Dental Sound Bites™

Career Pathways in Dentistry, a two-part special

How did you decide which direction you wanted your dental career to take?
Solo owner, small group practice, DSO?
A medical setting or a Federally Qualified Health Center?
Faculty or Military?
So many practice options! Where do you start?
Join us in the first of a two part dental career exploration as we talk to dentists who chose different paths, and dig deeper into how those choices fit their career interests, lifestyles and goals. Our hosts will also be testing out the newest career pathways quiz from the ADA Member App and share their results during the podcast!

Special Guest: Dr. Tanya Sue Maestas

“I share my story, and I encourage [students] to consider a career in public health and how rewarding it can be if they're looking for a different option that isn't your typical private practice. And that's the beauty of dentistry is that you can take different paths and it can change along the way. And yeah, I encourage them just to kind of be open to what those changes might look like."

-Dr. Tanya Sue Maestas

Show Notes

• Dr. Tanya Sue Maestas graduated from The University of Texas School of Dentistry at Houston in 2018. Upon completion of her residency, she returned to the El Paso Borderland community where she serves as a Dental Director at an federally qualified health center (FQHC). She also serves as a faculty member at the Woody L Hunt School of Dental Medicine in El Paso, Texas.
• Growing up, she lived in an area where many people didn't have the opportunity to see a dentist. So, to her, becoming a dentist was to give back to the community that she lived in, or a similar community.
• She came across the National Health Service Course scholarship that paid for her schooling  in return for service in an underserved area.
• Dr. Effie, Dr. Maestas, and Dr. Wright take the Career Pathways Quiz, available on the ADA member App, and reveal their results later in the episode.
• Dr. Dan Hammer, an active duty oral maxillofacial surgeon in the US Navy, tells us about his career in hospital and military dentistry.
• Dr. Efie Ioannidou shares her career path into academia and research at the University of Connecticut Dental School.
• Dr. Ioannidou's research focus is on kidney disease and the periodontal status of patients, especially when they go on dialysis.
• Dr. Maestas talks about work-life balance in an FQHC environment, and highlights that while no two FQHC’s are the same, hers offers her the flexibility to be involved in academia, stay on top of continuing education, and take part in leadership roles in dentistry organizations.
• Dr. Rob Margolin, a general practice residency director for a hospital in New York City, tells us about a typical day in hospital dentistry, what he enjoys most about his career.
• All three doctors reveal their surprising results of the Career Path Quiz on the ADA member App.

Resources

• Take the Career Path Quiz on the ADA Member App 
• Listen to Dr. Tanya Sue Maesta’s podcast, New Dentist on the Block, and follow her on instagram 
• Discover career options available to you after school and access helpful tools to guide you through your career

Transcript

Ioannidou: [00:00:00] There are so many paths in dentistry. How do you know which is right for you? Hello, everyone. I'm Dr. Effie Ioannidou. 

Wright: [00:00:08] And I'm Dr. Arnell Wright. And this is Dental Sound Bites. Today it's all about the different career paths in dentistry. 

Announcer: [00:00:18] 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: [00:00:34] I have a question for our listeners. How did you decide which direction you wanted your dental career to take? And if you're still in dental school, where can you turn to get a comprehensive picture of your options? Oh, we've got something for you!

Ioannidou: [00:00:48] That's right, we do. There are so many options in this episode, and in the next one, we will explore some of the many possible dental career paths.

Today we are hearing from dentists in federally qualified health centers, in academia, hospital and military hospital settings. 

Wright: [00:01:06] I want to welcome our guest today, Dr. Tanya Sue Maestas. You have a remarkable story. As a dentist, you have been making an impact in the profession and winning the ADA 10 under 10 award last year.

Ioannidou: [00:01:20] Woohoo. 

Wright: [00:01:21] Yes. Please tell us about yourself and how you decided your career path. 

Maestas: [00:01:27] Well hello, hello everyone. Thank you all for having me. I'm super excited to be here and I'm excited to talk about this important topic and I think it's important for our listeners to know that no matter what stage of career that you might be in, if it changes in your future, it's never too late.

Wright:I love that. 

Maestas: So a little bit about myself. I was born and raised in El Paso, Texas. I went to school in Houston, graduated in 2018, did an AAGD in 2019, and made my way back to the borderline hometown community of El Paso. I now currently work at A FQHC. About 45 minutes outside of the city, and I'm also a part-time faculty member at the Woody L. Hunt School of Dental Medicine in El Paso.

Wright: [00:02:03] Nice. Well, welcome. Welcome. 

Ioannidou: [00:02:05] And you both make me feel so old. 

Maestas: [00:02:07] Oh, no, no. 

Ioannidou: [00:02:08] Like literally you were, you graduated in 2018. Oh dear God. But anyway, 

Wright: [00:02:15] you’re seasoned. 

Maestas: [00:02:16] That's right, that's right. 

Wright: [00:02:17] We have lots of wisdom to share with us. 

Maestas: [00:02:19] We're here to learn from you. Yes, absolutely. 

Ioannidou: [00:02:21] Absolutely true. Before we ask you more about FQHC, I would like.

To do something a little unusual, a little bit fun. Did you all know that there is a career pathway quiz on the ADA member app? Mm-hmm. It's free to the ADA members, and if you're a student ASDA member, you already have an a d a membership. So you just need to download the app. 

Wright: [00:02:43] There you go. 

Maestas: [00:02:44] Got to do it.

Let's do it. Yeah. So. 

Wright: [00:02:46] Dr. Effie, Dr. Maestas, and I just took the quiz. It's short and easy. We're going to be revealing our results a little later in the episode. 

Ioannidou: [00:02:54] Yeah. I'm so curious to hear your results. 

Wright: [00:02:57] Yeah, mine were pretty surprising, so I'm super excited to hear everybody 

Maestas: [00:03:01] suspense. 

Wright: [00:03:01] Yeah. Yes. Yeah, I know, right.

So, Dr. Maestas, let's talk a little bit about your career path. What helped you decide to work at an FQHC? How did you find out about this type of practice? 

Maestas: [00:03:14] Yeah. Thank you for your question. So I grew up in an area where many people didn't have the opportunity to see a dentist, lots of friends and family, and living in a borderline community.

Many of our, our friends did take the opportunity when I was growing up to go over into Mexico to get a lot of their treatment done. And so I knew that. Becoming a dentist for me was to give back to the community that I lived in or a similar community, like El Paso. And so before I started dental school, after I had been accepted, I was looking to see what scholarships were available.

My dad always said, you know, there's free money out there. You just gotta look for it. So I did start looking for it and I came across the National Health Service Course scholarship that paid for my schooling in, returned to some service in an underserved area. So I got my four years of schooling paid for.

I do still have some loans out because dentistry and living on your own is expensive. Sure. And in return, giving some time back at the FQHC. 

Wright: [00:04:05] Awesome. 

Maestas: [00:04:06] And this kind of just fit with my mission and with my why, and it kind of just fit right in. So I didn't really know that this career path was something that would be available to me. But through some Google searching, that's kind of how I came across it, and I really enjoy being in public health and serving a community that really doesn't have a whole lot of, of other places to turn to. 

Wright: Yeah. I love that so much.

Ioannidou: [00:04:27] Isn't amazing the fact that you had this, first of all, you were smart enough, to find the free money, and then the fact that you were able to go back to your community and the surroundings and give back. I mean, this is amazing. You know, many times we think that things happen, like, by accident. But I think in your mind, as you said, you had a mission. Yeah. So you went for this mission. This is great. I really like it.

Maestas: [00:04:52] That's right. Yeah. Very well said. And, and this is a great opportunity for those who are, are listening to, whether it's the scholarship or, loan repayment options. It's a great way to give back to your community and get some loans paid off along the way. 

Ioannidou: [00:05:04] Yeah. What's your typical day, we all know about FQHCs, but it's really interesting to understand more about your day. You know, what is the advantage and disadvantage of working in FQHC so tell us a little bit more about this. 

Maestas: [00:05:20] Sure. Yeah, great question and no, two FQHCs are alike, so 

Wright: [00:05:23] I love that 

Maestas: [00:05:24] every person who you might find in a public health setting, their day may be very different. but typically I work Mondays and Fridays seven to noon, and then Tuesday, Wednesday, Thursday, seven to 5: 30. And pretty much from when we start to when we end, we have patients kind of coming in and out. I would say predominantly we do a lot of extractions, a lot of removable. Those are two areas that I feel passionate about. So I'm pretty content doing those procedures. But we do a ton of extractions and we save where we can.

Wright: Right. 

Maestas: But I would say that predominantly we are a large removable clinic. Mm-hmm. Yeah. That's kind of my day in and day out. I see about two to three patients an hour depending on what that procedure might look like. But yeah, that's my day in and day out. 

Wright: [00:06:04] Wait, did you say that you work Monday and Friday, seven to 12? Like, let's make, I'm everyone jealous who's listening to this. Like that's what I just wrote down. Did, did I hear that correctly? 

Maestas: [00:06:15] I do seven, so I work every day, but yes, seven. Seven to noon is when I work. And then Monday afternoons I'm at the dental school. 

Wright: [00:06:22] I was gonna ask, okay. Oh, I love that. 

Maestas: [00:06:24] Yeah. That was a way for us to.

