Tune in to this episode of Microcap Moments and subscribe on Apple Podcasts, Spotify, or your preferred podcast platform to receive updates on our latest content.
The Right Fit | Josh Johnson's Strategy for a New Dental Platform
In this episode, we highlight Josh Johnson the CEO of Shore Capital Partner’s new dental platform. Josh discusses his early experiences in starting a platform from the ground up, the early value of Shore’s unique approach in forming a Board of Directors, and the range of resources Shore brings to early-stage CEOs. Josh also discusses the future of the new platform and the excitement and possibility that drive him every day.
Transcript
Introduction
Michael Burcham: Welcome to Microcap Moments, a podcast from Shore Capital Partners that highlights the stories of founders, investors, and leaders who have taken on the challenge of transforming ideas and small companies into high growth organizations. The journey of building and scaling a business takes one down many unexpected pathways.
It's a journey where we learn from our mistakes, fall down often, but have the entrepreneurial grit to pick ourselves up and persevere. Within this series, we will share these stories of success and failure of the challenges and the rewards faced by those who dare to dream big. And through their lessons learned, we hope to inspire others who are on a similar journey of becoming, growing and leading.
In this episode, I am talking to Josh Johnson, a CEO, who joined the Shore Family earlier this year and will be launching a new dental platform for Shore Capital Partners. Prior to joining the Shore team, Josh spent over 10 years with Integrated Oncology Network, serving as CEO of that organization from 2019 to 2023.
Prior to that, Josh was with E+ Cancer Care, which was acquired by Integrated Oncology Network in 2019. Josh received his BSS in accounting from the University of Memphis and his MBA from Lipscomb University in Nashville, Tennessee.
Josh, thanks for joining us today. I'd love for you to tell us a little bit about your role and about the new dental platform you're creating with Shore.
Josh Johnson: Absolutely, Michael. So I partnered with Shore this year, joined the team at the beginning of February to become the CEO of a new general dentistry platform we're basing here in Nashville, which is my hometown focused on the southeastern part of the US. I'm going to be partnering with growth minded entrepreneurial type doctors that are really kinda at inflection point looking to take their business forward.
As you guys probably know, the dental industry has been consolidated for a number of years. Clearly, still a lot of white space available. We see the market probably around 30% consolidated, but obviously a large demand for services across the broader US healthcare market.
As we look to build these businesses, I've found that really the best businesses that are partnered with doctors are first and foremost based around finding doctors that have the right cultural fit, the right alignment for vision, and then really just a keen focus on operating the business and executing alongside us in collaboration with us on a day-to-day basis.
Michael Burcham: You're talking about basing this in the south, or is there a certain type of dentist you're looking for in particular, are you're looking for multi-location already or multiple dentists in a single practice, or is there an MO of what you're looking for to create this platform around?
Josh Johnson: Yeah, I think realistically the foundational groups, first and foremost is going to be based around fit.
I've always found as we think about partnerships and formation, particularly in the early stage, obviously there's kind of the pure play dynamics that we're looking for. You know, multi-site, some scale, good leadership, clinical quality, good economics and infrastructure and leadership to base the business on.
But before any of that, first and foremost is really around cultural alignment. People that are willing and wanting to collaborate with us to drive the business forward. And ultimately for us and for them, we've gotta see value in partnership. And so as you think about these early stages of development, the most important thing is that, is finding those folks that want to work together and drive together, together.
Why Shore?
Michael Burcham: Makes sense. So, Josh, you've had success long before now. What drew you to choose to partner with Shore in this endeavor?
Josh Johnson: So obviously been around healthcare services in Nashville for a long time. I spent the last 17 years inside a outpatient oncology services business. Had heard the Shore name and reputation through the years, but honestly been pretty heads down and just focused on building my business.
And I would say, you know, as this opportunity got presented to me, I guess at the late part of this last year, I was interested from the standpoint of it was early stage. I'd always enjoyed kind of the early stages of my prior business, which was E+ Cancer Care, and then later on Integrated Oncology Network and really working with that team hand in hand to drive that business forward.
