THE THREE PILLARS OF CLOUD DENTISTRY: SPEED, PRICE, AND QUALITY

Thank you for having me. I’m excited to be here.

It’s going well. It’s going so far. It’s as good as any day can go. Wake up and it’s going to be a busy day, but that’s the day I like.

Sure, you’ve done your research. I never imagined that I would end up in the dental space. My career path has been a zig-ag line all over the place. That’s great. Going back to the very beginning, I was born in Mexico City, lived there for the first 14 years of my life, and moved to the US when I was 14 years old, finished high school in Houston, Texas, and slowly migrated north from there. I went to Duke University as an undergrad and majored in biology and economics. I thought I was going to be premed because that’s a lot of smart people are always told, You have to do premed. If you’re good at science and math, you need to do premed. But ultimately, it wasn’t a good fit for me. I took the MCATs and everything, but when they got time to write the personal statements for applying to the medical schools, they asked me, Why do you want to be a doctor? I couldn’t think of a good compelling reason to write an essay aside from making money. This isn’t going to work. This isn’t going to get me into medical school. I pivoted.

I went to law school. I went to Harvard Law. While I was at Harvard, I taught two years of undergraduate economics as well at Harvard College. I graduated from law school. I enjoyed being a commercial litigator. I was a commercial litigator for about six, or seven years. I started at Ropes & Gray here in Boston. I enjoyed it. I did some very high-profile cases. It was a lot of fun. I enjoyed being in the courtroom and arguing cases. That was always the highlight. But the thing I didn’t like about the legal system is that it’s all based on billable hours, and so they don’t prize efficiency. I always prized efficiency. I said, Look, I just want to find the shortest point from point A or the shortest line from point A to point B, get the job done, and move on to something else. In the legal world, though, if I was very efficient and it only took me 10 hours to do a summary judgment motion for the court, and then it maybe would have taken a colleague of mine 30 hours to draft the same motion, that 20-hour Delta didn’t get me any bonus points.

They would just say, Oh, find another 20 hours to build someplace. Because of that, my dad was an entrepreneur, so I’ve had entrepreneurism in my family, I’ve always had my ear to the ground looking for entrepreneurial opportunities. Then one day, I just happened to be having dinner with a high school friend of mine. His name is Reza. I hadn’t seen this guy in probably 10 years. We had lost touch. But we’re catching up over dinner. He’s a dentist and I was a lawyer at the time. We get into this friendly chest-bumping match, arguing about who had a tougher job. Was it tougher being a lawyer or was it tougher being a dentist? Throughout that conversation, I think he ended up winning the argument if you can call it that, it’s more of a discussion because we ended up creating an entire business around his pain point. He was telling me that as a dentist, he’s in patient’s mouths all day long. Then he starts to run his business on top of it. So he’s both a clinician and a business operator. And then to add consult to injury, the staff was very unreliable.

And the reason for this is that the demographics are not set up in his favor. 50 % of the dental professionals are part-time or temporary workers. In any given month, he was going to be short-staffed for five days because people calling in sick, people going on vacation, and people quitting. There’s an annual 20 % turnover rate and he’s like, Trey, I’m trying to be pulling out my hair. It’s trying to run a business on Shifting Sands. I asked him, What do you do? If someone calls in sick or you’re short-staffed, what do you do? It’s a very huge pain point for dentists. He would either have to cancel his patients for the day, which would cost him thousands of dollars in lost production, or he would use one of two solutions. And this is scary as an outsider. He was telling me he was using Craigslist to find new hygienists and new assistants to spot him for the day. And he’s using Indeed and then also using temp agencies. I’m guessing you and your audience are probably familiar with both of those models. But the big critique of job boards is that they’re very much… They boast about having all these resumes, millions of resumes, but the reality is most of them are stale.

You message them, you don’t get any reply back. It’s like talking into a black hole. And then on the temp agency side, it’s a very human capital-intensive business. It costs a lot of money to make these matches happen behind the scenes because they’re using humans to make the matches happen. They charge 25, 30 % markups on the rates that the hygienists are charging. And then they also own the relationship. Reza was saying, Look, if I hire a hygienist through a temp agency, that 35 % markup, that’s my margin. It’s gone. I’m not making money for that day. Then two, if I like the hygienist and I want to hire him or her full-time, the temp agency is going to charge me $10,000 to buy out the contract. It’s very cost-prohibitive. Anyway, long story short, it was against that backdrop that the wheels started turning in our heads and we’re just like, This doesn’t make sense. As an outsider looking in, I’m thinking to myself, there are marketplace solutions for almost everything nowadays. If I needed a nanny, I could go to care.com and have a nanny tonight. If I needed someone to walk a dog, I could download the Wag app and get a dog walker.

