Dental Sound Bites™

Solving Your Dental Insurance Dilemmas

Dental insurance is essential for helping your patients get the treatment they need, but it can be a pain in the... well, you know. The ADA's resident insurance expert is here to help decode contracts and give you resources to help you get paid fairly. Special Guests: Dr. Sara Stuefen, and Dennis McHugh, ADA’s manager of third-party payer advocacy.

“Call the ADA Member Service Center if you have some sort of question with an issue that you're dealing with, with a patient's dental insurance, and they will take care of you. They can't necessarily get insurance to pay, but they're going to help you.”

 - Dr. Sara Stuefen, ADA’s Council on Dental Benefits Program

Show Notes

• Stuefen is a general dentist in rural Iowa and a volunteer on the ADA’s Council on Dental Benefits Programs. McHugh is the ADA’s manager of third party payer advocacy and has been with the ADA for 22 years.
• Both Stuefen and McHugh aim to help ADA member dentists navigate dental insurance issues ranging from unpaid insurance claims to terminating network leasing agreements.
• A frustrating issue for many dentists is providing “piecemeal” treatment to work within a patient's insurance, says Stuefan. “You're just trying to do the best thing for the patient and insurance interferes.”
• While not all issues with insurance companies can be resolved, there are common dental insurance pitfalls that are easy to avoid, such as making sure forms are completely filled out before submitting and submitting all the documentation with the original claim submission, McHugh says.
• Having the most recent Code on Nomenclature (CDT) manual, which comes out every year on January 1, is also essential to having documents submitted correctly and getting claims reviewed in a timely manner.
• If your office isn’t already accepting electronic funds transfer (EFT) payments, both McHugh and Stuefen suggest you should. In some cases you will receive payment within days of a claim being approved.
• One of the most common calls Hughes receives is: “How much can I charge for a non-covered service?” This can differ depending on a plan's policies and the state you live in. The ADA can help you find out the answer based on your particular situation.
• The ADA third party payer concierge service for members is a service that Stuefen calls first class. When you call the ADA member service center with a question or issue related to insurance, you’ll receive personalized guidance to help navigate this issue. The service may offer someone to serve as a mediator with an insurance company or help analyze your contracts to better understand your obligations.
• The ADA's 2022 Survey of Dental Fees is another tool member dentists can use to stay informed about the cost of dental care in your region and around the country.
• Data from the survey can be a powerful tool when negotiating fees, Stuefen says.
• While the federal antitrust legislation prohibits organized dentistry from getting involved in the fee negotiations process, the ADA has created a toolkit dentists can use when they want to have fee discussions with payers.
• Starting on January 1, 2024, dental insurance providers in Massachusetts will be required to spend at least 83% of premium dollars on patient care, among other reform measures that aim to “increase accountability and transparency for dental insurers and put patients first.”
• The Massachusetts Dental Society worked with the ADA to spread the message of voting “Yes” on this Medical Loss Ratio ballot initiative, which passed in November. McHugh is optimistic that more states will try to pass this legislation.

Resources:

• ADA’s Dental Insurance Toolkit
• ADA's 2022 Survey of Dental Fees
• Email or call the Third Party Payer Concierge™: 800-621-8099
• Find more resources at ADA.org/dentalinsurance

Transcript:

Hanlon [00:00:00] Hello, everyone. I'm Dr. Hanlon.

Wright [00:00:02] And I'm Dr. Wright.

Hanlon [00:00:03] And this is Dental Sound Bites and ADR Podcast, where dentists share solutions to challenges in life and at work.

Wright [00:00:10] And today, we're going to be talking about dental insurance. Tune in.

Announcer [00:00:16] From the American Dental Association. This is Dental Sound Bites created for dentists by dentists. Ready? Let's dive right into real talk on dentistry. Daily wins and sticky situations.

Wright [00:00:32] Welcome to our final episode of the premier season of Dental Sound Bites. First, we want to thank all of our listeners and all of our amazing guests this season for all of the learning. All of the pearls of wisdom that you shared with us. The mentorship that I have received from all of our wonderful guests and right here with you, Dr. Hanlon.

Hanlon [00:00:54] Thank you, Dr. Wright. I want to thank everyone, too, for your ideas and for making this a really successful first season for us.

Wright [00:01:02] And today, the ADA's resident insurance experts are here and they are going to help us decode contracts. They're going to help us talk about billing once and for all and give us some tips and resources to help you get paid. So I want to welcome Dr. Sara Stuefen and Dennis McHugh to Dental Sound Bites. Welcome. Welcome, guys.

Stuefen [00:01:23] Thank you.

Hanlon [00:01:24] We're so happy to have you here.

McHugh [00:01:26] Thank you.

Wright [00:01:26] So let's go ahead and jump right in. Dr. Stuefen, can you tell us a little bit about yourself and your role on the Dental Benefits Council? Tell us what that is and what you do there.

Stuefen [00:01:36] Absolutely. So I'm a general dentist in rural Iowa, and I serve on the Council on Dental Benefits programs. So that is a group of volunteer dentists from across the country that give their time to looking at all things dental insurance. So we're talking about industry trends and what's affecting our offices on a day to day basis. Certain policies that insurance companies are trying to create and maybe cause issues within our practice and trying to kind of combat that and make it work in our offices. And we're also looking at other things like standards for claim forms or the CDT. All those things are within the wheelhouse of that council.

Wright [00:02:19] Awesome. Awesome. I have some questions just flying off in my head right now for you, so I'm definitely going to - I'm excited to jump into those. But before we do that, I also want to introduce Dennis McHugh. So guys, if you've ever called the ADA with an insurance question, you probably have talked to Dennis because he's the guy with the answers. Hi, Dennis.

McHugh [00:02:39] Hi, Dr. Wright. Glad to be here. My name is Dennis McHugh and I'm the ADA's manager for third party payer advocacy, and I work in the Practice Institute's Center for Dental Benefits, Coding and Quality. I've been with the ADA for 22 years. And prior to that, I spent seven years working for the American Association of Orthodontists in a similar role. And what my department does is we help dentists who have problems with their patient's dental insurance. So, for example, let's say there's a claim that the doctor feels strongly that should have been paid. We can intervene and sometimes we can get those paid. Not always, but sometimes we can. Sometimes there's problems with the EOB language that might even impugn the doctor patient relationship. We can contact the plans and ask them to revise that language. There's been problems with dentists trying to terminate network leasing agreements, things like that. Those are all things where we can help our member dentists.

Wright [00:03:31] That is such good information and I know our listeners are going to benefit from it.

Announcer [00:03:39] Announcing the new... wait. This calls for a drum roll. Perfect. Announcing the newly reimagined. ADA member app designed for dentists by dentists. It puts ADA membership in the palm of your hands with features like a personalized news feed member, chat groups, personal documents, storage, even episode exclusives from Dental Sound Bites. The new ADA podcast. Tap into all the possibilities by searching for ADA member app in your app store.

Wright [00:04:16] I want to tell you guys how I feel personally about billing and insurance. First things first. I feel like we just don't learn enough about it in dental school. And of course, it's not that I feel like they deprive us from learning that. It's just they probably can't even fit anything else into the curriculum of four years. So for me, I just feel like there's a big gap. I'm five years out of dental school, so I know that this episode is going to help me a lot with some of the billing and insurance, I guess, struggles that I've had in practice these past couple of years. So I want to ask you guys, why is dental insurance and billing such a hot button for all dentists?

Stuefen [00:05:00] Well, it's something that we deal with every day and probably every hour. So I'm betting just about every dentist listener has had a patient where the dentist has recommended a treatment that they think is best, and then the patient looks at them and goes, "Well, is my insurance going to cover this?" And that's frustration within the office.

Wright [00:05:20] Oh, yeah.

Stuefen [00:05:20] Also, my max is only $8,000. I can't afford to do all that this year. And now we're having to kind of piecemeal treatment to make it work within the patient's insurance. Yeah. All those things that are kind of constantly coming at you every day that you just as a dentist, at least for me, I just want to take care of the patient and do what's best. And that's, of course, interfered with because the patient's trying to work around what they have as a benefit. Another thing that gets frustrating is when the insurance company says, "Yeah, we don't think the patient should have that," or "Yeah, we know you want to do an implant, but we'll pay for a bridge or we'll pay for a partial instead." Right?

Wright [00:06:00] Yeah.

Stuefen [00:06:00] So those things get really frustrating when you're just trying to do the best thing for the patient and insurance interferes.

Hanlon [00:06:07] Unbelievable. So let me tell you how I personally feel about billing and insurance Billing. I love it because I know that means money's coming in at some point down the road. But insurance not so much. I have watched the impact the insurance companies has had on our patients lives for the last 25, 30 years. And I think that we, as an industry and as a society, really need to start looking at this and how can we provide better guidance and value for our patients.

Wright [00:06:38] Yeah, I know. I can remember a time where I've had to do like a peer-to-peer because of that same reason the insurance company denied or said they just didn't see why I was going in one direction with the treatment that I had presented for a patient. And I didn't even know about peer to peer. But luckily the manager at the time did and suggested that I did. Peer to peer with the dental director of the insurance company. And that ended up working in my favor and in the favor of the patient.

Hanlon [00:07:08] That's awesome. Dennis, what are some of the common dental insurance pitfalls that are easy to avoid?

McHugh [00:07:13] One of the biggest concerns I hear is, you know, dentists will submit a claim form and they get sent back to them because it was incomplete. Now, I know when you use a practice management system, it's not so much an issue there, but if you're sending in a paper form, please make sure that the form is completely filled out because it gets sent back to you it could take another 30 days or so to get your claim processed. So that's one issue. And along the same lines there, too, as far as documentation goes, as we all know, a lot of insurance companies want certain documentation so they can see that the treatment fits the plan's payment parameters. So, for example, when it comes to scathing and root planning, a lot of companies want to see radiographic evidence of bone loss. So if you forget to submit that radiograph at the claim form, guess what? It's going to be sent back to you and then you've got to send it back in with the radiographs. So be careful to submit all the documentation with the original claim submission.

Wright [00:08:07] Yeah.

McHugh [00:08:08] Another thing to do is to make sure you code for what you do and to make sure you're using the current version of the CDT manual that comes out every year on January 1. But a lot of times, you know, we hear from doctors, they haven't purchased a book in a while. They sent in an old code. Well, if you send in an old code, I guarantee you the claims are going to be sent back to you. So that's another thing that's easily correctable. And the last thing I want to mention, as far as that goes, too, is when it comes to payment, if you can accept electronic funds, transfer EFT payments, it can really make your life a lot easier because you can get paid in less than seven days, sometimes even the same day. So I would encourage dentists to look at that. If you look at our medical counterparts, there's a much higher percentage of EFT use than there is in the dental side. So just throwing that out there for dentists to consider using EFT payments in the future.

Wright [00:08:57] Oh, those are some great, great tips. Now, I have a follow up question for you. What's one of the most common phone calls that you receive at the ADA from our member, Dennis?

McHugh [00:09:08] It's really, you know, how much can I charge for a non-covered service? And that gets really confusing at times because first of all, if you're not in that with the plan, you can charge up to your full fee for that service. Even if it's covered service, you can always bill up to your full fee. But if you're in network where the plan, the plan's policies may say that you can only charge the discounted fee for a non-covered service. So let's say, for an example, let's say the plan didn't cover implants. You did an implant. The insurance company is not going to pay for it, but they can limit you to the discounted fee. Now, the good news is that there are 42 states that have passed legislation that says if the plan doesn't cover the procedure, that the doctor can charge up to his or her full fee. So that's the good news. And then the thing with the legislation is, though, that only about half of your patients would be subject to that legislation because about 52% of people have what we call state regulated plans. The other 48% are self-funded plans. And unfortunately, they claim to be exempt from state laws and they claim to be subject to federal legislation, which is known as ARISA. So the bottom line is, if your state has that legislation, it might only apply to about half of your patients. And the other thing I want to mention on that, too, is when you look at your state statute and how they define the term covered service, usually the coverage service includes procedures that would have been covered had the patient not exceeded the annual maximum, for example, or frequency limitation. So even though the claim wasn't paid, if it would have been paid in that situation, it's still considered a covered service and the plan could hold you to the discounted fee.

Wright [00:10:46] We are getting into it, you guys. I hope you guys are enjoying this. So if you are not writing these things down, you may be listening to this on the road, but you're definitely going to want to turn back and play this again once you get to a stationary place. I want to bring you in, Dr. Stuefen, this may come as news to some of our listeners about a service that will help answer specific insurance and billing questions. It's the ADA third party payer concierge. Can you talk to us about how that works, what it is, the benefit to our members? Just tell us all the things related to this concierge service.

Stuefen [00:11:23] It really is a concierge service, first class service that the ADA provides to member dentists. Call the ADA Member Service Center if you have some sort of question with an issue that you're having dealing with a patient's dental insurance and they will take care of you. They can't necessarily get insurance to pay, but they're going to help you. So I know I dealt with this with a patient who we were having issues with getting coverage with scaling a root cleaning, and the insurance company was wanting to deny coverage. And I actually contacted the concierge and actually it was it was Dennis who helped me with the issue. We were able to kind of work through it and actually get payment for that patient. And so that patient could actually get their benefit. They will help you. Sometimes they can help you actually call the insurance company and kind of be that mediator within the issue. Sometimes it's just a matter of helping you understand what your contract is with the insurance company and understanding your network contract. Now, between the two of you, can either of you tell us how often our members are using this service?

McHugh [00:12:30] Well, I can I can answer that every day.

Wright [00:12:32] Yeah. Yeah.

McHugh [00:12:33] Yes, every day. So we get there's a couple of ways you can reach us. One, you can call us on the phone or you can send an email to the dentalbenefits@ADA.org mailbox. And either way, we usually get back within 24 hours, if not the same day. But yeah, we get calls every day. I guarantee you that.

Wright [00:12:50] That's amazing. I think this is so important for our early career dentist to know about because sometimes if you enter into practice, especially if you're in a DSO, kind of like I am, and you maybe you're in the office by yourself, or maybe you have someone that's there with you. But it's just really good for everybody to know that these things are available to us. Another thing that recently came out last month in November at the time that we're recording this is our ADA's 2022 Survey of Dental Fees. Now, can either one of you talk to our listeners about that survey, the value of it and how it can benefit our listeners?

Stuefen [00:13:30] So the Survey of Dental Fees is just that. It's a survey of what dentists are charging across the country. You can download that information. You can get kind of a wide scope view of what fees are at different percentiles throughout the country. And then it's also broken down regionally. So you can get an even better idea of the states within your area and what those fees are. So you can see, you know, ten percentile all the way up to that 90, 99th and get an idea of where you stand because fees are. I mean, that's our bread and butter, right? We want to make sure that we're kind of within what's expected and just helps to have a little bit of extra data there to to help us determine that.

Hanlon [00:14:12] That's great.

McHugh [00:14:13] And if I can add on to that, too.

Wright [00:14:15] Please, yes, please.

McHugh [00:14:16] So a common question we get, too, is if a doctor is in network with the plan, what fee do you submit? That your full fee, the discounted fee and the FDA recommends you always submit your full fee. If the insurance company is looking at submitted fees to determine, you know, what they're going to allow. If you're submitting a discounted fee to begin with, you're kind of, you know, watering down that those fees then. So make sure you always submit your full fee on the dental claim form.

Stuefen [00:14:41] And having this information, the survey between the survey and your information, when we're talking about potentially negotiating fees, a fee schedule with the dental benefits company, having that information is so important because the numbers are kind of your power here when you're talking about negotiation. So you've got to have what kind of what the averages are across your state and your region when you're talking to them, because they're going to try and keep you from increasing your fees. And you've got to have that information to work with when you're going in for negotiating.

McHugh [00:15:14] The ADA has put together a toolkit that dentists can use when they want to have those fee discussions with payers. And, you know, we get a lot of calls sometimes doctors haven't gotten an increase in years. Sometimes plans have lowered fees. So on an individual dentist basis, I should say a dentist can try and negotiate fees with the plan. Some plans may negotiate, some may not. But it doesn't hurt to try. And we put together a toolkit which you can find at ADA.org/dentalinsurance. It's just a guide. It kind of gives you some food for thought, gives you some ideas on what to do when you're having those discussions with the payers.

Wright [00:15:48] Perfect. Just for our listeners, this is a free service. Do you like this survey? This is free for you to download, am I right?

McHugh [00:15:56] Oh yes.

Stuefen [00:15:57] For members.

Wright [00:15:58] Thank you for clarifying. Awesome. That's awesome.

Hanlon [00:16:01] I think it's important that everyone take a look at their 2022 survey of fees because one of the things that I recently found out in a practice that I'm in the process of purchasing is that some docs don't ever change their fees. And I was shocked because some of the fees in this practice are at the 50th percentile, which means that you're leaving a lot of money on the table. So don't do that. Take in, look at the survey of fees and make sure that your fees are comparable to the docs in your area.

Wright [00:16:32] Yes, absolutely. Now, another question that commonly comes up that's often seen in social media threads is why can't the ADA advocate for higher reimbursement? I know you are prepared to talk about that today, right, Dennis?

McHugh [00:16:48] Yeah. Yeah. And, you know, I kind of mentioned, too, of what dentists can do. But unfortunately, federal antitrust legislation prohibits organized dentistry from getting involved in the fee negotiations process. And that's a question we get a lot from the members you know the, the frustrated at times. And we understand that. And that's why we put together the toolkit, because a lot of times when a doctor's office a call me and they'll say, well, "I haven't had an increase in years." And I'll ask, "Well, when's the last time you asked for an increase?" And they'll tell me, "Well, I never have." So if you don't ask for it, I mean, the odds of getting one are going to be pretty slim, right? So we've put together this toolkit that you can use. And like I said, some plans may be willing to negotiate and some may not. But it certainly doesn't hurt to ask and have that conversation with the dental plan's awesome.

Hanlon [00:17:34] I want to bring up the big win in Massachusetts for question two. Can we talk about that?

Wright [00:17:38] Yes, let's do it.

Hanlon [00:17:40] For those of you who don't know any information about this, this is the medical loss ratio legislation that we just passed in Massachusetts. And that means that a certain percentage and I believe it's close to 83% of every dollar has to go towards patient value and patient care, which puts the insurance companies on notice that you can't necessarily pay the big dogs first. And those big salaries that the CEO and senior administrators get, you actually have to pay the bottom line with 83% going to the patient and their needs.

Wright [00:18:17] Yes.

Hanlon [00:18:18] So it was a big win for Massachusetts. We've been working on this legislation for a very long time and we finally had the momentum to get it through. I know that any one of us from Massachusetts would be happy to help any of the states out there work on this and inform their legislation as well.

Wright [00:18:33] Right?

Stuefen [00:18:34] Right. Yeah, it's very exciting. Other states are getting excited about it and already drafting legislation. So it's pretty exciting to see where that's going to go and hopefully we can see a change within the dental insurance industry that they focus on patient care and taking care of their customers, you know?

Wright [00:18:50] Absolutely. So how long had that been something that the ADA was working on or I guess the state of Massachusetts and then how it passed so overwhelmingly, I think it was, what, like a 70% or more pass rate, right?

McHugh [00:19:03] Yeah, They actually in Massachusetts, they did a ballot. So the residents of the state actually voted on it. And the ADA committed $5.5 million to help promote it. And 49 state dental associations also contributed to the Massachusetts to help promote that. And I think that we'll see dividends, too, because more states will try to pass this legislation. And remember, before I talked about the non-covered services legislation? That was that the first bill for that came out in 2009 in Rhode Island. And, you know, now we're 2022 and we've got 42 states that have passed that kind of legislation. So we're looking forward to see what happens with the ...

Wright [00:19:40] Now, what's the best piece of advice that you guys can share with dentists when it comes down to billing insurance?

Stuefen [00:19:48] So if we're looking just at insurance, you've got to read your contract and it's boring and terrible and it looks long and daunting, but you've got to read your contract before you sign it. I can say I, I bought a practice right after I graduated from dental school and I did not read those contracts. So I signed. I just thought that's what I you know, I was supposed to sign the contract because the previous dentist had signed him and I was supposed to do that. But you can you can make changes in those contracts. They aren't necessarily just, you know, here's what it is and you have to take it. You can you can negotiate on some of those things. So it's really important that you do that. And the ADA actually has a contract analysis service. So they will help you analyze these contracts. And that's again, a free service within your ADA membership. So it's something so important to take advantage of because as a lot of dentists know, once you take on that insurance, once you decide to become in-network, it's a lot more difficult to leave that network, right? Because now you've built up this basis of patients and you're not sure how many are going to stay with you or leave. So use that service and understand because there's so many different things within the uniform policies and the processing regulations that are that benefits companies going to have that can affect your income. So it's not just the fee schedule that you need to be looking at. It's all of those policies that they have where they're bundling and doing all these other things, alternative benefits and all these other things that are going to affect your bottom line in your practice.

