Dr. Terryl Propper, Endodontic Practice Partners

Intro: [00:00:02] Live from the Business RadioX Studio in Atlanta. It’s time for Dental Business Radio, brought to you by Practice Quotient. Practice Quotient bridges the gap between the provider and payer communities. Now, here’s your host, Patrick O’Rourke.

Patrick O’Rourke: [00:00:21] Hi there, friends of the dental business community. This is your host, Patrick O’Rourke, Founder and CEO of Practice Quotient, PPO Analysis and Negotiation and National Public Speaker. You can find out more at www.patrickorourke.me. O’Rourke is spelled O-R-O-U-R-K-E for those of you who don’t have Irish friends.

Now, I am very excited today to chat with Dr. Terryl Propper out of Nashville, Tennessee, one of my favorite cities. And anybody who’s ever been there actually, I would imagine. Terryl, how are you?

Terryl Propper: [00:00:58] Doing great today, Patrick. Thank you.

Patrick O’Rourke: [00:01:01] Excellent. Excellent. So, Terryl, you are in a unique position where you are part of one of the only Endodontic DSO type organizations that’s very fast growing, I would imagine. So I would like you to introduce yourself to the audience and let’s get your background first and then how you came to be involved with the organization.

Terryl Propper: [00:01:38] Sure. Well, I am originally from New Orleans and went to college in New Orleans. I went to dental school in Memphis, the University of Tennessee. And I went to graduate school at UNC Chapel Hill, and received my Master’s in Science in Endodontics. I joined a practice here in Nashville. I’ve been the American Dental Association Assistant Director of Marketing is in my background. I’ve been president of the American Association of Endodontists. I’ve been president of the Tennessee Dental Association. And I was CEO and Managing Partner of a 3 location, 8 doctor endodontic group here in Nashville that’s 60 years old. So one of the premier endodontic practices in Nashville, Tennessee.

After being with that practice for 30 years, I decided to retire in January of 2019. I planned on opening a boutique consulting firm that did marketing for specialty dental practices. And during the time that I was looking to set up an office, I was called from our CEO, Sam Hutchinson, who’s got an MBA from Vanderbilt and worked in the medical field in mergers and acquisitions. And we sat down and talked about forming a company specifically for endodontists, run by endodontists, founded by myself and Sam Hutchinson and our COO. And we went to private equity firms, and they were very interested. We got several officers. We picked one and we got started.

Patrick O’Rourke: [00:03:18] Okay. How long ago was that?

Terryl Propper: [00:03:22] It was in 2019, and we’ve doubled our size each year. We’re across the United States. We’d like to think of ourselves as a specialty support organization because we only serve the endodontic field. We’re exclusive at this time to just endodontists.

Patrick O’Rourke: [00:03:45] And so you’ve doubled in size. If you’re based out of Nashville, is that growth primarily in the South or Southeastern United States? I’m just curious.

Terryl Propper: [00:04:00] No, we’re in Washington State. We’re in Oregon, Michigan, Massachusetts, Tennessee, Georgia, Florida. We’re across the different time zones. We’re not on the West Coast at this time. We appeal to a specific endodontist, mid age, 48 is our average age. And we like to think that we’re unique in the field because we are exclusive to endodontists. We haven’t diversified into other specialties. And we’re very endodontic-focused forward, I would say. Very focused on the doctor and patient and referral and happy doctors send other happy doctors. So that’s our focus.

Patrick O’Rourke: [00:04:53] I like it. So just for John Ray. With me, as always, is DJ John Ray on the mix tables over there. Endo is root canal so specialists that do root canals. So when she was talking about how she got her dental degree and then she did a residency is for root canals. So just for John Ray and maybe any of our other listeners that aren’t familiar.