To balance the schedule. We really should have two dentists at the clinic that I'm at now, but since it's just me, they've asked me to be there every day, and it was a friendly compromise that we were able to meet, so I could be at the dental school on Monday afternoons. 

Wright: [00:06:36] Awesome. Okay. 

Maestas: [00:06:38] Yes. Yes.

Ioannidou: [00:06:39] So you go to the dental school.

As a part-time faculty, obviously only Monday afternoon. What about your Friday? Your Friday is free?

Maestas: [00:06:46] Yeah, my Friday's free. That's, that's, that's party time. 

Wright: [00:06:48] Well balance. Well balance and wellness. And taking care of yourself. Like Yes. Talk about it all. 

Maestas: [00:06:53] Oh, I'm looking to work less. Sign me up. 

Ioannidou: [00:06:56] Yeah. Well played. Well played. Right. So as a faculty, how do you feel going back to dental school, because this is also giving back to education, right? So you, you are a part-time faculty in the dental school. How well connected you are with the setting, with the students, with the other faculty? How do you collaborate, and how did you think of going back to education?

Wright: [00:07:15] Yeah. Being what, five years out, right? 2018? 

Maestas: [00:07:18] Yes. So for me, Long-term wise, I'd like to be in education. Being involved in, as is a student really connected me with my fellow peers. And, students from across the nation. And I, I just found a passion in working with students, during my time in dental school and growing up, I was always told that El Paso would never see a dental school.

And during my time in ASDA, I connected with a dentist who was the trustee in the ADA, who was from El Paso, his name is Dr. Rick Black, and we connected actually at a meeting in Chicago, it was a joint ADA- ASDA meeting, and he told me, Hey, dental school is coming to El Paso. Would you like to be a part of it?

And I said, a hundred percent yes. And so I knew, you know, since even before graduating dental school and while the dental school here was just a, a vision at the time that I wanted to come back and be a part of the dental school and help our community and help those students who are at the dental school now.

And so, thankfully they have been very welcoming to me to bring me on as a part-time faculty, and they've allowed me to kind of grow in my skill and share the knowledge that I have with the students that are there. And it's great, you know, I'm there. I help in the pre-clinic if they're there in the clinic, if they are, and if they're in classes, I sit in there and, and try and grasp some more knowledge that maybe I miss out on in dental school.

Wright: [00:08:28] Mm-hmm. Wow, that's so good. So a couple of curve balls here. In your role as a part-time faculty, I feel like you're also a great mentor. Like you almost have to mentor some of these students  you probably saw on your way out or, you know, you're giving them some hope as well about returning back to the school.

Do you get a lot of questions and do you get the opportunity to share your story about how you went into academia, even though it's part-time right now? Do you get to share a little bit of that story with some of your students? 

Maestas: [00:08:58] I do, and, and hopefully I do serve as a good mentor to these students. They really are like a sponge. They wanna learn as much as they can. But yeah, I share my story and I, I encourage them to consider a career in public health and how rewarding it can be if they're looking for a different option that isn't your typical private practice. This. So I encourage them to consider doing something outside of the box and I share it with them, my story and kind of how I foresee what my future will look like in dentistry.

And that's the beauty of dentistry is that you can take different paths and it can change along the way. And yeah, I encourage them just to kind of be open to what those changes might look like.

Wright: [00:09:30] Which is what we're talking about today. And so for everybody who's listening, don't be afraid to share your story because you never know where it will land you.

Maestas: [00:09:37] Yes, absolutely. Absolutely. 

Ioannidou: [00:09:40] So after discussing and learning so much about FQHCs, it's interesting to go to another career choice. We have with us Dr. Dan Hammer, who practices dentistry in the military, and here is why he loves his career choice. 

Hammer: [00:09:54] My name is Dan Hammer. I'm an active duty oral maxillofacial surgeon in the US Navy, and I am outside Scripps Mercy here in San Diego, California.

And I just want to kind of share about dentistry in a hospital and, of course, as oral maxillofacial surgeons, we spend a lot of time with facial trauma and infections, but dentistry is needed in all hospitals. You could be helping out a cancer patient before they start radiation or chemotherapy, or helping a patient with emron or osteo radio necrosis and doing rehabilitation in these really, really difficult patients.

But it's so, so rewarding. I was lucky enough to do a GPR for those of you who are new grads, definitely something that. Will help you expand your skillset and make you feel comfortable with some of these more challenging cases. It definitely makes me a better dentist by integrating in the overall healthcare network of San Diego and, uh, leveraging my talents and learning from the amazing, talented people in the healthcare communities. 

Ioannidou: [00:10:52] See, this is so interesting because he brings up so many different aspects of the industry. Not only the fact that he's in the military 

Wright: [00:11:00] Right. Hospital setting. 

Ioannidou: [00:11:02] Correct. Hospital setting. Yeah. Putting the dentistry  in the center of the overall medical care. So I think it's really interesting and I think it's nice when you have the opportunity to work in the hospital and get also this dimension. So that's really a, a, a great career choice. 

Wright: [00:11:18] Yeah, and I was just gonna say, even from that one clip, I feel like our listeners can just garner and just see the many paths that they can take, and hopefully they can also find themselves throughout this conversation that we're having with Dr. Maestas today. 

Maestas: [00:11:31] Absolutely, and as you all are rockstar, Dr. Hammer's story is really, really awesome. Somebody to definitely look into. I, I think you all will be very impressed at all of his accolades. 

Ioannidou: [00:11:41] And a lot of people now after graduation try to do first an ADD or a GPI, right? I mean, this gives you a little bit of a different career skill, even for people that then decide to go to specialty.

But I think it's really important. I see that a lot of our students, at U Conn after graduation, before they make a choice of the specialty that they want to choose or to follow, they, they prefer to go through the experience of, you know, a little bit more adventures general dentistry. 

Wright: [00:12:10] Oh, yeah. Get a little bit more exposure to what your hands are gonna be doing.

Like kind of make that hands connection with, with what you're, what's already in your mind, right? Yeah. 

Announcer: [00:12:21] [AD] Group practice, FQHC, Faculty, which suits you? Find out in a new career path quiz on the ADA member app. Now through June 12th, 2023, quiz takers automatically enter to win great prizes. It's a win-win. See contest rules and download the app at ada.org/app. 

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Maestas: [00:13:20] Dr. Wright, did you do an AEGD or GPR? 

Wright: [00:13:22] No. And it's funny that you bring that up cuz I was gonna interject and say I kind of wish that I had done something like that, but life happened. I was actually pregnant in my senior year of dental school. I don't even know how I got through it, but… 

Ioannidou: [00:13:37] oh my God. 

Wright: [00:13:38] I know. Yeah, we and, and, and we weren't planning. Oh, that's stuff I know. And. So I was pregnant with my son, and so I kind of had to just pivot real quick and make sure that I had a job because I'm like, all right, I really have mouths to eat yeah, other than my own.

But I was able to learn, I did a whole bunch of continuing education and I still do to this day, just so that I can stay fresh and with the times. But yeah, that's one thing if I could have, that's one thing that I would've done. 

Ioannidou: [00:14:04] It's never too late. You know that. Right? 

Wright: [00:14:06] You know, I, I, I, you know, it isn't too late, but I think about it. I'm just like, okay, so what would I be doing? Would I be wasting my time? So now I'm really conscious of how I manage my time and how I use my time. Or I should say invest it. So I think about it all the time, and I, if I would be that one person that's kind of disrupting the flow of learning for other people who are fresh and who haven't been in the practice setting, you know what I mean? So I'm like six years out. I've thought about it though, but.  Not right now. 

Ioannidou: [00:14:33] Yeah. Maybe you can think about a specialty. 

Wright: [00:14:36] You know, I, I have thought about a specialty to be honest. Uh, yeah. Yeah, yeah. 

Maestas: [00:14:43] I love that. I love that. 

Wright: [00:14:45] So, well, we touched on academia already. Let's talk about that career path. Dr. Effie, why did you choose academia? What's a typical day like for you? 

Ioannidou: [00:14:54] It's so complicated. It's exactly what we said that sometimes life happens. So they, you know, I was in private practice. I spent a few years out there, not in the US back in Greece. Yeah. Things happen in personal level. We were relocated here and it was, a very nice coincidence to be recruited, the UConn Dental School.

And I started from a fully clinical appointment. Full-time. Most of my time was devoted to the clinics. Okay. And as time went by, shifted a little bit at more towards research. So there is no typical day for, for academics, right. Always there is, there is always something unpredictable. The same thing that happens in practice.

Right. Okay. There is no typical days. There is always something that will shake up a little bit. The spice of your day. Yep. So now I lead the Department of Periodontology at the University of Connecticut. So there are a lot of things with faculty, with students, it's a complete fluidity during the day. So it can be from, you know, there are days that are super calm and you can really sit down in your desk and complete the paper that you are writing.

And, there are days that you start a sentence and you will never finish this sentence for, you know, in eight hours. There are so many meetings, so many things happening and you know, we have our podcast, we have our service to the ADA, organized dentistry. Right? I volunteer my time to other organizations like the American Association for Dental Oral and Craniofacial Research. Yeah, the AADOCR.  So there are so many things during the day. Right. So, yeah, that's, that's why I like, I like academia because it's very unpredictable and keeps me young. Woo. 