McHugh [00:21:24] Yeah, just add on to that too. You talk about like the down coding, for example. We were just looking at a case today too, where if you do a posterior composite, a lot of the plans are only going to pay for an amalgam. And so especially the newer dentist, you know, they haven't seen this. "They'll call us up and say, why are they doing that? You know, my patient didn't want an amalgam." And, you know, we had to explain to them, well, when you sign that contract, there's usually a clause that says you agree to abide by those processing policies. And those are usually found on the web portals. And so you have to it's always a good idea to look at that, too. But there's over 800 different CDT procedure codes. So I know dentist don't want to look at every company's, you know, what they're going to do procedure by procedure, but that's sort of what it comes down to. And the other thing I would add, too, we talked about, you know, the importance of submitting a clean and complete claim form. And dentists are responsible for what goes out in the claim form. So it's always good to do a check of the claims that are being sent out to make sure all the information is correct up to date and that you're using current codes.

Stuefen [00:22:23] So going back to billing and Dennis touched on this earlier, but EFT is and accepting even is within your practice and how much more quickly you can get paid. So that has really kind of revolutionized our practice As far as our biggest payers, we're getting paid typically within a week and if you're waiting for a paper check, you're probably going to be waiting a lot longer for that. And then you're also worried about it getting lost in the mail or just getting lost between your office and how many different hands it gets transferred to and then getting to the bank. So I would definitely recommend if you are a practice owner or working within management of the practice that you take a look at taking of EFTs. It's also just safer. So a lot of people kind of have this concern that the insurance company can actually withdraw money out of the account and they're not allowed to do that. So that's just kind of an important thing to understand. They can put money in, but they're not going to just take money out. And so that's just something that I think sometimes people are scared of taking. And I see that on social media, like people are like, Oh, you have to stick with paper checks but get paid faster and go for it.

McHugh [00:23:36] Yeah, we talked about our website too. You talk about some of the information we have out there. We have a lot of dental insurance guides that are very helpful. We've got a whole bunch of recorded webinars and one of them features doctor stuff and talking about EFT and how that works. And we've got a representative from Nacha, the US Automated Clearing House Association. So that has some very good information. It can help you. You can call the ADA if you have further questions, you can talk to your clearinghouse, you can talk to the payers. There's a lot of room for help out there for those folks that are thinking about doing this but are a little reluctant yet. And also on our website, we've got faqs. We've got all kinds of good information. So I encourage everybody. If you haven't checked out our website too, please do so.

Stuefen [00:24:18] And even to piggyback onto that, just another thing that I think we hear from members, just like a lot of complaints, is virtual credit card payments and that they're being told they have to take virtual credit card payments from these insurance companies and you don't. So call the company and say, I. I don't want to be paid through a virtual credit card. Because, remember, you're probably if you're in network with that company, you're already taking a discount on your full fee for seeing that patient. And then you're may be paying a two, 3% fee for taking that payment as a credit card payment. So don't do that to yourself. Call the company. They have to offer you some other form of payment where you're not where you're not paying a fee. So depending on the company, they might be able to enroll you in EFT. or send you a paper check. But I just I refuse to take a virtual credit card payment within my office. And I think I think that's something that other dentists should do. And then they should also know that they don't have to be charged for an EFT. A lot of times companies will say, okay, well, we'll switch you to an EFT but we're going to charge you kind of a fee for doing this service. And they kind of are saying, you know, we're providing this like extra service for you for doing an EFT, but there is an option that you can do that is a no charge EFT. So they don't they, you can accept that fee, but you don't have to. And so you should know that.

Announcer [00:25:45] On the next gentle sound bites.

Wright [00:25:47] Season two will be here soon, and it's loaded with more sticky situations, amazing guests and a few laughs and lots of resources you can use in and out of the operatory.

Hanlon [00:25:59] Season two coming soon.

Wright [00:26:04] Thank you so much, Dr. Stuefen and Dennis, for being here to share all things with us about dental billing and insurance. It was so lovely engaging in this rich conversation with both of you.

Stuefen [00:26:16] Thanks so much. It was great.

McHugh [00:26:18] It was s pleasure to help.

Hanlon [00:26:19] Thank you. Dr. Stuefen and Dennis, so much for all of your pearls of wisdom. It's been great to really get some more background for our listeners and what we're supposed to do and how we're supposed to manage this very complicated topic and one that we didn't learn about in dental school. We just have to learn through the school of hard knocks. So we really appreciate your guidance.

McHugh [00:26:38] You're very welcome.

Stuefen [00:26:39] Thank you.

McHugh [00:26:39] And for our listeners, you can find everything we talked about today and more on our show notes section at ADA.org/podcast.

Hanlon [00:26:48] If you like this episode, go ahead and share with a friend. Subscribe to the podcast. So you know, when season two starts for us again.

Wright [00:26:55] You can also rate and write a review and follow us on social media.

Announcer [00:27:01] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show Resources and more on the ADA member app and online at Ada.org/podcast.

Money and Finances

New year, new budgets! It's time to set your money goals for 2023. In this episode of Dental Sound Bites, special guest and financial expert Stephen B. Dunbar III, J.D., CLU, shares tips for dentists at all stages of their careers to increase wealth and save for the future. Dunbar is the executive vice president of Equitable Advisors.

“All financial planning is (is) putting the road map, the Google Maps, together to show me how to get from where I am today to the fulfillment of the purchase of my needs and wants in the short, mid and long term.”

 - Stephen B. Dunbar III, J.D., CLU

Show Notes

Dunbar works with many professionals, such as dentists, to help them meet their financial goals and avoid money pitfalls that can often plague people with successful careers.

• One of the biggest mistakes Dunbar says newer professionals make is the “kiss of debt.” After getting a job with a bigger salary, they will “reward” themselves with lavish purchases using credit cards or loans with payments that will recur for years to come.
• Instead, Dunbar suggests a one-time purchase that you pay upfront, such as purchasing a nice watch or a dinner out and enjoying the gift to yourself without going into debt.
• He also says “expectations without being anchored in habits are a recipe for frustration.” Consistent habits, such as saving a set amount of money per week and increasing it over time is progress towards your financial goals. He says people need to celebrate such progress and consistency.
• Dunbar also suggests making such deposits into retirement and savings accounts automatic and to automatically increase the amount over time.
• Also, Dunbar says to be aware of other ways to save money such as saving extra cash after you’ve paid your social security tax for the year. This applies to people earning more than $160,200 per year in 2023.
• Procrastination is also a pitfall that Dunbar sees, where people don’t take the time to set up automatic withdrawals or meet with a financial planner.
• Dunbar suggests everyone write down their short-term, mid-term and long-term goals and find someone who they trust who will help them meet those specific goals.
• If a finance professional guides you into a plan that doesn’t meet your goals, Dunbar says there is “no emotional juice” and you will not stick with it.
• Later career dentists who are thinking about retirement should be not only focused on their financial finish line, but the “emotional” finish line, too. If they don’t know what to do with their time once they retire, they shouldn't, Dunbar says. Many of these former professionals can feel depressed if they don’t have an emotional plan in place for retirement.
• Stephen Dunbar is a financial professional who offers securities through Equitable Advisors, LLC (NY, NY 212-314-4600), member FINRA, S.I.P.C, offers investment advisory products and services through Equitable Advisors, LLC, an S.E.C.-registered investment advisor, and offers annuity and insurance products through Equitable Network, LLC. Equitable Advisors and Equitable Network are affiliated companies and do not provide tax or legal advice or services.

Resources:

• Contact information for Stephen B. Dunbar, III
• Read ADA financial resources
• Email sign up to receive Dunbar’s Financial Love Letter.

Transcript:

Wright [00:00:00] Hello, everyone. This is Dental Sound Bites an ADA podcast where dentists share solutions to some of the big challenges we face in life and at work. Now, I don't know about you, but I didn't get into dentistry to balance a spreadsheet. So, today we're going to get expert financial advice that will help us set up for success for this year.

Announcer [00:00:23] From the American Dental Association. This is Dental Sound Bites created for dentists by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Hanlon [00:00:38] Happy New Year. Dr. ArNelle, did you make any resolutions this year?

Wright [00:00:43] I don't really make resolutions. I typically try to set some goals. So, I have been in the goal setting process since October. That's when I kind of start thinking and projecting for the future year. So, I'm super excited for the year ahead. What about you?

Hanlon [00:00:57] You know, I do set goals, but I do not make resolutions either. So, I think that goals are critically important for me, it really helps me to gauge my year and make sure that I stay heavily focused on what I'm trying to accomplish. So, I'm really looking forward to 2023.

Wright [00:01:15] One of the things that y'all said you wanted to hear this year was getting some help with your money and your finances. So, in this episode we have a very special guest financial advisor, speaker and money author Stephen B. Dunbar, the third with some very can't miss money advice. We are so happy to have you here, Stephen.

Hanlon [00:01:35] Yeah. Welcome, Stephen, and it's really great to have you.

Dunbar [00:01:38] Thank you so much. I'm thrilled to be here. And a part of kicking off the new year for people. If I may, I'll go back to your question about setting resolutions. I would actually recommend people think about that goal setting, but habit setting goals.

Hanlon [00:01:51] And I love.

Dunbar [00:01:51] That habit setting because good habits lead to goals necessarily as an outcome. And if we adjust our habits, we will definitely meet our goals. So, it's about what habits are we going to lose and what habits we're going to add in the new year so that we can hit the objectives we have in mind.

Announcer [00:02:09] Announcing the new.. wait. This calls for a drum roll. Perfect. Announcing the newly reimagined. ADA member app designed for dentists by dentists. It puts ADA membership in the palm of your hands with features like a personalized news feed, member chat groups, personal documents, storage, even episode exclusives from Dental Sound Bites. The new ADA podcast. Tap into all the possibilities by searching for an ADA member app in your App Store.

Hanlon [00:02:47] Tell us a little bit about yourself and your background, Stephen.

Dunbar [00:02:49] So, I'm educated as an attorney. I practiced law for three years and was recruited to Wall Street, spent most of my career on Wall Street doing investment banking, then went into private equity. I've just described to you what I call the first half of my life. In the first half of my life, my career was a 12 on a scale of 1 to 10. Anyone from the outside looking in would have been very envious of my career. The challenge, MJ, is that when you looked at the other areas of my life, fitness, family time, just having fun, some of these other basic areas of life, they are ones and twos because everything was being sacrificed on the altar of professional success. So, right around 2007, 2008, I made the transition. I ended up in this industry in 2010, moving from what I call the institutional side of finance to the retail side of finance, engaging with people and let's say smaller companies. Because for me, let's not fall for that lie. We can have life in harmony. We can do well professionally, but also personally. So, all of my advice is around helping people have success in both those areas and not sacrificing one for the other, because that's the myth which we're told we can only have one at a high level, not both.

Wright [00:03:58] Hmm.

Hanlon [00:03:59] It is so true. And I think that those dentists out there that may own several practices, the more you own, the more crazy it gets. And it's hard to balance, you know, your personal life and your professional life. I know I have to get up at 5:00 in the morning just so I can fit my exercise in because I won't do it any other way. At the end of the day, I'm too tired. I think that we do have to make adjustments and good for you that you made that decision not only for yourself personally but for your family.

Dunbar [00:04:28] I think, MJ, honestly, what happens any time we step into a room as individuals, we're going to do one of two things. We either will bring a rain cloud with us that's an outflow of the negativity that we're carrying internally, or we'll bring the sunshine. And what I want to do is help people bring the sunshine, not just for themselves personally, but for those around them, their employees, their families, the communities where they do work.

Hanlon [00:04:49] That's awesome.

Wright [00:04:49] I love that so much. Can we jump into some big money mistakes that you're seeing that dentists and other professionals are making?

Dunbar [00:04:57] I'll start off really, let's say on the earlier side of the career. Number one is what I call the kiss of debt. The kiss of debt. That's the big one.

Wright [00:05:08] Not, the, the kiss of death.

Dunbar [00:05:09] And why is that a big one? Because what happens is I work really hard to get my credentials and I come out of now and I'm now practicing. I'm a professional. The first thing I want to do is reward myself with a lavish purchase. So, the kiss of debt, what that looks like is if you have $3,000 on a credit card, let's say 12% interest and you pay $50 a month, it'll take you almost eight years to pay off. You end up paying almost 1600 dollars in interest expense alone, which would just, for the privilege of charging your card. Here's what I'm saying. The big mistake is. Reward yourself. You deserve it. You've worked really hard to get through dental school. When you reward yourself, pick a discrete one time expense to reward yourself, not an expense that's going to recur for 60 months or 90 months. So, by the watch, go to dinner, maybe take a trip to something like that, as opposed to buying a very large house or buying a very expensive car. That's one, the other, I would say is what we started the conversation around. I see a lot of people that have expectations. Expectations without being anchored in habits are a recipe for frustration. So, instead of talking about expectations, hopes, dreams, these are all synonyms for each other. They're really just teaming up for a lot of frustration. Let's talk about goals anchored in habits that we can measure. Here's the big one, for, for early career people. Most people want to be a millionaire or a multi-millionaire. And so if I set that goal for myself and I'm 29 or 32 and I look at my bank account in my savings accounts tomorrow, well, I'm not a millionaire, so I have the opportunity to be frustrated. If I do it three years and I'm still not a millionaire, if I do it ten years and I still may not be a millionaire, here's what I'm saying. Rather than having the goal be $1,000,000, have the goal be a million set, set the habits to to reach the million, but then do micro goals. What do I need to save tomorrow? It's $20. I need to save tomorrow to be on pace. If I wake up and I get to the end of tomorrow and I've saved $20, I can high five myself because I'm making progress. Let's get lost in the progress, not the achievement. Progress, not perfection, is how people normally talk about that.

Hanlon [00:07:18] You just make little steps every single day with consistency. That's, I think, is the key, is the consistency. If you consistently stick to it, don't even pay attention to it, have it automatically taken out of your, your check when you do get it, you never miss it and you don't count on it. So, and it's just, it's amazing. I remember graduating from dental school. My daughter was five when I started, so I think she was about 12 or 13 years old. I had her start to work at my practice. And I started an IRA for her and it wasn't much. It's $250 a month, but by the time she was 21, she had $25,000 in that account that she could use to buy a condo or, you know, she used it for her first house. So, it did accumulate very quickly. So, I encourage anybody that's listening that even a little bit is better than nothing at all.

Dunbar [00:08:09] I'm going to highlight that because that's super important. Most people think that I need to earn an excessive amount of money to accumulate wealth. Not true at all. It goes to the point you're making MJ about small, consistent habits over a long time. So, the most comfortable client that I have, he was a principal. She was a school administrator. They have more than they know what to do with because, small and consistent over a total career. That's number one. Number two, when you think about this, it doesn't matter how much you start with. That's the other thing. To your point of the story, you just told MJ. Start anywhere. And not only have that come out automatically, but have increases happen automatically as well?

Hanlon [00:08:48] Yeah.

Dunbar [00:08:48] So, have my savings percentage maybe increase 1% every three months.

Wright [00:08:53] Oh, nice.

Dunbar [00:08:55] Because, that, that also happens automatically. The other thing, and this is a subtle one, is if I'm earning over $160,000 a year, I have an automatic pay raise built into my income that I don't realize and I'll spend if I don't if I'm not careful. For example, if I make 200, if I came out of dental school and I'm working for a system that's paying me 200, I will earn in the last two months of the year an additional roughly $2500 because I've paid into Social Security once I hit $160,000 a year, figure out at the beginning of year what that number is for you and plan to save it so it just doesn't end up in the checking and running through the checking out the door to something that doesn't count for anything.

Hanlon [00:09:34] Great point. Great point.

Wright [00:09:36] You're helping me so much here because I have young kids and I'm five years out of dental school. So, like even being on the receiving end or just hosting this podcast is helping me make some financial plans for my family and myself. So, thank you so much for that because, listen, I remember being a student in dental school and once I graduated, I had a completely different set of money worries than I do now. And so kind of keeping that in mind, I have a question for you, like about some common pitfalls. I know you talked about like the kiss of debt, but any additional pitfalls that we can avoid or any best practices that you can share about? For someone who's mid-career, someone who's graduating dental school and someone who's close to retirement?

Dunbar [00:10:18] The other pitfall is the P word, procrastination. That's the other pitfall is I will do it tomorrow and then tomorrow never comes. So, for those listening, I would say this is your opportunity. You've heard the pitfall. When you terminate this podcast this evening, take one step towards starting your financial plan. So for you, it might be starting your contribution. It could be writing the plan down. It could be reaching out to a professional who's going to provide your advice. But procrastination. Dr. Wright. That's the other pitfall that I see that hammers people, because let me give you an example. And I have the numbers here in front of me. If my goal is to save $500,000, if I start at 25, let's say, compared to starting at 45, the difference is my monthly savings has to be $189 a month as a 25 year old versus that's it versus $954 a month as a 45 year old. That's the cost of procrastination.

Hanlon [00:11:16] What is that? The, the factor of seven? What is that?

Dunbar [00:11:20] Oh, that's my favorite seven. Rule of 72. Rule of 72, ready for this one?

Hanlon [00:11:24] That's what it is.

Dunbar [00:11:25] This is fun. Anybody can do this. Let's do this together.

Wright [00:11:27] Let's do it.

Dunbar [00:11:28] Let's say we're solving for a 10% rate of return, meaning our expert, because we want the math to be easy, that we think we can earn a 10% annually. What that means is every 7.2 years my money will double because you take 72, you divide into it. Whatever your rate of return is, the answer or the quotient, that's the number of years you take your money to double. Here's the power of that, I think people miss.

Hanlon [00:11:50] It's amazing.

Dunbar [00:11:51] It's incredible. I'd say I started $100,000 just to really make it eye popping, in seven years I'll have $200,000. In 14 years, which is another seven, I'll have $400,000.

Hanlon [00:12:05] Now.

Dunbar [00:12:06] In, at 21 years, which is another seven, I'll have $800,000. Yes, that's the power of compounding. That's the other principle that is behind a lot of investing and math is the power of compounding, and that happens behind the scenes.

Wright [00:12:22] I am a first generation college student, first generation doctor. I didn't kind of have my path outlined for me, so I might just be getting some advice for myself here. But I think someone on the listening end can benefit from this. So, like wealth and generating it, those are not topics of discussion in my household, so I'm kind of having to figure it out. What kind of advice would you have? I know like, the procrastination, but someone who doesn't even understand bare minimum financials and they may even still be a doctor. Can you just coach us on that for a moment?

Dunbar [00:12:56] For sure. Let me start by saying, Dr. Wright, let me give you a for instance, I counseled a CEO of a company that did revenues north of $50 million.

Wright [00:13:06] Mm hmm.

Dunbar [00:13:07] This was a complicated company because it involved a little bit of science and some pretty complicated logistics. So, this was a gentleman that was highly, highly intelligent.

Wright [00:13:16] Mm hmm. Mm hmm.

Dunbar [00:13:17] And he admitted at the end of the process, he went with us. Because, for the first time, you didn't assume I was knowledgeable, nor did you speak down to me. And you gave me the information I needed to make a good decision. The point I'm making is this: Please do not put the burden on yourself or any of your listeners that because you're an excellent dentist, you should be an excellent financial person.

Hanlon [00:13:41] Here, here.

Dunbar [00:13:41] Totally unrelated concept, right, MJ?

Hanlon [00:13:42]  Absolutely. Amazing. Yeah, we can't be great at everything now. Obviously, I think, that, that we do fall short with explaining the business side of dentistry to our students.

Dunbar [00:13:55] Mm hmm.

Hanlon [00:13:56] But there's really not enough time. People spend 30 years to become experts in business and in finance.

Dunbar [00:14:02] So, here's what I would do. Take out a piece of paper, and I would create three columns on the piece of paper. We're going to do this real quick, and I think all of your listeners have all three columns. First column is short term. Second column is midterm. Third column is long term.

Wright [00:14:18] Okay.

Dunbar [00:14:18] And you want to give yourself enough room under those headings to fill things in. Document needs and desires you have over the short term. Short term is defined as 0 to 5 years. Needs and desires are, have in the short term, maybe buying a car, maybe deposit on a home. And let's skip over to the long term, because that's the most intuitive and obvious, needs and desires for the long term. The biggest one we tend to hear there is retirement. Right. But go a little bit further and say, what is my lifestyle I want in retirement? What do I see myself doing in retirement? Fill in needs and wants in the long term. Then do needs and wants in the midterm. The biggest one we tend to see in the mid-term is education for dependents.

Wright [00:14:58] Kids.

Hanlon [00:14:59] Mm hmm.

