DR. GREG WHITE: If you’re leading the right way and you’re a CEO, you will find yourself at times being in a room full of people, and you are completely alone.

AMAN KAUR: What part of leadership feels heavy when you’re going through that journey?

Dr. White, thank you so much for being here. I know you have traveled a long way, and we are here in London. I can’t thank you enough for taking the time to meet with me.

DR. WHITE: The pleasure’s all mine, Aman. Thank you so much for allowing me to be here. I really appreciate it.

AMAN: Every time I meet with you, you’re one of those people who teaches me things that I didn’t even know existed. So I know there’s going to be so much from this episode that everyone is going to learn from.

DR. WHITE: You’re very kind.

AMAN: Dr. White, I know a little bit about your story and how you became a dentist. I want you to share it with me. What made you become a dentist?

DR. WHITE: Well, I’d love to sit here and tell you that it was because I wanted to help all of humanity, which is in every application I think that’s ever been sent to a dental school—or at least back when I was applying.

But I’ll be honest with you. I grew up in a very poor area, in a house that had no running water until I was nine years old. We were farmers. We were sharecroppers, which meant we farmed other people’s land.

I can remember the anxiety in our family—needing it to rain at a certain time or not rain. There were just so many variables that were completely out of our control. I didn’t want to move forward in life with that same anxiety that I saw from my parents and grandparents.

So I started looking around at some of the people in the local town where I was raised and seeing what professions people were in that seemed not to have that same uncertainty in their lives.

Dentistry, and specifically orthodontics, was the one that rose to the top. It was a job that I felt like I could enjoy doing, and it would provide me with the security and stability I was looking for in my life.

AMAN: So not just a dentist, but an orthodontist—and coming from a family of farmers. How was that journey?

DR. WHITE: It was long and not direct.

Nobody in my family had ever gone to college. After the crops were out of the field in 1981, I got in my car and drove to Lexington, Kentucky, which was about seven hours away from where I grew up in West Tennessee.

I had a distant relative who was at school there at Transylvania University. I just wandered up onto the administration building steps one Saturday morning and waited around because no doors were open.

Eventually, this older gentleman approached me and asked me what I was doing there. I told him I was there to go to college.

He informed me that I had not gone through the proper process. Evidently, you’re supposed to actually apply, have interviews, and get accepted.

But I had to fast-track this because I remember I had $23 and a half tank of gas, and I couldn’t even get back home.

I told this gentleman, Dr. Monroe Musnick, who turned out to be the head of the biology department. He took me under his wing. He got me enrolled. He got me work-study and a job, and ultimately that led to a full academic scholarship there.

AMAN: Wow. Very impressive. I did not know that whole story of how you ended up at that college.

So you founded PepperPointe Partnerships after working as an orthodontist for some time. What made you develop a DSO or the structure you have?

PepperPointe is an organization that so many of us look up to in the industry.

DR. WHITE: Really, it came out of two things that happened at the same time.

The first was the complexity that had come to dentistry and the fatigue that complexity was creating for dentists and practitioners.

Technology was coming into play. Regulations were becoming more complex. Insurance companies and everything surrounding the revenue cycle management side of the business had become extremely complicated.

Dentistry is different from a lot of industries because the dentist is the provider. They’re having to do the work while, at the same time, managing the complexities of a business. Many of them just became exhausted.

At the same time, consolidation was occurring in dentistry. You started seeing a lot of private equity money coming in.

Those two things merged at the same time that the cost of dental education had escalated to a point where the old transition model of one dentist passing a practice along to the next generation really wasn’t viable anymore.

There was too much of a gap between what private equity was offering and what a new dentist coming out of school could afford.

Looking down the road, I saw that doctor ownership was leaving dentistry, and it was happening pretty quickly.

When I say ownership, I’m talking about who actually owns the nonclinical assets—the profits, the furniture, the fixtures, the equipment, all of that.

I saw a legacy getting ready to disappear and realized that it wasn’t the dentist down the street who was the competition. It was the changing marketplace itself.

At that point, I brought many of my colleagues together and said, “I believe we’re stronger together. If we can do this, we can maintain ownership and transition that ownership to the next generation at a lower cost—one they can afford.”

The founding doctors could recoup the balance through long-term passive income and ownership in a management company.

That’s how it was established.

Over the course of the next two to three years, surrounding COVID—right before and right after—PepperPointe was formed, and the great experiment in dental self-governance began.

AMAN: It’s been way more than an experiment. It’s something we all look up to in the industry.

Dr. White, you have this unique ability to always look ahead—how you chose your profession, how you’ve set up the organization. Where does this come from?

