firm that offers cutting-edge solutions addressing the most pressing issues of its clients. Focused solely within the dental industry and sourcing positions from regional manager to CEO, the company is strategically situated to customize advisory and executive search services based on the individual needs of the organizations it serves.