Building a “Yes” Culture: Bob Fontana on Investing in People & Expanding Care

Growth is easy to measure. Building an organization that gets better as it grows is much harder.

Healthcare leaders spend enormous amounts of time thinking about expansion, performance, efficiency, and profitability. But what happens when an organization grows faster than its culture can support?

Bob Fontana has spent nearly three decades confronting that question.

Starting as an office manager in a dental practice, Bob went on to found Aspen Dental and build one of the largest dental organizations in the country. Today, as Chairman and CEO of The Aspen Group, he leads an organization supporting more than 1,400 healthcare locations.

In this episode of The Operator, Larry Benz sits down with Bob to explore the leadership philosophy behind that growth.

Their conversation begins with a simple observation: traditional dentistry was saying no to millions of patients.

No to their insurance. No to evening appointments. No to convenient access. No to transparent pricing.

Bob saw an opportunity to build an organization that approached those patients differently.

But as Aspen expanded, he discovered that removing barriers for patients was only part of the equation. Sustaining that mission required investing in the people responsible for delivering the care.

Larry and Bob examine why culture becomes more important as organizations grow, how provider ownership changes the relationship between clinicians and their work, and why employee development should be treated as an operating investment rather than an HR expense.

They also explore the connection between autonomy and burnout, the importance of community in healthcare, and the role technology should play in making clinicians more effective without making care less human.

• Growth doesn't guarantee success. Culture determines whether expansion strengthens an organization or exposes its weaknesses.
• The patient experience starts with the team. Organizations cannot consistently deliver exceptional care without supporting the people responsible for providing it.
• Access begins with understanding the patient. Aspen Dental's approach grew from recognizing the practical and emotional barriers preventing underserved populations from receiving care.
• Training must produce results. Learning and development should improve clinical capability, communication, leadership, and ultimately patient outcomes.
• Clinical excellence alone isn't enough. Providers must also build trust, navigate difficult conversations, and help patients feel comfortable accepting care.
• Ownership creates connection. Giving clinicians a pathway to ownership can strengthen autonomy, accountability, engagement, and long-term commitment.
• Burnout is more complicated than workload. Control, community, purpose, and meaningful relationships all influence how healthcare professionals experience their work.
• Technology should make care more human. The right tools reduce administrative friction and create more opportunities for meaningful patient interactions.
• Meaning matters. Giving healthcare teams opportunities to serve their communities can reconnect them with the purpose behind their work.

One of the most important lessons from Bob's experience is that healthcare organizations have two groups whose needs must be understood: patients and providers.

Ignoring either creates operational problems.

Supporting both creates the conditions for better care and sustainable performance.

For healthcare executives, dental practice owners, physical therapy leaders, and anyone responsible for building clinical organizations, this conversation offers a practical challenge:

Are you simply growing your organization, or are you building something people want to be part of?

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