Terryl Propper: [00:05:22] Right. Our primary focus is saving teeth through trauma or cavities or cracks or a variety of other reasons that you might need a root canal. Pain is a big driver, but endodontist also do surgical procedures, root end procedures to save a tooth and bleaching and a number of other scope of services that are within our specialty, mini [inaudible] implants. And so it’s a narrow field, it’s a narrow specialty, but there are a lot of components within the specialty.

Patrick O’Rourke: [00:05:59] Indeed. Endodontist to me, when you need a root canal, baby, you need a root canal, and it doesn’t matter. I remember the last time I needed a root canal, which was quite a while ago, but nothing else mattered until I got into that chair.

Terryl Propper: [00:06:16] Pain is a good motivator. Pain is an excellent motivator. Yes.

Patrick O’Rourke: [00:06:21] Yeah. So I’m just curious, what draws — is there any common draw for somebody who’s getting your dental degree and then, you know, you could be, I think the draw for a pediatric specialist is obvious, right? I like it. So they’re going to be pedo and oral surgeons have probably some reasons why they’re going into it. Is there any common specific thing that usually draws folks into this specialty?

Terryl Propper: [00:06:53] Well, I think there are a couple of things. You get great satisfaction in a patient coming in, in pain, and a patient leaving out of pain or within a day or so, they’ll be out of pain. It’s also a referral-based specialty where the majority of our patients come from family dentists that refer to specialists that they trust. And so that’s a big driver. Another driver could be that you see a patient once or twice for a root canal. You don’t follow them their entire lives as you do when you’re a general dentist.

I was a general dentist first. That gave me a lot of really good background to become a specialist. But I think an advantage of being a specialist is you only do one thing and you do it really, really well. You’re an expert in your field. So general dentists are taught to do root canals, but the expertise is really after you’ve done a residency and you become a specialist because there’s a lot of variation in teeth, there’s a lot of variation in people. And so being an expert and only doing one thing really makes you good at what you do.

Patrick O’Rourke: [00:08:10] That makes sense. That makes a lot of sense. Is there more endodontists today than there were ten years ago or less?

Terryl Propper: [00:08:22] Actually, it’s about the same. There have been a few new programs. About 204 residents graduate from endodontic programs across the United States, including military programs. And that’s been relatively stable. Maybe there have been just a few new programs that have opened, but basically it’s relatively the same.

Patrick O’Rourke: [00:08:46] Got you. And as far as is there — is it a male dominated field?

Terryl Propper: [00:08:55] Well, quite frankly, it’s been a very heavily male dominated field until maybe the last, I would say eight years, where most of the dental school classes are 50-50 female, male. And now, most of the endodontic programs are about 50-50. And so way more females in the whole dental world as a whole. In my graduating class, I had 150 students. And out of the 150, we had 8 females. So it’s quite different than it was when I graduated.

I’ve been out a long time. I’ve practiced for 40 years. And I love seeing the trend. I love seeing where it’s going. And women in the field have made a difference in the workplace and the marketplace, and they bring different things to a practice that a male can’t bring. And I just think it’s fabulous that we’re seeing more women in leadership, more women at the board table, more women in dental administration and dental politics. So it’s a wide-open field for women who want to be active in their organizations.

Patrick O’Rourke: [00:10:11] Absolutely. And so, you know, maybe you don’t use the word, but do you feel like maybe help blaze that trail a little bit because you were one of the first ones to?

Terryl Propper: [00:10:25] Well, as far as I know, Patrick, I am the sole female in the C-suite in the endodontic focused support organizations in the marketplace. And it’s a unique place to be because it gives you the opportunity to be a role model for the younger female dentists that are coming up. And I don’t want to brag on myself, but I’m very proud of the fact that I was the first female president of the Tennessee Dental Association in 153 years. So there were two females that followed me, but I was fortunately in the right place to be the first female and to set the stage for others that followed me.

Patrick O’Rourke: [00:11:16] That’s awesome. That really is an accomplishment. You are a trailblazer. You’re the female Daniel Boone.

