Episode 27: A New Model for Dental Employment

00:19

Kristin Hohman: Hello, welcome to the ProdPod, a podcast from Dental Products Report. I'm Kristin Hohman, associate editor of DPR and host of the ProdPod. In each episode, we feature leading voices in the dental industry and highlight topics of interest to dental professionals including new products, clinical techniques, industry news, and trends, as well as tips and tricks for procedures and practice management.

00:53

On this episode of the ProdPod, I'm pleased to welcome Joe Fogg, CEO of onDiem, and Sue Jefferies, a talent acquisition specialist at onDiem. Today we discuss the company's beginnings, its partnership with Higher Learning Technologies, and why the company recently began offering paid time off benefits for dental professionals on their platform.

01:26

KH: onDiem made news recently with the PTO. But before we get into that, I wanted to start at the very beginning. So, can you talk a little bit about your motivation behind starting onDiem? What was it about the dental industry and its landscape that you felt this kind of platform was maybe lacking?

01:43

Joe Fogg: So first, I'm just going to say the name onDiem. onDiem is the combination of ‘on-demand, ‘per diem, and ‘carpe diem’. Those are combined to create onDiem. Previously, I was fortunate enough to be a part of other startups that we scaled, and we had successful exits—not in the healthcare field. In that industry, 1 of my last businesses I was a part of, we were looking at our expenses. And, as a business, you're always looking to see when you're running that P and L (profits and losses), what kind of expenses you have. One of our expenses that we had that we weren't getting a lot of use out of was our dental insurance for employees. We were in manufacturing, so a lot of employees really didn't have an opportunity to utilize their dental insurance benefits. The reason why is in a manufacturing environment, you didn't have time in the day to have a break to go see the dentist—and sometimes you may not even have transportation. So, we've given a benefit to a lot of employees that unfortunately didn't have the opportunity to utilize that benefit.

I was looking for a change post-acquisition 4 years after that. I was going to start mobile dentistry back in 2012. So, I dove into the world of dentistry—mobile dentistry, 4 operatory, 5 operatory. What does it yield from a top-line revenue perspective? Can I bring it to larger organizations—Nike and Columbia Sportswear, these big organizations are in Portland, Oregon. And they were extremely excited about it. They believed in preventative oral health because they know that that the mouth is the gateway to overall health. In those big organizations, in those big HR departments, they were advocates of getting their employees quicker access to the industry. In that, I had to really explore how do we staff it. That was the moment being the catalyst of creating onDiem. I discovered that in this industry, it's like nothing else. You have, let's say 100,000 small businesses that are dental practices that—based on the Affordable Care Act—if they have less than 50 employees, they're held to some different rules. Which means that some of the benefits that small businesses give to employees, there's a threshold based on the number of hours worked. For example, it could be you have to average 32 hours over the period of 6 months in order to do that to receive health insurance and PTO. I then uncovered that all of these small businesses just based on the nature of how they're set up, they may not be open on Friday, or they may not be running hygiene on Friday. So, then you had this labor landscape of a lot are 80% of part time employees—it’s a hygienist working Mondays and Wednesdays or Tuesdays and Thursdays. They're never going to accumulate enough hours throughout the year to fall into hit those requirements to achieve those benefits. And yet they're so critical to the success of the practice. They're patient-facing, they're building those relationships, they're doing those procedures of the cleanings.

Then I found out how valuable they were as what I would call as a ‘rate limiter’ to the success of the practice. If that provider is out sick for whatever reason—kids sick, they're sick, they want to take a vacation—they're really challenged to try to backfill their time that they want to take off to find somebody to replace them. Simultaneously, because they may only be working 2 days a week, they want to earn extra income on the days that they have off because they want to have a full schedule. So, that was kind of an “aha” moment. I used care.com for a babysitter, I used rover.com to walk my dog, I used Airbnb to go stay in a place. I looked into this, and I didn't find anything that was a complete end-to-end experience that could take all of the, what I call compliance and requirement needs, and just handle all that. I'm talking payroll, W2 taxes, unemployment, and malpractice—making it so easy for the practice to be able to post that temp shift and to fill that while simultaneously creating a level of compliance because it's illegal to be a 1099 contractor. You probably saw a lot of noise about that last year with Uber and Lyft for the misclassification of employees. In dentistry, it says you have to work in the Practice Act under the direction of control or direct supervision.