Dunbar [00:14:59] But it could be opening a business. It could be buying a practice, needs and want in the midterm. What you're doing is, you're anchoring your financial planning in your true needs and wants as opposed to what I ought to be doing. This is the other big mistake I see people make trying to do what they ought to be doing or what they are told to be doing, which has no emotional juice. And I will not stick with it. The moment something becomes hard, I'll bail because that was not my goal in the first place. So, start with needs and desires that are my own by documenting short, mid and long term. Then get with someone you trust to do some math, to finance your needs and desires in the short, mid and long term. That's all financial planning is, is putting the road map, the Google Maps together to show me how to get from where I am today to the fulfillment of the purchase of my needs and wants in the short, mid and long term. That's all it is.

Hanlon [00:15:51] It's awesome. Great advice. Now, you know, the only person that is really close to retirement in this duo here is me. So, let's, let's, let's talk a little bit more about retirement. You know, what do people get wrong and what do people get right? And, you know, I know we've heard the statistic that less than 1% of dentists in this country can actually retire on time. You know, most dentists are working until they're 70 or 80. And, you know, quite honestly, we've had the 2008 crash. We had, obviously COVID. And, you know, we have inflation happening right now. So, we have a lot of things that have happened in a very short amount of time I think, that is, really impacting our portfolios.

Dunbar [00:16:32] So, I think if I look at the mistakes that you're, let's call them later career dentists are making. A couple of things. Number one, the plan was never updated and adjusted. So, we don't have a clear finish line. And here's the thing that's the hidden trap for people. There's two kinds of clear finish lines. One is a financial finish line and one is an emotional finish line. Let me start with the emotional finish line, because that's the one that's not so intuitive when I get to the finish line, if I have not decided on something that will be a passion of mine post being a dentist, a post being a professional. Do you know the biggest issue people have in retirement who are able to financially retire? Depression.

Wright [00:17:12] Depression. I know you're going to say that.

Dunbar [00:17:13] Because they go from being the woman of the hour that's always on call, dealing with heady issues, managing crises, running successful firms to everybody returns my phone call to the phone doesn't ring anymore. So, I have to have something to emotionally transition me from professional to post professional. And if I don't have that, I don't retire. Not because I'm not financially ready. I'm not emotionally ready. So, that's the first thing we've got to dig deep and be ready for. Then there's the financial finish line. And here's the other pitfall I see when you think about later career people. They have taxable and they have tax deferred. The bucket they're missing is the tax favorable or tax exempt bucket. So, they have the investment accounts that wherever they have the retirement account at the office, they don't have the Roth IRA as an example. That's an important gap, because if I have all of my money in a retirement account, 401k, for example, my profit sharing, and I've done an amazing job, if I have $1,000,000 in there and I go to retire, do I have $1,000,000? No, I've got.

Hanlon [00:18:19] Not when the taxman comes.

Dunbar [00:18:20] That's it. The tax person is going to show I don't have $1,000,000. So, diversification of my tax bracket is what I like to talk about when I go into retirement, because then my money will last longer because I keep more of what I've earned.

Hanlon [00:18:35] That's awesome.

Wright [00:18:35] So, Stephen, do you have something like a five step guide to help our listeners set themselves up for financial success? Or like just some resources that you can tell us about?

Dunbar [00:18:45] Sure. So, if anyone's interested, I have a something called a love letter, and it's produced by an attorney and accountant and us as financial advisors. I'll share that as a resource with your listeners. It's a document that, you know about 20 or so pages, but it really you can use it as a guide to make sure you've puy your, not just your financial house in order, but sort of get a start on your estate planning, your legal documents, your will, your health care proxy, so on and so forth. So, anyone who's interested, reach out to me and I'll make sure you get a copy of The Loving, Love Letter.

Wright [00:19:15] Awesome.

Hanlon [00:19:16] So I'm curious, what's the best money advice you've ever received?

Dunbar [00:19:19] You said at the beginning of the call. Consistent, repeated steps over a long period of time will yield the outcome. And it almost doesn't matter if you're young enough. It almost doesn't matter what amount you start with. That's really the secret. The other secret. This one's going to hurt some people's feelings. Here's the other secret. Live below your means. So one of the.

Hanlon [00:19:40] Means.

Dunbar [00:19:41] Things I do, that's.

Wright [00:19:41] What I was going to say.

Dunbar [00:19:42] One of  the things I do is my wife and I. We are working on the discipline of reducing our expenses by 1% a year. We started this a long time ago. 1% of you.

Hanlon [00:19:53] Good for you guys, that's a great goal.

Dunbar [00:19:54] Because it doesn't it's not a big number again. Small, small, small. But you do 1% over a decade. That adds up. And ideally, hopefully your income is increasing at the same time you create that gap.

Wright [00:20:04] Stephen, can you tell us where people can easily learn about how to manage their money?

Dunbar [00:20:08] My thought would be there's a magazine called Kiplinger. I would recommend people read that it's actually designed to be for do-it-yourselfers. It has anything from a beginners knowledge level to use it, but you can also be an expert ... I actually am a writer for Kiplinger, so I have a monthly column on the online version of Kiplinger. So if you Google me with Kiplinger, my columns will come up and you can certainly read those articles as well.

Wright [00:20:33] Awesome. I wanted to ask if you could recommend, like, the top characteristics that we should look for in a financial advisor, like how do we vet them out? Someone to bring on our money team.

Dunbar [00:20:45] Look for someone who has credentials. So, beyond just getting the basic securities licenses required by the state and federal government, look for somebody who has a designation a CLU, a CFP, a CHFC, so on and so forth. That's going to show a commitment to continued learning. And you'll be the beneficiary of that. Look for someone that fits your style. That's really more important than anything else. And what I mean by that is try and get a feel for the way they give advice and the way you receive advice. If they're highly analytical and they're going to be all about numbers, and you're somebody who really desires to have things more in charts and graphs and pictures and make sure your styles align with each other. The other thing I would look for is someone that has duration in the business. So, you don't want to be working with someone that has three years. Find someone who has a decade or more in the business, as the author says, to become an expert or something, it takes at least ten years. So, really look for someone with about a decade or more of experience. So, you really are getting the benefit of that. The last thing I'll say is find someone who's a part of a team. Our financial needs are complicated, and to think that one person can handle everything from my household is just not a reasonable expectation. So, look for someone that's part of a team so that they have the ability to be good at what their lane is, but they have others to help. And then the last thing I'll say is, work with an advisor who is comfortable working with other professionals. So, an advisor who is trying to create a competition between you, he or her, and the CPA or the advisor and the attorney. That's not a good advisor. An advisor is somebody who's willing to work with other professionals, because again, they know that those other professionals provide a critical part of the service to provide holistic advice to the client.

Hanlon [00:22:23] Great advice.

Wright [00:22:24] The ADA also has a lot of resources on ADA.org/money. Whether it's refinancing your student loans, help keeping you on a budget or financial planning support. All of these resources are going to be free and available to our members. And for our listeners today, you can find all of the resources that we discussed on this episode and more in our show notes section, which is going to be ada.org/podcast.

Announcer [00:22:50] On the next Dental Sound Bites.

Wright [00:22:52] Dental insurance can be a pain in the well, you know, if you have billing and insurance questions, tune in. The ADA's resident insurance experts are here to help you decode contracts, billing and help you get paid.

Hanlon [00:23:08] Stephen, it was so amazing to have you on the show today. Thank you so much for all your advice. And, and I know that it's going to get to somebody and you're going to make a difference in somebody's life.

Wright [00:23:18] This is like a great starting point. So, this conversation needs to continue happening in our community. So, I just want to thank you so much for all of that wealth of knowledge.

Dunbar [00:23:25] Thank you so much.

Hanlon [00:23:26] If you liked what you heard today, please subscribe to the podcast wherever you are listening so you can get our latest episode.

Wright [00:23:33] You guys can also rate and write a review and follow us on social media. And don't forget, the conversation will continue in our member app, so please join us there.

Announcer [00:23:44] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show's resources and more on the ADA member app and online at ada.org/podcast.

Dunbar [00:24:00] Please be advised that this document is not intended as legal or tax advice. Accordingly, any tax information provided in this document is not intended or written to be used and cannot be used by any taxpayer for the purpose of avoiding penalties that may be imposed on the taxpayer. Tax information was written to support the promotion of marketing of the transactions addressed, and you should seek advice based on your particular circumstances from an independent tax advisor.

 

 

Be Well

There are times when dentistry can be physically, mentally and emotionally challenging. For many, the busy holiday season is one of those times. The holidays can bring with it stressful moments personally and professionally. In this episode, you’ll find self-care and wellness resources and tips from guest Dr. Alex Barrera, a member of ADA Wellness Ambassador program to help you incorporate wellness into your everyday life. 

“Little by little we (can) incorporate more healthy habits. That's how we get to do that “mental flossing.” It's preventative care, right? Just like going to your dentist every six months is preventative care. It's sort of the same thing with mental health.”

 - Dr. Alex Barrera

Show Notes

Barrera draws on experiences working with diverse groups within dentistry and training as a certified yoga instructor, to offer listeners tips and advice on how to make wellness and self-care a daily habit.

• Barrera is a general dentist in Houston, Texas, who works at a federally-qualified health center. He has a passion to serve the underserved and vulnerable populations.
• In 2019, he helped found the first official LGBTQ-focused organized dentistry group called the Houston Equality Dental Network and has been highly involved with the Hispanic Dental Association.
• He is dedicated to educating dental professionals and dental students on how to better treat and serve the LGBTQ community.
• Barrera is also a certified yoga teacher with a passion for wellness and self-care and enjoys educating others about the benefits of “mental flossing” or daily self-care activities that prioritize mental health.
• The results of the 2021 Dentists Well-Being survey report indicated an increase of dentists affected with mental and emotional health concerns. Barrera isn’t surprised by this finding. He says he has experienced high-functioning anxiety and depression himself in the past.
• Dentistry often attracts detail-oriented people, who Barrera says may find complete satisfaction from checking something off their to-do list and is always seeking out the next task. While this trait isn’t “bad,” Barrera says it can lead to little time to focus on self-care and wellness.
• The ADA Wellness Ambassadors are rolling out projects around their districts that include and incorporate wellness more deeply into the community. Find out more at ADA.org/wellness.
• The three things Barerra suggests doing every day to as part of “mental flossing” are:
  • Practice gratitude: this can be done by jotting down three things you are grateful for every day.
  • Move your body: a daily walk, stretching every morning or night or hitting the gym or yoga studio on a regular basis is a great way to lessen stress.
  • Breathing exercises: Barerra suggests a method called “box breathing” which includes breathing in four counts, holding your breath for four counts, exhaling for four counts, then holding the breath out for four counts.

Transcript:

Hanlon [00:00:00] Hey, everyone. I'm Dr. Hanlon

Wright [00:00:02] And I'm Dr. Wright.

Hanlon [00:00:03] And this is Dental Sound Bites and ADA podcast where dentists share solutions to challenges in life and at work. In this episode, we are bringing you steps that you can take to improve your physical and mental well-being in and out of the operatory in our personal search for wellness.

Announcer [00:00:21] From the American Dental Association. This is Dental Sound Bites created for dentists by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Wright [00:00:37] For today's conversation, please welcome Dr. Alex Barrera.

Barrera [00:00:40] Hello, everyone. Good to be here. I'm excited to be here.

Hanlon [00:00:43] We are so happy to have you here. So, Alex, tell us a little bit about yourself in the wellness work you do in your community.

Barrera [00:00:50] I am a general dentist in Houston, Texas. I actually work at a federally qualified health center. I had a huge passion to serve the underserved that started to grow and develop during dental school. So, I knew upon finishing up that I wanted to be out there and I wanted to work at a center where I can treat those that are underserved and those that are in vulnerable populations. So, I've been doing that since graduating for the past about five years now. I've also been pretty involved in the world of organized dentistry. I am a past alumni of the ADA's Institute for Diversity and Leadership, and I'm also been involved with my state and local organization as well, and always been pretty highly involved with the Hispanic Dental Association.

Hanlon [00:01:38] Awesome.

Barrera [00:01:38] In 2019, I helped found the first official LGBTQ-focused organized dentistry group called the Houston Equality Dental Network. And so we started in 2019 and, you know, quickly realized that we had a much broader reach. We're doing webinars and articles and presentations all over the nation now. So, the purpose of that organization was to kind of bring together LGBTQ dentists, hygienists, dental professionals in an environment where they can feel safe and included but also grow and network as a professional. At the same time, we learned that we can have a pretty big impact by becoming educators to educate the dental professionals out there today and also educate dental students on how to better treat and serve the LGBTQ community. At the same time, we're also giving back to the local community. So, that's where I spend a majority of my time and efforts. I'm also very, very passionate about the wellness world. I am a certified yoga teacher, so I do that part time. And that has been my introduction to the world of wellness. And primarily the past year I've been really focusing on how I can combine these two passions of wellness and dentistry.

Wright [00:02:54] You mentioned the Houston Equality Dental Network. I would love to go a little bit deeper into the work of that project, if you would. Talk about some of the challenges that are facing the LGBTQ community of dentists and the patients.

Barrera [00:03:07] This is something that started sort of as a social group, as, you know, a conversation between a few friends, colleagues. I was hearing the stories of people who are really passionate, excited to volunteer, excited to serve, but never really felt fully included in the world of organized dentistry or in the dental profession as a whole. Always maybe feeling a little bit reserved and a little bit worried about what others might think, what patients might think. And, you know, we started this as a social group to just to bring networking within a group of dental professionals. And little by little, we found out that this was so much more. We have started to present and host and teach at dental schools, dental programs, conferences on how to better serve the queer community. Something that we may not consider, but there's a lot of health disparities that still exist within the LGBTQ community. People who identify under the LGBTQ umbrella have much higher rates of things like anxiety, depression, drug use and abuse, alcoholism. We know that HIV and STDs are still a much higher burden in the community. And overall, you know, there are a lot of things that we just still don't know or are just starting to learn about the health of queer individuals, because it's a population, a group that had been lacking in research and studies and programs for so long. Because anxiety and depression exist so much in this population, this leads to these individuals to probably not seek oral health care as often as someone else would. This leads to these individuals being a lot more insecure about going to see a medical provider or insecure about their teeth and oral health, leading to, of course, much further problems as we neglect seeing a dentist.

Announcer [00:05:00] Announcing the new...wait. This calls for a drum roll. Perfect. Announcing the newly reimagined. ADA member app designed for dentists by dentists. It puts ADA membership in the palm of your hand with features like a personalized news feed, member chat groups, personal documents, storage, even episode exclusives from Dental Sound Bites. The new ADA podcast. Tap into all the possibilities by searching for a ADA member app in your App Store.

Wright [00:05:38] A really big segment of this episode is mental health. We know that there's a sense of urgency to tackle mental health in our community. We want to talk about some symptoms and main reasons behind anxiety and burnout and stress.

Barrera [00:05:52] I think as dental professionals, we enjoy staying busy, we enjoy working hard, we're very detail oriented, and these are all skills that we kind of needed to develop to lead us to where we are right now. And we stick with that, right? We stick with all these these detailed-oriented tendencies so that we can provide good dentistry, so that we can be good to our patients. And with all of this, I think we really forget to kind of take a step back a lot of the times, and it's hard for us. It becomes difficult for us to be still. And that's because we're just you know, we built the habits of always being busy, always moving. And when I was finally given that space to be still, it just opened a whole new world for me. I'm someone that has always struggled with anxiety and depression, and that's something that yoga also helped me kind of understand a little bit more now, as I've done that for a couple of years and I've kind of, you know, done different things to combat anxiety and depression, I'm able to just understand the way that my body, the way of my brain, the way that my my emotions work a little bit more. And just having that understanding is really important because, you know, it makes sense that we're not going to be our best at our best every day.

Hanlon [00:07:07] You know, several episodes of our podcast, our guests have talked about feeling isolated and and in our profession, you know, not just by themselves, but also, you know, stepping away from not being included. In the results of the 2021 Dentists Well-Being survey indicated an increase of dentists affected with mental and emotional health concerns. So, my question to you is, you know, what are the symptoms and the reasons behind all of this?

Barrera [00:07:36] Just like anything else, right, our mental health is a spectrum and things like anxiety and depression are a spectrum. And there's a lot of different types of issues with our mental health that we can combat. As you know, as far as being isolated, having depression or anxiety goes, the with our world is and the way that, you know, our our culture has been the past couple of years, we are constantly being bombarded with inputs, with noise, right. With stuff going on that are central nervous system is just really always triggered and always on. And yeah, it makes sense that, you know, now we're in a world where, you know, these rates of anxiety and depression have gone up.

Wright [00:08:15] Right.

Barrera [00:08:16] People react to different emotions and feelings really differently. You know, for me personally, someone that has struggled with both depression and anxiety now after doing things like seeking therapy, doing things like yoga, doing things like journaling that have all kind of helped me kind of figure out where I am right now. It's funny because sometimes I can notice my thinking or behavior going in a certain way, but now with kind of the tools and knowledge I have, I can kind of laugh at it. I'm like, "Oh, that's your anxiety. And it's no go away." You know? And so for me, a lot of my anxiety actually manifests as doing more. I feel like I have something called high functioning anxiety, and I think that's something that a lot of dentists can relate or a lot of people who are go-getters can relate, right? Always wanting to find the next task to complete. It's those of us that get like complete satisfaction from checking something off our to do list, right? And that's the type of person I am when I have a lot to get done or.

Hanlon [00:09:16] Know that was a bad thing, Dr. Barrera (laughs).

Barrera [00:09:17]  Yeah. And then it's not a, you know, not necessarily a bad thing, but it's a thing. It's a behavior, right? And for me, you know, that led me to realize that I'm always kind of looking at the next thing and I'm never fully present in the moment. And that's the way that my anxiety manifests by trying to tackle on more things.

Wright [00:09:37] Can you walk us through like what steps can we take maybe to identify when we're we're really not feeling our best?

Barrera [00:09:43] Something we can easily look at is how we treat strangers, how we treat the person that cuts us off. They're terrible person. I'm really upset and I'm going to go home to my family and be even more upset and ruin their day. Right. So how do we treat other people and also recognizing thoughts that we have throughout the day that might be negative. Right. Thoughts like that. And it'd be a terrible day like, oh, I know patient so-and-so is coming in. I know they're going to be a headache. I know this staff members and ask me a question, this question today that I've been dreading. So, things like that, right. And how we respond to stress. Right. We all experience stress and maybe starting to recognize how we respond to them. You know, is it man, I can't wait to get out of my office and go to the bar. I can't wait to get out of the office and, you know, just grab a bunch a pint of ice. Even, you know, 32 liters of soda and just drown it out because I need that. I need that release. Aw, man. It's like I can't wait till the end of the week. I'm just gonna go crazy. I'm just not, you know, blah blah, blah? Um, what is it that we're reaching for when we're stressed? Right? And are those habits helping or hurting us? You know, we hear a lot about self-care, but the truth is, is that self-care should not be something that you resort to because you're so overwhelmed that you have to call in sick to work the next day or that you're so overwhelmed that you can't do the laundry or do the dishes, or you're so overwhelmed that you get in a fight with your spouse or your your child or your best friend.

Wright [00:11:21] Right.

Barrera [00:11:21] Self-care should be something that we incorporate into our day. Little by little.

Wright [00:11:27] As a practice.

Barrera [00:11:28] Yeah. And that's something, you know, that that means starting from, like, how you go to bed the night before, are you going to go to bed eating junk food in bed and watching, you know, reality TV, which I obviously do a lot of times, right. That's okay. A little bit now and then. But when we wake up or are we going to kind of take a moment to ourselves to make sure that we do what we have to do to feel ready and energized, energized for the day? Or are we going to maybe take a step back for lunch? Are we going to, you know, take a little break for ourselves throughout the day, do little things like that that are just going to kind of maintain our wellness throughout the day, throughout the week, throughout the years.

Wright [00:12:07] Right.

Hanlon [00:12:07] I want to thank you for sharing your story, and I want to thank you for sharing so much great insight on some of the things that we can do. I have to share that, one of the things that I realized during COVID that I didn't know that I was overwhelmed and depressed. And it was only after reflecting back during that time, after it was over, that I realized that I was going through some sort of depression. And, you know, there was a lot of things going on at the time. Obviously, COVID impacted all of us differently. My role was to keep things going and figure out how I was going to manage having, you know, students come back into the school that I was at. But I didn't realize that I was being sidelined at the same time and I couldn't figure out what was going on. I remember having many outbursts with my family members. You know, if you notice that you're taking things out on your family more so than you would ever do it in the past, that might be a signal also that things are not going well or that you need stress reduction or some type of stress reduction. I just wanted to share that little piece of of my life. ArNelle, do you have something that you want to share?

