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The Group Dentistry Now Show: The Voice Of The DSO Industry – Episode 67

POSTED BY: GROUPDENTISTRYNOW OCTOBER 7, 2021

One of the winners of the Emerging Groups to Watch Award in 2020, Dr. Barry Deirmenjian, CEO of Smiles West, joins the Group Dentistry Now Show to discuss his DSO’s success.

A privately solo-owned DSO self-funded by the CEO without any financial sponsors or PE backing, Smiles West is compassionate to the dental provider, while understanding the business necessities of the company, all the while providing multi specialty dental services to the community regardless of payor type or economic situation. Every patient is treated equally and every dental staff and doctor the same. Smiles West’s goal is to create a healthy multi specialty dental opportunity for all communities through access and acceptance of all insurances, while providing an amazing and unique environment regardless of economic background. Their growth is a amalgamation of key acquisitions/mergers and strategic startups.

If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes http://apple.co/2Nejsfa and a Thumbs Up on YouTube.

Our podcast series brings you dental support and emerging dental group practice analysis, conversation, trends, news and events. Listen to leaders in the DSO and emerging dental group space talk about their challenges, successes, and the future of group dentistry. The Group Dentistry Now Show: The Voice of the DSO Industry has listeners across North & South America, Australia, Europe, and Asia. If you like our show, tell a friend or a colleague.

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Full Transcript:

Bill Neumann:

I’d like to welcome everyone to the Group Dentistry Now Show. I’m Bill Neumann. And as always, really appreciate everybody for listening in or watching us. So, if you’re listening to us on Google, or gosh, on Amazon, or Apple, or even on Spotify, or if you watch us on YouTube, or just go to the Group Dentistry Now Show website and check us out there, without an audience, we wouldn’t exist, and without great guests, you wouldn’t be here to listen in or watch. So, really happy to have Barry Deirmenjian here. So, Barry, first off, personal friend. I’ve known Barry for quite a while. I’m going to say it’s got to be at least five years, Barry, would you say?

Dr. Barry Deirmenjian:

Yes, yes. Absolutely, yes.

Bill Neumann:

But previous to the five years that I knew Barry, he’s been in the industry for a lot longer than those five years. So, we’ll talk a lot about the history of Smiles West, and that’s Barry Deirmenjian’s group, and what they’ve done in California, which is a feat. And just talk a little bit about what he sees as the future for his group, but then also the future for the industry, and how he’s gotten from the early days in 1996 with one location to where they sit today, and then at a pivotal point, I think, in the history, right, or that transition maybe that you might go through in the next couple of years or maybe less than that for Smiles West. So, we’ll talk a little bit about what he’s going to do. So, again, Barry Deirmenjian, Smiles West, thanks for being here.

Dr. Barry Deirmenjian:

Thank you so much, Bill. It’s an honor, it’s a privilege, as a personal friend also, for all the great work that you do and your group, Group Dentistry Now, does, giving us information monthly, weekly. You’re a big asset, and I’m very happy to call you a friend of mine. So, thank you for having me.

Bill Neumann:

Thanks. This is going to be fun. I’ve been looking forward to this for quite a while. So, like I mentioned before, Barry started his group back in 1996. And of course, the DSOs didn’t exist then, right? Maybe they were a DSO, but they weren’t called DSOs. So, I think they might have had another acronym. We’ll let Barry talk about that. But started in California, Southern California. Really interesting thing, I think, about Barry’s group, Smiles West, in particular is that they really are providing access to underserved communities. So, they accept all forms of payment, right? So, all sorts of insurance payers, and we’ll talk about the challenges there, because there’s certainly a lot of challenges with accepting all sorts of forms of payment. Maybe some of the challenges of working in California, which may not be one of the easiest states to work in, it’s probably not a secret, but still being able to provide quality care, the best patient care that you can. Talk a little bit about that.