Terryl Propper: [00:11:24] Maybe Annie Oakley.

Patrick O’Rourke: [00:11:25] Annie Oakley. I’ll buy that. Yeah, absolutely. So that feels good. And then right after you, there’s a couple more. And so do you think that as there’s been more and more females in leadership and in dentistry in general, how has the market as a whole, because this what we’re in is kind of, it’s a niche, right? I call it this little niche business when I explain my own business, but I’m like, look, you’re not going to get it, it’s a niche, the dental niche, if you will, here. How have — I know that there’s some DSOs that have responded to women, allowing them to for benefits, maternity leave, et cetera. But how about the market as a whole when it comes to, I don’t know, all of the things that you need in order to perform high level dentistry, and bringing a high-level caliber of care and deliver the best possible patient outcomes? How has all of the other participants within on that journey also responded to this, well, I’d say relatively new trend, but relatively?

Terryl Propper: [00:12:52] Well, you know, women as a whole are more active in business. You’re seeing more women in CEO positions. You’re seeing more women at the board table. You’re seeing more women get involved at the grassroots level. And I think that, quite frankly, in the specialty of dentistry, it could become women dominated in the next ten years. But certainly, women have every opportunity to be as successful as they want to be, to own their own practices. So much of the drive toward the support organizations and recruiting residents to enter these support organizations is the fact that student debt has just spiraled out of control. So the students are looking for an instant paycheck.

And so many of the support organizations in the market are recruiting heavily dental school graduates and residency graduates and endodontist. Especially, a specialty like endodontics that has a very low number of residents that are graduating each year, it’s a very competitive market. And so we have to be — Endodontic Practice Partners or EPP have to be at the top of our game to attract the brightest and the best residents. And we feel like that’s exactly where we are.

Patrick O’Rourke: [00:14:18] So let’s say that I am the brightest and the best. I can’t say I’ve ever been accused of that, but let’s just say for the sake of conversation here. And you find me the residency program and I want to go hang out at the pool or do whatever it is that young Patrick O’Rourke likes to do. And you guys say, hey, listen, Pat, you need to think about joining EPP, and this is why we’re awesome. What would you tell me?

Terryl Propper: [00:14:53] Well, this is exactly what I tell you, because I tell it to residents every time I talk to them. What you’re joining is a private practice, an endodontic private practice, well-established, state of the art, well-respected in the community, reputable and people that you want to go to dinner with, people that you will like, staffs that are established, processes that are in place, and you will be entering a private practice. It just so happens that that private practice is supported on the management and business side by EPP.

So you treat the patients the way you want to treat them. You treatment plan the way you want to treatment plan. You use the instrumentation that you’re comfortable with. You provide the top patient care you can give. We want the patient to have a good experience. We want the staff to have a good experience and we want the patient to leave happy. We want the referring dentist to be happy. But most of all, we want the staff and endodontists to be happy. So we’re about clinical care, but we’re also about building in efficiencies in practices that the practitioner might not see or might not have time or resources to pay attention to. So those are the things we bring to the practice, expertise and resources.

Patrick O’Rourke: [00:16:18] Well, you know, let’s say I’m from a small town. And I’m like, you know, I just hang my shingle right out there and I’m just going to say I do root canals and I know all the people in town. My family’s lived there for a couple of generations, you know. But what’s in it for you guys?

Terryl Propper: [00:16:41] Well, I’m not sure what question you’re asking, Patrick. But I think what you’re asking is, is there still a place for someone to open their own practice and be successful? Yes. There’s always a place for that, but we can bring resources and business acumen to even a solo practitioner who’s just getting started. In fact, we love offices like that because we can help mold the direction the practice is going to in the beginning.

I think that some people have a general misconception about a dental support organization. When it’s applied to a specialty, it’s a different beast than it is when it’s applied to a general practice. And I think that a lot of people equate a general practice DSO with a specialty services organization like ours, because we’re focused keenly on the endodontist and endodontic experience.