Wright [00:13:24] So you guys all know that I was diagnosed with breast cancer last year, and I went through chemotherapy, radiation, surgery. But at the same time, I did hire a therapist and I made sure that I spoke with her on a regular basis. And I still have meetings with her actually probably once a month in the very least, because I notice that I would just be irritable. And part of my irritability was I feel that it was due to some of the medications that I was taking at that time and some of the medications that I'm still taking. So, I did really want to make sure that I leaned in and tapped into someone who was a professional who could help me just walk through that that difficult time of my life, you know. So, for me, that's kind of where, you know, this whole wellness journey, like, I guess peaks for me. I feel like I've been on the wellness tip for about six years since dental school and even my senior year of dental school. That's when I really started going in to like see a therapist to make sure that, you know, once I enrolled in the working world, I was like my best self. I was super healthy. And now it's just one of my passions where I try to help other women do the exact same thing because I feel like we it's something that we just overlook quite frequently.

Barrera [00:14:35] I'm glad that you said that about to see a therapist, even if it's monthly or kind of regularly, because that's what it comes down to. Just how we maintain our car, how we maintain our houses, how we maintain our physical bodies by exercise, by watching when we eat. It's the exact same thing, right? We have to maintain that because we we don't have the wait to the point where we have a panic attack, to the point that we're we're so depressed that we can't get out of bed or the point where we're so irritable to our loved ones.

Hanlon [00:15:04] And I think it's important to realize, too, that that some of our teammates may be experiencing things also. And we've got to be aware of that. You know, certain behaviors that all of a sudden become prominent that never used to be there, that could be an indication of of some issues happening in their lives. And and helping them to prioritize their mental health is is important for all of us as dentists to realize and support them.

Barrera [00:15:34] Absolutely. You know, it's our responsibility as professionals. As providers, as caregivers, as employers to watch for these things, whether it's a staff member or a patient. We might be the only person that they interact with that entire year that may see the symptoms or see what's going on and can maybe provide some sort of help.

Wright [00:15:52] I love that you said the phrase watch for these things. I feel like it's easy, as dentists, to kind of just put your head down and focus on like the clinical dentistry, but watching for certain behaviors and certain patterns in our teammates or the people who work right alongside us. It's easy to kind of pick up on those things if you're alert and if you're aware of them.

Hanlon [00:16:14] So, what do you think we can do to prioritize our mental health on a day-to-day basis?

Barrera [00:16:18] We're dentists and we understand the importance of flossing. Right. So we need to kind of incorporate a little bit of mental flossing within our lives.

Wright [00:16:26] I love it.

Barrera [00:16:27] Yeah. Yeah.

Wright [00:16:28] I love it.

Barrera [00:16:29] Something that was very helpful for me when I was, you know, really struggling was to journal. And it's something I don't do as often anymore. But there was a time where I just did a gratitude journal, whether it's on a phone or a physical piece of paper every morning. I would just write three things that I was grateful for. And when I kind of removed any pressure of how monumental or crazy these things have to be, that's when the habit kind of really became easy for me. I would wake up and the first things that would pop in my head or I was grateful for my mom because I spoke to her yesterday. I'm grateful for this breakfast that I'm about to eat. I'm grateful for my carpet because it felt nice when I got off the bed. You know, I think little simple things like that. And that just it just it plays tricks on our brain that were just quickly things you know start the day off with a good note whether it's in the morning or at nighttime. And, you know, if we journal, for example, we're able to kind of just put our feelings, our emotions out there. These are all things that, of course, develop time to turn into habits. We need to turn them into our routine. And it doesn't have to be, you know, writing something down physically. We can kind of figure out what is the mental flossing that we need individually, right? For me, you know, it's it means leaving the office during my lunch hour just to get some air to go somewhere to get a different environment. I know I have other colleagues that like taking the naps in the dental chair right during the lunch break if they can. Other people might get a coffee or might, you know, do something to kind of just break up their day a little bit. And same thing, you know, after the office, maybe it is listening to really good music at the end of the day, maybe it's calling a loved one or family member after the you know, after you finish at work, maybe it means cooking dinner or doing something with a loved one. Right. So little by little, we incorporate more healthy habits. That's how we get to do that mental flossing. And so that we it's preventative care, right? Just like going to your dentist every six months is preventative care. It's sort of the same thing with mental health.

Hanlon [00:18:28] That's awesome.

Wright [00:18:28] Alex, can you tell us what kind of wellbeing programs there are that are available for dentists and how we can approach them?

Barrera [00:18:36] So just recently the ADA created a Wellness Ambassador program, and so this is a subcommittee within the Council on Dental Practice. And the purpose of the Wellness Ambassador program was intended to express and expand this awareness of physical, mental well-being and the challenges faced in the dental profession, but also to prioritize the needs that dentists have, the different needs that we'll have throughout the different stages in our community, starting from being a student to buying a practice to afterwards. Right. How do we make sure that we are well as a profession throughout this entire career that we've chosen? And so, you know, there are already a lot of great resources online. Members can go to the ADA.org/wellness There are a lot of fantastic resources, but with the new ADA Wellness Ambassador program, these are ten dentists, including myself, that are from all around the country that are all going to start creating projects around their districts, including and incorporating wellness a little bit more deeply into the community. And so for a lot of us, for me, specifically in Texas, that is one of my my project goals is to create either a wellness committee or have some, you know, some sort of representative or an ambassador as well per say, that can be the go to person when someone is struggling, whether it be with addiction, with anxiety, with depression, someone I can help distribute these resources and put on programs and events. My other project will be teaching yoga for the ADA members and this is something that will be virtual and be incorporated every couple of months or so and will be included for for our members.

Wright [00:20:24] Excellent. You know, Alex, I'm hoping that we can leave our listeners with some concrete things that they can do. So just give us three things to practice every day that might improve our mental health.

Barrera [00:20:37] If I would narrow down to three things. Number one would be to practice gratitude like we talked about, whether it's something small or something more significant. And it could be in any way that works for you, that works for your daily routine, that works for your lifestyle, whether it's gratitude, whether it's looking in the mirror and just saying what you're grateful for, whether it's writing on your phone or just expressing to someone that you love, that you're grateful for them. And we can show or even thinking that if we can just sit down and enjoy a meal in silence and say, Man, I'm grateful for this food. I'm grateful for my home, I'm grateful for my practice. Any sort of sense of gratitude is really important. The next thing I would say is to move your body, right? Find something that makes your body feel good. Whether it's going in a walk in nature, whether it's going on a jog, whether it's finding some sort of exercise or gym routine, whether it's yoga, dance, whether it's dancing with your kids in the living room. It could be even, you know, stretching in the morning or stretching at night, stretching during your lunch break. Find a way to physically move the body in something that's constant, right? Something that can be a habit. And lastly, I would say focus on your breath. We tend to hold our breath. We tend to clinch our drawers. And if we really start kind of noticing a little bit more notice, it's like, oh, we're just holding my breath for the past like 20 seconds because I was stressed about something else grinding my teeth and I was, you know, thinking about what I had to do later on and thinking about this next patient. Whenever we have a stressful situation or something, I would suggest something that I practice is is box breathing. There are many different breathing techniques, but what box breathing is is breathing in four, four counts, holding your breath for four counts, exhaling for four, four counts, then holding the breath out for four counts. So creating a square sort of deal with the counts, right? So practicing that a couple of times is really beneficial. Looking into things like a meditation app, a guided meditation app. There are a lot out there. There are a lot that have specials for medical providers. And stay tuned because that's something that the wellness ambassadors may bring towards for our members soon. So access to that.

Wright [00:22:50] On the next Dental Sound Bites. New year, new budgets. It's time to set your financial goals for 2023. Listen in for expert financial advice that will help you set yourself up for success this year.

Hanlon [00:23:08] Alex, you have shared some great insights with us today, and we can't thank you enough for taking the time to be with us.

Barrera [00:23:15] Yeah, well, thank you so much. I was really excited and happy to be here. And at the end of the day, you know, we're all dentists and we can't lose sense of that community. Right. Community is a very important aspect to wellness as well. So, surround yourself with people that you love. Surround yourself with those that make you better. And remember that, you know, as a profession, we're here to support one.

Hanlon [00:23:35] Another, especially with the holidays coming up. We know that it can be stressful. So, I think you've given us so many good self-care tips, so we thank you so much for your time, Dr. Barrera, for being here. All of the information that you shared with us and our listeners, I was taking notes frantically, so.

Barrera [00:23:52] Thank you both so much for having me. I was really excited to be here.

Hanlon [00:23:55] Now, if you like this episode and think it can help a friend or a colleague, go ahead and share it with them. Also, please subscribe to this podcast wherever you are listening so that you can get the latest episodes. We'd also like to invite you to rate and write a review and follow us on social media.

Hanlon [00:24:14] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show resources and more on the ADA member app and online at ADA.org/podcast.

 

 

 

The Power of Connection

As the holidays approach and 2022 is winding down, it’s a good time to reflect personally and professionally on how to grow the dental community and network more effectively. Guest Dr. Cathy Hung joins the hosts to talk about making more powerful connections with colleagues and patients now and in the year to come.

“If you carry yourself in such a way that your compassion shows, it doesn't matter if (your patient) speaks your language or you speak theirs, or if you practice the same religion or culture, it will come through.”

- Dr. Cathy Hung

Show Notes

Hung is a practicing dentist in New Jersey and an active member of the ADA’s new   Wellness Ambassador program. She is passionate about making connections with her patients, especially those from diverse cultural backgrounds. She wrote a book on the topic: “Pulling Wisdom, Filling the Gap of Cross-Cultural Communication for Health Care Providers.” In this episode, she talks about her book and efforts to help fellow dentists focus on their relationships with patients, their personal wellness, and opportunities to expand their networks.

• Originally from Taiwan, Hung was educated in the U.S. and some years after becoming a dentist wrote her first book, “Pulling Wisdom” focused on what she has learned as an immigrant to the U.S. trying to navigate the healthcare system. It also offers advice to health care workers who interact with patients from diverse cultural backgrounds.
• She is passionate about writing and connecting with fellow dentists at all stages of their careers.
• Hung remembers feeling isolated after dental school when trying to find a community and encourages students to start building their networks now, so they have people they can stay connected with once they start practicing.
• According to recent study, peer mentors, such as a fellow students a few years ahead of you, can help students practice soft/non-technical skills, Hung says.
• Finding ways to connect and build trust with patients is an essential part of being a good healthcare provider, according to Hung. Adjusting your demeanor when you meet a patient and leading with compassion is a good place to start, she says.
• Mentors can help younger dentists not only build these skills but also grow their careers. Seeking out a mentor takes work, and like any other relationship, Hung says it should develop naturally over time.
• Private social media groups for dentists are good places to start making connections, as well as in-person conferences and dental events. Hung says you can start making connections by asking specific questions to extract information from potential mentors.

• Hung talks about advice in her book “Pulling Wisdom” dentists can use to connect with patients from different cultural backgrounds that includes asking questions, offering options, decoding non-verbal cues, and understanding how finances may come into play for patients with ties to other countries.

• Another important part of Hung’s professional mission is to help dentists focus on their personal wellness. She is part of the ADA’s Wellness Ambassador Program.

• Three things every dentist can do for their well-being is: rest, connect with the things and hobbies you enjoy and connect with the people who you love.

Transcript:

Hanlon [00:00:00] Hello, everyone. I'm Dr. Hanlon.

Wright [00:00:02] And I'm Dr. Wright.

Hanlon [00:00:03] And this is Dental Sound Bites an ADA podcast, where dentists share solutions to challenges in life and at work.

Announcer [00:00:12] From the American Dental Association. This is Dental Sound Bites. Created for dentists by dentists. Ready? Let's dive right into real talk on dentistry, daily wins and sticky situations.

Hanlon [00:00:28] It's almost Thanksgiving. And with the holidays approaching in 2022 winding down, this is a great time to reflect personally and professionally.

Wright [00:00:35] Today's guest is going to give us some food for thought on how to grow our dental community, network more effectively. And she has some self-care tips to keep wellness in check as we manage our personal lives and our careers.

Hanlon [00:00:50] Please welcome our special guest today, Dr. Cathy Hung.

Hung [00:00:53] Hi. It's such a pleasure to be here.

Wright [00:00:55] Welcome to dental sound bites. Dr. Hung, can you tell us about your background and your career path?

Hung [00:01:03] Sure. I'm originally from Taiwan. I came to the U.S. when I was 18 years old for college. I started at Cal State, Fresno in California and transferred to UC Berkeley, and I decided that I want to be a dentist. Applied, got into Columbia and I moved to the East Coast. I started a solo practice in 2009 because I always see myself as a practice owner. I really did enjoy being in a solo practice, but I kind of feel like I was sort of living in a bubbles at times. My parents were living very close by at that time. My father was diagnosed with prostate cancer. He eventually passed in 2017. I had a lot of struggles sort of juggling between my practice and having two very young children. And we're first generation immigrants from Taiwan and in through the whole taking care of him, at that time, I really wanted to tell my story and especially about the cultural part of it. You know, a lot of things are not being translated well. And I have to communicate with my father's, late father's oncologist. So, you know, one day I just woke up and started writing. It was meant to be a memoir, but somehow turned into my book, "Pulling Wisdom, Filling the Gap of Cross-Cultural Communication for Health Care Providers". So it was not intention to be a book that talked about cultural competency. But because of my life, I was moving around a lot and I learned English, you know, English as a second language. I came over here and I moved around from West Coast to the East Coast. And there's just a lot of stories I feel like I should share with the world. Once I started writing, I feel like I couldn't really stop. So, right now it's becoming a hobby slash passion.

Hanlon [00:02:56] That's awesome.

Wright [00:02:57] What an amazing professional journey you have. Dr. Hung, you have so many years of clinical experience here of solo practice. You're author speaker and on a really, really important topic, especially for health care professionals, which is a cultural competency. Recently we had a conversation with Dr. Joy Nisnisan. She was the vice president of ASDA for the 2021 to 2022 year, and she mentioned a reality for most of us, which is the feeling of isolation. And you mentioned that too. So, if you could, why don't you enlighten us on what we can do to prepare for that transition out of dental school and into the workforce?

Hung [00:03:40] Isolation is definitely very real. I was class 2000, so I consider myself to D26 and when I went to dental school more than 20 years ago, our class would go out in groups and hang out and we were having a good time. But when my residency started, all that was gone and nobody prepared me for that. So, I feel like I was living in the dark and back in the days that's when the internet just started and there was no social media. So, I really felt like I wanted to connect with people, but I didn't really know how. I was the only one here and my parents were still back home. And so I would phone my good friends and family members to vent the stress. So, now things have changed quite a bit. I feel that social media really is a big part of many people's life, and that's what a lot of people are leaning on for information and connections. So, it is not really a substitute for a face-to-face interaction, but it does give us additional ways to make friends. I think the best way to deal with isolation is to be aware that isolation may come and it may come at different times, and that awareness is what can help you to brace for the impact, because you know that it's coming. It may come after graduation when you start a residency or a different time, but the career. So, I would start building that support system very early while you're in school and stay connected with people where you feel like you have a connection with.

Announcer [00:05:14] Announcing the new... wait. This calls for a drum roll. Perfect. Announcing the newly reimagined ADA member app designed for dentists by dentists. It puts ADA membership in the palm of your hands with features like a personalized newsfeed, member chat groups, personal documents, storage, even episode exclusives from Dental Sound Bites the new ADA podcast app into all the possibilities by searching for a ADA member app in your App Store.

Hanlon [00:05:52] Dr. Hung, I'd really love to know what are the non-technical skills you consider important to develop and what are the benefits of having them?

Hung [00:06:01] Earlier in this year, in January, I have presented coaching and mentoring through Accelerator Series and there was one research article that I quoted. It was conducted in Spain as one of the dental schools in Spain, what's called peer mentoring. So in Spain apparently there are five years of dental school and the clinical year starts during the third year. So, what they were trying to investigate is could senior dental students mentor junior students in their clinical years to develop what's called non technical skills or what we call a soft skills? And the soft skills? Some people don't like that term, but mainly these are skills that are not clinically related and this can be social intelligence of verbal and nonverbal communication skills, listening skills, reasoning, problem solving skills, decision making or use assess information to show self-confidence. And so they have found that there is a significant difference when the junior students are being mentored by senior students, there is an improvement of these non technical skills. And so this also serves a pipeline, building a pipeline of leaders, because when the senior students are ready to get out of school, a lot of them may stay behind as faculty. So, we are actually building a pipeline of educators. Yeah, I think that as far as non-technical skills, what is important is, it is in my experience that you need to connect with people first.

Wright [00:07:34] Yes.

Hung [00:07:34] When you see your patients, they don't know how good you are in making a crown or in doing your canals or extractions. So, building trust is really important because so many people are afraid of the dentist or will be telling you, I hate dentists. I didn't have a good experience. So in order to build trust, non-clinical skills are really essential because your patients don't really know about open margins, but they will know and remember how they're being treated.

Hanlon [00:08:02] Totally agree.

Wright [00:08:03] Exactly. I try to tell my team all the time there's like a person connected or attached to the teeth or attached to the gum disease or the situation. And so I feel like you just kind of have to meet the person where they are and then you provide that excellent clinical skill. So, yes, I totally agree with that 100%. So from your perspective, in your experience, can you tell everybody what we can do in our day-to-day to cultivate those stronger and better relationships, either with our team, with the patients one another? What are some of those things that we can do to cultivate better relationships?

Hung [00:08:37] One of my patients came into the room and he saw I have a wall with my diplomas, and he saw that I was a psychology major in college. And he asked me, what does psychology have to do with dentistry? And I wanted to tell him, you know, everything.

Wright [00:08:52] Yes, everything. Oh, my Gosh.

Hung [00:08:54] Yeah it's everything. Because we are treating a lot of people's fears. And it is your demeanor, you know, that affects your patient first. It's not your clinical skill. If you carry yourself in such a way that your compassion shows, it doesn't matter if they speak your language or you speak theirs, or if you practice the same religion or culture, it will come through.

Wright [00:09:17] Now, I remember, Dr. Hung, being in dental school and there were D2s where older the older students would have like a younger student. And at our school it was called a big little system, right where we would be have like a mentor-mentee type of relationship. Can you talk to us a little bit about what a good mentor-mentee relationship looks like from your experience?

Hung [00:09:44] I think that a good relationship is never forced, just like any other type of relationship, and you should develop naturally over time. So, you can't just claim some somebody and say that should this person be my mentor, it has to come organically. So this relationship, it can be really on a personal and professional level at the same time. So, psychological safety is a big element of that because if you don't feel safe, you won't share. If you don't share, how do you benefit from it? Somebody who's a mentor usually is older but may be more experienced in certain areas, and mentee is somebody who is seeking for advice and mentor is somebody who is giving advice. So, a big element of mentor-mentee relationship is about giving and receiving advice on a personal level based on your past experiences. So, I think that if I were the mentee and I want to benefit, I need to be very specific about my queries. You know, I and I think that it is very important to do your homework first. So, if you're interested in something, you can just go to a person and say, I want you to be my mentor and tell me, give secret sauce and just tell me all the secrets. It doesn't work like that. You have to do your homework first. So, for example, if you're interesting in applying for oral surgery, instead of asking somebody your or who you consider to be a mentor, I want to do surgery. This sounds interesting. Do you think I should do it? I don't think that that's a very specific question, because nobody can really make that decision for you. You'll have to make the decision for yourself. On the other hand, if you have already done some of your homework and asked your mentor, he said, I've been shadowing all these different places. Here's where my grades stand, and I'm also in omfs club. What else do you think I can do to be a better candidate? That would be more of a specific question. Being a mentee really is about how to extract information from your mentor by asking specific questions.

Wright [00:11:42] Yeah. For everyone listening to this podcast, I do want to encourage you to download the new ADA member app. And while you're there, I want you to take a look at the 1-to-1 chat feature. There you can build more connectivity with other dentists in your area. You can find a mentor. You can just connect and build more relationships, which is what we're talking about today.

Hanlon [00:12:07] Dr. Hung, how did you find your community and your mentors in dentistry? Where did you search them out or did they just present themselves and help you along the way?

Hung [00:12:20] I started really with social media. It was very blind to I saw I was sorta looking for more connections and there are some private groups, sometimes I was invited into and I didn't really know what it was about and so I would just accept being invited into some kind of private group. This can be a support group for dentists or various. There's so many of them on different things. And when I joined, people started talking to each other and I started giving advice and some people like that. And so I started to discover that social media aspects of support group and befriended people that I never met with in person. But I have a lot in common. So, I think that the beginning of that first groups helped me to realize the power of social media. My main thing is Facebook. I do have a Twitter account which I rarely use, and I do use Instagram professionally. I use LinkedIn. LinkedIn is my favorite for professional connections, just because you can really cut out that personal part. So, I can I can't tell you that there's one single way or particular way that I found my people, but they just come at different times, you know, through different activities. And this can be even through a actual conference or convention that I attended, a C course, and then somebody is sitting right next to me. I just started a conversation, maybe asking for something. So, a lot of these relationships come unexpected. I wasn't really looking for somebody, but when you actually have questions and you want to better yourself through maybe even reading books, you know, signing up for courses and you have questions and you start to ask people, people answer you back. That type of connection, it's very basic. It's no different than if you were in elementary school or a kindergarten and even, you know, trying to make friends. Then it just becoming a domino effect. It just roll bigger and bigger and bigger, right?

