667: Scaling with the Right Culture - Dr. Brett Levin & Dr. Jennifer Derse

Growing a practice is more than acquiring or opening new offices. And it’s hard! Dr. Brett Levin & Dr. Jennifer Derse have done it with their Espire practice. And have the secrets to scale your business and keep the culture you want. Learn more in Episode 667 of The Best Practices Show!

Episode Resources:

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• Learn more about Espire Dental - click here 
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Main Takeaways:

Make a discussion of your culture part of your daily stand-up meetings. 

You have to have a structure to the culture. 

A one-size fits all blueprint might not work for expansion. You may be leaving great ideas on the table for each unique practice. 

It’s hard to maintain consistency when you try to grow a practice on your own. 

Quotes:

“We had a lot of people asking us how did you do this? How did you create an amazing culture? How are you fee for service? How are you getting all of these referrals? How are people traveling? We saw 5+ years ago that the dental industry on the precipice of change. We wanted to try to control our destiny in that change. And really create a private practice DSO model. And that means something different for every person. But we didn’t want to do it where someone comes in and buys your practice and now you’re part of a bigger conglomerate and you don’t have to do any type of change. That’s not really pushing yourself to grow or become collaborative. We also saw that a lot of younger dentists really craved mentorship and growth but didn’t have the time or the means for someone to nurture and support them. I think Jennifer really had that vision and was spurred on to help create it and that was the genesis of how this fire started. We have 28 practices and 352 team members” - Brett (14:16—15:41)

“We have been really fortunate to have met a lot of wonderful people…within dentistry but also others who share our entrepreneurial mindset. And through the McKinsey course we met some entrepreneurs who we picked their brains, one of whom had done something in eye care and we said how did you do [grow and keep your culture]?...We started Espire with 4 essentials. It’s our playbook. It’s our credo. It’s our mission. It’s our values. And we weave this into our daily huddle. And every day not only do we talk about the procedures we’re going to do and the patients we are going to see, but some dynamic of our cultural playbook gets put in it so we can all encourage and put supportive of one another. So that was the foundational start of the Espire. And I think culture is a big buzzword but I think that’s something people talk about but don’t really put words and conviction to. And when we would talk similarly-minded doctors about what we are doing and then show that we are talking about this but we actually have something like a beacon to hold. It was easy to get the right doctors to work for us. ” - Brett (16:41—19:12)

“If your culture doesn't have some type of structure, then you don’t have a culture. You have to have a structure to the culture. ” - Jennifer (19:47—19:54)

“We thought our office could be the blueprint for every office and you carbon copy it. I think what I learned is that every doctor, every office, every location, has unique qualities to it that might be different from ours. So what I think we learned is instead of saying do everything like us, it was what core things where we found success do we think you could apply and then still be independent and unique for whatever location you’re going to be in and use the best of what we found to work, but also use the best of what you’ve found to be working and if it works better in your office, let’s take that idea and have it go throughout Espire.” - Brett (20:36—21:26)

“Some pitfalls were…it’s harder than it looks. Sometimes in finding cultural alignment you…it’s like dating…In our first year we reno’d this practice, we did all these things and we learned it wasn’t a good cultural fit and we divested it.” - Jennifer (21:58—22:30)

“We have learned to ask better questions to make sure the person in the deal is a right fit and is ok being uncomfortable. Because you come into Espire and there are a lot of things we can do to support you but we are also going to challenge you and ask you to do a few little different things that you maybe you wouldn’t have to do if you joined another type of company.” - Brett (22:58—23:26)

“There are a lot of other DSOs that are really hands off. That is not us…We are all partners at the top level. So you are now part of a real group where every doctor who is an owner owns all of the company. So it’s in all of our best interests to help elevate each other and life each other up. You’re not on this island. THe culture is so different that way. And if you want that direct line of mentorship…I don’t know if some of those other organizations do that. I didn’t experience that in my 6 months of [somewhere else]. But here, when our young doctors are in first smile designs, I’m in there with them coaching them like this is what you do. But I’ve never placed an implant in my life and they need mentorship there, I who to call in the company who is going to go over and mentor them through that process. I think we are so much more integrated and aligned with each other that you really do feel like you’re part of a team.” - Jennifer (28:04—29:24)

“For me, a land grab…if someone said ‘I primarily want to be paid top dollar for my practice and I don’t care’…that may not be someone that we want. We can pay top dollar but we want you to bring more to the table than just saying ‘Pay me and I’m not going to do anything different or I’m not going to work anymore.’ A land grab is just where these companies grab whatever they want. They don’t care the quality. They don’t care to have consistency within them because they’re searching for a certain number of practices, a certain financial number that gets on to the next cap event or whatever it is. We want more than that. We want to have those opportunities but we want to have it in a much more choreographed and deliberate manner than a lot of other places to.”- Brett (30:00—30:56)

