Servant Leadership

How a deep sense of caring for patients and team members has guided North American Dental Group and its CEO and Co-Founder Ken Cooper through a tumultuous year.

The COVID-19 pandemic hit organizations across all industries hard. The North American Dental Group (NADG) was no different. NADG was forced to close 80% of its dental practices during the spring to comply with local government orders shuttering non-essential, non-urgent services. “That obviously led to a significant impact in our revenue and forced us to make some difficult decisions,” said Ken Cooper, CEO and Co-Founder of NADG.

However, NADG never strayed from its servant leadership mindset and the values that remain the foundation of the company, Cooper said. “Our top concern was for the health and safety of our patients and team members.”

Efficiency in Group Practice asked Cooper how his organization was able to support its team members and patients amid the pandemic, as well as how this year’s lessons can position group practices for success in the future.

Efficiency in Group Practice: Can you describe to us the tenets/keys of your leadership philosophy? 

Ken Cooper: Our culture is defined by a servant leadership mindset, which guides our day-to-day operations and decision-making. I try to infuse empathy and vulnerability within our leadership team and create a deep sense of caring for our patients and team members. We look for these same values in the people we hire and the dental practices we are fortunate enough to be affiliated with.

Our core values of being Emotionally Intelligent, Approachable Educators who carry a Healthy Bravado are designed to be differentiators in how we show up. I often refer to the importance of “how we show up” matters substantially more than “what we are doing” on any given day. Our cultural norms of compassion, accountability, integrity, and service aim to remind us daily to live up to those ideals in everything we do.

Our motto is “Caring people, caring for people.” We train our teams on self-awareness, and I personally believe everyone is responsible for investing in their own leadership development journey.  

Efficiency: How were these tenets put to the test in 2020?

Cooper: Without question, the COVID-19 pandemic caused tremendous challenges for our company. We were forced to close 80% of our dental practices during the spring to comply with local government orders shuttering non-essential, non-urgent services. That obviously led to a significant impact in our revenue and forced us to make some difficult decisions.

But we never strayed from our servant leadership mindset and the values that remain the foundation of our company. Our top concern was for the health and safety of our patients and team members. We complied with orders to temporarily close many of our practices, keeping just 50 practices open to provide emergency dental care in the communities we serve and to help alleviate the pressure on overcrowded hospitals and emergency rooms. This decision also helped to minimize the spread of the virus and keep our patients and team members safe.

Financially, with our business largely dormant, we were forced to make the difficult decision to furlough team members during practice closures. But, again, our concern was caring for them even while they were unable to work. Our team members continued to receive healthcare and dental benefits through the furlough period with NADG paying the team member’s portion of the premium. Additionally, team members could borrow up to two weeks of paid time off (PTO) against future balances to bridge any income gap before they started receiving unemployment benefits. A low-interest loan program was also established, and many NADG team members voluntarily contributed to our Smile With Heart Foundation’s Employee Relief Fund to assist team members experiencing economic hardship.

We kept the lines of communication open with our furloughed team members, keeping them informed of changes and new protocols that were being put in place, so that when they were able to return to work they felt comfortable and reassured in their changing work environment. When guidelines allowed dental practices to reopen, local teams had a voice in deciding when NADG supported practices would re-open based on their comfort level with new safety protocols.

Also, while keenly aware of the devastating impact this pandemic was having on other healthcare workers and first-responders, we were called to a stronger sense of community. To address the widespread shortage of N95 respirator masks needed for physicians, hospital workers, police officers, paramedics and others, NADG donated about 6,000 masks to hospitals and law enforcement agencies in hard hit areas of Pennsylvania and Ohio. We also assisted with COVID-19 testing efforts by turning some of our temporarily closed dental offices into COVID-19 testing sites to relieve the burden on medical facilities and help satisfy high demand for testing.

Meanwhile, we were making plans to reopen safer office environments for our patients and team members. We appointed an internal committee that worked to establish new safety procedures – which includes head-to-toe personal protective equipment (PPE), enhanced infection controls with frequent cleaning and sanitizing, comprehensive screening of team members and patients, and updated visit protocols to encourage social distancing and minimize risk. These procedures were above and beyond those eventually established by the Centers for Disease Control & Prevention (CDC) and the American Dental Association (ADA). In the interest of public health, we shared these innovative guidelines and related resources across the entire dental industry by publishing them on our website.  

Efficiency: What were your overall expectations heading into 2020? How were you able to adjust?

Cooper: In general, our expectations for 2020 were for continued growth through gaining new practice affiliations across the country and continued support of our teams to provide best-in-class oral care for our patients. As mentioned before, we carefully seek to partner with dental practices that fit with our company’s values and demonstrate a patient-focused approach.