Bill Neumann:

And then a little bit of background on Barry, and then I’m going to let him fill in any of the blanks on Smiles West, and then also on his background. Barry graduated from undergrad California Irvine with a BS in Biology, and then graduated from University of Pacific dental school, and worked at Guards Dental Group for a little while back in the early to mid ’90s. And they had 40 dental offices. They were part of SafeGuard Dental Insurance, which is now part of MetLife. So, I had never heard of the Guards Dental Group, so that’s a new one. But I’m going to stop there, and I’m going to let you fill in the blanks, Barry.

Dr. Barry Deirmenjian:

Sure. So, yes, we graduated in 1992. And my first job was at Guards Dental. It was a insurance company owned dental group that was approximately 40 offices. This is before anyone was really looking at growing. There was very few people that were able to do this in California that you needed the Knox-Keene license. And that’s some type of regulatory license where you’re able to own multiple offices. Back then in California, you can only own two offices, and spend 50% of your time in one office and 50% of your time in the other office, and that’s it. So, you could have a partner, and maybe you can own four offices. Back then, these were called MSOs as we started to grow. And the laws changed in the late ’90s, to where you can now own multiple offices.

Dr. Barry Deirmenjian:

My start with Guards Dental was probably the best for me, because this insurance company would see their insurance patients, and they would see PPO patients. They would not see any other payer mix. No other managed care plan except their own. And it taught me so much. I’m a 24 year old kid right out of school, bright eyed, bushy tailed, and I was ready to learn. And I went to my manager, who I still see at conventions, she works in the industry. And they taught me about the insurance contracts, and what all this means, and how do you work with patients with different insurances? A great learning experience. At the end of ’95, I decided it was time to go off and do my own thing. My ex roommate came to me, and they said, “Let’s go open an office somewhere.” And we said, “Okay, we’re going to Los Angeles.” Where are we going to open, Bill? They said, “Go to a retail location, next to a supermarket, next to a pharmacy in Los Angeles. That’s how you are successful.” Okay, great. I don’t know anything about this stuff back then. And that’s how we started.

Dr. Barry Deirmenjian:

And we got in contact with insurance companies. We contracted… We felt that we needed to contract with all insurance companies and accept all payers, because Los Angeles is its own state. There’s over 10 million people just in the city and the county. So, we decided to open an office in a retail location and accept all insurances. So, when one person walked in, and the dad had a PPO, and the mom had an HMO, and the daughter had a Medicaid program, and the other one had a capitated Medicaid program, we didn’t want to segregate and say, “Mom is great, dad is great, but you know what? Your kids have to go somewhere else.” Because we didn’t think that that’s the right thing to do. And we followed through with this concept, where we would accept all insurances, no matter what it is. And we would work with the patients. We would work with the insurance companies to give access to everybody that wanted dentistry for all specialties, and provide them with good oral health care. And we continue with that thought process all the way through now.

Dr. Barry Deirmenjian:

And patients over time switch from one insurance plan to a different type of insurance plan to no insurance. But once they are tied down and they know that you’re taking care of them, they always stick with our offices. So, that’s really what’s been able to make us successful in our business. And that’s where we started. And then from Los Angeles, 1997, I said, “Where are we going to go next? You know what? Let’s go to Oakland, California. It’s only a six hour drive away. And let’s go there.” And we opened an office in Oakland, California. I would get on a Southwest flight every Monday morning, come back on a Tuesday night. And we worked with the insurance company back then, because there was a big need in that area, and we continue to grow there. So, we went from Los Angeles to Northern California. And then we got a call a couple months later from the insurance company saying that, “Hey, you’re doing such a great job for us. Can you open us an office in a different city?” No problem. I can name that tune in 30 days. And we moved to Fremont, California. And from there, we grew to Northern California, a little bit further northern. We went to Nevada. We went to Northern Nevada in Reno. And everything was working out great.