There’s Instacart, there’s Airbnb. There are lots of things. I was like, Why did something like this not exist in dentistry? We looked around online, but there was nothing. There was nothing. It just seemed, Oh, my goodness, this is such a golden opportunity. The fact that there’s a proven business model that has worked for countless other verticals. And there’s an industry, a large industry that hasn’t adopted it yet that it’s primed for. I told Reza right then and there I said, Reza, I’m in. Let’s do this. If you’re in, we’ll pull together some money. I’m happy to work full-time and spearhead this thing. It seems too good an opportunity to pass out. I quit being a lawyer and I dove headfirst into the entrepreneurial life. And then here we are. That’s great.

Correct.

People throwing? Sure, it has been quite a journey. I think it’s almost a prerequisite for entrepreneurs that you have to be a little bit naive because if everything that this is going to entail and all the work that’s going to be to get you to where you want to be, most people wouldn’t embark on the journey. You have to be a little bit naive thinking, Oh, this is going to be pretty easy. Especially in the early years, it’s gotten easier since. Definitely, in the earlier years, it was very challenging. I remember going office to office, meeting with hygienists in person for coffee, and trying to get them onto the platform one at a time. It was brutally difficult. It took me almost a full year to get my first hundred clients, probably over a year to get to a hundred clients. It will probably over a year to get to 100 clients. Now, today, we have about 5,000 subscribed paying offices on the platform. So from 100 to 5,000. After that first year, when it took me forever to get to 100 offices, I was like, How am I ever going to get to 500 or much less 1,000?

Never mind 5,000. It was an insurmountable goal. But if you keep chipping away at it, you can make it happen. You have to keep making improvements, keep changing and pivoting, and take a very iterative approach to the product. And now to answer your question, in the markets where we’re strongest, dental practice is very, very reliant on cloud dentistry, both on the dental offices and the professionals looking for work. So in places like Austin, for example, which is one of our larger markets, one out of every three dental offices is currently a subscribed paying customer. In Houston, it’s about one out of every four. Same story for Dallas, one in four. Atlanta is about one in five. Denver is also a very large market of ours. We managed to scale across multiple geographic areas and get significant market penetration in each of them. In many ways, we must do so because it’s ultimately a network play. Someone could go out and copy Facebook or LinkedIn, the UI/UX that is of no value unless you have the users. And so there’s a lot of power that comes from having a large network. Once you have all these users on the platform constantly making matches happen, then things start to take off.

Every month, we’re doing over 11,000 placements every single month. And so it’s being utilized like crazy and offices are very thankful for us because it’s making their life a lot easier. We’re talking to them a lot of time, a lot of money. And then on the other side, the professionals love us too, because they get more flexibility. They get to choose when and where they work. They get to set their rates. We give them a lot of power as well. So it’s been very well received.

Talking about some of the competitors?

Sure. What we like to say is that we remove all the friction and disintermediate the market, allowing offices and professionals to connect in a completely seamless fashion. It’s all product-driven. All the matches happen to the product itself. As I mentioned before, we do 11,000 matches every single month. No one on my team does anything for that. It’s all product-driven. So it’s a very seamless, very easy experience for the user. I think that’s critical. Cut out costs, you have to cut out time and effort. All of it has to be completely seamless. People are used to that. They’re used to Uber, they’re used to Apple. All the user interfaces are very easy to use and very intuitive, and everything just works. And so when I first launched the platform, it’s funny, when you think about, Oh, I’ll make a platform people to match. It should be pretty straightforward. It’s not. The devil is in the details of the product. When I first launched, I remember distinctly having to call professionals who were booked on the platform and remind them to go to their assignments. Or if someone were to show up late, I’d be on the phone like, Where are you?