Maestas: [00:16:32]: You blend right in with the students, Dr. Effie. 

Ioannidou: [00:16:34] Yes, that's right. 

Wright: [00:16:35] There you go. There's a statement that I, I think both of you can attack in this moment, and I kind of think it should be done away with, and this is another curve ball.

You guys know I'm good for that. But it says, those who can do and those who can't, they teach. So I wanna know what you guys' reaction is to that and I I, I'm, I'm gonna start actually, because one of the things, so I love academia, I love teaching. I was actually a science teacher, before I went into dentistry. Right?

And when I heard that statement almost makes me feel like, oh, I wanna be ashamed of the fact that I like to educate, because then with this statement out there, people will think that I can't perform clinically, so I want to know you guys' thoughts about that statement. 

Ioannidou: [00:17:21] I, I have an alternative statement. The one that says, you see one, you do one, you teach one. 

Wright: [00:17:26] There you go. Wow. Okay. I think that wraps it up really, really well. Oh, there you go.

Maestas: [00:17:32] I, I think so. Yeah. Really, really good. I don't think you can beat that with a, that's a great rebuttal song. Yeah. I'm, I'm just gonna say ditto. 

Wright: [00:17:39] Yeah, I'm gonna use that actually.

So, well, tell us what is it that you enjoy the most? and if you could change anything, what would you change about a typical day? And Dr. Maestas, you, you can answer this too. 

Ioannidou: [00:17:50] The thing that I find, very rewarding, in academia, is that I feel that I'm a part of a very large community that kind of, Is synced all the time.

So what, what do I mean when I say this? I have so many friends and collaborators in so many different schools, like you know, in Texas, in California, in Kentucky, in Florida. Right? And it's so nice to share experiences, learn from each other, collaborate. You don't feel that you are restricted in very narrow local institution.

You feel like you are kind of a citizen of the world of academics, right? So, This freedom and this open communication is something that excites me and that's one of the most exciting things I think in academia that I didn't have in private practice. I didn't have, other people might, but I felt like I was, you know, in my own really solo, small practice in my own world.

Wright: [00:18:45] Yeah, yeah. 

Ioannidou: [00:18:46] I don't have this feeling in academics. 

Wright: [00:18:48] Mm-hmm. 

Maestas: [00:18:49] Yeah, that's very well said, Dr. Effie. you know, I, I love the questions that the students bring in, in the realm of academics. I think that being at an FQHC, is rewarding and challenging in a lot of ways. You know, it's rewarding because you're providing a service to those who may not have anywhere else to turn, and you, you get to build a bond with, patients in the community that you're in. but it can be very, very busy. And unfortunately, since I am the only dentist out there, the wait times, I mean, they're long right now. I mean, we're booked out to the end of the year. Really booked out. It's really, really saturated.

So it's, yeah, we're, we're overworked for sure. So I, I would say that if I could change anything, I wish that we had more help in the community to provide the care that's needed. 

Ioannidou: [00:19:28] Yeah, that's interesting. You are both younger than me and when I started my career, we discussed this with Arnell before, things were very difficult or more difficult for women in the workforce.

You are in a different generation. How do you see, is there any flexibility for you, Tanya, in the setting of the FQHC say that you, you know, you wanna start a family or say that you want to develop as a dentist. How do you see this so our audience understands a little bit more about the work-life balance?

Maestas: [00:20:03] Right. So like, like I mentioned earlier, no two FQHCs are the same. Yes. But for me, I, I would say that when I do get to that point where I'm, I'm ready to start a family. I think that they would give me that flexibility to do so. They're very open to me taking CE courses. I think that they have been very generous to me to go ahead and, you know, go out and with the commitments that I have and the leadership roles that I'm very passionate about, they're very generous in allowing me to do that.

And take some days away from the clinic to go ahead and go out and, and travel and be a leader. so I, I have felt that flexibility there. Uh, would we like more flexibility? Of course. But I, I, I think that maybe that'll come with time. 

Ioannidou: [00:20:39] Yeah. And it's really nice because they have the understanding, which is great, the understanding that if they allow you to do this to be a leader, this basically reflects back on them.

Right. Because they can be proud of you. 

Wright: [00:20:52] You took the words out of my mouth. I was literally gonna say I. Feel like there is just this understanding that we're starting to see in the world, and especially with like the rise of social media and businesses starting to utilize social media and I, I  feel like at leverage it to their advantage, it only helps them when you become better because you're pretty much a representative of them when you're not in the practice.

And so I think you add value to them, by being even better. You know what I mean? And so I just. Feel like companies are starting to realize that, or maybe they are always have, but maybe employees, like in our case, we're starting to talk about it a little bit more and it's a growing kind of thing. Right? 

Maestas: [00:21:36] Yeah. Dr. Wright, that's a great point and one thing that I struggle with, even when I'm away from the clinic, although they, you know, they give me that time, is that guilt. I still feel guilty at not being at work. It's just really hard to manage that sometimes and to leave work at work and not have that in the back of your mind.

So that can still be difficult. Hopefully they think that way and I haven't heard any complaints. Yet, but it's definitely something that kind of we'll find out after this podcast. They'll be reaching out.

Wright: [00:22:05] Yeah, I know, right? Well, hospital dentistry is an exciting career as well. Here's Dr. Rob Margolin telling us a little bit about what his days are like. 

Margolin: [00:22:14] Hi, my name is Rob Marlin. I'm currently a general practice residency director for a hospital in New York City. I didn't choose hospital dentistry so much as a great opportunity presented itself, and I chose to take it about 20 years ago.

I've never looked back and I've never been happier in my dental career. Some of the things I like about hospital dentistry, It gives me the ability to work with and treat an underserved and diverse patient population. I have a great sense of comradery working with other dental specialists and my medical colleagues.

We're gonna optimize our patients for dental care, and the part I liked best is the opportunity to work with young dental residents as they begin their dental journey. Typical day for me is usually lecture combination of seeing patients, varying degrees of medical and dental complexity with the dental residents, and also time for administrative duties.

Ioannidou: [00:23:00] I'm sure it's very exciting to bring the hospital setting in New York. 

Maestas: [00:23:04] Oh yeah. Wow. 

Wright: [00:23:05] I feel like from a hospital perspective, what I love just hearing these stories is it's like, you know how some people when they're like they're general physicians or whatever, they are like, okay, well you're just a dentist.

You know that whole thing that is like that statement, you're just a dentist. And I feel like in the hospital setting you may be regarded as more than just a dentist, that word in front of our careers. You know what I mean? Yeah. So it sounds really, really fun to get to do. And it sounds like he also gets to give back and teach and do some of the same things that both of you guys are doing.

Ioannidou: [00:23:39] You made a very good point. You're just a dentist until they have a dental problem, right? And then you become a doctor. 

Wright: [00:23:47] I think you're good about having some good rebuttals. Like you have some great rebuttals. 

Maestas: [00:23:53] Dr. Effie, we are going to take you on some debates. 

Wright: [00:23:57] I know really. you're quick on your feet. 

Ioannidou: [00:23:58] No, but isn't it true?

Isn't it true? That's true. Yeah. I, my research for quite some time was and still is on, kidney disease and, the periodontal status of patients, especially when they go on dialysis. So I remember when we first started this. Project maybe more than 10 years ago, the Nephrologists were so suspicious, like, eh, is this an issue here?

But the more we were educating them and the more they saw in their patient's eyes, the appreciation that the patients are getting now an exam on the dialysis chair, some of them were getting a cleaning during dialysis, so they were, ‘oh, that's. that's a good service’. These people know what they're doing.

Yeah. So, yeah, I completely get it. And I know that there is a moment that this culture will completely shift. 

Maestas: [00:24:46] I hope so. I, I would say that I've definitely heard that sentiment said several times. 

Ioannidou: [00:24:50] Yeah. 

Wright: [00:24:51] Are you all ready to reveal your results from the career path quiz? 

Ioannidou: [00:24:55] Yes, 

Maestas: [00:24:56] I am eager to hear Dr. Wright's results.

Ioannidou: [00:24:58] Me too. Me too. 

Maestas: [00:24:59] Because she said she was surprised. 

Wright: [00:25:01] I actually am not. In this practice setting, but I feel that as I continue to grow in dentistry, I will eventually be in this setting. And so, drum roll please. Ooh. My primary was to be in a small group setting. I'm a very collaborative thinker, and so that was actually the result that came about, and I was like, ah.

I can see how that, that definitely describes me as a provider. I love to like pick someone else's brain or I like to present a situation and share, even if it's a pitfall. Like I don't really have a lot of like embarrassment about if I don't know something, something. Off bat, especially if there's someone who's more seasoned than I, like, I know that there's only so much exposure that I'll have at certain stages of my career, and so to see that the quiz recommended or said that I would be in a small group setting, I was like, okay, yeah, that that would definitely be. Really, really like, that's accurate. It describes to me very well. 

Maestas: I like it.

So what about, what about y'all's? Let's see who's gonna go next. We are gonna say Dr. Effie. 

Ioannidou: [00:26:07] Mine was relatively surprising. The primary was hospital, dentist, and the, a little bit down the list was the dental faculty. Okay. So, yeah, I mean, Not very surprising, but, I guess some of the answers were capturing both I, I think education and hospital setting, which is the reality of the matter.