So, we knew that if we could build a platform that can facilitate an easy, compliant place to provide work and do it in a compliant way, and give opportunity—because we get leverage of scale and volume—to then bring benefits to this labor class to be able to help practices. That is how it was born. And that's when we pivoted to instead of going with mobile dentistry, let's build this platform to equally help both sides of the marketplace.

06:24

KH: You mentioned Uber and Lyft, and then there's Instacart and all these other gig economy opportunities, or even some people call them like a ‘side hustle’—these terms that have been used to describe the kind of freelance opportunities like meal or grocery deliveries, taxi services. What made you think that that model could be applied to healthcare?

06:44

JF: You're 100% accurate. The reason it can apply so well to healthcare is that the need is so critical as relates to the success of the practice, and the success of that practice providing patient care. About 8 years ago, I saw a lot of articles that spoke to the different generations—millennials, Gen Z—in that demographic, it's all about ‘convenient’, and not ‘relationship’. So, when I went to the dentist, I knew my hygienist, I knew my dentist. There's a generation now that doesn't even know who their dentist is. So, that population is so focused on convenience, that if that practice, x percentage of their patient base is a certain demographic, they're susceptible to if you cancel that day, you may lose that patient. Then you have that patient that wants to access the care, and it's being canceled. And then you add a pandemic on top of it and everything else. It really creates some turnover.

We knew going into this, that because you have a mutual beneficial need for each other—the practice needs the hygienists and the dental assistants to be able to make that practice run smooth and take care of their patients and those providers need that practice as a source of income and in an industry that they truly care about. So, there's such a huge need for them both. The only thing that we saw that was facilitating this was Facebook. There are Facebook groups for every state hygiene association, dental assistant association. They would have these Facebook groups and say, “Hey, private message me,” bringing people in with no idea if their license is in good standing, they're not covered under workers’ compensation, and they’re not covered under malpractice. The risk that is exposed to those dental practices and those doctors and to those providers for simply facilitating it through that is so high. Now, sometimes they do it because as a small business, unfortunately, dental practices sometimes haven't had the business liability risk exposure. So, they may not even know what they're exposing themselves to. Part of that is we knew that the value that we could bring was mutually beneficial to both sides. That's how we knew we had the chance to be successful.

08:55

KH: Sue, I'll get you to jump in here. For anyone who is not familiar with onDiem, can you explain the process of finding work on the app and how employees are vetted through the app.

9:08

Sue Jefferies: We are kind of a self-serve, a la carte business. And what I mean by that is on the professional side, they set up their profile. And in their profile, they are able to select where they want to work—the distance, the range, how far they're willing to drive—and they put in their licensing information, and they can put in some resume-type information, anything that they want to present to a potential employer that makes them marketable. And on the other side of that, the practice does the same thing. They create a profile and they put up a picture of what their practices look like, they can provide a description of what their practice stands for, what their values are, and what they expect in a professional. Simultaneously, the professional and the practice can be logged into onDiem, each looking for what they need to serve themselves, and they find each other. You can click on a button that says, 'Hey, I'm available, and I see you have a job, and I would like to take that position.' And on the practice end, the practice gets to go through everyone who has applied for either that part time position, or a permanent position and select who they want to reach out to and invite them into their practice to work that shift.

So, what's really great about it, it's a matching of personalities, it's a matching of desires, it's a matching of cultures. And so the hope is, is that only people who have had an opportunity to either who they're requesting to work for or who they're requesting to come in and work for them, is a match before somebody even walks through the door. It's professional, it's selective, and it's personal. And that's what makes us different.