Wright [00:14:32] Chatting with people, having just genuine conversation and then the relationship develops in an organic way. Now, in your book "Pulling Wisdom," you mentioned some key elements of bonding with our patients, which is super, super critical to what we do all day. Can you give us a sneak peek into that topic?

Hung [00:14:52] I just love the word wisdom and I use the acronym of it as sort of thought back to my past experiences have made that into a section of the book, so that W stands for Weave and that means weaving all the pieces of information together by asking questions. So, what I like to do in my office is just to look through the patient's charts and the questionnaires that they fill out. You can be a health care information, you can be their demographics. And I tried to piece together and try to make sense of it. Then the I stands for Initial conversation. So, aside from reviewing their medical history, I do make small talks with them, which I sort of this is a skill that developed over the years because in my culture we don't really do small talks. It was very uncomfortable me to me at first, but I learned to become very comfortable and interested in my patients lives. In this part of New Jersey where I live, there are a lot of first immigrants from all over the world, and that makes it really interesting to make small talks. I like to eat, so I actually get tips from them. Where can I buy ethnic supermarket? When? Where can I find a restaurant? That kind of stuff. S stands for cultural sensitivity and that is the awareness that we are different. If you are aware that we are different and we accept that we are different, then you will be more likely to want to learn about the differences. And that's the beginning of building cultural competency. The D stands for decode. So, decode, nonverbal cues or body language. We don't have to speak the same language, but if you walk into a room and see that there is a patient curling up in a chair, you know that they're a scared and you can tell by how they look at you, how they express themselves, you know, to see what kind of emotion they're in, regardless of language. And that's very important. O stands for Offer Options and Resources. So for example, if you are not able to provide them with the services that they need, can you suggest someone else who could or, you know, if they're not able to pay their a copay, are there different ways you can offer them? Sometimes you need translation to convey that concept. So and that M stands for the money factor. And that has to do with how a lot of the first generation immigrants have access to separate health care system. One in their home country and one in the U.S. And a lot of times patients will compare their co-pay. You know, they'll go with whatever co-pay that may be lower and a lot of the time that will be in their home country. So if I can pay less and, you know, go to a doctor that speak my language, why should I pay more to us doctors? So, a lot of times the explanation will be focus on continuity of care. If you have a procedure done overseas, you know, in your home country and there's a problem, there's no continuity of care and it's really hard to communicate. So, the wisdom stands for these factors. And of course, you know, definitely check on my book if you're interested in knowing more.

Wright [00:18:07] I love it. While right now we have a special treat for our listeners, you guys, you need to check out the bonus content from this episode and it's only available on the ADA member app. You're going to find details on how to get a special gift that you can redeem by January 31st, 2023, while supplies last.

Hanlon [00:18:27] Dr. Hung, part of the importance for many people of building connections is for support in one's own personal wellness. Can you tell us about the Wellness Ambassador program? What is it about and who's it for?

Hung [00:18:39] The Wellness Ambassador Program is a program that's designed to share information with more dentists to improve their wellness. And I'm very excited to be part of the first cohort for the Wellness Ambassador program, which is part of the Council on Dental Practice. ADA recognizes the importance of wellness to dentist health, and this is a new initiative for everyone. So, you can find this information about a wellness ambassador or program on ADA.org. As ambassadors we do not serve as therapists to offer clinical advice, but we will serve as entry points on the local and state level to facilitate connections with clinical professionals and other resources. There will be monthly meetings to learn about wellness related topics, including, but not limited to stress management, suicidal prevention, substance abuse, work life balance, etc.. So, I'm very excited. Again, this is a train the trainer motto. So going forward, we're going to be expanding the network.

Wright [00:19:45] Perfect. Thank you. Thank you.

Hanlon [00:19:47] Dr. Hung, what are three things that every dentist should do for their well-being?

Hung [00:19:51] So, number one, I think the most important thing is to allow yourself to rest as we're being glorified for working all the time. We're hamsters on the wheel all the time. Resting is just as important for your body and mind as to recoup as working, so block your schedule out to rest. What I say is that I date myself. I would block out, schedule a say on a Saturday for a couple of hours and take myself out for a date. I'm going to eat what I want to eat. I'm going to go to a bookstore and read the books that I want to read and maybe even watch a movie. I will do a personal retreat a few times a year. I have a really good understanding with my husband. He knows that he didn't really understand that concept at first, but now he really understand where I'm coming from. So, I would maybe book out a weekend and just go away by myself. Not talking to anyone for an overnight weekend that works for me. So you. We want to allow yourself to rest. Number two is to connect with your essence. And what do I mean by that? Is that when you were young, maybe there are some hobbies or interests that you love that you really enjoy. And this can be talents as well. Some people are as talented musicians. Some people do arts and crafts, and some people are really good at knitting or cooking or playing guitar, anything like that. So, these are things that you can fall back to when you have stress. And so, you know, when we get really busy with dental school, we may forget that, right? Or maybe we don't have time for that. But you want to connect with your essence because that's what gives you the sense of yourself, who you are on a fundamental base. And number three is to connect with people that you love so your friends and family, of course. And you can definitely meet new friends through social media. And there are some people that I have never met in person, but I feel like I connect to them and talk to somebody if you're in trouble and don't bottle everything inside. And if you need professional help, go get it.

Hanlon [00:21:58] You know, Dr. Hung, I couldn't agree more. I do think that we always have to start with ourselves first, because, quite honestly, if you don't love yourself or you don't care for yourself, who is going to care for you? Nobody can care for us better than ourselves. So, I couldn't agree with you more. Thank you for that insight.

Announcer [00:22:18] On the next Dental Sound Bites.

Hanlon [00:22:20] Dentistry can be physically, mentally and emotionally challenging. We all know that during this busy holiday season, we've got resources to help you care for yourself in stressful situations, in the laboratory and in life. Plus, our special guest, Dr. Alex Barrera, shares his best wellness advice to keep you healthy during the entire season.

Wright [00:22:43] Thank you so much, Dr. Hung, for your time today and sharing all of these wonderful gems. I know that this episode is going to inspire deeper connectivity and mentorship and help our guests learn how to lead in the field of dentistry.

Hanlon [00:23:00] Thank you so much for being with us.

Hung [00:23:02] I'm so grateful to have the opportunity to be here to speak to everybody. Happy Thanksgiving to everyone.

Wright [00:23:08] If you think this episode can help another colleague, please share it with them. Subscribe to this podcast wherever you're listening so that you can get our latest episodes. And we also encourage you to rate and write a review so that we can continue bringing you amazing content.

Announcer [00:23:25] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show resources and more on the ADA member app and online at ADA.org/podcast.

A New Day for Dentistry

Dentistry is changing. From the demographics of new dentists entering the profession to new challenges, we're diving into the data to see what's coming next. Plus, special guest Marko Vujicic, PhD, Chief Economist and VP of ADA's Health Policy Institute, shares the three big opportunities in dentistry right now.

 

“Meeting consumers where they want to be met, reducing cost barriers and making meaningful collaborations with primary care touchpoints, that's going to bring millions of more patients into the (dental care) system.”

- Marko Vujicic, PhD

Show Notes

Every month, Vujicic’s team, the ADA’s Health Policy Institute publishes new data about the economic outlook and emerging issues in dentistry as a way to take a pulse of the dental profession. In this episode, Vujicic explains the latest trends and opportunities in the dental health care sector.

• Vujicic holds a PhD in economics and in his role of chief economist and vice president of the Health Policy Institute at the American Dental Association, he is passionate about bringing evidence and data to help inform dental professionals and policy makers.
• Each month, his team publishes a monthly collection of data about the dental sector. The latest trends show dentist offices are at 90% of pre-pandemic patient volume, which could be a new normal
• Hiring challenges are the number one issue facing dental offices. Forty percent of practices are in the market to hire either an assistant, hygienist or front office staff and 90% say that it's nearly impossible or very, very difficult to hire right now.
• Vujicic says, as in other professions, people are reevaluating the place of work in their life. He says there is an opportunity to improve upon how dental offices are run to attract and maintain workers with long term retention strategies.
• Offering benefits packages with paid sick leave, 401ks, retirement packages and more is something dental offices should look into. “We are running small businesses, so let's treat them like that.”
• Other trends Vujicic shared revolve around demographics. He says as more boomers retire in the next five years, the field will be mostly younger dentists of the y and z generations. He says the data are showing that younger dentists are much more likely to go into group practices or DSOs versus owning their own practice.
• Vujicic says three major opportunities for growth for dentists, according to the data are:
  • To be more responsive to the convenience and transparency needs of the consumers.
  • Innovate ways to reduce the cost of dental visits.
  • Bust down barriers between dentistry and the rest of health care and form partnerships that will bring patient’s from their primary care physician directly to a convenient dental appointment
• More than half of Americans don’t receive oral health care and Vujicic says with the right innovations, that can change and millions more can be brought into the system.
• “Half the population goes to the dentist regularly and half do not. That is not anyone's vision of oral health in America, you know what I mean? So, there's so much opportunity to bring dentistry into a new era.”
• For more information and reports from the ADA's Health Policy Institute, visit: ADA.org/HPI

Transcript

Wright [00:00:00] Hello. Hello, everyone. I'm Dr. Wright.

Hanlon [00:00:02] And I'm Dr. Hanlon.

Wright [00:00:03] And we want to welcome you to Dental Sound Bites, an ADA podcast where dentists address the solutions to challenges in both life and work. Today, our conversation is going to be on the topic of dentistry is changing and why it really is a new day for dentistry.

Announcer [00:00:21] From the American Dental Association. This is Dental Sound Bites created for dentists by dentists. Ready? Let's dive right into real talk on dentistry, daily wins and sticky situations.

Hanlon [00:00:37] Today. We're talking to Dr. Marko Vujicic, chief economist and vice president of the Health Policy Institute at the American Dental Association. We love talking to Marko because he has so much great insight into everything that's happening in our industry. So, we're really looking forward to doing this episode. We're going to examine some of the trends and how they'll impact the profession. Everything has been changed quite a bit. We all know that. But how are things changing and what does it all mean for the future of dentistry? A look at the new opportunities and challenges and what every dental professional needs to know now to navigate a new day for dentistry.

Wright [00:01:11] Welcome to the Dental Sound Bites, Marko.

Vujicic [00:01:12] Pleasure to be here. Thanks for having me.

Hanlon [00:01:14] You know, some of us have really known you for a long time, but can you tell the audience a little bit about yourself and what you do?

Vujicic [00:01:20] So, I've always been passionate about bringing evidence and data to practical policy debates, and I've done that in various aspects of health care. I lead an amazing team of analysts, researchers, economists, social science researchers, psychologists, you name it. We have all sorts of skill sets in a group called the Health Policy Institute at the ADA. And we're kind of the numbers people. We're looking at what the data are showing about trends in the dental care sector.

Hanlon [00:01:49] So, let's dive into the latest research and data about the dental workforce. What can you tell us about the dental population?

Vujicic [00:01:56] Something we're really proud of here at the ADA and in my team is we have monthly data collection, so I'm bringing you stuff that's basically in real time. The latest numbers show that we're at about 90% of pre-pandemic patient volume, patient flow. That's pretty good. Given where we were a year ago or even six months ago. That has been kind of flat the last few months. And some of the indicators are showing that we're probably in a holding pattern or a new normal in terms of foot traffic in dental offices. But issue number one, loud and clear, is the hiring challenges in the sector. So, we have the latest data show about 40% of practices are in the market to hire either an assistant hygienist, front office staff. Those are huge numbers. And when we ask them how challenging is it, 90% plus say that it's nearly impossible or very, very difficult. Right. So I think, honestly, where we are today is the patient side has recovered quite healthy, I would say, throughout this whole last two years of the pandemic and post-pandemic, if we can call it that. But issue number one that's really affecting practices is this workforce shortage. And it's kind of across the board. We can talk a bit more about that. This is large groups, small groups, you know, rural areas, urban. It's even worse in rural areas, practices. Honestly, there's a major shortage out there.

Hanlon [00:03:23] So, what is at the heart of it, Marko, is it just people in general don't want to go back to dental offices after COVID?

Announcer [00:03:35] Announcing the new...wait. This calls for a drum roll. Perfect. Announcing the newly reimagined. ADA member app designed for dentists by dentists. It puts ADA membership in the palm of your hands. With features like a personalized news feed member chat groups, personal documents, storage even episode exclusives from Dental Sound Bites. The new ADA podcast tap into all the possibilities by searching for a ADA member app. In your App Store.

Hanlon [00:04:14] So what is at the heart of it, Marko? Is it just people in general don't want to go back to dental offices after COVID?

Vujicic [00:04:22] People are reevaluating the place of work in their life. Great resignation or a great reset or great rethink or great upgrade. I've heard so many of these terms. And we're still we're still going through that. That's economy wide. Right. And that is biting. In dentistry, for example, we've lost about 5% of the hygiene workforce compared to pre-pandemic, been kind of early exits, early retirements or not wanting to work as a hygienist anymore or not wanting to work, period, etc.. On the training side, the latest data show that in hygiene programs, we've we've recovered to pre-COVID levels after being down for a couple of years, but we're not seeing any upward trend. And you look at existing programs, there's been a long term downward trend. Right. So part of it is just the workforce behavior changing in terms of choices. And that's not dentistry specific that's going on all across health care and other jobs. You see it everywhere, right in the economy. But there is kind of slow, I would say stagnation or downturn in training programs. When we look at this as as economists, I mean, you don't need a Ph.D. in economics, which I have. This is not a situation that's resolved overnight. I think this is this is going to take multiple years, in my view, to kind of work through this shortages. And I mean, you are both dentists, there there are a lot of you know, people are trying to find what are technology solutions that maybe can can replace some labor. What are ways to more effectively use the workforce for efficiency gains? A lot of companies or I see popping up with, you know, basically temporary staffing in innovative ways. So, there's a lot of innovation there. But practices are really hurting for staff and that's one of the reasons keeping that patient volume down. I want to highlight that too. Like when we asked practices, why aren't you seeing more patients in your practice this week? There tend to be two camps right there. There are those that say, well, it's patient cancelations or not enough patients making appointments, but there's a significant share, up to one third of practices saying it's because I can hire more staff if I can hire more staff. Dr. Wright, you're in the field and with you, Dr. Hanlon, too, if that resonates. But that's what the data show.

Hanlon [00:06:36] We're even seeing practices that we've turned the hygienist into a two chair producer because they're motivated, entrepreneurial and and want to be treated like the dentists. And in our view, we actually prefer to see a proactive hygienist and team together. And we've had really good success with that because that the team is making more money and we are also showing increased benefits in our small group of practices that where we're running in, and that's making a difference too. So I wonder if these few things that we could do. I mean, dentistry has never thought about paying benefits or never thought about, you know, providing extra, you know, whether it's learning services for their team, anything like that for the staff. And I think it's time that we start looking at our team as as a true team and we are running small businesses, so let's treat them like that.

Vujicic [00:07:31] I'm so happy you raised that because we we recently released in September a pretty in-depth report looking at what drives retention among dentists, dental assistants and dental hygienist. And I really want to underscore, Dr. Hanlon, what you say, because the research is crystal clear in support of what you just said: culture, benefits, growth opportunities. Those are the three factors we found are very strong in driving retention and recruitment. And I got to tell you, there was something that really surprised me on something that I just took for granted. Paid sick leave. We found that if you look at a national sample of dental practices across the country, only 45% provide paid sick leave for hygienist and 55% for assistants. So I just took that for granted. I'm like, of course you have paid sick leave.

Hanlon [00:08:23] We don't.

Vujicic [00:08:24] But there's something there, right, that I think honestly in the future environment that's going to get more and more competitive. So, you know, to the dentists, the hiring, people listening in, I mean, you're going to have to take a hard look at your benefits package. 401ks, retirement packages. We're seeing more practices start to offer those very interesting innovation. One of the larger DSOs, Peak Dental, they're offering ownership equity tracks for hygienists. That's the first I've heard. It's an example. I thought of something out of the box. Right. So talk about trying to keep somebody long term. Right. So, I'm really happy you both raised this because this issue of kind of, again, workplace culture, the benefits landscape and growth and development opportunities, you're absolutely right. This cannot be viewed anymore as like temporary, short term labor that doesn't have a long career track, no more. Yeah, we have to view this as an integral part of the team and have long term retention strategies.

Wright [00:09:22] I love that.

Hanlon [00:09:22] Couldn't agree more.

Hanlon [00:09:23] I was actually going to ask for newer dentists in my age group, even those that are not owners yet. Like with the data that you're going to present and the conversation that we're having today, where should we focus in and how what should we extract from this conversation? I know we're going to talk a little bit about, you know, where new dentists fall.

Vujicic [00:09:41] Doctor, I don't know if you're Gen Y. Gen Z, I presume you're not Gen X, but there was there was there was a really interesting, just recently, a DEA, the Dental Education Association, did their survey of seniors and they found that 35% of the Gen Z cohort of graduates that's coming into the profession plans to go into a DSL and dental service organization. So again, I use that more loosely. The point here is that we are seeing a big generational turnover among dentists. We have a lot of Gen Y, Gen Z dentists, we have a lot of boomers and we don't have a lot in between. So,, it's almost like there's two big groups of dentists out there. It's not like a smooth bell curve, so to speak. It's like two big factions or two big demographics. And in the next five years, a significant share of that boomer cohort is going to age out and retire. So, then we're left with a really young dentists to workforce. So, the point here is the big trends we're seeing and what the data are showing clearly is that younger dentists are much more likely to be going into group practices of different shapes, forms and sizes and multi-specialty. DSO where I'm an employee DSO where I have an equity track or large group that's dentist owned and dentist manage, where I have an equity ownership track somewhere, I don't have an ownership track. All sorts of flavors of large group practice. That is about to take off and accelerate faster than we've seen before. I'm convinced of that. 57% of the incoming dental student class is women. Only a few years ago it was 50. And so there's a big gender angle there, right? Or sex angle. And we know that women are more likely to be in larger groups than their male counterpart, dentists. We're seeing more diversification by race and ethnicity. We also know that plays into practices. That the white dentist population tends to be more of that private practice. Also legacy, maybe I plug into my dad, mom's uncles, aunts practice, etc. We're not seeing that in kind of the nonwhite dentist population. So, there's a lot of change going on. And I really see we're actually at the early stage of what I think is going to be a big transformation of the practice model.

Hanlon [00:12:02] So Marko, I'd love for you to elaborate on this transition to the DSO market because being a boomer, I know that that many of my friends and all the docs that I started in practice with are heading in that direction. So, what is it going to look like? How are they going to sell their practices? Are they selling most of their practices to DSOs? I know there's a huge part of that generation who refuses to sell to the DSO. So, what what's going to happen there, do you think?

Vujicic [00:12:28] I mean, definitely that the trends are that kind of fewer young dentists out of school are going to be buying up a solo practice and practicing solo. We don't have hard data, Dr. Hanlon, and we're pretty disciplined researchers, on kind of okay of the practice sales last year, who bought them, etc. but I'm comfortable saying that increasingly it's larger groups in DSOs that are buying up the practices versus again. Now again, those are general trends, right? There's space for every type of practice model, a large group, concierge fee for service, all that there's there's space for all this. I'm giving you a big picture. 30,000 foot trends, right. It's undoubtedly going towards larger groups are increasingly the buyers there. To your point about, you know, is it a retiring dentists vision that they sold to a large group or a DSO or a quote unquote, corporate practice versus having their associate kind of take it over, etc.? I've heard lots of stories of people going through associates and they don't want to buy it. They don't want to buy it either. Like, I don't know, maybe Dr. Wright can chime in. It's just a different generation and I've given some reasons why in terms of the demographics of who's going into dental school. But there's a whole business side to right the complexity, right? As an economist, when you look at the complexity of running a successful practice today, I mean, it's exponentially changed from even five years ago, let alone 20 years ago, putting up the proverbial shingle. That was fine in the eighties. Right? You cannot do that now. You need sophisticated H.R.functions. You need somebody dedicated to dealing just with insurers, right? You need data systems. Now, think of the technology needed to run a successful practice? Its just very complex and more competitive. So I think that's a big one, too. And frankly, I don't know. I'd love to hear if Dr. Wright has hobbies and side gigs. You know, the new generation's got a lot of things they want to do after 5:00. Right. And and on the weekends instead of doing payroll. But Dr. Wright, I mean, is this resonating?