I mean, UConn Dental School is one of the few schools in a health center, so mm-hmm. Yeah. We are, we practice in a hospital setting and I am a dental faculty. So yeah..

Wright: [00:26:39] I love it. Oh my gosh. All right. Tanya Sue, you're up. 

Maestas: [00:26:43] Yeah, I, so I got dentist in federal settings and the additional recommendations were dental faculty and FQHC. Makes sense. Oh my God. Yeah. Hit it right on the head there. Right. No, no surprises there. I was hoping for a big twist, but yeah, 

Ioannidou: [00:26:55] so this is great. Yeah. This means that the test is validated by the three of us. There we go. Great. We validated the test 

Maestas: [00:27:02] Statistically, statistically. That's probably a good sign. 

Ioannidou: [00:27:05] Yeah. Yes. Yeah, yeah, yeah. Scientifically. Yeah. And so if our audience wants to take the test, we will add the link in the show notes so you can download the ADA member app.

Maestas: [00:27:16] Yeah, there's lots of great information in that app. Aside from the career test. 

Wright: [00:27:20] I agree with that too. 

Announcer: [00:27:22] On the next Dental Sound Bites, 

Wright: [00:27:24] our Career Pathways conversation continues. We are looking at how to navigate the dental practice market 

Ioannidou: [00:27:30] from buying your own practice to joining DSO. You will hear from dentists who have gone through it and learn more about the ins and outs of this career pathway in dentistry.

Wright: [00:27:40] That's on the next episode of Dental Sound Bites. 

Wright: Well, this has been such a phenomenal episode. I feel like we got to learn a lot about you, Dr. Maestas. So before you go, can you tell all of our listeners where to find you a little bit about some of the fun activities that you have going on? 

Maestas: [00:27:59] You know, such an honor to be here with you all and you can find me on the gram. Like most millennial dentists we're on Instagram, at TSMaestas.dds. I also started a podcast New Dentist on the Block. 

Wright:Woo-hoo. 

Maestas: So, if you are a new dentist and you'd like to be on the podcast, or if you have some information that you'd like to share with new dentists, please let me know. It's a great way to continue to build connections, which I, I believe that you all are doing as well with your podcast. So congratulations to you all as well. 

Ioannidou: [00:28:23] And is this something that you do Friday afternoon? 

Wright: [00:28:25] There we go. 

Maestas: [00:28:27] Actually, don't, you know, for wellness I actually don't book anything on Fridays. I try to do it during the week, and I try to do it during lunch when I can. 

Ioannidou: Well done. 

Wright: [00:28:35] Oh, that's amazing.

Ioannidou: [00:28:36]: Well done. 

Wright: [00:28:36] So thank you once again, Dr. Tanya Sue Maestas, for being here with us today. We are so excited that you were able to join us. 

Maestas: [00:28:43] Thank you for the opportunity. 

Ioannidou: [00:28:44] Thank you. Thank you. And if you like this episode, go ahead and share it with your friends and colleagues. Subscribe to this podcast wherever you are listening so you can get the latest episodes.

Wright: [00:28:55] And don't forget the conversation will continue on the ADA member app. Bonus content- what you didn't hear on the show. 

Announcer: [00:29:03] 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.

Wellness: Prioritizing Your Mental Health

May is Mental Health Awareness Month! We know that dentistry can be a demanding profession with long hours, high stress levels and the pressure to provide top-quality care to patients. But, taking care of your own needs is just as important as taking care of your patients. Join our expert guest, Dr. Diana Dill, licensed coach and consulting psychologist for the ADA Wellness Ambassadors program, to discuss stress management, self-care, and building a supportive community to help you maintain a healthy mind-body.

Special Guest: Dr. Diana Dill, licensed coach and consulting psychologist for ADA Wellness Ambassadors program.

“Seeking out positive experiences is what gives us that resilience. We want to have trusted confidants to turn to if we're feeling like we don't have our usual good spirits. And they can help us figure out what's going on and what we need to do. Of course, some people love being social and some people don't love being social. So I think it's important to figure out what makes you happy.”

-Dr. Diana Dill

Show Notes

• Dill is a psychologist who specializes in helping healthcare professionals manage their mental health.
• She defines mental health as "our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices."
• Mental health is just as important as physical health, according to Dill. “When we're not mentally healthy, it can impact our work performance, our relationships, and our overall quality of life."
• Healthcare professionals can be at a higher risk for mental health problems than the general population. This is due to the demands of their work, Dill says, such as long hours, high stress, and dealing with difficult patients.
• A recent ADA survey on well-being found that 12% of dentists might report being depressed or might report having a substance use issue. Anxiety, stress, and burnout are much more frequent in dentists. Dill says anxiety comes from “meeting the steady demand of being a technical person and an intellectual expert and combining all that to meet a patient's needs.”
• She encourages dentists to take care of their own mental health by setting boundaries, getting enough sleep, and exercising regularly. She also says taking mental health breaks throughout the day is essential. She says that we can work for 3 or 4 hours and be fully, fully top of our game, and then we need a half hour downtime. She also says that this is especially important as we age.
• You can help your peers who are struggling with a serious issue by listening and offering support. Dill walks through a demonstration with
• Ioannidou playing the part of a dentist going through a tough time. The role play scenario offers strategies you can use as a peer supporter to help coach someone to find a solution.
• To stay ahead of burnout, Dill says it is important to build resilience and the feeling that we have enough “oomph” to rebound when “hits” happen throughout the work day.
• She cites Barbara Fredrickson's research, which suggests that people need a ratio of three positive experiences to every one negative experience to thrive and be able to rebound.
• Dill says seeking out positive experiences is what gives us that resilience. Examples of positive experiences include: finding meaning in the work you do, feeling proud of what you were able to do at work, feeling proud of the friend that you are, or the wife or husband or parent that you are.

Resources

• Learn more about our guest, Dr. Diana Dill
• Read her articles on stress management and the heart of health care
• Assess your positive and negative experiences throughout the day with a self-assessment tool from researcher Barbara Fredrickson, Fredrickson B., The positivity ratio
• Explore Med Pep courses (choose from 20 topics)
• Browse the dentists well-being directory
• Read about the Health and Wellbeing Survey Report findings
• Learn more about the various stressors which may affect U.S. dentists today.
• More about  Hope for the Day
• American Foundation for Suicide Prevention

Transcript

Wright[00:00:00] How do you prioritize your mental health? Hello,Hello, everyone. I'm Dr. ArNelle Wright.

Ioannidou[00:00:05] And I'm Dr. Effie Ioannidou.

Wright [00:00:07] And this is Dental Sound Bites.

Announcer [00:00:13] From the American Dental Association this is Dental Sound Bites created for dentists by dentists. Ready? Let's dive right into real talk on dentist's daily wins and sticky situations.

Ioannidou [00:00:28] May's Mental Health Awareness Month. And today we have a special guest to talk about the mental health challenges dentists face. Please welcome Dr. Diana Dill.

Dill [00:00:38] Thank you, Effie. Thank you, ArNelle.

Wright [00:00:40] You are very, very welcome. Welcome here. We are so excited to have you, especially because of all of your experience with working with dentists. What can you tell us a little bit about yourself?

Dill [00:00:51] I'm a psychologist. I have a mission to support caregivers in medicine and dentistry. The people who are doing all the heavy lifting for all of us. And I work with clinical groups and one-on-one to help people develop the best workplace experiences they can have and to prevent and come back from burnout. So, over the last ten years, we know clinicians have recognized that they're not as sturdy as they are. They've recognized that they're not superheroes, and they have limits like everyone else. And so where I work is helping people understand their limits and helping them figure out workarounds so they can get back to being, performing their best and feeling their best at work.

Wright [00:01:37] That is so good. You said a mouthful, that I hope we get to unpack throughout this episode. Seriously. Since we started the podcast, we have heard some of our colleagues share challenging stories related to their mental health, both with interacting with patients and on their own interpersonally. And that's amazing because the more we talk about it, I really believe the better we will be. So if you can briefly tell us the importance of mental health, what is it and what are we really talking about here?

Dill [00:02:08] Well, when I think about mental health in the workplace, I think the key issue is are we above the line or below the line? Do we have enough resilience to bounce back from the daily stressors or are we really just, have we gotten to a point that we're overwhelmed? Burnout is when people are overwhelmed day after day and can't come back from it. High functioning, well-functioning is when we can do our best and regroup. If we have a negative interaction with a patient, if we have an argument with a coworker, if our child calls us upset, we can regroup and we can problem solve. These are events that happen in everybody's life. When we can no longer regroup and problem solve when we're in deficit mode, we're heading towards burnout. And that's a problem for a lot of reasons, and it shows up in different ways and different people.

Wright [00:03:06] So you mentioned regrouping and being above or below the line. So, would high functioning be above the line?

Dill [00:03:14] Yes. Okay.

Wright [00:03:15] Awesome. Awesome.

Dill [00:03:16] Yes. Thank you for clarifying. Yes, yes, yes. It's like you're in the black. You've got enough to draw on. And in fact, ideally, you feel good most of the time.

Ioannidou [00:03:26] Yeah.

Wright [00:03:27] When I think of high functioning, immediately when I hear the phrase, I instantly feel that it's a negative thing. Could you expound upon...