So knew at some point this would be the next step in my career, but it was never really the right place, right fit, right time for me to move on. And so as I got plugged into Shore and plugged into the opportunity, obviously I like this would be focused in Nashville and the Southeastern corridor, which is home to me.
I like the fact, it was in the broader oral healthcare space, which, you know, I had a number of colleagues that had been in around, whether it be orthodontics or oral surgery or even general dentistry. I knew that they had a lot of success and ultimately the culture of the overall industry was one that was really open and sharing in nature.
So that really checked the mark for me. And then lastly was just the fit aspect of it was Shore. And so was able to have a little bit of conversations with folks that were on other Shore platforms. Able to share their conviction of them being the right partner. And so as I entered into the early conversations, got to know Charlie, Chris, and then later on in the process, Justin, I could tell that, you know, it was the real deal.
These guys were focused on supporting folks like myself, focused on supporting the business and focused on supporting their doctors at the local level. And so, as I took a step back and looked at the broader state of the opportunity alongside knowing that I had support services in a pretty vast way beyond your normal private equity sponsor, it wasn't necessarily the right time for me, but it was the right opportunity for me and ultimately decided to make that next step.
Michael Burcham: So Josh, as you've gotten to know Shore, where do you find your values most aligned with Shore's values that cause you to jump into this situation? Because it's not easy putting a company from the beginning, but there had to be some sort of alignment of value and philosophy to do this.
Josh Johnson: Yeah, I think as you think about philosophy, my own approach has always been.
We talked a bit about fit before, but a lot of organizations can grow for growth's sake, and you find yourself in a problem down the road. And I would say even to this stage, I'm 120 days in and we remain patient in finding the right business to partner, the right people to partner with. And so I think first and foremost, as I really look through the lens of how I thought they approached the business.
It it aligned from the standpoint of you don't necessarily have to be the biggest, but what you want to do is be the best. And so I felt as though those sort of philosophies aligned and how we would approach growth and how we would approach partnership. And then beyond that, just frankly, the core focus on operational excellence and understanding sort of the core themes of you need data and intelligence to operate your business.
I clearly heard that theme loud and clear as we were moving forward. And so it seemed as though strategy, cultural philosophy around alignment and then being smart around how we approach the business day in, day out really aligned with me and just, I think you could see it within sort of the Shore, broader ecosystem, the type of talent that they recruited and brought into the organization and that aligned with the way, historically speaking, I tried to bring talent.
Provide people opportunities, give them rope to run with, and kind of test out their own sort of creative thoughts to move the businesses forward.
Michael Burcham: In the following segment, Josh shares the method Shore Capital uses informing a board of directors and how that has helped him quickly acclimate to the dental space.
The Shore Board Experience
Josh Johnson: As I stepped in Shore, had built out the board, which has been a major support system for me thus far. The board is a little different from what I'm used to. We have a number of external folks which consist of ex-DSO leaders, marketing, leadership, clinical leadership, and I'd say broadly speaking, it's been super helpful for me to touch base and get up to speed and frankly, expedite, I would say my knowledge of the industry and trying to think about what works here, what are the commonalities from what I've experienced previously versus what are the differences in building this business.
So the board members in particular have been of great assistance to me, and so in the early days, thus far it's been really about building the strategy, aligning on the vision, so that way we have a plan forward of what we want to be. Beyond that, it's been developing out the broader execution and growth plan, and then clearly the biggest priority thus far is finding those folks to partner with. And I think we've had a lot of success thus far in identifying folks, the message resonates, find the right fit first, and things will play out.
And so again, the balance here is being aggressive to move forward and being patient, not to make kind of an unwise decision from a foundational standpoint.
Anderson Williams: Will you say just a little bit more about the board experience?