You got to get over there. I was still behind the scenes micromanaging all of these things. It was very demoralizing for me at the beginning because we would have a booking on the platform and then about 40 % of the time, the professional that was booked for that assignment wouldn’t show up 40 % of the time. That’s true for Craigslist, that’s true for Indeed, that’s true for Facebook. When dental offices reach out to professionals, there’s about a 40 % chance that they’re going to get ghosted the day of the assignment. Ghosting seems to be like a demographic thing for the younger generation, but they don’t even give you the courtesy of a call. They just don’t show up and they just disappear. That was incredibly demoralizing. I tell you the story because it just goes to the point of the iterative changes we had to make to the product over many years to get all the details right. By gamifying the entire system, so we’ve gamified system, we’re tracking no-show rates, we’re suspending users, they can earn points for responding quickly, and we’re getting good reviews. There’s a massive amount of gamification under the hood.

And because of that, now, when we have a confirmed booking, we have less than a one % no-show rate, and so it’s working. I think that one of the biggest competitive advantages is that our product is just far and away superior. If you talk to other offices who have used competitor platforms, they complain over and over again about the same problem I had several years ago. I paid people not showing up because they haven’t properly designed the platform to truly disintermediate and create a frictionless experience. The second big differentiator, aside from the product, is the business model. So if you look at a lot of the competitors out there, most of them are temp agencies with an online veneer. They’re still charging 15, 20 % markups on the bookings. They’re still charging buyout fees if you find someone on their platform that you want to work with. I’m like, okay, I have it innovated. They’ve added an online component that makes it a little bit easier to use, but fundamentally, they still are temp agencies. Whereas with cloud dentistry, we are a true marketplace solution. We take out the middleman, office contacts professionals, they book them, and they make the assignment happen.

The professional sets their rate. They choose how much they want to make on the platform and everything they make goes 100 % to their wallet. There’s no % markup on the professional’s rate. And then if an office likes working with a professional and wants to hire that professional full-time, there’s no buyout fee either. They’re not paying us $10,000 to buy out that contract. There’s zero dollars extra. It’s pure SaaS play. In that sense, we’re vastly different from all these other staffing agencies, and companies because we’re like the iTunes model. You pay one flat fee and you get unlimited music with iTunes. And if you want to add us to your playlist, there’s no extra for that. You can just add it to your playlist. Same with us. You pay one flat fee, you get unlimited hygienists, and you get unlimited dental assistants. Do you want to add some of them to your team full-time? You do no extra fees to us. And that business model is a complete 180. We completely turned the staffing agency model on its head, and that’s our second biggest differentiator.

Sure. I think for the longest time, dental professionals, felt like they didn’t have any power and that they were undervalued in many ways. They want to feel appreciated. They want to feel like they have options. They want to feel like someone is looking out for their best interests. And with cloud dentistry, we’re trying to give them all the tools to accomplish that. So it doesn’t matter what lifestyle they want to live. If they want to work every day of the week, we can accommodate that. If they only want to pick up one extra shift per month, we can accommodate that. And a lot of these hygienists, have semi-full-time jobs at dental practices. But the dental practice, it’s an idiosyncratic element of dentistry that a lot of dentists only use their hygienists four days out of the week, maybe even only three days out of the week. They reserve one or two days for business matters, for surgeries, for things where they don’t need the hygienists. You have a lot of hygienists that have a full-time job, pretty much a four-day-a-week job, and they have these fractional units of labor that go unmonetized that they would like to be able to monetize.

They didn’t have Cloud Dentistry and an easy, seamless way of doing so. Now they can. They have complete control over their calendar, their rates, everything. I think it’s that mission of empowerment that excites dental professionals. Then when you add on top of it, the fact that for the longest time, they were being controlled and handled by the temp agencies. The temp agencies would say, You have to work here, you need to work there. And, Oh, by the way, the office is paying this amount, but you’re only getting this amount. And we’re keeping that middle portion. High citizens didn’t like that. They felt like they were being treated unfairly. Now, when we tell them, Look, that gap between the office pays the temp agency and what you receive is now nothing. You get 100 % of it. We’re about empowering you. That message very much resonates with them. They’re like, Wow, the Cloud Dentistry has my back. And then that mentality pervades the platform. There are other details. If an office cancels the assignment on a professional at the last minute. In the past, the professional would be out of luck. What professional is going to hire a lawyer and sue the dental office for what one day’s pay?

They just eat the cost. But with Cloud Dentistry, if you’re canceled at the last minute, you let us know, and Cloud Dentistry will front that money to you, and then we worry about collecting from the office, if at all. And so that extra protection, again, engenders a lot of trust for the professionals because they say, Look, Cloud Dentistry, they talk the talk, but they also walk the walk. They say that they have our back, that they’re about empowering the professionals, and they truly are.