DR. WHITE: I think it comes from the story I told you about growing up.

When you grow up the way I did and everything you do and everything you have is surrounding you in nature on a farm, there are always uncertainties. Every day is an uncertainty.

You have to look at the uncertainty that is today, live through that day, but also anticipate what’s down the road so that you’re not always playing from behind and operating in reactive mode.

The only way to be proactive is to try to anticipate what’s going to happen in the future.

Those great predictors come down to a couple of different factors. One is what’s happening in the environment around you, and the other is an understanding of human nature.

Human beings are quite predictable in nature. I don’t think we’ve changed very much in the last 4,000 years. We just have much nicer caves now.

AMAN: That’s a nice way to say it. So you’re saying human beings are more predictable than we think?

DR. WHITE: Yes.

People are predictable in the sense that most people are motivated by fear—fear of loss—much more than they’re motivated by gain.

If you understand what people are afraid of losing, and you can anticipate that, try to mitigate it for them, and show them a path forward, generally they will respond favorably.

I also believe that humans, by nature—and it’s becoming even more so culturally, especially in the United States—have a tendency toward self-focus.

I can remember having a camera for 25 years and never once thinking about turning it around and taking a picture of myself.

Now, I don’t know the last time I saw a photograph of someone without them holding the camera.

If there’s ever a clear indication that self-focus has become primary, just take a look at the photos you see.

AMAN: That’s such a unique perspective. I’ve never thought of it that way.

The way you’ve set up PepperPointe is about looking ahead—making sure your partner dentists aren’t just taken care of today, but that the next generations are taken care of as well.

It has to be very complex. I know you’ve made personal investments time after time and have always been there when needed.

Why is this so important, even in today’s very challenging work environment and economy? You continue to make this your North Star. Why?

DR. WHITE: The orthodontic practice I was in, White, Greer & Maggard Orthodontics in Central Kentucky, invested tens of millions of dollars back into the community through schools, the arts, sports—you name it—across 300 communities over a couple of decades.

We believed that any company has a responsibility to do what it can to add to the culture and help create a community where people want to live and stay.

Orthodontics was simply a mechanism to feed back into the community.

Over time, that’s a legacy that gets created, and you don’t want to lose that legacy. I’m extremely passionate about that, and I still am.

I’m 63 years old now, Aman, and this is how I choose to spend the rest of my years—doing this—because I care so much about it.

I would say the greatest challenge in the PepperPointe model—the model of self-governance, where the doctors truly own all of the assets, clinical and otherwise—is that one side of the coin is that they own it all. They have all the power and control.

The other side of the coin is that they own it all. They have all the power and control, and they can make all the decisions.

When you bring together independent dentists who have operated independently within their own microenvironments—the four walls of their offices—and you try to bring 30, 40, 50, or 60 of them together to function as a group with self-governance and free will, it’s very, very difficult to keep everyone focused on the same goals.

We naturally tend to revert to human nature.

AMAN: Was there ever a pivotal moment, decision, or setback that helped shape PepperPointe into what it is today? Is there something you look back on and think, “That was the moment”?

DR. WHITE: The first moment was simply the realization that a third option needed to be formed.

Going it alone in private practice is death by a thousand paper cuts. Margin compression, regulations, and especially post-COVID staffing issues, rising inflation rates, supply shortages—all of it has become incredibly difficult.

I wouldn’t say there has been any one great moment since then that has shaped PepperPointe.

PepperPointe is, as I said, an experiment: Can dentists really come together and stay focused enough to move forward?

It’s a daily challenge to hold that together.

Rather than pivotal moments, it’s a daily grind that I embrace.

Sometimes you look around and think, “Man, this just sucks.” And then you’ve just got to embrace the suck.

AMAN: It has to be wearing to deal with so many human emotions, especially when sometimes it’s five steps backward and two steps forward.

I know you like progress, and you like to move at a good speed.

DR. WHITE: I do move fast, and the results have been incredible. The financial results of PepperPointe have been absolutely amazing.

You just keep pressing forward.

I believe a leader has to have a couple of qualities. They have to get up every single morning with fight in them.

They’ve got to embrace the fight and charge into it every single day. No matter what’s happening, no matter what the circumstances are, you never, ever believe you’re going to lose.

You cannot think for one moment that you’re ever going to lose—because you’re not.

Winners will not face the possibility of loss. They will fight for it, and they will fight for it.

I get up every single day, and my mindset is: Just make a little progress today by always doing the next right thing.

The next right thing is rarely popular, but it’s always the right thing.

I will live by that and stand by that in everything I do.