You mentioned it was different than maybe what you expected or what you had seen before. Can you just articulate a little bit more about, particularly in these early days, this sort of having a board in place and how your experience with a Shore board is different than maybe what you've had before?
Josh Johnson: It's the management team. It's the sponsor, clearly. And then historically speaking, for me, it's been an outside independent director that I've worked hand in hand with that that's had some experience around broader based healthcare services. And again, it's beneficial previously in my experiences to have sort of outside influence to help navigate sort of the world of managing our business and sort of the board and expectations as well.
And so there's always been a balance there. But the Shore board is much more, I'd say, dynamic in nature from the standpoint of there's many more outside players that can bring unique perspectives, and I think that plays well with the way you think about building out a team, broadly speaking, or as I look to build out the management team, you don't want everybody to have the exact same experience and insights because there's no need.
You're bringing the same thing to the table. And here I'd say it's nice because I have folks that have gone through what I'm looking to go through, done it, and been successful, and understand just the mechanics of building out a dental platform, as well as those that have much more experience around marketing, direct to consumer healthcare services, then obviously clinical leadership is always great. So you have a bit of a more dynamic, diverse subset of folks that have experiences probably different than mine and different than any of the others on the board to bring to the table. And so it's been, like I said, a real pleasure to work with those folks.
And I think I've gotten much more up to speed in this 120 days that I would've done alone. And I think that's really what it's all about is get there faster together.
From 1,000 to 2
Michael Burcham: From a team of 1000 to a team of two. In the following segment, we talk about the startup feel of this stage of the platform that Josh is building with Shore.
Josh, you've been a CEO before, but this feels a little bit like a startup 'cause you're starting at almost zero, which is where many startups do. Talk to us about that. Have you been in this spot before? That feels like a startup, and what you're thinking around it as compared to some of your prior experiences?
Josh Johnson: My prior life in the organization I spoke to, previously the the outpatient cancer care business, I joined in 2005. The business was formed, kind of middle part of '02, so it was early stage, but not startup stage at that point. I held a number of roles throughout that business from accounting, to FP&A, to a development Chief Development Officer, Operating Officer, and then later the CEO.
So I saw a wide transition of that business over a long life cycle and, and ultimately in that business pivoted a couple times to really convert that business from an outpatient cancer imaging business to a multi-site cancer treatment services business that that grew to, you know, 50 plus locations over 15 states.
And so I would say I experienced the transition from small stage, early stage to a much more broader scale organization. But this is a different experience starting from nothing. You know, moving from a team of a thousand to a team of two at this point is a drastic difference. But it's been a lot of fun.
It, it was a challenge again that I knew I wanted to take on at some point in my career just to experience it, frankly. The early days of E+ and working with that team, that executive team is an experience I would never trade out, frankly. And I think, oh, a lot, uh, that team at that point in time in my career, just giving me the opportunity to be successful and make an impact.
And I think, you know, as you think about building a small business like that, a lot of relationships I have today were foundationally built in the early stages of that business. And again, it was the most fun I'd ever had, and I'm looking to do it again.
Michael Burcham: Yeah. Something you said resonates though, that you maybe have a team of two, but you're getting to pick literally everyone on your team.
You're not inheriting anyone.
Josh Johnson: That's right. And sometimes I'll make a great decision and sometimes I'll make it terrible. And that's the way it goes.
Michael Burcham: You can always fix the bad ones, right?
Josh Johnson: That's right. Yeah. Yep.
Michael Burcham: So with a team of only two or three, you wear a lot of hats. And a lot of competing priorities.
How do you manage that in your mind now at this stage, while you're looking to find the right partners, looking to build a platform, doing analysis of perhaps companies you already are looking at with one eye, looking around the landscape at the next thing.
Just talk to us a little bit about managing and juggling all the priorities with a small team right now as you're getting this off the ground.
Josh Johnson: Yeah, sure. So, I mean, a little bit in the early days is you have to take a step back and realize you don't know it all. And so I would say the first few weeks, and really all of this has been about, there's a bit of self-motivation and resiliency that goes into it, just a keep pushing forward and understanding.