Hanlon [00:14:30] In my mind when I first became a dentist, I only thought about private practice, right? Because that's kind of all that I knew until I was approached by recruiters and things like that from the DSO world. And of course, you know, working for corporate and I say that with air quotes, it's kind of it was frowned upon once upon a time. And once I went into a DSO, I just realized all of the freedom that I had and all of the work that it takes, as you said, to run a successful dental practice. And I will say that my approach is a little bit on the fearful side and not that I want, you know, our listeners to be fearful, but just because of my background, I don't have anybody who I can go to to say, "Hey, how do I run this dental business?" When I say I don't have anybody, I mean in my family, because that's the first place that I would look. If, you know, I were going to be opening a business, I would be trying to turn some to someone who has that experience and who can just literally hold my hand and walk me through it. Now, do I have mentors? You know? Absolutely. But their time is limited and valuable. And they can't just sit with me on a Saturday and walk me through numbers, the PNL. So all of these things, I'm kind of taking a little bit of a slower approach to my path of ownership because I want to make sure that when I do get there, I don't fumbled the ball, if that makes sense, with my business and my career, how I make a living. So, you know, I get a little flack sometimes from people when I talk about it because they're just like, you should totally be a practice owner. And I'm like, in due time, I'm not pressed. I'm not in any rush because I really want to do it right. I want to do it well. And, you know, again, with air quotes, I don't want anybody to think that owning or buying into even a corporate office is wrong, because that's not you know, it's whatever works for you. But for me, I just want to make sure that I understand, you know, my balance sheet, my financial statement, like labor laws and all of these things that we just can't spend enough time learning in dental school because we'd be in dental school forever, in my opinion.

Hanlon [00:16:30] So true. So true. To that point, one of the things that, you know, I've always said, even if you do have an MBA, that doesn't guarantee you're going to understand every aspect of this business. And I think it's important for us to realize that, you know, everybody has their way even you know, if you do have some business background and you do have a little bit of a foundation, it doesn't guarantee you success. I mean, I did have a little bit of a foundation, but I made every mistake in the book so you can learn by the school of hard knocks or you can learn and have somebody consult with you and help you run the practice. But both options are definitely out there for the younger dentist to reach out for.

Vujicic [00:17:11] This is simply a natural evolution of every profession, right? Dentistry has kind of been the last one. And I know there is a group of people are saying, we got to hang on to this. And I'm like pharmacy physicians, eye care, ear hearing care, mental health now, even like every single sector of health care has been through this journey. And to me, like, honestly, I look at the research, I look at the data, I don't see like big negativity around this at all. At all. And I think we just got to honestly, like, get a grip, accept this, move on. There's all sorts of practice models. Dentists are looking for different things. There's lots of diversity in practice models out there. There's room for everyone.

Hanlon [00:18:00] Quick question for you, Curveball about, you know, the boomers are aging out of the field. Do you think that it's going to be the early career dentists who are going to kind of get a grip, take it and run with it? Is that what the data showing essentially?

Vujicic [00:18:13] Absolutely. I see so many opportunities for dentistry to really be elevated.

Hanlon [00:18:20] Yeah, let's talk about opportunities because I think that's what people want to hear about, especially the younger dentists. Absolutely.

Wright [00:18:26] Yeah.

Vujicic [00:18:27] Okay. So there are, I think, three big opportunities that I see looking our sector in the face. Right. One is how do you leverage the huge consumerism trends on the patient side? So, we talked a lot about the generational shift in providers, but there's just a significant generational shift happening in society with patients. You're getting boomer patients being replaced by millennial and let's say more Gen Xers and certainly Gen Z coming. Right. That is a different patient mindset. That is a patient mindset that prioritizes convenience, transparency, consumer centric models of care that meet me where I want to be met as a patient. The idea that the office is closed Fridays because the dentist is golfing. That's out the window. Right. That's a very old model. People want to be connected digitally to their health care providers all the time, but not necessarily physically going unless they need to. Right. So there's lots of these trends. I feel that the next generation of dentists is actually going to innovate and harness. And basically you can grow the patient base if you are responsive to kind of these convenience and transparency needs of the consumers. Right. So that's one one big area. The second big area is we know a lot of people don't go to the dentist because of cost issues either. They don't know what it'll cost and they're scared of the uncertainty or they feel that, oh, dentistry is really expensive. Now to the clinicians out there and those that study is, we know dentistry is not expensive. It's better to go now and save money later. That's not how the average person thinks, right? They look at their medical insurance, you know, do I have to pay 50% co-insurance when I go get a heart valve replaced? No. Right. But the minute you need a crown or implant, you run into those issues with the insurance model. So there's a there's a broken insurance paradigm in dentistry that the ADA is starting now to really work hard and try to fix and innovate. But anyway, there's an opportunity there, in my view, for innovations to reduce cost. There are entrepreneurs working out there like How do I make it cheaper? Or for somebody to go to the dentist. So that's the second big one. The third one I think is actually most exciting, and that is in a sense, how can dentistry break down the silos from the rest of health care and the rest of primary care? We know half the population in the U.S. Doesn't go to the dentist and as I mentioned, cost is a big issue. But for the millennial population, convenience is huge. Now think about if you had CVS or Walgreens or primary care physicians or somebody managing a pool of a patient pool of diabetics. What if they really bought into the value of oral health screenings and they wanted to get their patients into dental care? Right now, that's really hard. It's like, go see a dentist. That's very different than "On your way out, we will book an appointment for you in a network of dentists we know accepts your coverage and you can book automatically a convenient appointment time now on our app. Okay, that's a different piece of advice than "Hey, it'd be good to go see a dentist." But my point is the millennial generation of dentists and what follows. I think they're the group that are so entrepreneurial, so open to different innovations and are going to be working in groups. I really think they could bust down some of these barriers between dentistry and the rest of health care. Why are these three innovations important? Again, meeting consumers where they want to be met, reducing cost barriers and making meaningful collaborations with primary care touchpoints that's going to bring millions of more patients into the system. And that's where I feel like if there's one statistic that really grinds my team and kind of upsets us, so to speak, it's that half the population goes to the dentist regularly and half do not. Like, that is not anyone's vision of oral health in America, you know what I mean? So there's so much opportunity to bring dentistry into a new era, and it's going to be to the original question. It's going to be this generation of dentists that's going to do it.

Hanlon [00:22:54] Absolutely. So, Marko, what's coming next in HPI research?

Vujicic [00:22:58] Well, we have monthly data that's refreshed on basically the current economic situation. Some of the statistics I shared, but it look in the coming months for a larger project on how long dentists stay in DSOs and different types of practice models and what the turnover is and do we eventually own practices. So, I think that will have a lot of really interesting stuff for the profession.

Wright [00:23:21] That's going to be good.

Announcer [00:23:24] On the next Dental Sound Bites.

Wright [00:23:26] As we approach Thanksgiving, we want to talk about the mentors we're grateful for, and share tips & resources for networking, mentorship and creating community in dentistry. Plus, our special guest, Dr. Cathy Hung, on the 3 things every dentist should do for their well-being.

Hanlon [00:23:44] Well, Marko, we can't thank you enough for being with us today. I hate to have our conversation end because I think the two of us could talk to you forever. We really, we really appreciate you being here. So thank you.

Vujicic [00:23:55] I appreciate it. And if anybody wants to kind of keep track and receive new research out of my group as it comes, you can simply go to ADA.org/HPI, and there is a button there that says "Sign up for newsletter." But thank you for having me.

Hanlon [00:24:11] Awesome.

Wright [00:24:12] Thank you so much for being here.

Hanlon [00:24:13] Thanks for being here. So, everyone, if you liked what you heard today, please subscribe to the podcast wherever you are listening so you can get our latest episode.

Wright [00:24:22] You guys can also rate and write a review and follow us on social media. And don't forget, the conversation will continue in our member app, so please join us there.

Announcer [00:24:33] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show's resources and more on the ADA member app and online at ada.org/podcast.

Why Join Organized Dentistry?

At ADA’s SmileCon 2022, hosted in Houston, attendees enjoyed a new feature – the ADA podcast stage. Dentists gathered to watch and hear a live recording of Dental Sound Bites with host Dr. ArNelle Wright interviewing Dr. Joy Nisnisan in front of an audience while co-host Dr. MJ Hanlon joined the conversation remotely. The topic of the episode was organized dentistry from the perspective of Nisnisan, a 2022 graduate of the UTHealth Houston School of Dentistry, who was also an active member of the American Student Dental Association.

“The ADA is here for you if you need to talk, if you need resources and more. First and foremost, it's the place dentists call home. It's the people that fight for us when we're not aware of it, while we're in practice, while we're on vacation. ADA is family.”

- Dr. Joy Nisnisan

Show Notes

Dr. Nisnisan shares her path into the profession and the positive role organized dentistry played in her decision to become a dentist and continues to play now that she is in practice.

• SmileCon being hosted in Houston this year was particularly special to Dr. Nisnisan, who grew up in the city and was embraced by the local dental society when she first became interested in the profession
• Nisnisan is a first generation Filipino-American and grew up with parents who worked in health care. Her father is an internist and her mother a nurse. She became involved in organized dentistry as a pre-dental student to make connections in the field and met many welcoming dentists through the Greater Houston Dental Society.
• She became active in the American Student Dental Association (ASDA), where she learned about the House of Delegates and the power dentists have to determine how they practice. She was also vice president of ASDA during her fourth year of dental school.
• “Organized dentistry has done so much for me and it's taught me the importance of dentistry as a profession, not a trade. And the expectations that you have as a future dental professional to provide for your patients and the public at large,” she says.
• Shortly after the COVID-19 pandemic took hold in March 2020, Dr. Nisnisan saw first hand the power of organized dentistry when dentists across the state advocated to the Governor of Texas through organized dentistry and were able to get back to work months before other healthcare workers who were initially deemed “non-essential.”
• Dr. Nisnisan is now involved with the New Dentists Committee at the ADA and encourages her fellow new graduates to get involved too.
• She says the resources and access to experienced dentists who listen to her concerns is valuable and she now has a network of connections that feel like family.
• She says organized dentistry has “really helped me realize that as a dentist, I have my duty to my patients, but I have a duty to the profession as well.”
• Propel your success with ADA membership. From the support of a community ready to help you thrive and a team of advocates working to advance legislation that matters to you and your patients, to exclusive member tools, it’s a great time to be an ADA member. Join the ADA: https://www.ada.org/join-the-ada, or renew your membership:
• https://www.ada.org/join-the-ada/renew-ada-membership
Learn more about ASDA: https://www.asdanet.org/

Transcript

Wright [00:00:00] Alright, Houston, we've got a podcast. Hi, everybody. I am Dr. Wright. And joining me remotely to host this show is Dr. MJ Hanlon. How are you today, Dr. Hanlon?

Hanlon [00:00:14] I am awesome, Dr. Wright. This is one of the coolest things I have ever done with you there and me here, and we just get to do this together. It's just awesome.

Wright [00:00:25] Yes, it really, really is. This is Dental Sound Bites, which is an ADA podcast where dentists address solutions to challenges in both life and work.

Announcer [00:00:38] From the American Dental Association, this is Dental Sound Bites. Created for dentists by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Wright [00:00:53] So, today, we are recording in front of a live audience here at SmileCon. So when you look around and you feel this energy, you guys can see what brought us all here today. Organized dentistry, right? So, I think it's really, really important for us to talk about why it matters to us and how all dentists can help shape the future of our profession. We have a special guest today on the episode in this amazing event for dentistry and joining us here on this SmileCon podcast stage, our special guest is our ASDA the 2021-2022 Vice President and as the consultant member of the ADA's New Dentist Committee, Dr. Joy Nisnisan, so welcome to Sound Bites, Dr. Joy.

Nisnisan [00:01:36] Thank you so much, Dr. ArNelle. It's such an honor to be here today. I would have never dreamed I'd be here at SmileCon in Houston at a podcast. So this is such a wonderful opportunity for me.

Hanlon [00:01:47] So, tell us a little bit about Houston. How has it been, Dr. Joy?

Nisnisan [00:01:50] Houston's been great. I've lived here for the past 20 years. I was born in New Jersey. So I tell people, I'm Jersey born, Texas bred. I've lived here for 20 years and it's hot, but it's really fun. Good food, so diverse, so much to learn from. And I love my local dental society and the dentists in Texas, they've been so kind to me, so welcoming. And it's a big part of why I'm here today.

Hanlon [00:02:11] That's awesome.

Wright [00:02:12] Dr. Joy, can you tell us a little bit about yourself and your career journey?

Nisnisan [00:02:16] Absolutely. So, a little bit about myself. I'm a second generation Filipino-American. I come from a big family of four children, three out of four. I'm the first one born here in the States. I have a health care background. My father is an internist. My mother is a nurse. So, I grew up in the medical field. I thought I wanted to be a physician my whole life, graduated high school, went to college here at the University of Houston, worked for my dad as a medical assistant, and I wanted to be a surgeon. And he said, "Oh, that sounds great. You're just going to be in school for another 20 years." and I was like, "Wait a minute. Work life balance is huge for me." And I said, "You know what? Let me give dentistry a chance." I shadowed a dentist, and after that day of shadowing, I put all my eggs in one basket and dentistry. And here I am.

Announcer [00:03:00] Announcing the new... wait ... this calls for a drum roll…[drum roll sound effect]. Perfect. Announcing the newly reimagined ADA member app. Designed for dentists by dentists. It puts ADA membership in the palm of your hands with features like a personalized news feed, member chat groups, personal document storage, even episode exclusives from Dental Sound Bites. The new ADA podcast. Tap into all the possibilities by searching for a ADA member app in your App Store.

Hanlon [00:03:38] Dr. Joy, you have a unique perspective in your journey so far. You're so young. So, tell us a little bit about why you got involved in organized dentistry.

Nisnisan [00:03:47] I got involved in organized dentistry because I didn't have any dental connections when I was interested in becoming a dentist. And so my first exposure to dentistry was the Greater Houston Dental Society, and I kind of jumped all in. I didn't know anyone. I introduced myself. I went to a local meeting and I said, "Hey, I'm a pre-dental student now, I'd love to get involved." And they said, "You know, why don't you go to the Star of the South dental meeting." Which is a huge dental meeting here in Houston we host every year. This year we've combined it with SmileCon, which is awesome. And I worked there for five years learning about research, the table clinics, networking with dentists. And eventually I found a dentist that I could volunteer for and that turned into an opportunity to assist. She taught me how to assist in her practice. I got into dental school a little bit after that. So, organized dentistry has done so much for me and it's taught me the importance of dentistry as a profession, not a trade. And the expectations that you have as a future dental professional to provide for your patients and the public at large.

Wright [00:04:49] Oh, that's beautiful.

Hanlon [00:04:51] I really want to know what your experience was like to be a student and work in ASDA.

Nisnisan [00:04:55] To be a dental student, and work at ASDA, you're wearing many hats. Dental school is a very stressful time, and ASDA was a great way for me to kind of separate that space of dental school and to still be in dentistry, but be aware of all the issues that you're facing as a future professional. Be aware of everything that's going on in the House of Delegates. Dentistry is so special because as a profession we have such a huge say in how we practice. Not a lot of healthcare professionals have that power. And so being a dental student, being involved, was it a lot? Absolutely. Were there sleepless nights and running from the airport to clinic and pre clinic and jumping into seeing patients 100%? But that experience really prepared me for what it would be like as a dental professional.

Hanlon [00:05:45] Did you find that becoming involved in organized dentistry helped you find a role in dentistry like your first job?

Nisnisan [00:05:51] I think it did. I did network very well with DSO companies, and I made connections with certain private practice owners. Even after graduation, I took about two months to really hone in on what I wanted to be as a practitioner, where I wanted to be, where do I want to be in five years, what I want to be in ten years and what would be best for me right now. So, I made so many connections through organized dentistry and all the trips. I'm now connected to the New Dentists Committee at the ADA, and it really feels like this big family of people I can talk to about anything. I was telling them last week about some of my episodes on practicing by myself for the first time, and it's so relieving to hear that, "Oh, you know, we've all been through that. It's okay." And you know, you have this network of people that are around you that you can access at any time. And when you graduate dental school, you tend to feel isolated, right? We had this big family of 108 students. We were all so supportive of each other. We were like we were there when to pick up each other when we fell. And so now it's like now you're on your own. Everyone's moved away. Who do I have in my corner? And I have a new dentist committee. I have ASDA. I have all these dentists here who are excited to support me. So, I made really good connections here that did help me find my current job and friends and family that I can rely on to talk to.

Hanlon [00:07:07] Yeah. Excellent.

Wright [00:07:07] Organized industry. What can it do at the state, the local and the national level for dentists, in your opinion?

Nisnisan [00:07:15] Organized dentistry is it's like this whole other side of the profession, right? We have our clinical side and then we have organized dentistry that's fighting for us when we're sleeping, when we're in dental school. I think on the state level it gives people the opportunity to have a more home-like feel into what organized dentistry is getting involved, especially as a new dentist, like getting involved in local society, finding where you fit, what you like to do. At the national level it's just it's so, it's so, different. The management style is different, the expectations are different. But it's so exciting to get there because you're learning so much more about what the ADA does for dentistry in terms of how they're fighting back insurance, in terms of how we're fighting to make sure fluoridation is accessible for people, how are making sure that things are beneficial for our patients. So, I really think that every component is so important in how we make sure people are involved and the local level is where it starts. And then you come to find like, "Wow, I really care about this issue in practice. I see it happen every day" and if you want to do something about it, the ADA is there for you to share your voice and to take action. So, I think where there's a disconnect sometimes is like people are mad about what's going on, but they don't say anything, they don't do anything. They just kind of live with it day to day. But that's what the ADA is here for, you know, and so making sure, like, we're getting people on the local level to understand what we do and hopefully getting them involved on a national level is so paramount because there's so many things the ADA does for us and for dentistry.

Wright [00:08:53] Yeah. And would you call those benefits of organized dentistry?

Nisnisan [00:08:57] A hundred, 100 percent. There are tangible and intangible benefits. Right? The tangible benefits are what the policy is the ADA fights for and how that directly affects you in practice. One particularly that happened during COVID, we had so many Texas dentists speaking with the governor on opening up Texas dental practices again, and that got us back to work in just a couple of months after the pandemic hit. And that's powerful. There are so many other health care professionals that had to stop working. But the reason why dentistry was back to work is because of organized dentistry and the connections we shared. That is powerful. Right. And then you have the benefits of networking, you have the benefits of friendship, and you have the benefits of people who understand exactly what you're going through, even if they're not from the same state or city.

Hanlon [00:09:44] You teed that up for me so well, Dr. Joy, because one of the things that I wanted to share with the audience was that I was past president of Massachusetts. And one of the bills that we have on the Hill right now legislatively is the medical loss ratio bill. And the ADA got behind us 100% of the way. And we have almost 50 states that are actively working towards helping us pass that bill. People don't understand that even though you may not be involved, all of those things are being done for us behind the scenes and we benefit from it as dentists.

Nisnisan [00:10:18] Absolutely.

Wright [00:10:19] So what kind of positive impacts or personal a-ha moments has it brought you? Being a member of organized dentistry?

Nisnisan [00:10:27] My first a-ha moment had to be in the boardroom of the Greater Houston Dental Society. I was part of the Legislative Action Committee and the Dental Health Committee that revolved around volunteerism and giving back. I was sitting there and they were talking about at the time the legislative agenda and how it would affect dentists in Texas, and how, if it wasn't passed, it would have had a negative effect. And dentists were planning volunteer events, willing to stop their practices for a day and use all their materials to provide such a service. And it's like dentists are a jack of all trades type of profession. And they're there's so much leadership, there's so much growth, and I'm so big on leadership. And I wanted to become someone who could create more leaders. And dentistry gives you that opportunity through whatever you're interested in, whether that's community service, whether that's legislative, whether that's wellness, whether that's mental health. You can do so much through dentistry. And I was like, "Wow, I think this is the profession for me." So, just just seeing people in action and actually helping other people and seeing that I'm a busy person, but I'm, I make time to give back to my profession because a lot of them were telling me, "I'm going to be retired in five years, but you're going to be taking over. And I want the profession to be as great to you, as it was to me." And it's like, wow, this there are people that care about me that don't even know me, but because I'm a dental student, they're out here saying, you know, it's our job to leave the profession better for you than it was for us. And that's why we're here. And and there's this ownership of how we treat each other professionally and and how we manage things. And it's just such a nice profession and organization to be part of it. It's unlike anything else.

Hanlon [00:12:14] So, do you find that many of the students that you went to school with are involved in organized dentistry?