Dr. Barry Deirmenjian:

About 2007, we had about 14 offices between me and my partner. We came to a standstill, where everyone wanted to go their own way. So, we disbanded the partnership, which is not unnormal in this industry. But it was a very amicable breakup. We sold off a group of offices. I took a couple offices in Los Angeles, he took a couple offices in Northern California. Life was great. From there, I feel like I was in the Al Pacino Godfather III movie, where every time you try to get out, they pull you back in. Well, guess what? We got sucked back in because we don’t do this for anything more than the love of dentistry and the love of the business and the love of the culture that we are around. And we grew then from two offices, now we’re at 20 offices. And we were at a point where it was a little difficult in the beginning, because when you’re between… And this is just my view. When you’re between three and 10 offices, you’re in quicksand, no man’s land. You’re not too big, you’re not too small. It just is very difficult. But once you get over the 10 office mark, in my opinion, that’s where you can get economies of scale, you bring in a corporate staff, a corporate team, centralized services, and that’s where you’re able to continue to scale at a faster level. And that’s what we’ve been doing since then.

Dr. Barry Deirmenjian:

And we have grown by de novo, we have grown by acquisition. And a lot of times, we’ll keep our brand that’s been there. If that brand has been there for 30 years, and the area knows that brand, we don’t want to rebrand it. Many times we do rebrand it if it’s something that we feel that we would add more by using our Smiles West name. But we have two or three other brands. Well, one is called Desert Dental Group in the San Bernardino area. Ponderosa Dental, and my wife has an office. My wife’s a dentist too. And her name is… Her office is Dental Wonderland. So, we have a few different brands that we are going to continue to grow on as we continue to grow with Smiles West. That’s in a nutshell how we grew from 1996 to 2021. And we are looking to further grow in California, different areas, underserved areas, and areas of need. And we’ll be offering more services, more adult, more pedo, more ortho, providing a lot of services that people don’t have access to due to their type of insurance, and due to a lot of providers that don’t accept any type of insurance. So, we want to be the premier office in our space to be able to do that. And I think we’re on the track. We’re already on the right track of continuing to do this.

Bill Neumann:

Excellent. Well, thanks for laying out all that information. Now, you’ve just given me a bunch of questions to ask, so this is good. So, you know what? I’m going to take a step back, which I didn’t mention, shame on me. So, Smiles West was a winner of the 2020 Emerging Groups to Watch Awards. And at that time, so there’s an application that has to be filled out, so the application was filled out, my guess would be sometime in late 2019, so pre COVID. And at that time, you had 16 locations. So, you mentioned now you’re up to 20, so you were able to add an additional four locations during COVID, which is just an incredible thing. I know it is a challenge for anybody under normal circumstances. And then given COVID and the shutdown, and being in a state that probably a little bit more locked down than some other states are, so I’m sure it wasn’t easy. So, maybe we talk a little bit about growth during COVID, which I think will be a great thing to talk about. And then I’ve got a couple other questions for you. So, maybe we talk about that if you’re okay with that.

Dr. Barry Deirmenjian:

Sure, sure. COVID was very challenging. We had to do a lot of changes to our team and our staff. We tried to keep everyone together. We just told everyone just hang tight with us. You’re our family. We will take care of you. Just give us a little bit of time to catch a breath. Let’s just kind of… We got sucker punched all of a sudden, and we just got up off the canvas, and we’re like, what do we do next? What’s the next thing? And we started working with offices that were centrally located, and we converged multiple offices into one, taking emergencies only in the beginning, and then eventually reopening up into areas that we can provide more services for the patient. So, it was very challenging. We have an amazing team. We have amazing providers. They all stuck by us and we stuck by them. And we were able to continue to navigate this difficult journey that we have. We’re kind of like on the Titanic right now. We don’t know what to do. Do we jump? Do we try to hang in there?

Dr. Barry Deirmenjian:

We all hung in there. If your basic concepts and your ethics and everything is in line, everything will work out. And that’s what we really believed. And it did. And as we were growing, we ran into areas where there were some offices available that we had our eye on that were underperforming. And we said, “Okay, let’s try to bring those groups on. Let’s keep the staff together, and let’s continue to grow.” And we did that. And we added a few more offices into the group. Continued to grow our platform, adding a call center, more centralized services, centralized marketing. And everything just fell into place. And we were going out of our way. We were doing things that other people were not doing. We weren’t sulking. We were saying, “This is a great day. We need to make things better. Let’s try to serve patients. Let’s try to keep emergencies out of the emergency room and make things better.”