Patrick O’Rourke: [00:17:50] And so, yeah, I’m just sort of playing devil’s advocate a little bit. I’m real familiar with the specialties. Amos, I’ll be speaking to Amos in San Diego Plug. If you don’t get enough of my compelling rhetoric today and you happen to be in the oral surgery space. And I’ll say, and I’ve had several folks on the show, is that not all DSOs and or specialty organizations are the same. Sometimes they kind of get lumped in a bucket, but they’re not all the same. There’s different focuses, different niches, different methodologies, different strategies, both internal and external.

And so what I see sometimes when I’m out at a committee or out at a convention or something, is that, and I call them the kids, right. And I’m not that old, but the kids. There’s a bunch of folks that are like, hey, you guys should come talk to us, right? And you guys need to come work for us. And so I know that a lot of those kids listen to the show. and so they may get kind of pitched out, you know, by the time they’re talking to the fourth or the fifth booth, right, and they just want to go to the pool and get a tan or relax.

And so I guess what I’m trying to say, is there any catches? Because if it was me and I was walking around, I would just be like, all right, so I heard this, we’re doctor-centric. I do hear that. Now, what’s in it for me is that I don’t have to worry about business part, right? Because I don’t know much about business. I just graduated, right. And I got all of this debt. Have I ever hired anybody and managed anybody? No. And I don’t know how painful that’s going to be until I actually do it. I get it.

I think that there’s probably something that you guys are going to tell the best and the brightest Pat that why he needs to come to EPP. And then am I starting my own practice? Are you putting the best and the brightest and you’re saying, hey, Pat, do you want to go to DC or do you want to go to Atlanta or do you want to go to Nashville? Like, how does it work? And because I really don’t know, because I’m not the best and the brightest usually.

Terryl Propper: [00:20:11] So it works both ways. The majority of the time, we place new residents in established practices, well-established practices in demographic areas and locales where people are going to want to live. Because when we select practices that we partner with, we select practices in growing areas where people are going to want to live because that’s where the endodontic market is.

And I think that one component that we offer is not only the business support, but we offer the ability for the senior doctor or the other doctors in the group to mentor a new practitioner because, you know, you learn a lot in your residency, but what you really learn when you really learn is when you’re in practice. That’s why they call it practice, because you practice a lot on people. And so oftentimes, a new resident needs some mentorship, needs some guidance clinically or communication wise or working with referring doctors. Sometimes there’s challenges and the older, more mature doctor can impart wisdom upon some of the new graduates.

Patrick O’Rourke: [00:21:29] Amen to that. I think everybody can serve. You know, I’m a big believer in Napoleon Hill, the mastermind alliance. You know, in order to attain wisdom, you really need to access different perspectives from folks, you know?

Terryl Propper: [00:21:46] Right. It’s very lonesome. It’s very lonesome to practice by yourself, especially in a field like endodontics. It’s very tedious. We use a microscope. We use a 3D imaging to diagnose and treatment plan. And it’s helpful to have someone else to confer with, to look at a case with. And we have a very, very high success rate with the residents that we’ve brought in to our practices. The residents have an opportunity to buy into the practice as a partner. They buy into our holding company. They have stock in the company. So they’re actually owners in the company, as are all of our doctors that affiliate with us. So it’s not the big bad wolf company telling our doctors how they’re going to practice. It’s our doctors deciding how they want to practice on their terms with some guidance from EPP.

Patrick O’Rourke: [00:22:44] Got you. And then they don’t have to worry about managing people for the most part.

[00:22:49] Right. Because all support organizations provide HR services, payroll services, accounts payable, rev cycle, insurance verification, IT, HR, benefit packages. Most of the support organizations do in general, the same kind of, provide the same kind of services. But it’s who the people are that are in the management team, what the attitude is, what the vision is, what the core values are of the company that make a difference in the whole culture of the company and its culture that you’re really selling. Here’s three companies. We all have a different culture, we all have a different approach, we all have a different strategy, and we all have a similar endpoint. But it’s how are you going to get there and who are you going to get there with?