I think the traditional staffing agencies, ‘ biggest downfall is that they’re using human capital, and human labor to make matches happen. They’re calling up people on their phones saying, Hey, I need someone to work this Friday at an office. They send out a text blast to all their people, then they get people to respond, and then they match them to the office. It’s a very manual process, and because of that, it’s slow. It takes time. Usually, if you put in a request to a temp agency, it’s going to take hours to fill it or maybe even days to fill it. Whereas with cloud dentistry, because it truly is on-demand, our response time for getting a confirmed booking is less than 10 minutes, so it’s very quick. So temp agencies can’t compete on the speed. The other factor is the cost. As I alluded to earlier, the human capital element makes it very expensive to make these matches happen. They’re charging these huge markups on the daily rates for the professionals, these huge buyout fees. If you compare our prices, our cost structure is about 90 % less expensive than the temp agency model. We eradicate them on price.

Speed is way better with us, price is way better with us. And then the final metric is quality. When a professional is working through a temp agency, they’re just a cog in the machine. The temp agency is telling them you go to this office, you go to that office. The person’s reputation that’s on the line isn’t the temp, it’s the staffing agencies. The temp doesn’t have a huge incentive to show up on time, show up with a smile on their face, or do good work because there’s no skin in the game for them. Cloud dentistry, it’s a very profile-centric site. If your users were to envision it, it looks very much like LinkedIn. Kind of like LinkedIn on steroids. You have all these profiles and user reviews. And so on our site, the professionals, have a living, breathing profile with their face on it. It has all the reviews the offices have left for them. It tracks all their work history. And they’re like, This is very valuable real estate for them. And so they don’t want to go into an office and not be smiling, not show up on time, or do poor work. It’s going to reflect badly on their public-facing profile.

Now, because the professionals have skin in the game, the quality of the professionals has been elevated. Over 95 % of the professionals on our platform are ranked four out of five stars or better by the offices. There again, we exceed the temp agencies by far in our quality metrics. We deliver this rare trifecta of benefits. It’s price, speed, and quality. Altogether, we went on all three of them.

Sure. On the office side, it’s very simple and offices oftentimes think it’s too good to be true. It’s free to create your account with us and to look at all the staff in your area. There’s no charge for looking. You can log in, see all the profiles, see their schedules, see their rates, and see the user reviews for all the people in your area. What’s neat about that is that the American Dental Association did a recent poll and they found that 90 % of dental offices say that they’re either having an extremely hard time or a very hard time finding dental hygienists. So these dental offices, can’t find hygienists. Then they log in to Cloud Dentistry for free, create their account for free, and then see hundreds of hygienists who have logged in within minutes of them logging in because we showed the last login rate. If I were to do a demo right now and show you, you’d see hundreds of hygienists within minutes of our having this call here today and they’re blown away. They’re like, Whoa, I haven’t been able to find hygienists anywhere. And the industry has a ton of hygienists.

Not only do they have hygienists, but they’re very active. They’ve logged in within minutes. Let me message these people. And so it’s a freemium to premium model for the offices. Once they’re in the system and they see that we have hygienists, they see that they have live schedules that they can book, then when they go to message a professional or book a professional, they’ll hit a paywall and it’ll prompt them to upgrade to a paid subscription. It’s very nominal. It varies by geography, but on average it’s about $100 per month per location. It’s very affordable. They pay $100 and then they can book with impunity. They book that hygienist, they book as many other ones down the month as they want, and they’re done. It’s very simple, very straightforward. We have a system called Cloud Direct Pay that integrates with Stripe Connect. Once the booking is done, this is optional for the office. They can use the Stripe Connect feature and we’ll withdraw money from the office’s account, deposit it into the professional’s account, and we’ll be responsible for issuing the 1099 forms so the office is completely turnkey from their perspective. They book and we handle all the payments, we make sure that the professional shows up, and everything is done.

So it’s a very simple, very easy process for the offices. But everything from the account creation part to upgrading to a subscription to actually getting bookings on the platform.