Nisnisan [00:12:20] Surprisingly, I feel that a lot of my classmates are more interested in getting involved now that they're outside of school. Now that they're in practice, a lot of people are messaging me and saying, "Joy, how do I get involved? Who do I talk to?" I'm noticing something while I'm practicing, and I'm just I just have a lot of questions about it. I feel alone. I feel isolated. I feel like no one else relates to what I'm going through. And I'm like, we have such a wonderful network of dentists here in Houston, in Texas, in the ADA, that would be more than happy to help you with what you're going through. And so my angle at it right now is, you know, I'm trying to let them know you have a dental family that has your back and you just have to reach out and talk to someone. So in dental school, you're stressed out, you don't want to think about anything else. And then now that you're in practice, you feel alone and you need support. And I feel like the ADA is a support new dentists need. Just preaching that and telling people about that is going to be really instrumental in getting new dentists to join the ADA.

Hanlon [00:13:21] So what do you think some of the challenges are that the ADA is facing right now?

Nisnisan [00:13:26] We need more dentists, like inviting new dentists to meetings, giving it that human component and saying, "hey, like, how long have you been out? Like, you know, there's this really good meeting here at the society or here at the ADA. I think you you'd really benefit from coming to it." And just just simply saying that to new dentist is is so impactful because a lot of us just were too scared to ask.

Hanlon [00:13:48] Yeah. You know, it's not uncommon, Dr. Joy, very often, if you just felt welcome, you'd come to more meetings. We as mentors, we just have to remember that we have to be more welcoming.

Wright [00:14:00] Absolutely. Listen. And it sounds like that personal touch point is a recurring theme that we hear oftentimes in our meetings, just like extending your hand, I think at one of our past in NDC meetings that the phrase was coined instead of like being at the table, it's like pulling up a chair. So, it's kind of like allowing someone to like have a seat by you. Like you can sit with me. Not that. "Hey, no new friends. You don't need to sit with me." Like we have to just kind of bring the newer generation alongside. I mean, I'm still within that 1 to 10 year time frame, so I'm still an early career dentist, but I am five years out. And MJ, you mentioned that five year mark. There's just something that changes after that. Yeah, so that five year mark, it's a really key point throughout our journey. So, that personal touch point is something that I think we all could benefit from. So, tell me about attending national events. How do you think that attending these national events have helped you find your role within organized dentistry?

Nisnisan [00:14:59] Attending national events as a dental student really exposed me to the ASDA House of Delegates. Yeah. And the ADA House of Delegates. And they both run a little bit differently. And that's important because if you want something done in the house, there's, there's different channels it has to go through. Yeah, yeah, there's protocols. And another one of my a-ha moments, coming back to another question, was walking into the ASDA House of Delegates as a dental student. And I walked in and there were, you know, the separation of the delegates in the front. There were the guest chairs, there was the stage, there were the lights. And seeing how the house is run, I was so taken aback because it's like, wow, we really have our own voice in government. Like, it's like you hear it all the time, you know what I'm saying? Like you hear people tell you that. But seeing it and being in the room is so different from just hearing it. And then when I walked into the ADA House of Delegates last year, I had an even bigger a-ha moment because it's like there's, there's just, there's so many things to it and all these protocols and processes and that's a huge deal for an organization. It's really helped me realize that as a dentist like I have, I have my duty to my patients, but I have a duty to the profession as well. And I can fulfill that duty in the ADA, whether that's me just doing something locally or even hopefully in the future doing something national and all of it matters. Not one is more important than the other.

Wright [00:16:32] So, this conversation is so enriching to me. Like I love to hear that you are so passionate about organized dentistry and all the work that you've done because, so, I didn't get involved in ASDA during dental school, so I didn't have that experience. So, it's kind of like it's a really big fire hose for me. So, I've been kind of learning as I as I've gone. I was involved in SNDA and as you said, with ASDA in the House and all of those things, they were completely different from one another. So, what takeaways or what messages, any additional information that you would like to for us to send to future dentists about organized dentistry?

Nisnisan [00:17:07] I think future dentists just need to know that the ADA is family, first and foremost. And family doesn't leave when times get rough. Right. You don't. You identify the problem. You find a solution. Sometimes they just. You just need someone to listen to you, right? You call up your sister or I'll call ArNelle and I'll say, "Hey, like I had a really bad day today. Can I just talk to you about it?" That 30 minute conversation means so much more to a new dentist than being told. "Wow, you did it this way. You should have done A, B, C, or D like, I can't believe you did it that way. Or, Oh, you work for a corporate practice and that's why that happened." Or you know, like sometimes you just need to listen. Sometimes we need they need some help to walk them through the problem they're going through. But the ADA is a family and the ADA is here for you if you need to talk, if you need resources and more. I mean, there's so much growth in the ADA, but first and foremost, it's the place dentists call home. It's the people that fight for us when we're not aware of it. While we're in practice, while we're on vacation. ADA is family.

Hanlon [00:18:15] So, if I was going to sum it up in one word, I would say that organized dentistry is about connection.

Wright [00:18:21] There we go. Yeah, absolutely. I feel like the fact that we're all in it together, like we are protecting that profession by being involved, you know, like, so we all know that we got to protect the profession, push the profession forward. We've heard those conversations. But I feel like by us all being here, we're already contributing to that. Yes.

Nisnisan [00:18:39] Absolutely.

Announcer [00:18:41] On the next Dental Sound Bites…

Hanlon [00:18:43] Dental workforce is changing. We're talking to Dr. Marco Vujicic, chief economist and vice president of the Health Policy Institute at the American Dental Association. We're going to examine some of the trends and how they'll impact the profession. A look at the new opportunities and challenges and what every dental professional needs to know now to navigate a new day for dentistry.

Wright [00:19:06] Dr. Joy, it has been such a pleasure to have you on the Dental Sound Bites podcast. We are so grateful for all the work that you are doing that you have done within ASDA and now within the ADA. You know, the New Dentists Committee, we love you to pieces, so yep, you're our baby dentist, you know. But you won't be a baby dentist for very long, so do not get used to that phrase. And don't stick with it. Oh, no.

Nisnisan [00:19:28] Yes, ma'am. Yes, ma'am.

Wright [00:19:30] Yeah. So we just want to thank you so much for being on this episode. We hope to have you back on the show sometime soon.

Nisnisan [00:19:37] Yes, absolutely. Thank you so much for having me. Hearing my story, representation matters being, you know, minority ethnic women, being a woman in dentistry is a big deal. You know, timeline wise, it's women in dentistry is a relatively growing and new thing.

Wright [00:19:55] In HPI data.

Nisnisan [00:19:57] The statistics are very interesting. So, I loved this the session being here being surrounded by wonderful dentists and this opportunity. Thank you so much.

Hanlon [00:20:08] So if you liked what you heard today, be sure to subscribe to the podcast and make sure you get the latest episodes.

Wright [00:20:13] And you can also rate and write a review for us so that we can continue pushing out this amazing content for our doctors.

Announcer [00:20:23] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show resources and more on the ADA member app and online at ADA.org/podcast.

Sticky Situations with Kirthi Tata, DDS

Every dentist has tales of difficult, confusing or downright weird situations. Our hosts and guest Kirthi Tata, DDS, share some sticky situations from dental school and the operatory, the solutions that got them through and lessons learned.

“I feel like maybe five years is the mark where you start learning little tricks and tips. Someone told me something that stuck with me: if it hasn't happened to you yet, you haven't been practicing long enough!”

- Dr. Kirthi Tata

Show Notes

Today’s guest, Dr. Kirthi Tata, is an early career dentist providing family dentistry in Arnold, Missouri. Tata had her fair share of sticky situations as a dental student and since graduating five years ago. She shares some of her experiences and explains why she thinks it's good for dentists to discuss the not-so-typical scenarios they encounter with patients.

• Wright kicks off the sharing of sticky situations with a memory from dental school that has stuck with her. She decided to challenge a professor with a tough reputation over a point missed on a quiz. She was sure the professor “was out to get her” and after approaching him realized she was in the wrong and had in fact missed information and deserved the missed point. .
• She was upset about the situation and another professor helped “center” her by reminding her that no one was out to get her, everyone wanted her to succeed and “Your whole entire career is not going to fall apart based off of this one quiz."
• Realizing that you can't nail every single thing you try is important, Wright says.
• She still feels like she made a fool of herself during the situation but now can look back and laugh.
• Tata says she also had to learn not to sweat the small stuff in dental school, even though she was voted “most likely to need a Xanax in the middle of clinic”.
• As a practicing dentist, she has faced many sticky situations and one in particular sticks out, involving an anxious teenage patient.
• To help ease the patient’s anxiety she offered to act like a racecar announcer and served as a “commentator” during an hour and a half appointment that involved all four quads and multiple fillings.
• “Any time I would stop commentating or commenting … talking this scenario out, immediately, panic settled (in the patient),” she says.
• Talking about patient management and the things some dentists do to keep their patients happy isn’t always discussed in dental school or at professional development events, Tata says.
• She hopes sharing her story will get the conversation started and more dentists will come on the podcast and share their tales of sticky situations and make people in the profession feel less alone.

Transcript

Wright [00:00:00] Hello. Hello, everyone. I'm Dr. Wright.

Hanlon [00:00:02] And I'm Dr. Hanlon.

Wright [00:00:03] And we want to welcome you to dental sound bites. This is an ADA podcast where dentists address solutions to challenges in both life and work.

Announcer [00:00:14] From the American Dental Association. This is Dental Sound Bites. Created for dentists by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Wright [00:00:30] So, to all of our listeners out there, sometimes things do not go as planned. We all know that. But these things present great opportunities for us to learn. For us to grow. For us to get some experience in the process. So, today we're going to be talking about some sticky, sticky situations that happen during practice, maybe during dental school, all throughout the field of dentistry. And we're going to give you some solutions to the things that got us through some of those situations.

Hanlon [00:00:59] For our conversation today, please welcome Dr. Kirthi Tata. Welcome to the show.

Tata [00:01:05] Hi. Thanks for having me.

Hanlon [00:01:06] Is it true that you inspired a lot of the episodes that we're putting together for Dental Sound Bites?

Tata [00:01:14] So, I'm really excited about this episode because, you know, we all have those days that we finish them and go in our office and are like, "What the heck just happened?" Or "Did that just happen?" And you know, dentistry is always one of those things. It's like you think, "Oh, is it just me?" And then you talk to people and realize that, nope, it happens to everyone. So, I figured it would be a good, good topic, a good episode to have just to hear some of the crazy and kooky things that have occurred to all of us and have us feel a little bit more, you know, not alone. And that everyone has these experiences.

Wright [00:01:51] Yeah.

Hanlon [00:01:52] Absolutely. So tell us a little bit about your background and how you ended up getting here.

Tata [00:01:57] So I went to dental school at the University of Missouri, Kansas City, graduated in 2017, went to Oklahoma for a year for a GPR residency. And then I moved back to Saint Louis. And I've been here ever since.

Wright [00:02:12] That's awesome.

Announcer [00:02:18] Announcing the new. Wait. This calls for a drum roll. Perfect. Announcing the newly reimagined ADA member app. Designed for dentists by dentists. It puts ADA membership in the palm of your hands with features like a personalized news feed, member chat groups, personal document storage, even episode exclusives from Dental Sound Bites. The new ADA podcast tap into all the possibilities by searching for an ADA member app in your App Store.

Hanlon [00:02:56] I think we have some big sticky situations coming up there. Dr. Wright. Yeah. Why don't you go ahead and start sharing your story with the audience.

Wright [00:03:05] This is actually an embarrassing moment that I had in dental school, but it's something that I feel would benefit all of our listeners. When I was in dental school. You start off, you know, we all chat with upperclassmen. And so there was always certain professors that people would be like, "Okay, you got to make sure that you're on top of your game because this professor tries to get you and things like that." And so for me, there was one particular question on a certain quiz that I thought that I should have gotten right. So I was like, no, no, no, I'm going to totally dispute this. I totally want to speak to the professor, see where I went wrong and if I can get that one point back. So I booked an appointment, made in office hours with the particular professor and it kind of went okay. But then I spoke to another professor afterwards and I started explaining how I'm like, "I know that this professor is out to get me." And I literally made a complete fool of myself in that moment because the professor wasn't out to get me. They were just trying to explain that there was a part that I actually missed. I learned this from the words of the second professor that I discussed the whole situation with the professor kind of just like centered me and was like, listen, she's like, "ArNelle, no, it is too early for this. You just got started. Like your whole entire career is not going to fall apart based off of this one quiz." She taught me how to learn to just kind of go back to the drawing board, understand that you can't nail every single thing even though we try. And it's awesome that I made that attempt.

Tata [00:04:34] Yeah,.

Wright [00:04:34] But the, the main thing is to realize that it was too early in the game, I guess, of dental school too, to be disputing just one point. And so that's my sticky situation from a dental student's perspective. And I got through that, not that I stopped trying in dental school to, you know, excel and overachieve and be amazing at every little thing. But I stopped looking at it as like, "Oh, this professor is trying to do this thing to me." Because they all wanted me to succeed. And so here I am. And that's just a sticky situation for a dental student, and I hope that someone listening can relate to it.

Hanlon [00:05:11] So I think a lot about emotional intelligence, right? And I think about how when you're young and you're a first year dental student, how much you grow between first year and fourth year.

Wright [00:05:23] Absolutely.

Hanlon [00:05:24] So when you reflect back.

Wright [00:05:27] Mm hmm.

Hanlon [00:05:27] Was that moment a real. It sounds as if it was a huge learning moment for you.

Wright [00:05:35] It was. It was. Yeah. I learned a few things. Number one, not to just listen to what every single thing that everybody says and then not to just, you know, act on it just on a whim like I was just so like in the moment. I just wanted that one point back. I just want it to, you know, win that thing and say, no, no, no, no, no. I just kind of want to go to bat for what I believed in, which is good. And I, I still encourage people to, you know, go after what they believe in. But I do believe there's a way in which things should happen in a way in which you should approach certain things. And I totally just went about it the wrong way. And now when I even, you know, I'm five years out, whenever I connect with that former professor, when I returned back to the university, we kind of chuckle a little bit and it's kind of like this little unspoken thing that we both know. You know, it's like ahhhh. You know, you were just kind of fighting about some little point. But I really did learn just not to be, you know, just easily influenced, you know, really to even put in more work, you know, and understand questions. There's so many things that I feel like I can get out of that particular scenario.

Tata [00:06:46] So funny enough, my class is fourth year. You give out these awards. I got voted most likely to need a Xanax in the middle of clinic. And I think of that and I look back and you know, it's funny because looking back, I'm five years out as well. You know what the worries we had as first years and the worries you had as fourth year and now there's so different, just wait like two years and your your battles that you have are so different. And I look back and I chuckle at the fact that I was voted that because, you know, that one point, my first year would have drove me crazy. But now, you know, my what drives me crazy is when insurance needs, like a third narrative of why I need to, you know, replace a front, to the same day I extract it. You know, it's, it's such different battles that we have. And. Right. You said, Dr. Hanlon, you know, the, the emotional maturity and growth is, it's, it's interesting.

Hanlon [00:07:48] Uh-huh, you know, I find that even working with students today that the worry hat goes on immediately. Right. Instant. And I don't know if you guys have experienced this, but. I see escalation and I see the meltdowns occurring right in front of my eyes. And I think to myself, "Oh my gosh, you're getting so upset and so worried about such a mundane thing today." But in their world its huge.

Tata [00:08:18] it's 100% right.

Wright [00:08:19] It was huge. Yeah, it was huge for me. Yeah, right. Yeah. It was a huge discount.

Hanlon [00:08:23] That experience. You have to understand that at that moment in time, they are there and they're experiencing this and they don't they do not know how to manage it. They really don't.

Tata [00:08:35] It's crazy. You know, I always said no matter what kind of person you are, no matter what your practice philosophy, your study philosophy is, you are -- my class was 109 big. So we're literally together with 108 other type-A people.

Wright [00:08:52] Right.

Tata [00:08:54] This is what we've done, all the way up into getting into dental school. You know, we, every point, every little thing, it's what we've been critiqued on. So, you take all those people, you put them together, you're the best of the best. And now you're, you know, competing, not even competing. But you just see other people around you and you're like, "Well, why didn't I get that point? Or Why?

Wright [00:09:13] Right?

Tata [00:09:14] Why did their practical pass and not mine?

Hanlon [00:09:16] But I did have a conversation with a student yesterday and I said to her, "Stop worrying about this stupid stuff." I said, "Whether you graduate number one in your class or last in your class, if you graduate, they still call you doctor." So, you know, start concentrating more on the bigger things and not concentrating so much on the little.

Wright [00:09:40] That's exactly where, what I took from that conversation. And I will say. MJ, like, the words that you spoke to that student, they may not land with him or her right now, but now when I reflect on that situation, I feel like that faculty member actually helped me a lot to not get so rattled. And another thing that she helped me with was to not feeling like I had something to prove because I felt like, okay, just with my background, trying to get in a dental school, you know, going through all of the rigors and all of these ropes and things like that, I felt like I had something to prove not only to myself but also to everybody else who was in the class with me who may have also known my story. So, it kind of made me do a little bit of a deeper dive and to reflect on myself and to see what was I trying to prove and why was I trying to do that? And it actually centered me and I feel like it really helped me grow, like, almost instantly in that moment. Not that I let every little thing go as far as my grades went at that time, but I feel like it made me stop and remember that I didn't have anything to prove because I was in the class with those individuals.

Hanlon [00:10:50] And look at you today.

Tata [00:10:51] Yeah. You quickly learn what's important and what's worth it. I feel like, you know, especially between first and second year, I, I, was that person, again. I was that person. And it, just overwhelmed. You can't keep up with it. It's not possible to sustain that and sustain, you know, your sanity. So, I, at some point in time and I don't know how I came to this wisdom, but I would ask myself the night before any test, anything, and I would ask myself, did I do everything that I could within my power to prepare for this? And if I could tell myself yes, then, you know, whatever happens on that test, whatever happens on the practical happens. If I say no, then you know it's on me. But then I would ask myself, why? Why, no? What did I do otherwise? And maybe something else wasn't more important, you know? And you learn what interests you. I mean, I, I, love orthodontists. I hate ortho for my whole life. Like, I, not a single case will I touch. So, you know, I did what I needed to do to get out of those classes and ,and get done with them. But I put my interest in things that I liked and went above and beyond in those things. So I think, you know, that's something you slowly grow not only in dental school but in practice as well.

Hanlon [00:12:09] Agree, agree. So, Dr. Tata, why don't you share your story with us?

Tata [00:12:14] All right. So I have a weird schedule. I work 7 to 7, 3 days in a row. So Monday through Wednesday, 7 to 7, work straight through. So my Wednesday 5:00 appointment will make or break how my week goes. I, it will, it will test me. So, one day I decided to be brave and I decided to see this -- I had a 16 year old or teenager, you know, just finished ortho and he, he didn't, unfortunately not the best hygiene and we had to essentially do quadrant dentistry and all, all four quads and multiple fillings and he was anxious and he was curious. Mom did not want to go to, you know, a sedation dentist. So, I said I would try. Boy did I try. So, you know, it was, two hour appointment. We scheduled it. It took me about 30 minutes to convince my patient that, you know, nitrous will be great for you. Just. Just put the nose on. We'll go slow, it. And if you don't like it, we can take it off. But I think it's going to help you, especially with his. The anxious tendencies, the, the very curious lot. Very chatty. Had a lot of questions. So, we finally got the nitrous nose on him and it was great. Somehow we. So, one weird fact about me is I love Formula One racing. I think it's so cool. I mean, I want to drive one of those cars. How can my dentistry skills transfer over to Formula One? I don't know. But when I figure it out, that'll be great. Somehow we came up on that topic and he also mentioned that he liked Formula One racing. So with this nitrous nose if you know, the nitrous finally went on for the last hour and a half of the appointment. Again, 5:00 now, 5:30 on a Wednesday after I've already worked 2, 12 hour days, I had to be the commentator for an hour and a half. And we pretended that my patient was a Formula One race driver. And you could see the foot, you know, press on the pedal and everything. But any time I would stop commentating or commenting and like, you know, talking this scenario out, immediately, panic settled. So, for an hour and a half, I pulled every brain cell I had together and somehow magically made it through this appointment as a commentator. And at the end of it, we cheered. I cheered because I was done, you know, he cheered. It was done.

Hanlon [00:14:48] I'd be cheering for you too.

Tata [00:14:49] My assistant cheered that we were all done. It was happy, you know. The only thing missing was like the champagne spray bottle. I would have really appreciated that. I remember walking, we were done. I walked into my office and I just put my head on my desk and I think someone came in to ask me a question. I just put my hand up and I was like, no words, no words, no energy. And I think my front desk just laughed at me when I left. And I just, like, had my head down, like my face was drained of energy. I think I just, like, rode home in silence cause I didn't want to hear anything. I didn't want to talk. I remember my mom called me and I just texted her, not today. And I mean, you know, it's funny what we do to try to get patients comfortable. And I don't even know how the situation happened or how that creativity came together, but it did. And, you know, the patient ended up being great. I for all the, you know, rest of the appointments from then on out, nitrous went on right away and they became, you know, a lot shorter. But that first appointment.

