When we last left our story, we had decided to raise capital to expand our services and affiliates at a much more rapid pace. Now, a post on the vagaries of becoming a public company and dealing with life as a public company is a matter for its own blog. That is not what we are discussing here. I’ll sum up the process by saying this: lots of time, lots of lawyers, lots of headache, lots of distractions but unbelievable sums of money available to run your business. By December of 1994, a company called Orthodontic Centers of America had been formed, raised about $18 million (after fees) and began trading on the NASDAQ.
With the extra funds, expansion began rapidly. We could build offices almost anywhere we wanted (provided a doctor was available) and acquire the agreement to manage numbers of offices in one fell swoop (provided the other side wished to enter into an agreement with us). When we went public, we were managing 75 offices. With capital, that number quickly moved to 200 and in excess of that as we were able to raise more funds and add affiliated practices.
The expansion required us to be even smarter, more efficient and technologically knowledgeable to provide services to a large array of services to a wide ranging array of practices. What works for a practice in Charlotte, NC may not produce results in Minneapolis, MN and so on. We also needed to be able to provide top notch services in an efficient way. With 50 offices, you can review large reports, pick out what matters and then devise a plan to act on that information. With 300+ offices, that’s almost impossible to do the old way in a reasonable time frame. You need to process data efficiently and be good at what you do to get to the heart of the matter quickly. On top of that, in our environment, the process did not slow down. We had funds to grow and our shareholders expected us to use their money to do just that as quickly as possible.
Over the next several years, in addition to the continued addition of new offices, 3 major developments shaped us:
- A base of talent was thrown into the fire and had to figure out exactly how to provide services in an effective manner, in a stock-market-impacted environment, with no slowdown in growth. Over time, they all developed individual levels of expertise, relationships with doctors (so incredibly important) and experience that could not be replicated in any other environment. You have heard or will hear from those folks like Michael Cusimano, Derek Leonard, Dennis Buchman and a host of others on this site.
- Because we were unique as a business, we developed a number of technologies and systems on our own rather than deal with 3rd party vendors who developed products for the general population. Over time, we developed our own practice management software, online purchasing application, online reporting application, trouble ticket system, marketing plan implementation systems and a number of others. To develop these systems, we needed a ground up understanding of each of the services provided by these applications. Not only that, but because we wanted to provide the best service possible, we also learned a lot about customization and implemented that knowledge in our systems.
- We entered markets outside of the United States. It all started with Japan in 1998, followed closely by Spain and Mexico. Later, Brazil and China would come onto the radar. Not only did we have to have the same level of knowledge we had in the United States, but we had to adapt our systems to various languages, cultural norms and laws.
By 2001, the company was pushing 600 total offices, gross revenue from combined practices of around $500 million per year. Services had expanded to include pediatric dentists as well as a little bit of general dentistry.
A number of doctors that had been affiliated with us for some time had grown very comfortable with the systems that we had surrounded them with and wanted to do more. A number of them had 2 or 3 offices with maybe an associate or 2 helping them. We wondered, why couldn’t that 2-3 office number become 10-12 offices with multiple associates. If we could monitor and manage hundreds of offices from a central location, why couldn’t those principles be applied to individual practices to turn them into their own group practices? We felt that this idea could be a mode for motivated doctors to build something special for themselves.
As it turns out, this idea worked quite well. Practices in Tampa, Atlanta and Dallas, to name a few, added offices and maintained or improved upon excellent responses to the quality of care provided. Doctors were able to focus on the more complex treatment issues in their practices while leaving the day-to-day operations to us. As such, a doctor's personal income would rise substantially while allowing him or her to
By 2005, this expansion and the acquisition of OCA’s largest competitor pushed the office number to its highest levels ever. The experience level grew substantially with each new challenge and originality of solutions to problems flowed like water. Later that year, a combination of Hurricane Katrina, a hedge fund, Sarbanes Oxley and some fallout from that acquisition combined to “break up the band.”
Bart, Sr. and I took on the international practices and manage them to this day. Others went to run their own businesses or took their talents to the highest bidder.
In 2012, we decided that all of the knowledge we had built over the years was going to waste if we didn’t share it with the world. An appropriate cost for the knowledge seems to be zero. The economy is tough out there and we didn’t see any need to burden the doctors with costs related to consulting services. MyPracticeEngine was born in 2013. As such, we’ll continue to post and we hope you will continue to read, comment and enjoy.
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