The pandemic obviously slowed some opportunities for us during the first half of the year. But in other ways, it has created new business prospects for us to explore that we are very excited about. Since the emergence of the pandemic, we have fielded more inquiries than we anticipated from dentists who are considering affiliating with a dental service organization (DSO). The pandemic has put a spotlight on the benefits of being part of a DSO where dentists can rely on administrative support to navigate challenges brought on by the pandemic – maintaining new safety protocols, patient communication, access to deeper supply chains, and managing financial stress – while collaborating with fellow doctors on clinical topics. As a result, we still have an opportunity to achieve some of our growth expectations for 2020 despite the devastating impact of the pandemic on our industry.

As for our patients, with the temporary closure of many of our practices and understandable concerns and fear over the spread of the virus, we were forced to cancel nearly all dental appointments for a two-month period during the spring. And even when we were able to reopen, it still took time for patients to become comfortable enough to return to the dentist for the oral care they need. I’m pleased to say that we’ve seen a healthy return in patient activity as our practices have reopened. Communicating to our patients about the extensive safety protocols that are now in place and the overall importance of essential, proper oral care has been the key in regaining that comfort level.

Efficiency: How did you strive to maintain a caring work environment amid the pandemic?

Cooper: Not only did we care for the financial health of our furloughed team members by continuing their benefits and covering their premiums, allowing them to acquire additional time off, and setting up funds to assist with financial hardships, but it was equally important they remained confident as a member of the NADG family. We kept the lines of communication open with both our furloughed team members and those who were still in their traditional roles, shifting to remote work and flexible working hours. It was important to keep everyone engaged during this period so they would be prepared and confident enough to provide the dental care our patients needed the moment our practices were able to reopen.

We sent communications to all of our team members several times a week, keeping them apprised of the new protocols we were establishing, the assistance we were providing in the community, and the information we were sharing with our patients to help reassure them of our efforts.

Furthermore, to maintain our sense of community internally, NADG invested in development content and programming to keep our team members engaged and hosted interactive webinars designed to support our team members through the stress of the pandemic. The programs ranged in titles from “How to Be Happy” to “NADG’s Secret Sauce.” We also organized online yoga classes and virtual happy hours.

Finally, when the message was delivered by local governments that non-urgent services could resume, we left it up to individual practices to decide when they were comfortable with reopening and seeing patients again for routine oral care and elective procedures.

Efficiency: What did you learn about your organization amid the pandemic? What things are you doing differently as a result?

Cooper: I am deeply impressed and owe heartfelt gratitude to our entire team for the resilience everyone has demonstrated. As stated at our recent virtual Partner Meeting: Individual team members are only as good as their team and a team is only as good as its individual members. We had to make difficult decisions to see our way through this pandemic, and we’re fighting our way through it. There are many routes we could have taken, but we followed the route that is the foundation of our company. We showed empathy and invested in our team members so that we could all see our way through this pandemic. We reverted to our motto: ‘Caring people, caring for people.’

The pandemic is not over. Trials remain. But I like the approach and the path we have chosen to combat a pandemic that has had a deep and pervasive impact no one could have predicted. The challenge for us internally now is to imagine how we can eventually emerge from the pandemic a better company, with new ideas and new fortitude.

Efficiency: What long-term challenges will dental group practices have to continue to navigate?

Cooper: From a business perspective, we’re probably no different than most other industries who are facing a great number of challenges and an unpredictable outlook. How long will the pandemic last? What’s the long-term impact of the pandemic on our industry? How do we keep our team members and patients safe?

Additionally, the cost of safety – the additional PPE, screening standards, and cleanliness protocols – will have an impact because these measures were put in place for us to safely reopen our practices and will remain long after the pandemic ends. The answers to these questions must now be factored into every dental office and DSO’s day-to-day operations from this point forward.

Efficiency: What are your expectations for 2021?

Cooper: As our safety protocols continue to take hold, I expect demand for dental appointments and routine oral services and emergency care to return to pre-pandemic levels and beyond. We’re not that far from that point now. Proper oral care is essential. It is scientifically verifiable that your oral health is connected to your body’s overall systemic health. Our patients are keenly aware of this and it is important that dentists remain prepared to provide patients the care they want and deserve.

I also believe the pandemic has reminded us that dentistry is a form of essential healthcare, and we will continue to push to assure that it is recognized as such going forward. NADG played a major role early on in this pandemic by providing necessary emergency dental care that helped patients in need and alleviated pressure on hospitals and physician offices that were beyond capacity.

Also, dentists will continue to be recognized as the infectious disease control experts they are. Dentists will play a major role in helping our country continue to combat COVID-19 by being available to assist with COVID-19 testing and administering its vaccine, when available.

The future for dentistry is bright, rewarding and essential.

About North American Dental Group

North American Dental Group (NADG), based in Pittsburgh, Pennsylvania, was cofounded by Ken Cooper and Dr. Andrew Matta in 2008. NADG was created to transform the dental experience for its patients, clinicians, and its support teams and today consists of a network of over 230 dental practices in 15 states. The values of maintaining an emotionally intelligent approach, being thoughtful educators, and displaying a healthy bravado fuel our day-to-day patient care and operations. These founding values are alive and well as NADG celebrates its pioneer spirit by solidifying its partnership with Jacobs Holding AG.