You don't know it, but you'll figure it out. And so every day you come in, you learn a little bit more. I think it's the way I would say viewed the industry or viewed the opportunity in day one versus day 120 is much more refined. And it's always about listening, learning, taking information in. Pressure testing that against what you thought the strategy was and continuing to refine your thinking about it.
And so I'd say every conversation I have, you have to continually take those inputs and think through, do you have it right? And again, I'm not saying today we have everything perfectly, but I would say we're aligned on our thinking and where we want to go. And it's really now about, I would say, continuing to take those inputs and refine the execution plan today.
And so I would say the biggest balance of everything right now is about continuing to think about how we're going to execute once we have our foundational partners, and finding the foundational partners. So there's always a bit of development at play in working with the rest of our team to drive forward and get the business foundationally built and understanding that once that happens, there's going to be expectations that we operate and we have to be as educated as we possibly can and ready to move forward at that time.
Lessons Learned
Anderson Williams: I'm curious as you describe that, it's almost like coming in and recognizing you don't already have it all figured out, means you basically, you have to be the fastest learner around for this to work. And I'm curious in this first 120 days, any lessons you've already learned, maybe about yourself, but also about the business in such a short period of time.
Josh Johnson: I think probably the biggest thing that I'm continuing to learn, and I think I've mentioned it earlier, is you're always testing your own patience. I mean, ultimately coming out of the organization I was in before, having a team built, a vision, a plan, a strategy, a business to operate. There's times I've wake up and realize, okay, I'm ready to have something to operate.
So there's a balance between, okay, we need to go get something undone and be aggressive. And also understanding you have to be patient to find the right opportunity, not a opportunity. And so I'd say the biggest sort of challenge has been probably my own desire to move at this point, but understanding it's better to wait and be smart about how we approach it.
It's going to come and it's going to come fast when it does.
Michael Burcham: In the following segment, Josh compares his prior work as a leader in the cancer care space to this new role he's taking on in building a dental platform.
You spent quite a bit of your career in the cancer treatment area. What are some lessons you've learned from that and various leadership roles that you've described that you're bringing into this experience for you?
Josh Johnson: As you think about cancer treatment services and what we're looking to build here in the dental world.
I mean, there's clearly some similarities and some vast differences as well. You're looking to partner with doctors to support what they do on a day-to-day basis in support of patient care. And so you have to take a step back and understand everything we do here, sometimes it can get lost in translation, but at the end of the day, we're taking care of folks and we're supporting other businesses and other doctors that are taking care of patients, and so the patient experience dynamic is clearly one that you can continue to focus on and know that that comes first.
Beyond that, it's really about taking a step forward and thinking about the local team. We are here to support them, not the other way around. And so building a team, I really can focus on that is of utmost importance. And so taking care of the patient, support the local operations, support our doctors and enable growth are probably the biggest, most important things we can do on a day-to-day basis to really drive these types of organizations forward.
The First Partners
Michael Burcham: In this next segment, we talk about the importance of the first physician partners who will join Josh in creating this new platform. I particularly enjoyed our discussion on building trust and the milestones in building a new business.
Anderson Williams: Can you give a little more specificity around the type of physicians that are going to make good partners for this platform? But particularly, I'm intrigued because your experience in cancer and then the notion of really thinking about that patient experience, not just clinical outcomes.
Can you just describe a little bit more about what you see early in the process as the kind of foundational leadership from the clinical perspective that you're looking for?
Josh Johnson: I think from a clinical standpoint, first and foremost, they have to care about the patients and understand that those folks that walk in the door every day have a need. And it's not only what's going to impact them is the clinical care, it's also their experience from scheduling, to how the bills get collected or paid and that are in action, they're the front desk.
It's every interaction along the way can change a patient's perspective of whether that was good quality or not. And that can be fortunate and unfortunate, but ultimately we have to recognize that the entire sort of continuum of that patient's path within our local clinic can impact that.