Patrick O’Rourke: [00:23:46] That’s excellent. I like how you put that. You just nailed it.

Terryl Propper: [00:23:53] It’s really the truth. I mean, you can go out look for a car. All the cars are going to get you where you’re going, but which bells and whistles do you want and what kind of comfort do you want? So it’s similar with a specialty support organization like ours. There’s competition in the market. We’re one of the youngest companies in the market, but we’re going to be very successful because of the people that are in our management, in our C-suite.

We have expertise. We’re approachable. We’re down to earth. We don’t try to be somebody that we’re not. We’re transparent. We want our doctors to be happy because happy doctors refer their friends, right? And it’s about growth. We want to grow the practices. We want to grow the company. We want to provide opportunities for the new doctors. We want to provide professional development for the more mature doctors. We want to educate the staff. So we have a lot of goals that we want to reach, and we have tremendous cooperation from our partners. So, you know, we’re a young company, we’re growing quickly, and I think we provide a tremendous service.

Patrick O’Rourke: [00:25:09] I like that. So different cars can get you different places. A Yugo, for example, at one time.

Terryl Propper: [00:25:19] Right.

Patrick O’Rourke: [00:25:20] And a phantom Rolls-Royce.

Terryl Propper: [00:25:22] Right.

Patrick O’Rourke: [00:25:22] Well, technically, you’re going to get you from A to B, but it’s going to be a totally different experience.

Terryl Propper: [00:25:27] That’s correct.

Patrick O’Rourke: [00:25:29] You know.

Terryl Propper: [00:25:31] Another thing, Patrick, is EPP keeps the same culture. So if we come in and we partner with the practice, it’s still the name of the practice. It doesn’t take on EPP. In fact, we’re almost like a silent partner, providing practice management, consulting services, and business services. So it retains the culture of the doctor that built it from scratch. It takes a long time to build a successful andodontic practice. And certainly, we want our doctors to maintain their touch and their personal attention to the practice, what they formed and raised. And this is their baby. And we want that baby to remain their baby. We just want to help them be more efficient with their business practices. That’s the main focus of our company.

Patrick O’Rourke: [00:26:31] Got you. So if I may put this into my own words.

Terryl Propper: [00:26:35] Okay.

Patrick O’Rourke: [00:26:36] All right. So let’s say that I’m an established endo provider. The product really is the docs, it is the providers. And it’s incumbent. And they have relationships and roots in their communities within their professional circles and probably within their civic circles as well, their business and civic communities, depending on how involved they are. And so you’re looking for somebody that’s mid-career, that wants to grow, right? But they still want to — if it was my name on there, Patrick O’Rourke, O’Rourke Endo, it’s still going to be O’Rourke Endo. If I’m doing well, you guys want to throw a little bit of gasoline on the bonfire?

Terryl Propper: [00:27:29] Right. We want to help the practice grow. You know, it’s hard when you’re an endodontist, you’re on a schedule every day for 8 hours. You don’t have — you have a family to go home to and things like marketing. So marketing is something that, you know, it promotes business for the practice, but it also gets your name out of the community. It also can be community supportive. It can bring in employees that have heard that you’re a good place to work.

But marketing is one thing that we provide, and we do very well at it. And it’s something that most endodontist don’t do, mainly because it’s a pain driven specialty and patients come in on their own. But in competitive markets, a good marketing plan and a strategic marketing plan can really make a big difference in the success of a practice and practices that do little to no marketing will fall by the wayside if a practice that does great marketing is able to get a foothold in the community. So, yes, to your question, O’Rourke Endodontics is going to be more successful if they partner with EPP than if they stay on their own because of resources and expertise.