Dr. Barry Deirmenjian:

It was very difficult. Everyone’s afraid. They don’t know COVID. I’m going to get sick. My family is going to get sick. People couldn’t work. We adjusted a lot, Bill. We allowed a lot of people to work from home, made those arrangements for everybody, tried to take care of a lot of the people and make sure that they were able to take care of their family. And then family comes first, work is second, but we were able to get people to balance that and continue to take care of our patients. And a lot of offices were closed, still are not a full capacity. We are above and beyond full capacity. We’re probably about 140% of where we were during COVID. And we didn’t skip a beat. We had a little bit of a hiccup for about between the end of March till the end of May, where everyone did. We had some great resources, the government, PPP loans, the HHS grants that were given out really helped us to continue to grow. And it all worked out well.

Dr. Barry Deirmenjian:

So we’re continuing to grow. Our growth pattern, we’re looking to grow about four to eight offices per year moving forward starting 2022. We’re looking to grow into different markets. We have a lot of opportunities out there. And we’re just trying to see what the right way is for us to grow in a healthy manner as we continue our path, and to give a little bit of tips to the younger DSOs or the young kids that are out there. And I’ve learned from a lot of people that we need to be giving back to people that are where I was five or 10 years ago. Maybe when I started, that wasn’t my mentality, but I will always be there to help someone, mentor someone, teach them, open up whatever we have to help them grow as well. And you get to the point of, okay, now we’re at 25 offices, 20 offices, and we are self funded, we’re private. There is no partners besides my wife, who’s my biggest asset and my best partner, and where do we go next? Can banks work with us to keep growing at the pace that we want to grow with?

Dr. Barry Deirmenjian:

And I think if three to seven to 10 offices is the quicksand, kind of, to try to get your offices to grow, I think 20 to 25 offices, you’re looking at what’s the next way to grow. And that may be with a equity partner to continue to provide equity to continue your path, your goal, your dream of growing your business. And we have a goal. We have a dream. And I get asked this question a lot, when’s it enough, Bill? And I thought to myself, when it’s not fun anymore. It’s been fun for 30 years. I wake up every morning and I’d say, “It’s a great day. I’m lucky I’m blessed. I’m in such a field…” My brother’s a forensic psychiatrist. My nieces are all in medical school going through all this medical stuff. I feel like I’m in the best business and profession that’s out there, because I can take my business skills along with my love of dentistry and helping everybody out, helping the community, and mix that all together, and that’s Dr. Barry Deirmenjian.

Bill Neumann:

That’s great. So, what a great quote there, when is it enough, and when it’s not fun anymore. So, that’s really… That’s a great perspective. That gives you a great idea when you start not having fun, you better go, okay, well, what should I be doing now differently? Yeah, so the four practices that you added during COVID, were they… You mentioned that there were some practices that were underperforming that you had your eye on. So, were they all acquisitions, those four?

Dr. Barry Deirmenjian:

They were all acquisitions. So, in 1996, it was a lot easier to do de novos in California, because the price of construction was maybe one sixth of what it is today, one fifth, one sixth. Cost of rent was maybe 25% of what it was today. And it’s a lot more saturated now, even though there’s enough room for everybody. Let me just tell you that. There’s enough room for everybody, but there’s a lot more saturation now, not just from DSOs, but from single owners. If you have one office on the left and one office on the right, and there’s a sliver of space in between, someone’s going to find a way to put an office in there, because he’s seeing that these other guys are successful, which is okay. Competition is great. And we never look at any other office being as competition, because everyone does their own thing. And at the end of the day, if your goals and you’re mentally aligned that you want to serve the people and take care of them, everything else falls into place.

Dr. Barry Deirmenjian:

So, these four offices are offices that I might have had in discussions with before. And it didn’t work out. A friend calls back saying they want to get out. They’re not into this anymore. And we would jump in there, and we would 100% try to keep the whole staff, and then what can we do to take what these doctors have built, their legacy, and make it better? And that’s what we try to do. I’m actually going to an office today for someone that used to be part of another group that I bought. And I’ve looked at it before, and he wants… He can’t really survive in the COVID world right now, post COVID world. And we’re probably going to acquire that office in the next 30 to 60 days. So, it just keeps coming, Bill. It’s fun. This great stuff.