“We have a CEO, CFO, COO, CMO, Regionals, Practice Managers. We have all of that in place. And every Wednesday our leadership gets together from 9-12…and that’s where we have the opportunity to bring up ‘Hey I need support over here. Hey this doctor is struggling and I haven’t told you about it. Can you go and help them, Jennifer?’ We go through all of that process.”- Jennifer (31:29—32:11)

“That is seems easier than it is. You think it’s going to be a lot easier than it is. And a lot of dentists might start the process on their own thinking I got this. I can do this. As doctors we get a lot of positive reinforcement all day every day…but when you go into this other side of things you think that’s going to be really easy too and most dentists max out what they’re able to do. I just think about what we put into our practice. We have the 12 treatment rooms and it was like we had two jobs. I would go home at night and pass out for a few minutes and then I’d wake up and get started on some kind of marketing project.”- Jennifer (36:49—37:39)

“When you define your culture and your way early on, it’s much easier to say ‘I don’t think this is working.’ Jennifer said ‘Fail fast.’ I don’t think we have gone through this. We can find when people are becoming uncomfortable with some of the accountability. I don’t mean that in a bad way…It’s not the perfect scenario for everyone.” - Brett (40:27—40:48)

“If you buy another practice and you’re working less, you’re probably ruining that practice. What are you driving there?”- Jennifer (40:27—40:48)

“[A year from now] I hope we have created enough awareness in the community of we are doing. That we are real people behind this trying to do something. Do the right thing. And do something well. That we are more than just a group. And I hope by then we’ll start to have this reputation in the community.”  - Jennifer (43:25—44:12)

“[A year from now] I want us to be an agent of change for good in dentistry. There are so many things that the DSO corporate world…people interpret that as this big negative and I want to be a place where people want to come work for us because we know they’re going to have an exceptional experience, exceptional support and be able to do great things because we are going to want to push them to do great things. I don’t want someone who is going to sit and coast. And I hope that people look at Espire as a place that you can do great things from top to bottom.” -Brett (44:20—45:07)

Snippets:

0:00 Introduction.

14:00 Creating culture.

20:36 What worked and what didn’t. 

23:28 Change is hard. 

28:04 The Espire Difference.  

29:36 A land grab. 

31:15 Leadership. 

36:42 What others are getting wrong.

43:20 What’s on the road ahead.

Dr. Brett Levin Bio:

After obtaining his dental degree at the University of Pennsylvania School of Dental Medicine, Dr. Levin returned home to Denver to practice with his father, Dr. Alan Levin. Having served the Glendale/Cherry Creek area for over 20 years, he values the “idyllic” relationships he has created with his patients. He is committed to upholding the traditions of Espire Dental while incorporating the best of modern dental practice technologies.

Dr. Levin is one of a select few clinical instructors at the prestigious Kois Center, a clinical program designed to integrate the latest advances in esthetic, implant, and restorative dentistry. As a leading Denver cosmetic dentist specializing in dental veneers, same-day crowns, and clear aligners, he is uniquely qualified to give patients the smile of their dreams.

Dr. Levin is a respected member of the Denver dental community, having served on the board of the Metro Denver Dental Society (twice) and being awarded 5280 Magazine’s Top Dentist every year since 2008. He has also traveled on medical mission trips, providing dental care to communities in need. 

Follow Dr. Levin on Instagram https://www.instagram.com/brettrlevindmd/

Dr. Jennifer Derse:

After dental school at Marquette University School of Dentistry, Dr. Derse focused her practice on cosmetic dentistry in Scottsdale, Arizona, and taught at the Arizona School of Dentistry. In 2010, she moved to Denver to join Espire Dental, formerly Levin Family Dental, where she has maintained a Top Dentist award by 5280 Magazine every year since.

Dr. Derse completed the Kois Continuum and focuses her dental practice on esthetic and restorative dentistry. She is actively involved in the Denver community, serving on local non-profit boards and fundraising with Smiles for Life. She has also gone on numerous medical missions to the Dominican Republic and Guatemala to provide dental care in needy communities. To build upon her service in non-profits, she started the Derse Levin Foundation, Espire’s philanthropic arm that funds humanitarian work along with local charities.

Dr. Derse loves puppies, traveling, cycling, and spinning (you can ask how she fell off the spin bike). Fun fact: as a leading cosmetic dentist specializing in dental veneers, same-day crowns, and Invisalign, she is often called up as an expert witness for dental cases presented to the Colorado Dental Board. 

Follow Dr. Derse on Instagram https://www.instagram.com/espiredental