Dill [00:03:37] What does it look like?

Wright [00:03:38] Yeah, what does it look like? And I know it manifests differently in others, in everybody.

Dill [00:03:42] Yeah. Yeah.

Wright [00:03:43] But is this a good thing? Is it a bad thing or?

Dill [00:03:46] Great question.

Wright [00:03:46] Yeah, we jumped all in already. We are here right.

Dill [00:03:50] When we're well, we have a lot of energy, both physical energy and emotional energy. We feel connected to people. We can use really good relationship building with new people. We can be comfortable and secure with the people we know well, and we're doing our best work. Those are signs of feeling well. Okay.

Wright [00:04:12] Okay.

Dill [00:04:12] Anything that interrupts that and interferes with it, then we start thinking, What's going wrong? Like you probably both have great days. You can describe times when you really felt like you were in a groove. What were they like for you?

Wright [00:04:27] When you said not having the, I guess, the ability to regroup? That struck a chord with me, actually. So I'm sitting here, I'm listening intently because I'm like, “Hmm, when were those opportunities or those, there was times in the office when I felt depleted.” I don't know if that's the right term?

Dill [00:04:46] Depleted, that is a great word, ArNelle, like emptied out. Like you don't have the fuel you need to do what you want to do.

Wright [00:04:56] But where do we draw from?

Dill [00:04:57] Ordinarily when we're feeling good? Yeah. It's our natural state to feel good. Yeah. I think the things that we can be aware of to keep ourselves feeling good are to make sure we have enough positive experiences in our life. In fact, I put a website in the resources for the listeners so that they can look at. Barbara Fredrickson did some really beautiful work on how to go and seek out positive emotions for yourself and just how important they are. So if we have enough positive experiences in our daily life, we just naturally feel good. I love that. Unless something's going wrong. That's human baseline.

Wright [00:05:38] Right.

Ioannidou [00:05:38] In previous discussions that we had on the podcast, we brought up the different personality traits, which I'm sure apply here too, as well as you know, I will, I will go to this and they will say aging, right? So when I reflect on myself and I think about me, you know, 15 years ago or 20 years ago, right, I could go 24/7, communicate with people, speak the whole day, you know, respond, write emails, do this, do that, come home and still be equally available. Right.

Dill [00:06:14] Right.

Ioannidou [00:06:14] As time goes by, based on my personal experiences, and my own reserves, they seem to be consumed. And sometimes you feel that, you know, this 24/7 is not possible. And I know that my personality hasn't seen some equally extrovert as I used to be when I was 20. But you need some moments of silence.

Dill [00:06:36] Yup. You're raising such an important issue, Effie, I'm so glad you did. And in fact, when I was talking about clinicians realizing they're not superheroes, they're realizing they cannot meet not never ending demand. They just can't do it. They don't have a minute to catch their breath anymore in our current workplace. So what I would like to see is workplaces adapting to make sure clinicians do have the breaks they need. And also I think we have to realize, again, we're not superhuman. We can work 3 or 4 hours and be fully, fully top of our game, and then we need a half hour downtime and more and more so as we age. It's definitely true that aging affects this, but I think somebody like ArNelle probably relates to that too. Like if you don't get half an hour off every 3 or 4 hours, you feel it. You start getting fried. Maybe you're able to do things okay there you can do automatically. But any of the outside of the box thinking or the dealing with a complicated relationship that gets harder to do if we're going all day long. 8 to 6, 8 to 7. No break, no lunch. Yeah, we need the calories.

Ioannidou [00:07:55] Yeah. With your experience in the dental community what do you see as the most common mental health problems in practicing dentists?

Dill [00:08:03] Probably anxiety, stress and burnout, some depression and some substance abuse. But I think the ADA just did a nice survey of well-being, and that was like 12% of dentists might report being depressed or might report having a substance use issue. Anxiety, stress, burnout, or much more frequent. And the anxiety comes from meeting the steady demand of being a technical person and an intellectual expert and combining all that to meet a patient's needs.

Ioannidou [00:08:43] Yeah.

Wright [00:08:43] Man, there are so many things like that I'm just thinking about right now of how just like my day-to-day can be affected. And to your point about the Wellbeing survey, some of our dentists have even told us that they feel a stigma associated with asking for help.

Dill [00:09:00] Right? Isn't that such a shame?

Wright [00:09:02] Yeah.

Dill [00:09:03] It's true of American society in general that we're not supposed to admit shortcomings or vulnerabilities. It's our culture, and I think we're up against that. But then plus, anybody who works as an expert with people and their bodies, they're worried that their patients may freak out if they show vulnerabilities. There is added pressure on them to be perfect and probably in their training they learn to accept the pressure to be perfect, to present a certain professional face to their patients. So of course we don't want to lose it in front of our patients ever. However, I don't think this message has to extend to our whole lives. Right?

Wright [00:09:49] Right.

Dill [00:09:49] Can't we confide in our colleagues?” Wow, I'm having a rough day.” Can't we go home and tell people "I need a day off?" Can we not, like, find somebody to confide in, to say "I'm just worried all the time and I can't seem to put the worry aside and refocus and be present in my life?".

Ioannidou [00:10:12] Yeah. You brought up so many very interesting issues, and I'm thinking even to the level that we express vulnerability, I think our community evolved a bit.

Wright [00:10:24] Definitely.

Ioannidou [00:10:24] Perhaps 20 years ago, I always count with 20, 20 is my reference point.

Wright [00:10:29] Your favorite number.

Ioannidou [00:10:30] Yeah. Yeah. You know, 15 years ago, it was not socially acceptable in the scientific community to even bring up the work-life balance. It's this is a pretty recent setup.

Dill [00:10:41] We're accepting now that we're not superhuman.

Ioannidou [00:10:44] Absolutely. And not only this, but, you know, I'm bringing another aspect to this. As women come to the workforce in a lot higher numbers, especially in dentistry you know, being a mother or being a caring, elderly, caring person. Right. Is not anymore held against you. Right? It used to.

Wright [00:11:04] Absolutely.

Ioannidou [00:11:05] I have memories of this. It's not like a different generation. It's, I'm talking about me. When I, when I had my daughter in the back in 2004.

Dill [00:11:14] Right.

Ioannidou [00:11:14] I had to manage this in a way that God forbid anybody knows that they have to go home or I have to pick up from daycare. Like it was another undercover kind of life.

Dill [00:11:26] Oh, my gosh. You needed to still present the image that you were all there for your professional self and your patients?

Ioannidou [00:11:34] Absolutely.

Announcer [00:11:38] Is your practice short staffed? Find the right fit with Stynt. From dental assistants to hygienists to office managers, Stynt can help find vetted candidates for short or long term positions. ADA members save $50 on their first hire. Learn more at Stynt.com/ADA. Group practice. FQHC. Faculty. What suits you? Find out in a new Career Path quiz on the ADA member app now through June 12th, 2023 quiz takers automatically enter to win great prizes. It's a win win. See contest rules and download the app at ADA.org/App.

Wright [00:12:20] So people often ask, what can we do to support our peers if they're struggling with a serious issue? Dr.

Dill wants to walk us through a demonstration of what we can say and what we can do to support a colleague. So Dr. Effie is going to be playing the part of a dentist going through a tough time.

Ioannidou [00:12:36] Let's do it.

Dill [00:12:38] So, Effie, I noticed that lately you don't quite seem yourself. What's going on? You're a little low down, it seems to me. What's going on for you?

Ioannidou [00:12:48] There are so many things in my mind, and I kind of feel a little bit overwhelmed at work. I feel like 24 hours are not enough to finish what I start in the morning. So just like by 10 a.m., I'm already ready to go and take a nap.

Dill [00:13:04] Wow. So you're feeling pretty overwhelmed at work, and by mid-morning, you've run out of steam.

Ioannidou [00:13:11] Yeah.

Dill [00:13:11] Wow.

Ioannidou [00:13:12] This happens frequently, I think. I tried to get some coffee, get hydrated, and I tried to do all the right things, but still, the mind is really tired.

Dill [00:13:24] Hmm. So that must be upsetting for you to see that.

Ioannidou [00:13:27] It is. I try to regroup in the weekend, but maybe two days, Saturday, Sunday are not enough to regain energy. So I feel like Monday we start and again the same cycle of hard work with no end.

Dill [00:13:44] Hard work with no end.

Ioannidou [00:13:46] I mean, don't get me wrong, I love my patients, but, you know, without, you know, having, having this level of commitment and the hard work during the day, this really, really exhaust me.

Dill [00:13:59] Mm hmm. You're noticing that you don't have the energy you're used to having. And yeah, I've seen you seeming a little less of the usual bounce that I think of you as having.

Ioannidou [00:14:11] Yeah.

Dill [00:14:12] How long has this been going on, would you say?

Ioannidou [00:14:14] I would say a few months.

Dill [00:14:16] And what do you think is causing this downturn in your energy, Effie?

Ioannidou [00:14:21] Oh, I think I overextend that. And I double booked patients, took some more responsibilities outside the practice. And, you know, maybe I should have learned earlier to say no.

Dill [00:14:35] So you're thinking that maybe you're tired and tired enough to feel like you can't go on a 10 a.m. at work?

Ioannidou [00:14:44] Yeah.