11:00

JF: Actually, if I can add to that, I mean that was spot on. Just a quick visual that I'd like to share with you. When you look at those different attributes, it is significant as far as the continuity of being able to be in the office. So, if you're a professional, you want to look for work, you're going to see different things. You can see here's an opportunity on the 16th, and here's the 19th. You can see the pay rate, you can see the providing PPE, you can see here's another one for 60 and 50, you can see other jobs. You can also then see where they're going to be at located in relationship to where you live. If I'm the practice, you get lots of insight—it is a kind of akin to a LinkedIn-style approach versus just the Facebook—you have the opportunity to see their abilities, you have their desired rate, you see experience, you see a personal bio. You also see special tags that are going to be relative to your office. She is selected, so you see she works in general dentistry and she's worked in perio, she's selected her types of certification that she has, she's selected the type of software she has. These are different data points that we use to provide better matches. So, now you're not just selecting somebody because they said there was a hygienist, you see that they're on the Facebook group. You actually see that the goal is they have the certifications that you need. That means they have experience and exposure that you're looking for and they're going to know the software that you're utilizing. It just makes all of that kind of flow better.

12:25

KH: OnDiem didn't actually stop with an app. Last fall, you had partnered with Higher Learning Technologies (HLT) to provide professional development tools. Can you explain that and how that program works and why it's important?

12:39

JF: I will give it 1 small explanation, then I'm going to pass it on to Sue. Essentially, the opportunity there is they're the #1 study app that both dentists and hygienists use to help pass board exams. I love technology—I have 3 kids right now that are all about to take driver's license test, they're all in the ODOT app studying for that. That is what HLT provides to the dental community. What we wanted to be able to do is set the stage for an opportunity, post-graduation, to handle some of this work, whether it's creating their free digital resume, creating the ability for them to go to working interviews. Sue actually is spearheading some of the initiatives we're doing with that alliance, so I'm going to let you kind of speak to that.

13:27

SJ: I'm so excited about this endeavor. I don't know I'm more excited about this endeavor or the PTO. I have been in dentistry over 35 years. I'm pretty well-known throughout the industry for various reasons. One of the things that I am known for is authenticity, and really sticking to my guns on what is important. I accepted a position with onDiem because their culture and their values align with mine. And what I mean by that is, we all know that dentistry is hard. You know, there's the saying that, 'Life is hard,' and I have a thing that says, 'Dentistry sometimes is harder.' We work really hard, and we work in many situations without benefits that shows up in what we do. And PTO, time-off, self-care, reconnecting with yourself, re-energizing yourself is so important.

As the CTO and co-founder of Dental Mental Network, I spend a lot of my time working with people who are stressed—they have no resilience left in them to pick up and carry on anymore. So, we're beat down, we're tired, we're exhausted, we're stressed out. We're all of those things. And PTO is so powerful and so impactful because it gives the professionals the opportunity to breathe—that day off with their family, to reconnect with their family. I know as a hygienist, Sunday afternoon at 4:00 p.m., my mood started to change because Monday was right around the corner—14 hours away. And I was going to start another week in which I knew I was going to be exhausted.

In many cases, dental professionals do not feel valued, you know, we feel undervalued. And that is a stress in-and-of-itself. When you think about overall wellness, mental wellness, occupational wellness is so important, and PTO plays a big role in both of these.

So, what we're doing as far as PTO is critical to the health and the wellbeing of our professionals, who are front-and-center in the care, values, and in the culture of onDiem. I couldn't be prouder to be affiliated with any company—I'm honored to be here and I'm honored to be a part of this initiative. I hope all of dentistry sits up and pays attention, and they raise their head, and they raise their voices, and they acknowledge that the only constant is change. And this change is needed. it's warranted, and it's positive. I just hope everybody wants to become a part of this.
I couldn't be prouder, as well, to be a part of this initiative, too. Essentially, what we're doing is again, we are connecting professionals with potential employers. And so, what that looks like is we reach out to a list of new graduates, we reach out to professionals that we find in other means.