AMAN: Dr. White, what do you believe CEOs get wrong when they’re thinking about building lasting teams and persevering through challenges?

DR. WHITE: Two things. But I’ll preface that by saying, first, you have to have the time to do it.

In today’s consolidation environment, the predominant model has a three-to-five-year window—recap to recap. You have this time limit. It’s a time-bound, finite period.

Whether you’re in that model or not, you have to do two very important things.

Number one, you have to have a clearly defined purpose, and you have to stick to that purpose.

That doesn’t mean the strategy can’t change or the tactics can’t change. But the purpose has to be known. Everybody has to understand it, and you have to constantly repeat it.

The second thing is that you have to establish and maintain a strong culture.

You have to have the right people in the right seats.

The right people are those who believe in the same core values you believe in. The right seat means they’re uniquely capable of doing the job they’re in.

Once you’ve accomplished that—you’ve got the purpose, the right people in the right seats, and the right processes—then it’s about accountability.

You absolutely have to hold people accountable.

To do that, you need specified roles, responsibilities, and measures for each of those seats.

If you don’t hold people accountable, you’ll start seeing deterioration, because you get the culture you tolerate, and you get the culture you deserve.

AMAN: Absolutely. It’s easier said than done, especially with current staffing challenges.

Sometimes you think, “There’s so much institutional knowledge here. This person may still be better than what I’ll be able to find outside in the next six months.”

What do you recommend in those situations?

DR. WHITE: It is a challenge, but I believe great cultures attract great people.

The people within your organization generally know more people like themselves.

We recruit pretty heavily from the people we already have. What are your best friends doing? Let’s bring them in. Let me talk to them.

You always know whether your culture is good or bad by who’s leaving.

If the people you want to leave are leaving, you’re right on.

If your good people are leaving—the people who are great for your culture—then you have a problem.

And I don’t necessarily mean people who are great at their job. I’ve been around people who really believed in what we were doing at various points in time and then became nonbelievers.

It’s time for them to move on.

I view a business like a stage production.

You have actors who are part of some scenes and not part of others. You have some who make cameo appearances, and you have some who are there from the opening curtain to the final curtain.

You never know who those people are going to be.

Since you don’t know who will be on the stage at the end, you have to stay true to the plot.

The plot in a business is the purpose.

AMAN: Dr. White, in today’s world, sometimes things have become about process instead of purpose.

It frustrates me. It’s like the tail wagging the dog.

How do you deal with that? Have you encountered challenges where everything becomes about the process and the purpose goes out the window?

DR. WHITE: In our model, we have all these independent dentists who have come together, and they still own it.

It occurs to me—we’re here in London, and we’re approaching the 250th anniversary of the founding of the United States.

I’m kind of a history buff.

When the Revolutionary War was over, you had 13 colonies. Those 13 colonies came together for one purpose: to win their independence.

But as soon as it was over, they all wanted to revert to being independent colonies.

The Articles of Confederation held them together very loosely. It took six years before the Constitution was finally written. And it was a four-and-a-half-month brawl in Philadelphia trying to extract some of that independence away from those colonies so they could see themselves as one.

When I say human nature hasn’t changed in 4,000 years, it certainly hasn’t changed in 250.

That’s the challenge: How do you get people who have ownership to come together and look forward toward a purpose without constantly thinking, “How does this affect me?”

The big “we” is way more capable than the individual “I.”

That’s what we’ve proven at PepperPointe over time. If you can get people to stay together and remain focused on purpose, you get amazing results.

But I also find it’s much easier to bring people together in wartime—such as the Revolution or COVID—than it is to hold them together in peacetime.

AMAN: Greed kicks in. I was listening to something where they said if you acknowledge it—what is your greed, what is my greed—then you’re speaking from a place of honesty. It’s just on the table.

DR. WHITE: Every organization has issues.

If you look at dentistry right now and consolidation, probably 85% of the dental service organizations that were scheduled for recap since the summer of 2022 have not had that occur yet, and there’s no clear line of sight for it occurring.

You can look at that and say that grouping has issues. Within that broad issue, there are micro issues all the way down—labor shortages, turnover, incentive alignment, and all the things that go into creating a fragile business.

What we’re all trying to do is build durability.

You build durability by having aligned incentives with all stakeholders and keeping them aligned toward a single purpose.

That’s the goal.

Durability in an organization means you thrive in the great times and survive through the bad ones because your belief in the purpose is far greater than the individual self-centeredness that comes from natural human behavior.

AMAN: Dr. White, what’s the advice you find yourself giving to young dentists or young CEOs?

You give me a lot of advice, and it has always served me very well. Is there a common theme you feel they need to know?