So very similar. Again, we try to remove any friction, any hurls to getting work is essentially the goal here. So it’s as easy as creating a Facebook account or LinkedIn account. You go to the website and you create your account, you upload your picture, usually takes less than 24 hours for us to verify you because we verify all of the dental licenses for the professionals. We only want licensed professionals on the platform. After about 24 hours, your profile will be approved. You set your work parameters. You tell us when you want to work, how far you want to travel, and how much you want to make. Your profile goes live and then you start receiving booking requests. Most professionals who create accounts with us will have a job within the first two or three days of their profile going live. It’s very efficient at getting them the work they want.

Something on our roadmap. AI is going to change everything. It’s right to see how quickly AI is taking things over. I predict in my previous industry, the legal industry, I think 80 % of lawyers will be out of work. I think AI will be able to do most of what lawyers do. It’s incredible to see. I think companies that want to stay ahead have to adopt AI, no question about it, both on our product offerings. I think you suggested a few. I should take notes here. Those are some good ideas. I think resume optimization and interview training, I think are all great ideas. And then also on the back end, like using AI to help with marketing, to help with operations, there’s a lot of things AI can assist with, and it’s a part of our roadmap.

I think really in many ways we are the beneficiaries of good timing. You hear this a lot about companies that what makes a startup company successful is the funding, is it the funding? Is it the team? Is it the experience? Is it the product? They’ve done aggregate analyses of this. All these factors matter, of course, but the one factor that seems to predominate all others is timing. We have a great idea, but if you’re too early, it’s no good. If you’re too late, it’s no good. We’re in many ways a beneficiary of good timing. The one niche or idiosyncratic thing about Cloud Dentistry is we were hit especially hard by COVID when it comes to staffing, harder than other industries. And post-COVID, the healthcare industry, one in five healthcare workers quit and didn’t return. That’s a blow number one to dentistry. Of the hygienists and the dental assistants, one in five quit. They got used to a single-income lifestyle where they were relying on their partner to be the breadwinner. And they said I like this. I’m not going back post-COVID. One in five quit. Then the other big demographic shift is post-COVID. The female workforce participation rate is at a 33-year low.

So very depressed female workforce participation rate. Dental professionals, hygieneists, the dental assistants are 98% female. So there again, it’s a one, two points where healthcare and they’re also a female-driven industry. The labor supply has gotten very tight. That’s where a product like cloud dentistry shines because again, we unlock extra fractional units of labor that weren’t available otherwise. If you have a hygienist who is working and who’s working four days out of the week, she’s not going to put up her resume on Indeed to try to pick up one extra day. But if she has an easy-to-use platform where she’s in control and she can get work through the platform seamlessly, she can put up that one day and monetize it. We’re standing the labor pool in an environment where the labor pool is very tight. That’s one thing about dentistry that I think has timed well for us.

Absolutely.

Sure, I’ll give it a shot.

I would say currently probably social media because I have to engage in social media because of my job. But the social media algorithms are very good. Once you start using it for purpose A, which is a good legitimate purpose, you’re using it for business, next thing you’re scrolling to your feed for 10, 15 minutes that you didn’t have to spend on that. I wish I could break that habit of an extra 10 minutes here, an extra 10 minutes there on social media, just be a little bit more efficient. Because again, I pride myself on efficiency. I don’t like the way that algorithms manipulate me.

What job? Yeah. What job do I despise doing?

Oh, a chore. This is the segue into another business idea of mine, but I loathe doing dishes and just can’t stand doing dishes. Yeah, I think it’s right for one because it’s not worth hiring a cleaner to come by just to do the dishes. It’s not worth their time to drive out here and do the dishes and then leave after 5, 10 minutes. If we could pool users together and they knock out 50 sets of dishes in one dense neighborhood, then it economists right for everyone involved. There’s a gap there for sure.

I’m really into science fiction and sci-fi. Anything science-related, especially when it comes to pushing the boundaries of physics, pushing the boundaries of space travel, and all that stuff is always very fascinating to me. I’m a nerd on it.

And- No shortage of those. Now with the aliens and everything, I’m like a kid again.

When I was a kid, if you would ask my mom, she always talks about how I wanted to be a fireman when I was young.

Yeah, I could see an astronaut too, although it was a fireman for some reason. I think kids just love trucks. They love the uniforms and putting out fires. It’s a heroic profession, so I think it lends itself to that idealized kid version of yourself.

He’d love trucks.

I did I last search on Google? Good question. I think this morning I did the Wordle, so I think I used Google to find the Wordle website.

It’s thankful. Absolutely. It was a real pleasure. You asked some great questions. I enjoyed it. Thank you.