And I get on a Zoom call with them. And... we really start getting into the nuts and bolts of who they are. This is definitely not an, 'Anybody will do' situation. This is, 'Who are you as a candidate? Who are you as a new graduate? Who are you as an experienced dentist? What is important to you? What are you looking for mentorship-wise? What are your core values that you know that your practice needs to also identify with?' So, when you're there for 8 hours a day—we're at work so much that we can't help that what happens there comes home with us. Just like what happens at home, sometimes comes into work with us. So, we want to make sure that this match is a match professionally, personally, value-wise, culturally, and what they hope to grow into as a provider. What are they looking to specialize in? Are you interested in implants? Are you interested in ortho?

When I talk to these students, and when I talk to these professionals, every single one of them is able to answer that question definitively without even thinking about it. They know what it is that they want to do. They know how they want to grow. They know if they want to become a leader, if they want to make work with one of our DSO partners, and take over a de novo, which is a brand-new practice that they're going to grow. So, some, they know right away, 'I want to grow into leadership and a DSO entity is better suited me because I know that they'll groom me, that they will provide the education I need. So that 1 year, 2 years, 3 years down the road, I have the opportunity to actually have my own practice.' And others know that that's not something that they want to do. They know that they want to go to work and provide the best care to their patients that they can. But at the end of the day, it's the end of the day, and they want to go home, and they want to focus on their family. And these are all important things to know.

So, what's again unique about this initiative is that we're caring about the people. We want to know what's important to them then know which practices, which is DSOs offer those services or have the same core values that are important to them, so that we can make great matches. We want people to stay in the roles that we match them with. We want longevity, no revolving doors—that's never good. When somebody loves to work and they stay at their work, then you optimize retention, which optimizes return on investment, which optimizes great word of mouth. Your clients want to come back, your profits go up, and you have an amazing culture and a great team. And everybody is happy.

20:25

JF: Here's the thing about onDiem—we are bringing on people that we want to help them find their career journey. So, we're not hiring them for ourselves. Now, they will work for us whether they do dentists locums or hygienist memberships and all that good stuff. But at the end of the day, they are our products and our value. So, our goal is to match them up with a customer, like Sue mentioned—whether it's a private practice who's looking for an associate, whether it's a DSO that's looking for this individual as well. So our goal is to understand our customers' needs on what we call the archetype of the profile that they're looking for. Then simultaneously, as we get significant top of funnel of candidates that are looking, we want to set them up for something that's going to bring them joy in their career. We're not just looking to play somebody to get a recruiting fee.

The beauty of what we have is we are a technology company that's human-centric. So we have the ability to overlay and combine both those attributes to leverage technology for ease of opportunity for all of the stuff that Sue just mentioned. But there's such a critical human effort that you can't get from filling out a form or digital form or on an app. It's that connecting of, 'What does this person want? What is this person looking for?' There's nothing more exciting than giving somebody their first job and getting that career, especially if you had to go through all that kind of schooling. And secondly, there's some sort of stat, I don't know really what the percentage is, of the shelf life of a dentist when they go to that second spot. Sometimes they take that first job, just really out of, 'I got big student loans, and I gotta get a job,' or they want to hone their skills. Whether that's private practice or corporate, they may find out in that 1, 2, or 3 years, that it's been great working there because they learned their craft, but it wasn't the right 1. So, then they want to go to that second location. And so we're giving them a mix of both those.

22:36

KH: Thank you to Joe Fogg and Sue Jeffries from onDiem for joining me and thank you for listening to the ProdPod brought to you by Dental Products Report. We hope you'll rate and subscribe in iTunes, Spotify, Stitcher, or wherever you listen to podcasts. Please leave us some feedback and let us know which topics you'd like to hear more about.

This podcast is produced by the team at MJH LifeSciences and our theme music is by Hook Sounds Music. Stay connected with Dental Products Report at dentalproductsreport.com; subscribe to our E-newsletter; and follow us on Facebook, Twitter, and LinkedIn. Thanks for listening and we'll be back soon.