Patrick O’Rourke: [00:28:51] With O’Rourke Endodontics beyond the goodyear blimp, that would be cool. Maybe. Maybe. It’s just, you never know, right?

Terryl Propper: [00:29:01] You know, the sky’s the limit. If you dream it, we will try to make it happen. That is a lofty goal, but, you know.

Patrick O’Rourke: [00:29:10] All right. Well, we will start with one of those planes at the beach that has a sign on.

Terryl Propper: [00:29:16] That we could do with the trailer behind it. Yeah.

Patrick O’Rourke: [00:29:19] I’ll buy that. Listen. That’s it. You got to start somewhere.

Terryl Propper: [00:29:24] Right.

Patrick O’Rourke: [00:29:25] I’ve been watching. Again, I’m a neutral observer. You know, I have clients that are — most of our clients are probably establish, very kind of higher end practices, if you will, or just by the very nature of our business, which is we have to go convince all of my colleagues at the insurance companies that they need to pay them a little bit more fairly. Hi, guys. I know you’re listening. It’s great to have you here. And, you know, I don’t think that’s a surprise to anybody that they’re not in a huge hurry to do that.

So one of the things I hear from our established specialists is they’re like, I can’t get another resident in here because there’s the folks at the schools. You guys are probably one of them. And, you know, like, it’s just the competition is so stiff to get residents and to get somebody to go into the more traditional partnership track like that has been done in the oral surgery and the endo world for what decades.

And so, you know, me personally, I’m like, look, you should — why fight city hall? What do I tell, let’s say Dr. John Ray, which would make his mama really proud? Dr. John Ray, you know, he’s got John Ray Endodontics over there and he’s like, I can’t get a resident in here, and I’m trying to retire, go fishing, but I don’t want to give up my practice either. I want to come in here and blah, blah, blah. And he wants to mentor and do all that stuff because he’s a good dude, right?

What do I tell? Let’s say Dr. John Ray is my client. And this conversation happens to me and to my team. So I tell Dr. John Ray, how do I facilitate an introduction to you guys? I mean, like, listen, John, instead of fighting the current here and trying to swim upstream, why don’t you at least have a conversation with them? Maybe they could do some of those things for you too, A, find a resident, right? I’m assuming. And as long as he’s in a desirable place and not like Port-au-Prince, Haiti, or something. That’s why he vacations —

Terryl Propper: [00:31:49] There’s nothing wrong with Haiti.

Patrick O’Rourke: [00:31:50] Oh, I like it Haiti.

Terryl Propper: [00:31:51] Great.

Patrick O’Rourke: [00:31:54] It was the first thing that popped into my mind, though. Some people want to go to Atlanta, live in Buckhead. They want to go to New York, Miami, Los Angeles, San Diego, but they don’t want to go to, I don’t know —

Terryl Propper: [00:32:10] Don’t say it, Patrick. We get the drift.

Patrick O’Rourke: [00:32:12] Yeah.

Terryl Propper: [00:32:13] So, you know, we have a director of recruiting and mentorship with EPP. And if there’s a partner doctor who might be interested in hearing what we have to say, then you can reach us on our website at endopracticepartners.com. It’s hard for a graduating resident unless they have an endodontist that they’ve known, that they’ve planned to go in with, or someone that they have a family friend in their community. It’s difficult for a solo endodontist to find associates now, but it’s still possible. There are a lot of people competing, a lot of companies competing for endodontists.

And you know, the residents can come out, they can get signing bonuses and incentives to join companies, companies like ours. It just depends what the resident is looking for, how much debt they’re in, where they want to live, how they want to practice. But for your friend, Dr. John, what I would say is I think it’s good to explore the market and see what’s available. You would think that a company like ours would attract an older clientele, but it doesn’t. There are a lot of endodontists that still want to grow their practices, but they’re confined by resources or time.