DR. WHITE: Don’t assume everyone wants the same thing you want.

I think a lot of times CEOs who are leading a company can become distant from the clinician. Many of them have never been clinicians, which makes it easier to become distant.

At PepperPointe, 80% of our team is in the same building every day. They have enormous access to me.

That creates a challenge because a lot of times you find yourself working in the business rather than working on the business.

As a CEO, you have to separate the two.

Get away. Get some clarity. Work on the business.

Then go back into it and charge into it.

It’s kind of like a fighter in a ring. You’ve got three minutes when you’re in the ring, and then you go to your corner. You have to get to that corner to refocus before you get back into it again.

And don’t assume everybody wants what you want.

Every individual in any job is ultimately there because they have needs in their own life. They have wants. They have desires. They have goals.

Usually, those are very local. It’s family. It’s friends. It’s community.

If their job and their position aren’t helping them meet their personal, financial, and professional goals, they will not stay.

Assume everyone has their own specific reason for being there, and rally around purpose, incentives, and alignment to create something durable.

AMAN: Do you believe great leaders are born, or are they created by pressure and instinct? Where do they come from?

DR. WHITE: I would say entrepreneurs are born entrepreneurs.

Entrepreneurs and leaders are not the same thing. I’ve found that out.

Being an entrepreneur and a founder is very different from being a CEO.

Those things can work together beautifully, and they can also work against one another. I’ve seen both in my own experience.

Founders and entrepreneurs want to charge hard. They see the vision. It’s as clear as a beautiful day, and they want to get there so fast.

They just want to charge into it.

But a lot of times, you forget—or you don’t accurately reflect to others—what it is that you see. Other people will not charge into it as fast as you will.

That’s fine when you’re a founder in a startup and you have people with that same vision as you’re beginning something.

But as time goes on, many of the people who were there and founded it with you aren’t the same people who are around you now.

Leadership requires you to communicate that vision and bring people with you.

You have to understand that the people around you may not see what you see as clearly as you do.

A CEO has to recognize that difference and adapt.

AMAN: As a leader, there are also moments when you’re carrying things that no one else can really carry with you.

What part of leadership feels heavy when you’re going through that journey?

DR. WHITE: If you’re leading the right way and you’re a CEO, you will find yourself at times in a room full of people, and you are completely alone.

That’s part of leadership.

There are decisions that ultimately come back to you. There are responsibilities you can’t delegate. There are things that other people may not fully understand because they’re not sitting in your seat.

You have to be comfortable with that.

You have to stay focused on the purpose and continue making the next right decision, even when it’s difficult and even when it’s unpopular.

Ultimately, leadership isn’t about you.

For us, it’s about how we care for patients.

None of this is about dentistry. None of this is about the dentist. None of this is about me.

It’s about how you put something in place that’s going to provide the best care for the people who blindly trust you.

AMAN: Absolutely. And it’s such an intimate need because a smile is their life.

Dr. White, I want to know about your relationship with ambition. Has it changed from the beginning to now?

Or do you continue to stay as ambitious as you were in the beginning because you want to see this through?

DR. WHITE: I’ve given 43 consecutive years of my life to dentistry.

I wouldn’t have done that if it wasn’t important to me.

I’ve always made every single decision through the lens of what’s in the best interest of the patient.

I did that as a clinician. I do it as CEO of PepperPointe right now.

It’s not always popular, Aman.

AMAN: I know. It’s hard.

DR. WHITE: There’s a natural tendency toward expediency—taking the easy path.

But leadership requires you to continue doing the next right thing, even when the right thing is difficult.

That’s what ambition has become for me. It’s not simply about accomplishing something for myself. It’s about seeing this through and protecting what we’ve built for the people who depend on it.

AMAN: As we close, I know you’re a student of history. Is there a leader you particularly admire or someone whose leadership you think about?

DR. WHITE: Winston Churchill.

What I admire about him was his ability to lead through a period when the issue wasn’t one of growth. It was one of survival.

What I love about what he was able to do was rally a nation together and give them the confidence that, in the face of what looked like certain defeat, if we could just live one more day—one more day, one more day—something would happen that would turn it around.

He was able to do that from just a few blocks away from here, in the war rooms.

He was able to navigate that from basically a basement and save democracy for an entire world.

So, yes. I admire the Lion.

AMAN: That’s wonderful.

Thank you so much, Dr. White. It’s been quite a pleasure.

I’m going away from this episode having personally learned so many things. Thank you so much for being here.

DR. WHITE: It’s been my pleasure, Aman. I always love talking to you. Thank you.

AMAN: Likewise. Thank you.