Angela Weber is the president and concept creator of Smilebliss, a franchise-like provider of turnkey orthodontic practices with 30 (and growing) doctor-owned locations. Here’s how she’s reinventing the DSO concept for dentists who value ownership.

What’s stoking demand for assistance with opening and building independent ortho practices?
Consolidation in the market. The orthodontic practice business model has been so good for so long, which attracts investors and corporate dentistry. When I started out 20-plus years ago, what surprised me most about this industry is how anti-advertising it was. The American Association of Orthodontists was 100 percent against advertising. Then Invisalign came along, and you’re suddenly competing against DSOs that are advertising, and that left the independent orthodontist saying, “I’m bringing a knife to a gunfight.”

Did that insight inspire you to found Smilebliss?
Smilebliss is a response to strong demand from doctors who have an appreciation for what a DSO provides but are entrepreneurially spirited. They want to own a new practice or revitalize their existing one, where they can concentrate on patients and leave business matters to someone else, but continue to own it. They want the best of both worlds.

How is Smilebliss different from other practice management firms?
Smilebliss is a ready-to-go orthodontic practice in the same way McDonald’s is a ready-to-go restaurant concept. We help with building out or renovating the office, hiring, getting set up with insurance. With most practice management firms, if you pick 200 clients at random, they’re most likely doing things 200 different ways. This makes it difficult to demonstrate repeatable success. Smilebliss is like the franchise concept in that we own the IP, the brand, the operational know-how, the proprietary knowledge and the systems we put in place. But the doctor owns 100 percent of the practice.

Your first practice launch was less than two years ago, and now there are 30 offices. Why is Smilebliss is taking off so quickly?
Our startup practices are doing, on average, 600 starts a year. Prospective owners know they’ll hit the ground running. Immediately before the practice is even open, we’re plugging them into our marketing and social media. Most orthodontic practices under-invest in marketing, so we make that investment decision easier because we have a proven track record that if you invest X, you’re going to get Y right. So it’s showing them this and doing a lot of projections and pro formas for the offices. We’re aligning their growth goals with what we know to be possible.

“An integral part of our marketing is devoted to preparing patients before they come into the office. This is where price transparency comes in.”

Six hundred annual starts is impressive. Yet while your marketing is effective at getting patients in the door, isn’t the case-acceptance onus on owners?
An integral part of Smilebliss marketing is devoted to preparing patients before they come into the office. This is where our price transparency comes in. Case acceptance is very easy at that point. They come in. They knew the price before they made the appointment. The only question is, do they need braces or not?

Can you guarantee such success for every owner?
It all starts with identifying potential. New practices are more of a blank slate; we can help shape them from the start. Conversions are a different animal. We won’t take one on if there is something fundamentally wrong. For example, doctors who don’t want to open up a ton of patient days and who have let their asset decline, that’s not a good fit for us because we know we can fill the chairs and it’s a high-growth model. We need a doctor who has the means and the spirit and the desire to grow but just hasn’t succeeded for a lot of factors that are maybe a little bit beyond their control. For some of the offices we converted, it was a matter of putting the right team in place or retraining the existing team. We start with the belief that everybody wants to be good at their job, and we’re giving them the tools and training they need to be successful. And the Smilebliss brand is fun. I think doctors can
understand the brand’s culture and decide if it’s right.

Is a high level of due diligence the way you build confidence in the brand among doctors?
Every client must be a good fit. We spent a lot of time on the market research side. We evaluate the potential of the community in terms of specific demographics that we’re looking for. Will this office have enough potential patients within its immediate area to really grow and thrive? All criteria must be met. And that’s what the doctor is specifically signing up for.

How do you structure deals with doctors?
It’s strictly a three-year contract with 5 percent of collections, so this is where our skin in the game comes in. There’s also a onetime licensing fee that varies depending on whether the client is a startup or conversion.

What will the next five years hold for orthodontists?
Ortho is such a great business that it’s going to attract more investors from outside. Doctors will need to figure out whether they’re going to be employees or lead more with an entrepreneurial mind and figure out how to compete as a private business owner. Maybe
that’s being more selective about the markets they’re going in, but orthodontists who want to own their practice will need to be thoughtful in an industry with a lot of consolidation. DSOs aren’t without their own struggles. They’re acquiring less. They’re having to look at profitability in their existing practices. When you’re competing with big businesses that are hyper-focused on the bottom line, it opens opportunities. Suddenly, patient satisfaction goes down because a DSO is short-staffed, or the DSO has disgruntled employees because they’re not taking care of them, and independents can capitalize. There’s always going to be space for private practice owners if they can do something unique.