Bill Neumann:

So, another thing you mentioned, and it’s nice to see the smile, so you’re, right, you legitimately are still having fun. Talked about the three to 10 being quicksand. Talk about how you got out of that quicksand. How do you make that move? Because that is a definite pivot point., whether it’s three, whether it’s seven, whether it’s 10. You hear that all the time, and I think a lot of people, a lot of groups get stuck in that quicksand, and then they… Help, right? And then they look for the help, and maybe they could have gotten themselves out of that somehow, and grown, and then eventually sold, but sold for more, or partnered maybe with somebody that they maybe wanted to, versus I’m stuck, I need help, and then just look for whoever’s going to throw the anchor out to them.

Dr. Barry Deirmenjian:

So, the three to seven, let’s just call, three to seven, three to eight, no man’s land is what I used to call it. I call it quicksand, no man’s land. You’re at a point where the banks are now saying you’re not really a DSO. We’ll loan you for one office, maybe two. The third one, maybe. How are you going to get the other ones? Am I going to bring on a partner that I don’t want to partner? Am I going to bring on a silent partner that just going to bring finances in, but I’m going to give away all this equity for all the work that I’m doing? Or do I look for a bank that’s going to partner with me that goes from that. Because there are different banks that will finance one, two, three offices max. Then there are other banks that will take you from the three to eight. And then there the other ones that’ll take you from the 10 to 20 range.

Dr. Barry Deirmenjian:

So, we started off with one bank. We went to a second bank, and we just made it through. It was very difficult, because, do you have enough resources to bring on a vice president into the company? I have to give the shout out to my vice president. Her name is Lisa Iskandar. I would not have been able to grow without her. Honestly, she was amazing. And she came along… I shouldn’t… I don’t know if that’s the best way to say it, but when I made an acquisition, she was the office manager of this office. And I was able to see that she has the abilities to run a big operation, and she has made my life so much easier. And she protects and shields me from a lot of things, because I worry a lot, and I’m concerned about a lot, and she takes the brunt of that on. So, you have to find that Lisa. And I have Lisa, but not too many people have a Lisa.

Dr. Barry Deirmenjian:

So, when you have that, that is it. You’re able to grow when someone cares just like you are, just the way you do. Your mindset is aligned. Partners, the mindset’s not aligned. One person wants to work hard and one person wants to take it easy. One person thinks, yeah, I got all these offices, I don’t need to work anymore. I still put in 60 hour weeks when I need to. I fill in for doctors that might be sick or might be on vacation, just so that we don’t have patients not being able to be treated. And it’s not fair to them. It’s not fair to the staff to be giving them days off because the doctor called in sick. I’m always willing to jump in and help out, still do dentistry when necessary.

Dr. Barry Deirmenjian:

And it’s nice to see 30 years later, where not only did I see that that patient, I saw their child, now I’m seeing their grandchild. So, maybe I’m dating myself a little bit, but I’m on the third generation already, which makes me feel great. You’re able to see all these people. You’re walking down the street by an office, and someone yells at you, “Hey, Dr. Barry.” And you’re like, “Hey. I can’t remember your name very well, but I remember those teeth.” So, that’s the difference. You got to get past the 10 if your goal is to get that far. But early, we made a lot of mistakes. And we came out smelling like roses, because we were able to learn from the mistakes. That’s the only way you’re going to get better, if you make the mistakes, and then you keep growing. And we went backwards, Bill.