Dill [00:14:44] You're feeling tired because you're trying to do more than you can actually do.

Ioannidou [00:14:49] That's right.

Dill [00:14:50] So that's a tough situation to find yourself in. When you hear yourself say that, Effie, what do you think would make sense as a way of getting your energy back?

Ioannidou [00:15:00] I probably need a long vacation.

Dill [00:15:02] A long vacation.

Ioannidou [00:15:03] Maybe, you know, some peace and quiet. People not asking questions, no phone calls.

Dill [00:15:09] Some peace and quiet.

Ioannidou [00:15:11] And I need a break.

Dill [00:15:13] And after you had a break and got restored, what do you think you would do about the schedule you've taken on, given that it sounds like it's really too much?

Ioannidou [00:15:22] Yeah, I think what you're guiding me towards is something really obvious. I would need to structure my schedule in a way that it's more humane. I think, I, I really load my schedule with too many things and too many patients and then too many responsibilities after 5. So I would definitely need to kind of find a balance, which sometimes is difficult to do so. But I know I have to work on this, but I keep postponing and postponing and postponing.

Dill [00:15:52] So you're really pretty aware that your schedule is over packed?

Ioannidou [00:15:57] Yes.

Dill [00:15:57] But it's hard to make a change.

Ioannidou [00:15:59] That's right.

Dill [00:16:00] And do you think you'd consider with me right now what change it might make?

Ioannidou [00:16:06] I guess I would try to keep my appointments and allow some space between patients to regroup a little bit and be able to breathe and.

Dill [00:16:17] Okay.

Ioannidou [00:16:17] Have the time to go to the bathroom, which sometimes I don't.

Dill [00:16:20] So you'd set up your patient schedule during your work day so that it's not quite as jammed?

Ioannidou [00:16:27] Mm hmm.

Dill [00:16:28] So tell me what that might look like. How much time would you take as a break and how often?

Ioannidou [00:16:35] Ideally, I would like to take five, 10 minutes between patients, which right now I don't have. I go from room to room and, you know, maybe have a decent lunch break for a change and be able to sit down and have a salad and to speak with my staff or my colleagues in a slow pace without rushing and be able to breathe a little bit.

Dill [00:17:01] That sounds pretty tempting, doesn't it?

Ioannidou [00:17:02] Very tempting.

Dill [00:17:05] And so given, Effie, that you're saying, you know, you're feeling the effects of overworking and given that you have a picture in mind of how to set things up differently what do you think you can do to make that happen for yourself?

Ioannidou [00:17:20] I definitely need to restructure the office and train the front desk to respect those requests and make sure that we schedule to set up some ground rules and schedule the patients in a way that we just fantasized about.

Dill [00:17:38] That we're just fantasized.

Ioannidou [00:17:40] To deal with. Yeah, yeah, completely. Like the ideal way that the way that space is out the appointments and allows for me time to decompress at lunch. Right now my front desk things that I can really get going all the time like from 9 to 5. But clearly this is not the case. I think I'm losing my limit.

Dill [00:18:01] And they are probably looking for a direction from you, aren't they?

Ioannidou [00:18:05] That's right.

Dill [00:18:05] So I am wondering if I might challenge you to tell me when you might make this change.

Ioannidou [00:18:13] It's hard to make change because you have committed appointments, so I have to just do this gradually, I guess, and maybe even next week, sit down the staff, and just let them know what the decision is and how we can proceed for new patients and new appointments. Obviously, we it's very difficult to go back to the schedule as it is and restructure it.

Dill [00:18:35] Okay

Ioannidou [00:18:36] Starting from now, anybody new, perhaps we we can consider spacing out the appointments in a friendlier way to me and the staff, of course.

Dill [00:18:46] What a good idea.

Ioannidou [00:18:47] You made me come to the idea of seeing miracles.

Dill [00:18:51] And if you're feeling that exhausted, Effie, it may even make sense to postpone some patient appointments because you have needs too.

Ioannidou [00:19:02] Many times we feel that we disappoint people if we do this. But, you know, I guess you're right. Yeah.

Dill [00:19:07] And you're learning that you have a limit to how far you can push yourself. And, you know, if you want to be there for your patients, you may need to back off and reset the schedule sooner rather than later.

Ioannidou [00:19:19] Yeah, that's a great idea.

Dill [00:19:21] Okay. So may I check in with you about this in a few weeks and see how it's going?

Ioannidou [00:19:27] Yeah. Let's do this. Will be great.

Dill [00:19:29] Okay. Okay. All right, guys. That is how a coaching intervention for what turns out to be burnout, straightforward burnout. Effie is exhausted from overworking and it's finally caught up with her and she's trying to make sense of what's going on for her and find a solution, this is how a peer supporter could help coach someone to find that solution.

Ioannidou [00:19:55] Now, side note, this is the funny thing that they don't see patients anymore. I haven't seen patients for the last ten years. The whole scenario is like complete fantasy, but it works so well. and naturally, right.

Dill [00:20:06]  Yeah, you did.

Wright [00:20:07] You did a great job for sure.

Wright [00:20:10] It was very, very relatable. And as you were both going through the role play, one of the things that came up in my mind were those doctors out there who work for a corporate, kind of like me. Oh, you know, with, like restructuring their schedules, training the front desk. And it is not that you don't have that autonomy, but some of that operationally may be out of your control. So if you can I know this is, you know, a little on the spot, but what are your thoughts about maybe some suggestions on how we can go about talking to our staff and, yeah, kind of just curtailing some of those appointments.

Dill [00:20:47] You know, we're learning more and more all the time about what are reasonable workplace conditions, what are the best conditions for people to see patients, make their patients happy, do good work and enjoy the work so they want to stay?

Wright [00:21:05] It's a good phrase, right?

Dill [00:21:06] I think organized medicine and dentistry, you're finding that they're most compelled by wanting to retain their good people and if they exhaust them, they're not going to be able to keep them. Okay, So there is where the lever is for dentists. We need to have a good workplace or we're not going to be able to keep this up.

Wright [00:21:26] Okay.

Dill [00:21:26] And so we know a lot about what is a good workplace. Ideally at the local level, you define it for yourselves. You know, these are the hours we can manage here or when we need breaks. Here is the staffing we need to be able to do things well. And, you know, I'm trying to make that argument to your management. Yeah, that makes a lot of sense. I mean, I think for me, starting by for one, I think speaking up is one of those things. It's kind of like figuring out what you're struggling with and then kind of sharing that with someone.

Dill [00:22:03] Right.

Wright [00:22:03] Might be a starting to. Yeah, I mean, because.

Dill [00:22:06] Perfect start, perfect start. And if you find the three or four of you are all struggling with, how do we keep this up, then it's time to acknowledge this is too fast to schedule. It's too much. We're not going to be able to keep it up comfortably. I put in the resources for this podcast something called Med Pep, where there are 20 segments that people can choose from. It's a link to a series of talks about how clinicians can approach burnout, and a lot of them have to do with organizational interventions. So if people want to follow up on that, they might want to look at that resources.

Wright [00:22:46] Nice, nice. I'm pretty sure our listeners are going to enjoy some of the resources that you provided us. In addition to speaking up, what are some other things that we can do to reduce the risk of major mental health issues in our lives or in the workplace?

Dill [00:23:02] So, I mean, of course things happen, right? We have disappointments, we have heartaches. We have things that scare us. The pandemic scared everybody, you know, about their physical safety and their financial security.

Wright [00:23:17] For sure.

Dill [00:23:18] And it scared patients who came in and started sometimes taking it out on their dentists and the staff. So things happened and we're not going to be able to make them not happen. However, I think, you know, back to the idea of resiliency and feeling that we have enough oomph to rebound from the hits that happened is important. So the Barbara Fredrickson piece I mentioned, she thinks that people need a ratio of three positive experiences to every one negative experience to thrive and be able to rebound. And this is something individuals can take control over for themselves, whatever the workplace circumstances. In fact, Barbara, on her website, which I have linked the listener to, has a self-assessment tool where people are asked to rate how positive or negative, did they feel during these times of the day? And it gives them a baseline to redirect themselves from. So, I mean, it requires a certain amount of planfulness, but not too much. I think it means valuing ourselves enough to say our happiness is important and worthwhile. Valuing ourselves enough to say, "Well, I'm going to see my friends tonight because I need to and because it makes me happy," or "I'm going to go home and cook my favorite meal and unplug everything and make people leave me alone because it makes me feel peaceful." So seeking out positive experiences is what gives us that resilience. We want to have trusted confidants to turn to if we're feeling like we don't have our usual good spirits. And they can help us figure out what's going on and what we need to do. Of course, some people love being social and some people don't love being social. So I think it's important to figure out what makes you happy. Positive experiences are things like finding meaning in the work you do, feeling proud of what you were able to do at work, feeling proud of the friend that you are, or the wife or husband or parent that you are. Positive experiences are connected with somebody who's important to me. Or just like I like to play pickleball and I can't wait to get on the court. Seeking out positive experiences. We're in such a work culture, we lose sight of that.

Wright [00:25:59] Yeah, it does. If you or someone you know is struggling, please know that there are resources and people available to help. There's a newly updated dentists well-being directory available online. It's a state-by-state list of health care professionals who will serve as a point of contact and offer support during a time of need. And it's free for everyone, not just members. The ADA has a series on resiliency available, and you can even get see credits for watching.