And so finding doctors that understand that and it's more than just them is can be a challenge at time to make sure that they fit sort of the philosophy of that patient care cycle. So that's one. But I would say beyond that fit to me from a business standpoint is people that understand there's going to be good times and there's going to be bad times.
That's just the way it is. You know, there's ups and downs in every business, in every cycle, and it's easy to be aligned. And kind of good spirited when things are going good, but when we have a challenge or hit a road bump, it's how we act and how we treat each other in those times is where real partnership comes out.
And so it's hard to identify, but I mean, as you guys know, as you continue on these conversations and, and meet folks, you can read folks fairly easily and understand dynamically how they want to engage with one another and whether they really want a partner or whether they want just an exit strategy. And people that want to be your partner, understand the patient dynamic and understand the business dynamic and what it means to be a partner is what we're looking for.
Michael Burcham: I want to follow a train of thought here we're on. I've helped launch two or three of our platform businesses. When we're starting a brand new company that first or second partner who joins us takes a significant leap of faith because you don't have a big team. You don't have 10 other dental groups who've joined as your partners.
They're going to be the first, you're having to use a very different set of leadership skill and conversation skill to have that interaction than you will with the 10th one. Talk to us a little bit about how you're approaching that, knowing how important that trust relationship's going to be for the very first partner who joins you.
Josh Johnson: That's not right for everybody. This opportunity isn't right for everybody. And I think first and foremost, you have to recognize that some people, you know, are willing to sit back and wait and watch. For others, and this not only goes to, I'd say the foundational partners it's going to go to as I format out the leadership team, frankly, as well.
There's certain folks that like to take a little risk. Although I think this is hedged risk with a good foundational private equity sponsor behind you. And there's folks that want to drive something and build something together. And so back to fit. I think there are those folks out there, and I would say as you get to know 'em and you talk and you're able to talk about Shore's track record of doing this time and time again. They're betting on doing it with me. And so it's a little bit of talking about how I like to approach partnership and where I've been and what we've done and why I think we can do this together. And it is, it's, you gotta listen to where their needs are and understand, can we fit that or not.
Understand what their desires and aspirations are for growth and whether that matches as well. And so it is a lot about working with these other partners and determining whether they match our vision for where we want to go. And ultimately, the nice thing is the message has been resonating with folks thus far.
You know, in my prior life in building the oncology business, we're at this pivot point a couple different times where, you know, in 17 years of a 20 year old business, you sort of hit these marks where the industry changes, the landscape of the world changes, and you have to continue to evolve. But all along it truly is around building relationships, building trust, setting a vision, and then ultimately we're trusting each other that we're going to go do it together.
Michael Burcham: Mm-hmm. You hit on something that I think is worthy of just a brief diversion here. There's these milestones in a company that can be an industry shift, or it can absolutely just be your growth. That once you get to that point, skills you're going to need are different talent you're going to need is going to be a little different if the market shifted.
You gotta think about the product a little different, so you hit these points even in a more mature business, and you just get 'em a little faster coming at you in an early stage.
Josh Johnson: So again, as you think about what I would call the early stage versus the later stage businesses, I mean clearly, you know, we touched on it a little bit, but you've got your team, you've got your strategy, and you've a lot of times proven it out to a certain extent.
Now different dynamics change in the life of businesses, and I think that's where taking those types of insights and inputs in crafting the strategy is probably pretty similar to what we're doing today from the standpoint of, you know, we don't have everything figured out in later stages, you know?
Things change. And ultimately you have to be willing to take those insights in and craft the strategy for where you want to go or what is the next evolution of your business. And so we certainly experienced that in the cancer treatment space over the years. I think the other component of that is really, how you build your organization as well and just kind of the cultural aspect of, you know, are you willing to let people have creative insights and thoughts on where they think they can add value? And sometimes, not exactly the way you think about it, but you have to be willing to try some new things as well and, and make the right decisions at that time for the business.