Dr. Barry Deirmenjian:

So, when I was with my partner, we didn’t build a platform. We just kept saying, let’s add offices, and then we came back to build a foundation. But when I split off from him, and I only had two offices, I started off with the foundation. So, I learned so much. Partnerships for me can be great. Many times, they don’t work out, I’m going to put money on it, more than 50% of time, partnerships don’t work out. So, when that does happen, that, I was given a reset. And I think to myself, I could have been 50, 60 offices if I stayed with my partner, but I wouldn’t have been happy. So, being smaller, being happier, and continuing to learn and grow. And then we start getting into these meetings that we go to. I think we met at a Dykema meeting five, six years ago. And you learn, you get more resources, you partner with the right people like yourself, and you just learn a lot and you continue to grow. So, I don’t know if I answered your question, but-

Bill Neumann:

Yeah, you did. You sure did. So, it’s interesting, you’re at a point now where you’re considering bringing on an equity partner. So, you’re at that 20, that number you said, okay, well, banks, you’re not going to get the lending that you need, and maybe it’s time for an equity partner. Take us through, if you don’t mind, what you can disclose. What’s that process like? And just any maybe words of wisdom for somebody that might go through that in the next year or so.

Dr. Barry Deirmenjian:

So, I’m going to tell you that there’s three keys. First of all, lawyer, CPA, advisor. These are the three. And I’m more than happy to share who I work with and who’s made a big difference in my life. Brian Colao with Dykema has made a big, big difference in my life. Not only has he become a friend, he’s a great advisor, a great attorney. He’s just done a lot for me. So, find that right attorney, whether it’s Dykema, whether it’s someone else. For me, they were the right person. When you have the head of the DSO department calling you during COVID on a Sunday night, making sure that your family’s doing okay, means a lot. That doesn’t happen very often.

Dr. Barry Deirmenjian:

Second one, get the great accountant. Get someone that you work with well. We work with Mike White at CLA, and he has a ton of experience, and he has helped us get our financials in the right area that we needed to be, so that if someone asked a question, we can honestly say these are what our financial numbers look like. Thirdly is get a good advisor. I work with Craig Castelli and Kurt Harvey at Caber Hill and Associates. And they are amazing, wonderful. They have a lot of experience. And for me, those are the three keys that you have to have. That’s besides all the other friends that we have in the industry, just like yourself, that we can call and ask for, hey, Bill, what do you think about this? Can I get your opinion? Do you have a referral for someone that you can advise me on? And these are assets that that people need to have, and friendships that you have to build. This is just not a pick up a phone and meet somebody. But these are years of building and maturing of these relationships. And these are the things that are necessary to go to the next level.

Dr. Barry Deirmenjian:

And once you have all that going, I think you’re ready to go to the next level. And I believe we’re at that tipping point, that inflection point that we need to look at. We get approached all the time by private equity groups, DSOs. And we were never ready, but I think now we’re ready. And we’re ready to continue to take our path and our dream and our vision to the next level. And if you get those right people in place, it’s great. If you don’t, it could be tough.

Bill Neumann:

I think you mentioned, obviously, Brian Colao, well known, does a great job. And they have a great meeting. The fact that he called you on a Sunday during COVID to check in. And again, Mike White and his background, we’ve had him on the podcast a couple of times. And what he always talks about is making sure that you have your books in order. One of the first things you need to do is make sure you know where your business really is, right? He always talks about that, and how many groups don’t, right? You think you do. But having the actual numbers, not from you, right, but actually, from a third party, so you can actually look at where your business is, and have that perspective.

Bill Neumann:

And then Caber Hill and Kurt Harvey over there, and Craig, just, it makes a lot of sense. And I think a lot of groups, especially when you’re smaller, look at whatever the cost may be associated with having a law firm, or having a larger law firm that understands the space, and somebody like Mike White, an advisor, go, “I don’t want to spend that kind of money.” But the money that you save in the end or the money that you might make eventually is well worth the investment. And so, it’s definitely something that I hear a lot from, especially when you’re smaller, that nobody wants to spend the money. But well worth it. So, great people that you mentioned,

Dr. Barry Deirmenjian:

Don’t penny pinch on the important stuff. You get what you pay for. And these are all… If you want to go the next level, these are all the things that you have to… And it can be any legal team, accounting team. You really need to make sure that you get your financials and your books in order. As much as you think you know, you don’t know, until you get with the guys that are in this, and you understand that now you’re running a big business. This is not just a mom and pop dental office anymore. That’s how we all start. It’s a mom and pop. And because we’re dentists that are trying to run business, and a lot of people are businessmen, they’re trying to run dentistry, which might be a little bit easier. But we weren’t trained in accounting. We weren’t trained in all this stuff that’s out there. And especially in California with the employment laws, and the restrictions that we’re going through, I think we’re probably doing okay. We’re doing okay with navigating through these difficult… We don’t think that they’re that difficult, but anyone from the outside looks at it saying, “Hey, we don’t have to follow those rules. We don’t have to do that.” But you know what? It just… It works for us. So, we continue to grow, and nowhere else I’d rather be than California.