Ioannidou [00:26:28] Learn more about the value of mental health in your practice through resources from the Hope for the Day organization. You can find all these links and more resources on the show notes for this episode at the ADA.org/podcast. Keep in mind if you or someone you know is experiencing suicidal thoughts or a crisis, please text or dial 988 to be connected to the National Suicide Prevention Lifeline. This service is free and it's very confidential.

Announcer [00:27:02] On the next Dental Sound Bites, how did you decide which direction you wanted your dental career to take? Solo Owner. Small Group Practice. DSO. A medical setting or a federally qualified health center? Faculty or military. So many practice options. Where do you start? Join us as we talk to dentists who choose different paths and dig a little deeper into how their choices fit their career interests, lifestyles and goals. Your career roadmap next time on Dental Sound Bites.

Ioannidou [00:27:37] Thank you so much. This was a great conversation. We really, really enjoyed it.

Dill [00:27:41] Well, it was lovely to talk to you both. And I hope the discussion helps some of the listeners and that they find a way back to peace and happiness if they're struggling.

Wright [00:27:51] I had a great time. Yeah. Thank you so much for all the information that you shared. I mean, I was over here taking notes for myself.

Ioannidou [00:27:58] And I'm sure our audience would love to hear more and learn more about Diana Dill. So where can they find you?

Dill [00:28:05] I have a website. It's just plain Dr. Diana Dill dianadill.com, and they can find out more about me and my work at their website.

Ioannidou [00:28:16] I'm sure that they will be very curious and very helpful.

Dill [00:28:20] Thank you both. It was a pleasure.

Ioannidou [00:28:22] Thank you.

Wright [00:28:23] Thanks for being here. If you like this episode, go ahead and share it with a friend or a colleague.

Ioannidou [00:28:28] Also, don't forget to subscribe to this podcast wherever you are listening so you can get the latest episodes.

Announcer [00:28:35] 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.

Managing Difficult Conversations In and Out of the Dental Office

In this episode, we’ll guide you through strategies to manage sticky communication situations in the dental office. We’ll explore practical strategies and ways to improve communication skills to achieve a positive outcome for all involved. Guest: Tiffany Olson, speech communication expert.

Tiffany Olson 

“You need to be precise with your language, because if you're not, then the other person will be left to fill in the blanks and draw their own conclusion. Which isn't necessarily what we meant for them to draw. So that's why we have to be really precise with what we say. ”

Tiffany Olson, Communication Expert

Show Notes

• Olson says effective communication is when the speaker's message is received by the listener in the way that the speaker intended.
• Dentists need to be able to communicate effectively with their patients, their staff, and their colleagues and Olson says there are ways to practice effective communication skills.
• First, being aware of your own communication style is important according to Olson. She says that everyone has their own unique communication style, and it is important to be aware of your own style so that you can adjust it to communicate effectively with others.
• Being being mindful of your listener's perspective is also essential to effective communication. Olson says that it is important to try to see things from the other person's point of view, and to adjust your communication accordingly.
• To enhance communication and avoid hurting feelings or creating more conflict with the person receiving the message, Olson says you should use clear and concise language so the other person understands what you mean.
• Being open to feedback is essential if you want to sharpen your skills as a communicator and so is practicing effective communication skills.
• Dr. Rico Short, a dentist and listener of the show shared a story about being verbally attacked by a patient who wanted a root canal but didn’t want x-rays. He shares how he handled communication with the patient and the staff to better recover from the event.
• Olson offers three strategies dentists can use to better communicate with your dental team:

1. Let them know that you care. This means showing them that you are interested in their well-being and that you appreciate their work. You can do this by taking the time to get to know them, providing them with opportunities for professional development, and recognizing their accomplishments.
2. Listen to understand. When your team members are speaking, really listen to what they are saying. Don't just wait for your turn to talk. Try to see things from their perspective and understand their point of view.
3. Address difficult conversations head-on. Don't avoid difficult conversations. Instead, face them head-on in a respectful and constructive way. By addressing these issues early on, you can prevent them from festering and causing problems down the road.

Resources

Register for Olson’s ADA course in A Accelerator Series — Be Bold(h)er: Women Succeeding in Communication in the Workplace

Connect with Olson

Transcript

Ioannidou [00:00:00] Hey, we need to talk. Most people dread hearing these words, right? Hello, everybody. I'm Dr. Effie Ioannidou.

Wright [00:00:08] And I'm Dr. Wright. And this is Dental Sound Bites. This episode is all about having difficult conversations.

Announcer [00:00:17] 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.

Ioannidou [00:00:33] So in our last episode, we really talk about sticky situations that we experience in our practices. Today we thought that we can bring an expert to talk about how we can communicate more effectively dealing with these difficult, sticky situations. So please welcome Tiffany Olson.

Wright [00:00:52] Welcome, welcome, Tiffany. Can you tell us a little bit about yourself?

Olson [00:00:55] Sure. First of all, thank you for having me. I'd like to say that I'm a lifelong student of communication. I got my start in elementary school. I talked too much during English class. And Mrs. Hawkins, who was the English teacher and the speech team coach, recruited me because she's like, "Well, let's put this gift of gab to good use." So I joined the speech team and stuck with it all through junior high and high school and went to college and competed at the national level for the Illinois State Speech Team and got a master's degree in communication and have been teaching for the last 25 years, both in the college classroom and then more recently, the last ten years, I focused on corporate and organizational clients going into companies and organizations and leading communication centered workshops, things like how to effectively give a public address or how to listen effectively, how to have tough conversations successfully, which is obviously what we're going to be talking about today. And all of the workshops are tailored to that client and that industry. So that's me.

Ioannidou [00:02:07] That's great.

Wright [00:02:08] So just kind of kickstart our episode. Can you just tell us why it's so important for us to communicate effectively? Like, and maybe even start by defining what effective communication is.

Olson [00:02:21] So effective communication is when the thought in your head as the speaker, the thought that's in your head comes out of your mouth in the way that you intended and then is received by the other person and processed by them in the way that you, the speaker, intended it to be received. That's what effective communication is.

Wright [00:02:44] That's a lot of things to control. That's a lot.

Ioannidou [00:02:47] This is so complicated.

Wright [00:02:50] This is so complicated.

Ioannidou [00:02:51] Because we can control, say, that we become experts in communicating what we have in our mind. Right. Which many, many times I always tell my kids, I cannot read your mind. You have to use your words. Explain to me the cause. So this we can control. Sure. But how can we control the perception?

Olson [00:03:09] From the other person.

Ioannidou [00:03:10] That's tough?

Olson [00:03:11] And we don't have control because there are some people that we will talk to and they're no matter how thoughtful we were, no matter how precise we were with our language, they are not going to receive it in the way that we intended. But what you need to do is be aware of that is what it takes to be an effective communicator. And so you do the best that you can, be thoughtful, language is arbitrary and ambiguous.

Wright [00:03:39] Ooo-wee! That's so good. Oh, my gosh. I eat all this stuff up.

Olson [00:03:43] That's what I am, that's how I am. I love I'm fascinated by all of this.

Wright [00:03:47] Me, too.

Olson [00:03:48] So language is arbitrary and ambiguous, which means that your definition for, like, let's say I tell you "how was your day today? Oh, it was good. Good." Well, my definition of good means this. And Dr. Wright's definition of good means this. And so we all have different definitions of what good mean. Right? And so you need to be precise with your language, because if you're not, then the other person will be left to fill in the blanks and draw their own conclusion. Yeah, which isn't necessarily what we meant for them to draw. So that's why we have to be really precise with what we say.

Ioannidou [00:04:25] So what I hear, what you're saying is that we have to be precise because we cannot leave our statements to interpretation.

Olson [00:04:34] Right? Right.

Wright [00:04:35] Absolutely. Yeah. My problem is I want to be in control of like, the narrative. So that control piece, go figure, I'm a dentist. But I want to be in control of, like, how I'm perceived. But I will say the more that I practice and the further I get in my career, I do take steps back and I realize that I can't necessarily control that. I can only control myself, my body language, how I, you know, the statements that I use, how the tone that it comes across and on the listener's ears, like I can't control that so much. I will say that's been a source of contention for me in practice with like if I have like a conflict with a team member or a patient, if there some level of misunderstanding, sometimes I want to go overboard and overcommunicate, and that sometimes is to our demise.

Olson [00:05:23] Absolutely. This is a personal example, but I just went prom dress shopping with my 17 year old the other day and we do not have similar taste, in anything, clothing specifically in this situation, and she tried two dresses on one of them, I loved the other one. I didn't love as much, but I didn't want to tell her about it, about the one that I loved, because I knew that if I told her I loved it, she might want to do the opposite thing because I'm the uncool mom. And so she doesn't want to pick the one that I pick.

Ioannidou [00:05:57] Classic.

Olson [00:05:58] It's so complicated because I'm trying to I'm being very thoughtful in how I'm communicating. And yet to her, I wasn't being effusive enough with my praise of how she looked in the dress, but I was doing it for for what I thought was the right reason. And, you know, so we we can be really thoughtful. We can have the best of intentions. And still, that was ineffective communication, because what I meant did not get received in process the same way I meant for it to.