We have a lot of practices that want to open second offices. We have some de novos that we’re starting from scratch. We have group practices, solo practices. We have senior doctors. We have young doctors. We’ve helped all of them in different ways. Every practice is unique. And what I can say about our company is I think we try to personalize the services we provide to the practice we partner with so we don’t have one size that fits all because one size can’t possibly fit every endodontist.

So this endodontist needs marketing, we provide that. This endodontist has accounts receivable problem, we provide that. This office wants to recruit a new associate, we provide that. This office has high staff turnover, we try to do whatever we can to maintain staff, to incentivize them or to attract new staff or train the staff. So every practice is different.

So Dr. John’s looking for an associate. Then he needs to put out all the fillers he can and all the different venues he can. But we would be happy to talk to somebody like Dr. John to see how we might be able to help.

Patrick O’Rourke: [00:34:57] Got You.

Terryl Propper: [00:34:57] And certainly, there’s no fee for consultation. We’re happy to talk to anybody at any time.

Patrick O’Rourke: [00:35:04] Well, that’s good. I charge for consultations, and so does John, actually. So you got us beat.

Terryl Propper: [00:35:13] There you go.

Patrick O’Rourke: [00:35:13] So as we talk about the market, I see and have in my mind witnessed and observed a shift. I feel like it started with the general dentist market. And then it got into the specialist market of consolidation, of centralizing operations, if you will. And I have my own opinions, but, you know, I could just interview myself. So I would like to hear your opinion on where do you see the endo market? And by the endo market, I mean, the actual provider community itself. Where do you see that going over the course of the next five years or maybe even this decade, the roaring twenties?

Terryl Propper: [00:36:04] Well, here’s what I see. So I’m a student of the dental marketplace. I was president of the American Association of Endodontists in 2016. Consolidation in the medical field has been around for years. We have consolidation in oral surgery, in orthodontics, and pediatric dentistry, and those are fairly new market. The first company came to market in 2018. And now, it’s 2023 and there are approximately five companies in the market. It’s a very small slice of the pie, but it’s a very —

Patrick O’Rourke: [00:36:40] Important part, particularly if you need a root canal.

Terryl Propper: [00:36:44] It is. And I think what people are learning in the market is the value of consolidation, the value of strength in numbers, the value of being able to go to an insurance company and say we have however many endodontist and inflation is hitting everyone. Food is more expensive. Gas is more expensive. Cars are more expensive. Education is more expensive and dental services are more expensive.

But Patrick, not to challenge you, but dental insurance benefits have not kept up with the cost of doing business, the cost of inflation, the cost of supplies. They just haven’t kept up. And so I think that consolidation is probably going to force insurance companies to take another look at the fees they’re paying. Most patients have a benefit of 1000 to 1500 dollars a year. I graduated in 1982. I don’t think that benefit has gone up. You would know better than I do, but I think consolidation will have an effect on payer rates.

And I think that’s one thing that we can do for our practices. And we’ve already seen the needle move in in a positive direction on that. But I think that consolidation will be here to stay over the next decade. And there’s always a place for a private practitioner. There’s always a place for fee for service. My mantra is there’s always a place for someone that cares about their patients, that does excellent work and has some semblance of community and ethics and professionalism. They’ll always survive. They may take longer to build their practice, but there’s always a place for people like that. So this model isn’t for everybody. But I think in 2023, with what’s going on in the economy, joining a company like EPP diversifies your risk and allows you to be part of a bigger group that you wouldn’t have had the opportunity to be part of sitting in your office in Buckhead.

Patrick O’Rourke: [00:39:09] And very likely have annual meetings and nice places like the Conrad maybe.

Terryl Propper: [00:39:18] Well, actually, I am out scouting today for a nice hotel for our annual meeting, which will be in November here in Nashville. The American Association of Endondontists was supposed to meet here in 2020 and the annual meeting was canceled due to COVID. So we have a lot of people who’ve never been to Nashville, and I think it’s a great place for us to have our annual meeting in the fall.