Dr. Barry Deirmenjian:

But we are looking also, just to give you a little nother little nugget, that we are looking to spread out into different areas and different geographies, neighboring states outside of our area. As you continue to grow, you want to look at all opportunities, and that’s what we’re looking at right now as well.

Bill Neumann:

Well, that’s great. So, that ties into the next question I have as we wind this podcast down. One of the questions I had was, what’s the future of Smiles West look like? So, you talked a little bit about short term and equity partner potentially, right? The right partner. And then just what you had mentioned, so you’d be looking possibly outside the state of California or other geographies maybe within the state that you’re not currently in, so growth. Anything else when you look at the short term future, let’s say the next couple of years?

Dr. Barry Deirmenjian:

So, we’re looking to expand in our specialty division, possibly do some more ortho pedo standalone locations. Most of our offices, for lack of a better word, are like a super Walmart, everything under one roof. So, we don’t like to refer someone to another specialty where you go there, they don’t know who you are, they don’t have your X-ray. So, we keep everything in-house. And we are looking to grow into other specialties in our neighboring areas, continue to grow with our technology. And we get asked by a lot of companies to open offices closer to their business because they’ve heard of our name, and insurance companies that I’ve been working with people for 30 years, and they’re like, “Hey, Dr. Barry, we really need you in this area. What’s the chance that we can do something?” And I’m like, never say never. It’s all great.

Dr. Barry Deirmenjian:

So, we are looking to expand more different geographies, expanded services, expanded hours, and to give everybody a full experience of accessibility. And just because you have a certain type of insurance, you shouldn’t have to walk into that office with orange shag carpet and wood paneling. We want you to walk into an office, close your eyes, and feel like you’re in Beverly Hills. It’s okay. We can make our offices very nice. We’re very… We have pride of ownership, and we want everyone that has an option to be able to come to a place where it’s clean, where you’re happy to go to this office. And that puts us aside from other people. We don’t cut corners on certain things. For office location, and the decorations, and the build outs, we try to make it where people are proud to come to that office, and they’re happy, and they refer more people. It just… We do what we… We build like if we were coming to that office, what would we want to see? Then that’s what we want to envision our offices to be. And that’s what makes us successful.

Dr. Barry Deirmenjian:

I try to… I’m very humble on the successful part. I always say we just keep trying to do better. And if we ever say we’ve reached that goal, then it’s time to get out of this game. We’re always continuing to grow, try, be better, offer more, do more, and that’s our motto. What else can we do? What’s next?

Bill Neumann:

That’s great. So, let’s finish things up here. So, we talked a little bit about the future of Smiles West. Do you have a… If you can get out your crystal ball for the industry as a whole, we see a lot of consolidation, right? We all see that happening. And when we go back to even five years ago when we first met, and the size of the meetings, and how they’ve grown, and all this interest, whether it’s a couple of docs getting together and wanting to be a DSO, whatever that means now, or whether it’s all this outside money coming in, and non-clinicians wanting to own DSO, which can also… Could be a challenge too. And maybe it’s a good thing for the industry, maybe it isn’t, it probably depends. Talk a little bit about what you’re seeing, and what do you think where the industry is headed, and that’ll be a good way to sign things off.