And you're not always going to hit it right, but you gotta make that next right decision. And sometimes that's continuing the path and sometimes that's pivoting.
The Right Talent
Michael Burcham: In this final segment, Josh talks about the types of individuals he wants to join him as he embarks on the journey of building a dental company.
So we each have our strengths, and I know as I've built out my team here at Shore, I've been very careful to hire and bring in talent that has skills different than mine and compliment me. As you think about yourself and your own strengths, what kind of skill and talent do you want to surround yourself with to make this a really successful platform?
Josh Johnson: Yeah, sure. I mean, I, I'll say Michael, I'm pretty well aware of where my weaknesses are, that's for sure. And I think that the best thing you can do is just constantly be on the lookout for good talent. I'd say in the early stages of a business, you talked about multiple hat wearing, and that truly is the case.
And so being able to recruit and bring in sort of athletes I think is very important because later stage organization, you have a number of folks that are inside what I would call verticals, and they have a single sort of component of the business that they focus on day in, day out. And that's true in early stage companies as well.
But that being said, the needs and demands are what drives what we focus on every day, and having folks that have the ability and desire and want to take on other pieces of the business or other needs and make an impact or this can be very important. And so I think if you can find those types of folks that are willing and wanting to engage more broadly, it's only going to enable success faster because there's only so many things we can do on a daily basis.
And early stage companies can be a really a great learning ground for folks in their career at any point, frankly. I know for me, and I've mentioned the executives providing the ability for me to take on a lot of things that I didn't know, frankly, what I was doing when I got started, but it's a quick learning ground and larger scale companies, you don't seem to have that type of opportunity. But early stage companies, there's needs and there's only so many people to do it.
Probably another thing I would say, this may not be direct answer to the question, but as we think about Shore and kind of the why, one of the things, if you think about resource allocation and sort of the early stages of building a business and the resource constraints, one of the things that really attracted me to this as well was the fact that has resources and operational resources.
They've invested heavily in talent. It's really on par with a lot of the talent I was used to having within a business that had a thousand plus employees. I had folks focused on payor strategy and RCM or BI or whatever it may have been, and ultimately knowing that as I've formed a company and have a company of two, and I can't afford to have those types of resources to know that Shore is invested in those types of resources. Support folks like myself, support the other businesses.
It's a bit of a change from what you would expect in these types of early stage businesses where you just can't afford that type of talent.
Parting Advice
Michael Burcham: So Josh, what's the most important piece of advice you would offer to someone who's considering taking on the leadership of building an early stage platform with an organization like Shore?
Josh Johnson: Yeah, I'd say whether it's, early-stage business like this or whether you're a doctor looking to take the next step.
I mean, realistically it's all very similar from the standpoint of you just don't have to do it alone, frankly. I think I've always believed whether you're building a business, you're building a team, you're looking to take your business to the next step, finding the right partners to help drive things forward, taking on new perspectives and having folks support you is probably of utmost importance.
So to me, I just always thought find the right people you want to work with 'cause you're going to be bigger and faster and stronger altogether. And not to take a page outta the Shore book, but it really is true.
Michael Burcham: Josh, thank you for joining us today.
We're really excited to have you as part of the Shore family and what you're creating. And Anderson and I thoroughly enjoyed the conversation.
Josh Johnson: Thanks.
Anderson Williams: Thank you.
Michael Burcham: This podcast was produced by Shore Capital Partners with story and narration by Michael Burcham. Recording and editing by Andrew Malone. Editing by Reel Audiobooks. Sound design, mixing and mastering by Mark Galup of Reel Audiobooks.
Special thanks to Josh Johnson and Anderson Williams who shared in the interview with me.
This podcast is the property of Shore Capital Partners, LLC. None of the content herein is investment advice, an offer of investment advisory services, nor a recommendation or offer relating to any security. See the terms of use page on the Shore Capital website for other important information.