Wright [00:15:54] How many years out were you at that time?

Wright [00:15:57] This was two months ago.

Wright [00:15:58] Oh, okay. I'm going to say. I was going to say, because when we turn the curve, you know, five years out, maybe you're like, absolutely not. You know.

Tata [00:16:09] If you asked me to do this one, not even like two years ago, no. Wouldn't have happened. I would have referred right away. But, you know, especially I think since we have to deal with, like, insurance and reimbursement and all of the fun joy that we get. We were trying to work with patients because we want to keep them. And, you know, especially this is a whole family and, great family. And I, you know, I want to keep them as patients. The one thing they don't teach you in school is how to talk to people and how to do, kind of the patient management, which we do get some patient management. But, the I find that there are little things you have to do or boundaries you have to draw. And you don't learn how to do that in school because you know.

Wright [00:16:56] Yeah. Because we're trying to get our requirements.

Tata [00:16:58] Exactly.

Hanlon [00:16:59] Exactly, we have other things we are focusing on.

Tata [00:17:00] And. Yeah. And the same ,same week I had I, I'm sure you guys could probably relate, children can be fine, their parents sometimes it's the, it's the parents. And drawing the line of when and I think that's something that honestly I probably learned in the past few months because I've been seeing I, I, I need to talk to, to the front desk about my schedule. I don't know why I'm seeing so many teenagers, but I think that's another skill I picked up over the last few months was how to tell a parent: "I think it's best you sit in the front room."

Wright [00:17:34] Oh, yeah.

Tata [00:17:34] My, I mean, it got to the point I had, you know, and it wasn't just one parent. It was a few. Standing so close to my assistant that she can't even move her elbow. And I mean, there's a chair in the corner, but nope. And, you know, sometimes the kids do great. You know, the way our operatories are set up, we have a TV on the ceiling and TV in front of them. They put on whatever they put on and they're zoned out. But ,it, it is the parents sometimes. And I think again. These skills. I feel like, you know, maybe five years is the mark where you start learning little tricks and tips. And, you know, someone told me something that stuck with me. And I heard it the other day, too. And it's if it hasn't happened to you yet, you haven't been practicing long enough.

Wright [00:18:18] Haven't been doing it long enough.

Tata [00:18:19] Exactly, within reason. And that is something that I found myself saying. And I think it's such, such an important thing because once it happens to you, you like, realize maybe hindsight, you realize all the things you could have done better and then you start using them in the future. And I think again, that's something that just comes with time. And that's why I really pushed for this episode, because early on in my career there was so much that I'm like, Is it just me? No, it's everyone. We just don't like to talk about it.

Wright [00:18:48] Exactly. And that's, that's a big thing.

Announcer [00:18:51] On the next dental sound bites.

Hanlon [00:18:53] Recording live at SmileCon 2022 in Houston, we explore the value of organized dentistry, why membership matters, and how you can help shape the future of our profession.

Hanlon [00:19:09] Dr. Tata, I am so happy that you had such insight and vision for this episode, because I think we all agree that we could do version number two of this because of so many great, impactful hints that we can give to our audience.

Tata [00:19:26] Thank you. Yeah. Thank you for having me. You know, when you get enough dentists together and they start talking about all the crazy things that have happened, we can definitely provide a lot of wisdom.

Wright [00:19:35] Yeah. Dr. Tata, I'm super excited to have met you, and I think it's safe to say I made a friend tonight, so do not be surprised.

Tata [00:19:42] Definitely.

Wright [00:19:43] If we stay in contact. Tata [00:19:44] No, I would love that. Hanlon [00:19:46] That's awesome. So, if you like what you heard tonight, everyone, please subscribe to the podcast wherever you're listening, so you can get our latest episode. Tata [00:19:54] And we also want you to rate us. Write a review. Come back for more. Because this is just the tip of the iceberg. Announcer [00:20:03] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show's resources and more on the ADA member app and online at ADA.org/podcast.

Meet Dental Sound Bites

On the first episode of the “Dental Sound Bites” podcast, Drs. MaryJane “MJ” Hanlon and ArNelle Wright share their paths to dentistry and their intentions as hosts of the show. They interview Dr. Graham Naasz, a general practice dentist from Kansas City who helped the ADA create the concept of the podcast which offers “real talk,” advice and support for early career to the most seasoned doctors in the profession.

“Dentistry, kind of an isolating profession. A lot of times it's just you in the moment. So, (it's nice) being able to have someone to turn to … two friendly voices in your ear in your drive in, to talk you through some of the difficult stuff and really take the burden off of your own back.”
- Dr. Graham Naasz

Show Notes and Resources

Get to know the hosts of “Dental Sound Bites,” a podcast created for dentists by dentists that offers real talk on dentistry's daily wins and sticky situations.

• Hosts Drs. Hanlon and Wright share their paths to dentistry. Both took a few detours in their careers before entering dental school.
• Hanlon knew she wanted to be a dentist from age 14 but didn’t start dental school right away. She entered the profession first as a dental assistant and then went to dental hygiene school. Finally, she started dental school the same year her daughter started kindergarten and went on to own her own practice and become a dental school faculty member.
• Wright didn’t receive dental care during her childhood. But, her first trip to the dentist was a positive one, with a compassionate doctor who ultimately inspired her to look into the profession. As a first generation college student, she was unsure of how to gain admission to dental school and took a few different detours before graduating from the University of Florida College of Dentistry. She is now working for a dental support organization in Orlando, Florida.
• Hanlon and Wright welcome Dr. Graham Naasz to the show. Naasz is an early career dentist who practices in Kansas. He was part of the podcast co-creation team that helped the ADA develop the Dental Sound Bites.
• Naasz shares explains why he and other members of the co-creation team wanted to help the ADA launch a podcast. He says many dental students and early career dentists have questions about the profession that are not addressed in school.
• He hopes the podcast will address issues related to all aspects of the profession, from clinical or financial topics to how to maintain wellness.
• One mistake some early career dentists may make is “going too big too early” and living a lifestyle they cannot afford, Naasz says.
• Resources: Business Practice ADA.org/practice
• Resources: Financial Help ADA.org/money
• Wright explains that she is still driving a used car despite being out of school for five years because she knows waiting to make a big car purchase will help her reach her current goals.
• Because there is no “checklist” a dentist needs to complete before practicing, Hanlon says a lot of new dentists struggle to understand the rules and regulations that come with filing for a license in their own state. She hopes to address some of those issues on the podcast.
• As they prepare for the first season of the show, the hosts say their overall goal is to create episodes that serve as answers to questions some dentists may be too afraid to ask and to share their own stories and pearls of wisdom along the way.

Transcript

Dr. Hanlon [00:00:00] Hey, everyone, welcome to our very first episode. This is Dental Sound Bites.

Announcer [00:00:07] From the American Dental Association. This is Dental Sound Bites. Created for dentists by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Dr. Hanlon [00:00:22] Hi. I'm Dr. MJ Hanlon.

Dr. Wright [00:00:24] And I'm Dr. ArNelle Wright. And we're your hosts for this season of dental sound bites. Today we're going to be talking about how this podcast came to life, and we're going to give you guys a sneak peek into the season here in episode one. So, we have Dr. Graham Naasz joining us today as our very first guest on the Dental Sound Bites podcast. He was instrumental in helping bring this podcast to life with our ADA team members. But first, we are going to give you a little bit of introduction about ourselves and how we got into dentistry.

Dr. Hanlon [00:00:56] So, my journey into dentistry started when I was 14 years old. I knew my entire life almost that I wanted to be a dentist. It just took me a long time to get there. My path took me into dental assisting and then I went to hygiene school and spent 15 years being a hygienist and then went back to school to become a dentist. My first day of dental school was my daughter's first day of kindergarten, so it's kind of one of those things that I'll always remember. And the years flew by. One of the best benefits of being an older student and understanding the dental profession is that it made it a little bit easier for me in school. But I also had the ability to show my daughter what it was like to become a professional.

Dr. Wright [00:01:41] Absolutely. I actually did not know that I wanted to be a dentist until I was a junior in undergrad. I went to the University of Florida for my bachelor's, and then I ended up getting a master's degree as well, because at the time when I was applying to dental school, I didn't really have a clear understanding of all of the steps that I needed to take in order to get in. I am a first generation college student and I just did not have that guidance, so I kind of had to wing it on my own and figure things out as I went. But here I am. I ended up getting into dental school at the University of Florida College of Dentistry, so I am a triple gator. And from there, I started working at what's called a DSO or a dental support or dental service organization. And I am still in the DSO area, here in Orlando, Florida, and the rest is history.

Dr. Hanlon [00:02:35] That's awesome. Did you like it right away or was it something that you had to grow to like?

Dr. Wright [00:02:40] So what happened was once I ended up, like, shadowing and I found a dentist who really, like, took me under their wing. It's something that I really had a passion for because growing up I didn't have much dental care. So once I did, I found a dentist who was so compassionate and I really loved the impact that she made on me. She was so understanding of my situation, not having had much dental care growing up, and I just want it to be that same light in someone else's life.

Dr. Hanlon [00:03:10] That is awesome. I remember the first time I walked into an orthodontist office at 14 years old and I was immediately in love. I knew right then and there that this is what I'm going to do for the rest of my life. I don't think there's a day in my practice, in all the years that I have my private practice, that I said, I don't want to do this. I loved putting the key in the door every day, and I loved going in and determining what was going to happen. And even if I didn't know exactly what was going to happen, I loved problem solving. I think that was one of the things that dentistry has taught me the most is that there is no problem that we can't solve. I mean, we don't know what's coming in in our office every day, but we can solve the problem because we have been doing that for a long period of time.

Dr. Wright [00:03:56] Yep.

Announcer [00:03:58] Announcing the new... Wait. This calls for a drum roll. Perfect. Announcing the newly reimagined. ADA member app designed for dentists by dentists. It puts ADA membership in the palm of your hands with features like a personalized news feed, member chat groups, personal documents, storage, even episode exclusives from Dental Sound Bites, the new ADA podcast. Tap into all the possibilities by searching for the ADA member app in your App Store.

Dr. Wright [00:04:34] Today we have our very first guest, Dr. Graham Naasz, who practices in Kansas City. He was on the team who helped the ADA develop the Dental Sound Bites podcast and we are super excited to have him with us today. Welcome, Graham.

Dr. Naasz [00:04:49] Thank you very much. Very much appreciate being on here. It's definitely an honor to speak with two incredible women in the dental field.

Dr. Hanlon [00:04:56] Tell us a little bit about your career journey. We just mentioned a little bit about ours. We'd love to hear a little bit about you.

Dr. Naasz [00:05:02] Absolutely. So I am from Kansas, grew up in a suburb right outside of Kansas City, went to University of Kansas for my undergrad, then University of Missouri, Kansas City for School of Dentistry, and then headed down to Texas, where I did an AEGD residency at the VA in San Antonio. Moved back to Kansas City, and now I'm practicing in a suburb right outside on the Kansas side.

Dr. Hanlon [00:05:26] So how did you get roped into this project?

Dr. Naasz [00:05:28] So I got roped in, by, kind of answering, honestly, a kind of a call to arms. ADA was really looking for diverse backgrounds, as well as a lot of new career dentists input on ways that they could best help along that journey. So one of those ideas was a podcast in order to kind of talk about all topics dental, whether it be transitioning in from going from a dental student to residency life for a dental student to a new practice, or even helping out those new career dentists with kind of things that they really wish they would have had and really kind of starting off early. So, I saw that and my whole philosophy has always been, I can't complain about anything if I'm not actually doing anything actively to fix it or help out the situation. So, I jumped at the opportunity to be able to help out.

Dr. Wright [00:06:23] That is wonderful. Let's tell everybody, what's this podcast all about?

Meet Dental Sound Bites [00:06:28] So, we had a really strong team of people from all the way in, current dental students, all the way up to people that have been practicing for about seven years. So, we're really spanned the gamut and being able to pick everyone's brain about what they really wanted to see out of a good podcast, what topics to be created or we talked about, but also what issues we have today that they kind of wish they knew earlier. And that was my mindset going in and kind of what I wanted to lend to it is what I honestly would have liked to know earlier on in my career and even to this very day. Topics ranging from how to look at profit loss statements for the financial side of businesses, navigating different, either residency interviews or even reaching out and knowing how to ask for help from different specialists. Just really across the board being able to kind of ask that help and get that guidance. Because, like you very much, Dr. Wright, I didn't have any family that was in the dental field, so not much kind of like hand-holding or guidance through it. So, it would have been nice to have a place to turn to for some great topics on advice.

Dr. Wright [00:07:45] That's awesome. So, a lot of the dentists who were a part of the co-creation group, they basically wanted those pearls of wisdom, things that they didn't know earlier on.

Dr. Naasz [00:07:54] Exactly, whether it be clinical or financial, anything across the board or even just wellness. Dentistry, kind of an isolating profession. A lot of times it's just you in the moment. So, being able to have someone to turn to, whether it be two friendly voices in your ear and your drive in to talk you through some of the difficult stuff and really take the burden off of your own back that, Hey, it's not just you out there. There are some people out there that are willing to listen and learn some hands and get some great advice.

Dr. Hanlon [00:08:27] It's so true. And quite honestly, you know, everybody's practice is so different. You got to create your own way. I'm curious next about the name and how did it all come about?

Dr. Naasz [00:08:40] The name was a hot topic. I think we came across maybe 50 different things and luckily we had a good group of people that are pretty avid podcast listeners, so we definitely had some great puns out there. But I think Dental Sound Bites really does encapsulate what really the goal of it is. Provide very good, succinct information that is easily accessible for everybody.

Dr. Hanlon [00:09:05] Perfect.

Dr. Wright [00:09:05] I love it.

Dr. Hanlon [00:09:06] Yeah, I do too.

Dr. Wright [00:09:07] So can you tell us, Graham? What's the importance of us having these conversations?

Dr. Naasz [00:09:13] I think the importance really kind of comes down to if there's no resource out there or it's not talked about, then there's not much to be done to kind of help out the situation for anybody or there's not anywhere for someone to turn to to even kind of start the conversation or get information on it.

Dr. Wright [00:09:32] Absolutely.

Dr. Hanlon [00:09:33] You know, I think you're absolutely on point, Graham, Because one of the things that I have noticed even about myself personally is when I hear somebody talk and they give me an idea, I can't put it down. I have to get the research done. I have to look up ways to expand on it. And it's just because of somebody mentioning a concept or an idea that it just brings all this, this, this motivation forward to go and research what you need to know. I love the fact that you brought up the business side, because as a former educator, I know that firsthand that's one of the weaknesses in our dental school education, not that we can fit anything else in the format, but that we are not teaching dentists to be great businesspeople. And that's a shortfall for all of us, right?

Dr. Naasz [00:10:24] Absolutely. I mean, dental schools have great foundation and building blocks…

Dr. Hanlon [00:10:29] Absolutely.

Dr. Naasz [00:10:30] For dentistry. But there's so much that everyone's just trying to pack in there that it's just not enough time necessarily. So, unfortunately, that does kind of fall by the wayside where even if you enter into public health, but also any type of DSOs, having that kind of business understanding of a few things definitely prepares you a little bit better of how to read contracts and understand that a little bit more. So I completely agree with you, dr. Hanlon.

Dr. Hanlon [00:10:55] So what do you expect to get out of the podcast this season?

Dr. Naasz [00:10:58] Oh, that's a fantastic question. I would go back to what Mary Jane was talking about earlier as well, is the kind of the financial side of things and which touches on a little bit of contracts as well. Just understanding, not necessarily the financial side of a practice, but managing loans. If you have those, how better to budget, how not to make the new dentist mistake running out there and buying a new car.

Dr. Wright [00:11:24] Yes,.

Dr. Naasz [00:11:26] Getting in and over your head and living outside of the lifestyle that you can afford at the moment. Just kind of a bigger picture of the financial side of life. We've been in school for so long that a lot of those times and those big financial decisions were kind of delayed for a lot of us.

Dr. Wright [00:11:42] Yep. I tell some of my mentees this all the time about how even right now, like, I haven't bought like, the brand new car. I'm five years out and they are always surprised they drop their jaw. They're just like, Oh my gosh, Dr. Wright. And I'm like, Yeah, you have to wait. Sometimes you have to wait. And there's something called delayed gratification. And so I really believe in that. And I'm excited that we get to have this platform and use it to just educate and to teach and to share. Use our experiences and kind of just do some direct mentorship right here through podcasting.

Dr. Naasz [00:12:17] Absolutely. I mean, I'm sure you remember getting out of school and there's unfortunately not much of a roadmap. It's more, hey, congratulations. Here's your diploma. Here's your state board's license. Figure it out.

Dr. Hanlon [00:12:30] Well, that's a big thing right there, too, is there's no list of items that you have to complete before you start practicing. At least that I've never seen one. And I think it's important that young dentists understand all the things that they need to be aware of before they file for their license. In fact, I do a lot of remediations across the country. And I got to tell you, one of the biggest things that I see on a regular basis is docs just don't read the rules and regulations for their own state. They are daunting. I understand that. But this is your profession and it's important to understand and know those things.

Dr. Naasz [00:13:07] What are you two envisioning from this podcast? What are your hopes out of it?

Dr. Wright [00:13:12] I'm hoping that my voice would encourage more students as they take their journeys into the field. I'm hoping that I would give them confidence as they enter into dentistry and know that again, they're not alone. Mentorship is something that I'm super, super passionate about because I really feel that if I didn't have good mentors along the way throughout this journey and even now as a practicing dentist, like, I wouldn't be as successful in my opinion as I currently am. And one of the things about mentorship to me is you have to be willing to let someone know that you don't know. But then it also takes a level of awareness within yourself. And so it kind of requires you to continue those self assessing exercises that we learned in dental school that we hate so much, to give ourselves a grade on certain things because then we point out certain things to others, but there's so much value in it. So, for me, I really just hope that some of the topics that we cover here, they serve as answers to questions that someone may be too afraid to ask, but they're also getting their questions answered in some way, shape or form.

Dr. Hanlon [00:14:30] I think when I'd love to be able to offer the audience. Even though I'm much older than both of you, that my experience in being in the profession for such a long time can be helpful, you know, just understanding what it's like to be in the field and how to become successful in that field. I know I have a few tidbits I can pass on here in there.

Dr. Wright [00:14:55] MJ, you're probably going to help me all the way throughout this podcast anyway, so you're going to be mentoring me as we're helping everybody else.

Dr. Hanlon [00:15:04] It would be my pleasure.

Dr. Naasz [00:15:05] I'm excited to see what you all create here just because, as ever advancing as a field as dentistry is, where you close your eyes for 5 minutes and something new hits it. So, I'm excited to see what you all come up with here.

Dr. Wright [00:15:18] Dr. Naasz, it was such a pleasure having you on the podcast today. We are so grateful for all of the work that you have helped put into this project, and we thank you so much for your time. Thank you so much for being here with us today.

Dr. Hanlon [00:15:33] Dr. Naasz, it has been a pleasure to meet you and thank you for all the work that you're doing on behalf of the young dentists and the ADA.

Dr. Naasz [00:15:40] Thank you so much for having me on here and thank you two specifically for really taking up this helm and leading the charge to help out young professionals in the dental side of things. Because without the guidance and mentorship of people that have done it and are willing to also help carve the path of other people, we would be lost. So, thank you very much for all your effort.

Announcer [00:16:03] On the next dental sound bites.

Dr. Wright [00:16:05] Every business has their tales of difficult, confusing or downright weird situations that happened in the operatory. We're going to be sharing our stories of some of the stickiest situations and the solutions that got us through them.

Dr. Hanlon [00:16:20] So, everyone, if you liked what you heard today, please subscribe to the podcast wherever you are listening so you can get our latest episode.

Dr. Wright [00:16:27] You guys can also rate and write a review and follow us on social media. And don't forget, the conversation will continue in our member app, so please join us there.

Announcer [00:16:39] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show, resources and more on the ADA member app and online at ada.org/podcast.

An all-new podcast from the American Dental Association, Dental Sound Bites!

Real dentists, real issues. Real solutions for how you practice, and how you live.

Dental Sound Bites is a podcast created for dentists, by dentists.

Join our hosts, representing different paths in their careers, for real talk on dentistry’s daily wins and sticky situations.

Tune in to benefit from the wisdom of your peers and share some laughs along the way.

Come for the camaraderie, stay for the insightful discussions with leading experts from our industry, and beyond.

Dental Sound Bites, Subscribe to the show on Apple Podcasts, or wherever you listen to podcasts, so you’ll never miss an episode.