Dr. Barry Deirmenjian:

I wish I had that crystal ball so I could know when to buy cryptocurrency and when to sell cryptocurrency. But my crystal ball says to me that there is going to be continued consolidation. I think it’s going to continue to grow another 10 or 15 years. People are going to grow these groups, and then they’re going to consolidate into larger groups, which is not a bad thing. A lot of people need the help. They need that part of it. But I think, like for us, we don’t… We plan on continuing to grow. Our path is to get to 100 offices. Maybe that’s very aggressive. But I think at some point, you start to gain a little more speed for the growth. For everybody else, I think that there’s going to be consolidation. People are going to still grow these groups. There’s a lot of room for growth. And I encourage everyone that wants to get into this field, jump in. There’s room for everybody.

Dr. Barry Deirmenjian:

And then I think at the end, maybe down the line, 15, maybe 20 years later, you’re going to see, it’s going to be like the pharmacies, where you’re going to have only CVS and the Rite Aid and the Duane Reade at the end. You’ll still have your boutique offices that everyone wants to go to, which is normal, but you’re going to see a lot more where it’s going to be the big three or the big five or the big 10. But I don’t think that’s going to happen for another 20, 25 years. So, hopefully, I’ll be around to see that. I’d be happy to see it. I think we’re going to start to slowly see these larger dental groups, what’s the next level for them? I think that they’re going to go public. And all this is a cycle. This happened in the ’90s, and it didn’t work out well for a lot of people. But I think now, they’re grown where they’re too big to fail, really. And I think that they’re going to start to grow, and they’re going to go public probably in the next five or 10 years. You’re going to start see some of the larger groups. They just have to. They can’t continue to do what they’re doing. So, great stuff coming. Great industry. Great people that you’re involved with. It’s a fun ride. The ride’s still going, so we’re staying on. We’re not getting off.

Bill Neumann:

Yeah, that sounds great. Okay, and I love the positive note at the end. This is the positive note through the entire podcast. I’m happy, first off, happy to have Barry here, 2020 Emerging Groups to Watch winter, Smiles West. It’s been a pleasure, and a lot of great tips for some of the folks out there that might have one office that maybe just wants to add a second one, or somebody that might be in that quicksand that Barry mentioned in that three to 10 that’s going, hey, can I get out of this or not? And certainly, Barry was through it, and his team, and they were able to get out, and now, all of a sudden, they’re at 20. Looking for a potential partner and looking to get to 100 at some point. And then the fact that… And great point about maybe some of these groups going public. I think we saw it with Dental Corp in Canada recently, so we’ve already seen one in the Canadian market go public. But at some point, you get to such scale where you’re going to have to go public.

Bill Neumann:

So, a lot of exciting things, and glad to hear that at least for the next 10 to 20 years, there’s still opportunity. So, that gives a lot of us hope that we can stick around for a while, which is great. But again, thanks, Barry Deirmenjian, CEO, founder of Smiles West. Thanks for being on the Group Dentistry Now Show. We appreciate the insight.

Dr. Barry Deirmenjian:

If there’s anyone that needs help with anything, they can always reach out to us through Bill. We’re always out there to help anybody that needs help. So, please reach out. Bill, you’re doing an amazing job. Your group, your program is amazing. We can’t wait to see your newsletters every month, because you are always on the cutting edge. Thank you for all your… Everything that you do for our industry, because you add us, and you make us better with everything that you’re doing. So, thank you again. Thank you for having me. This was a pleasure. I was a little nervous at first, but time flies when you’re having fun.

Bill Neumann:

Well, you didn’t seem nervous, so maybe we’ll just edit that part out. Barry, if it’s okay, are we able to put your email address in the show notes if anybody wants to talk to you?

Dr. Barry Deirmenjian:

Absolutely. I’ll put it out there. I’ll send you my logos because you wanted the logos too. And you really do a great job. I got to know you a lot better in Detroit, your history, and all the stuff that you’re doing. But kudos to you. You’re the premier person in your department of what you’re doing. And continue to grow, and continue to do what you’re doing.

Bill Neumann:

Thanks. I’m going to stick around just like you are, so I appreciate it. Thanks, everybody, for listening and watching us. This is the Group Dentistry Now Show, and until next time, I’m Bill Neumann. Thanks.

Dr. Barry Deirmenjian:

Thank you so much.

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