Patrick O’Rourke: [00:39:45] Yeah, shout out to Conrad and Nashville as a whole. If you have not been there, highly, highly recommend it. It’s really one of America’s treasures. Well, you know, you did say something. And I’m just going to reiterate this fact for all of my friends and colleagues on the other side of the aisle and the insurance industry. I feel I’m not going to paint everybody with a brush, but there’s certainly this decade rates are coming down or not up and the cost of doing business, you just heard it, is going up. And so, you keep squeezing, keep squeezing. And then this is kind of what happens.

And that could be one of the pivotal and primary reasons why folks jump into a larger practice is because they feel like they have no chance and they’re getting squeezed by the larger insurance companies who are also consolidating. Whether that’s fair or not, this is very true. And so, you know, you and I are on that same side of the fence from the insurance industry, but all of my clients are providers. So I try to be as neutral as possible, but we represent the provider community. Does that make sense?

And so sometimes I’m defending the insurance industry, but I feel like I’m trying to — we’re a bridge between the provider and the payer communities because the provider community speak Japanese and the payer communities speak Portuguese, and we’re fluent in both. But the more that folks come on here and they kind of express the pain that they are seeing in their own practices, especially with inflation and especially with all of the improvements that you guys had to make with COVID and the whole staffing shortage of people just disappearing beats me. But you know, I can’t get a pizza delivered to my house when there’s 20 kids about to burn the place down if we don’t feed them. That’s a problem.

Terryl Propper: [00:41:47] No, staffing is the problem. Staffing is a problem across the United States, and that’s one thing we focused on. All of our practices are looking for stable staff. I don’t know where everybody went after COVID, but we are able to recruit good staff. And, you know, there’s a lot of things, there’s a lot of moving parts in the dental marketplace now. There’s just a lot of things changing in the marketplace.

And one thing that I say to endodontists that I talked to is, you know, you need to be aware of the changes that are going on. You can’t practice like you did in 1982 because the market will pass you by. And I think that’s one of the attractions to companies like ours is we’re on top of things. We understand the market. We see where things are going. We understand how you can negotiate better supply rates and better equipment rates and better insurance rates. When you have numbers and when you are across the United States, it’s all very important to the bottom line. It’s also very important to provide the top equipment and the most recent technology and education. And everything cost money these days. Nothing’s free and we try to do what we can to make all of our practices just as high-end and topnotch technologically, educationally, and patient-friendly as possible.

Patrick O’Rourke: [00:43:29] Amen. So one more time, Dr. Terryl Propper, I’d like to thank you very much for being on our show. It is an honor. If our listeners out there in dental business land would like to reach somebody at, well, it wouldn’t be you, right? It would be who at Endodontic Practice Partners would they want to reach out? Is there a 1800 awesome endo or something?

Terryl Propper: [00:43:57] Well, you know, since your listeners have heard from me and they see my picture, I think you’re perfectly welcome to reach out to me personally. It’s Dr. Terryl Propper. My phone number 615-422-6702. Or you can reach out online to endodonticpracticepartners@eppendo.com. I almost gave the name of my practice that I had been with for 30 years. I almost forgot and gave them the plug, but happy to talk. If you call, I may refer you to somebody in our development department. Alex Nulty is our senior director of Development. But certainly, you can start with me and then I can get you to the right person that can answer the question.

Patrick O’Rourke: [00:44:46] That’s terrific. Terryl, again, thank you so much.

Terryl Propper: [00:44:50] Thank you.

Patrick O’Rourke: [00:44:51] And this is your host. All of our listeners, thank you, guys, for listening. As a reminder, the show’s sponsored by me. That’s right. So if you like the content, great. You can always hit me up at info@practicequotient.com or check me out at patrickorourke.me. I’m in Instagram somewhere too. If you didn’t like the show, please take it up with our sponsors. And thank you very much for your time. Until next time. This is Patrick O’Rourke.