Ioannidou [00:06:30] You know, sometimes I wonder the strategies that we use in our with our teenagers, you know, they may be applicable in our professional life. Frequently as parents, we say, pick your battles. Right? You know, we don't need to argue with the kids every day, all day we could. Yeah. But we choose not to. I wonder if this isn't a strategy that might be useful in a professional setting.

Olson [00:06:58] Oh, absolutely. I'm just thinking of staff, let's say, other people have ways of doing things that may work well for them. And just because it's different than our approach doesn't mean that it's wrong. It it's just it's different. And so.

Wright [00:07:11] Certainly.

Olson [00:07:11] I know that I'm not good at letting things go. I want to correct everything. I'm not good at letting some things go and picking my battles. And that is I absolutely think there's validity to that. And you are able to conserve your energy, too, if you're not picking every battle.

Wright [00:07:31] So you mentioned a few things that I would love for us to talk about. You said emotional intelligence. You talked about awareness. Can we just talk about a whole bunch of those things? Because I feel like a lot of our doctors out there, we may be operating in those same spaces. Maybe we're not as emotionally intelligent, although it's a common buzz word. Maybe a lot of people may not know what that is and that awareness piece and being experienced. Can you look like, Let's go there? Can we?

Olson [00:07:59] Yeah, I think emotional intelligence is so necessary because people are complicated and our reasons for saying some of the things that we say are complicated. Maybe somebody else was feeling insecure, in our own insecurities we will lash out or we will say things. And yeah, I think that having the emotional intelligence to think in that situation, why would the other person have said this? What was the meaning behind this and reading nonverbals? And so they seemed offended by that thing that I said that seemed to to throw them off a little bit. So checking in with people, that's a huge thing that we need to do more of is checking in. When I said that you did this thing with your face, what what can you tell me about that? What did that mean? Were you confused or did I say something that offended you? Checking in with the people that you're talking to, to make sure you understand so that you can clarify in case you misunderstood.

Ioannidou [00:09:01] Tiffany, if you do this, could people perceive this as confrontational? Like if you turn to someone and say, you know, I noticed that you did this, I just want to make sure that I understand correctly what I was not misunderstood. So do you think that people can immediately become defensive and like, instead of the conditions, you make them even worse?

Olson [00:09:20] Yeah, absolutely. I think that people can. And so that's the reason that we need to monitor our delivery. "Yeah, please know, I don't mean anything by this comment, but I just want to check in with you because your your face seemed to indicate, you know, and I've got a smile on my face as I'm saying it, and I'm, you know, I'm making sure" with these we call these minimal encourager, these hand gestures that we do in these these things that we do nonverbally to display meaning. And so " I'm I'm sorry, I, I didn't mean to imply anything, but I just wanted to check in with you and make sure that. Did you understand when I said that I was not trying to be fill in the blank, disrespectful, blah blah, blah. Yeah. I just want to make sure that that you understood that." Your tone and you can say the same words in different ways and, you know, tone.

Ioannidou [00:10:12] 100%.

Wright [00:10:13] Makes all the difference. Right?

Olson [00:10:14] And sometimes it will be misinterpreted. Yeah.

Wright [00:10:17] You know, I am the queen of like I said, I believe in breathing. Taking that pause. Right. I sit back and I wait. I do believe that, like, whenever you're in a difficult conversation, whoever speaks first kind of loses. So what I do with my patients and this happens to me quite often, patients come in, they pretty much already know what they think is the right treatment or the right course of action for them. But I'm the person, I think very big picture, I think and begin and end with the end in mind. And sometimes that does not go over very well with my patients. So I always pause and I say, "Okay, what questions do you have for me?" And I think this is one of my strategies instead of being like, do you have any questions? Or okay, is that that's everything And, you know, I'm out of the room. I always say, all right, what questions do you have for me? And I will sometimes be there until they have no other questions. Because again, this is me trying to be in control of the situation. And I'm like, I want I don't ever want them to feel abandoned because I feel like when you don't communicate, patients can feel abandoned. Sometimes I don't have all of the right words in that moment, but I still want to give them space to share because I don't know, you know, people, they don't really share everything right up front. Sometimes I feel like our patients play games with us and they like, want to see what you're going to say first before they share, you know, the true situation. So like, how do we navigate some of those things? Or I don't know if I just gave my own strategy to myself, but that's definitely one of my strategies. What are your thoughts about that?

Olson [00:11:54] Yeah, I think that's good. Just even in the phrasing of the question, "What questions do you have for me?" As opposed to "Do you have any questions?" Because you're right, a lot of times, "Oh no, I don't have any." And then we think about it. So even giving a pause, that's something that I teach people all the time is the pause, the pause is so important because I know when I was a first year teacher in graduate school, I you know, it was only a couple of years older than my students. And I just was not comfortable in front of the classroom yet. And so you're there and I would end the class with does anyone have any questions? But I didn't feel comfortable in that silence. And so I would give a nanosecond and then I would say, "Okay, great seeing, you know, see you on Friday and all right."

Wright [00:12:40] Bye bye.

Olson [00:12:42] And so sometimes it's just sitting in that pause and letting the person think through. "I don't know, what if I do have a quick oh, I do have a question. And just letting them sit in that pause for a second, That's really good, because sometimes it's not on the tip of our tongue. And I think that, you know, going to the dentist is complicated for a lot of people. There's fear involved. There's just different feelings involved. And so sometimes that stunts us, stunts our brain from working quickly and saying what it is that we want to say when we want to say it.

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Ioannidou [00:13:56] It's funny because I love the fact that you touched upon clinical dentistry and academic dentistry, both like a very uncomfortable silence in the auditorium as a teacher especially, you know. And I think it has to do also what I find difficult is if you are in the extroverted personality trait, this at the pause is a very hard thing to zip it and listen first of all. So it's it's it's a sign of growth. I get I mean, I used to speak endlessly at the very beginning of my career. Now I speak a little bit less, although many people don't feel the difference. But then and it's so hard to just be a listener and try to take a moment, pause and allow the room to react to what you announce or just said many times. For extroverts, people, this might be a problem. And on the other side that I am sure that there are different stresses and different defense mechanism for the introverts in their own right in terms of communicating. So I find that this is also how can you speak about this a little bit, because I know in academics, you know, it's it's always a small meetings and conference rooms of like eight to maximum ten people and those close communications that are more than one patient. Right. But those close communications can be tricky frequently.

Olson [00:15:20] Yeah. I like what you said about the introverts and extroverts. I don't know if you've read the book "Quiet" by Susan Cain. And it's all about introverts and extroverts and the difference in communication styles. Introverts tend to take longer to process and they're less. I'm an extrovert, and so my thoughts, the thought pops into my head. It is out of my mouth before I've edited it.

Wright [00:15:41] I can be like that.

Olson [00:15:42] And sometimes then I'm like, Oh, right, I shouldn't have said that yet. Okay. And also the listening part, the key to listening is to listen for clarity. To listen, to understand, not to listen, to respond.

Ioannidou [00:15:58] Yes, That's so good.

Wright [00:16:00] So hard.

Olson [00:16:01] And that's what we do so much of, right? Yeah. Yeah. We listen in and someone's talking. And the only way I know of to combat that is to just keep telling yourself, like, "Nope, bring it back. No, bring it back. Stay focused on them. Yeah. Not about stay focused." And just keep drawing yourself back because your time will come to reply. But right now we're just focused on this person and what they're saying and understanding what they're saying.

Ioannidou [00:16:28] Oh, that's so good.

Wright [00:16:29] That was really, really good. I will say this in any other setting other than now. So I violated this rule already today because I've interjected several times, but that's only because I'm super duper excited when I'm in the office or like if I'm face to face with someone and I'm having a conversation, I forget where I heard it from. But they say just kind of like, take your hand and put it over your mouth. And that kind of keeps you from like when you're tempted to jump in and interrupt or, you know, kind of just say something and respond quickly. I just take my hand and I just kind of like put it in front of my mouth. And it is almost as if I'm thinking, which I am, but I'm thinking harder not about what I'm going to say, but about not interrupting and jumping in to to just respond super quickly. Right? So that's the strategy to for all our listeners out there. Yeah.

Ioannidou [00:17:14] I'll share with you a Greek wisdom. We always have a Greek wisdom to share. I'm sure we should make this, you know.

Wright [00:17:20] In an episode.

Ioannidou [00:17:21] Yeah, yeah. The classic anecdote in our podcast. So my grandfather in Greece back in, you know, he was born in 1920. So you can understand there that he's not alive with us anymore. But but he used to say, before you speak, dip your tongue in your brain.

Wright [00:17:39] And dip your tongue in your brain.

Ioannidou [00:17:42] He used to say this for me when I was like little young, you know, elementary, high school student. But, you know, I it was something that really, really helped me in life. Do I do it very frequently? I started to, it took me 50 years, but now I know how to do it, I think. Yeah, but you're absolutely right. You're absolutely right. And I completely agree with what you said about the deep listening.

Wright [00:18:04] Yeah, well, let's take a moment and listen to a story from a colleague who was in a difficult situation. And we're going to hear how he handled it. And I think that we can develop some conversation around this situation. How about that, guys? Sure. Let's do it.

Short [00:18:18] My name is Dr. Rico Short, so I remember having a lady coming off. She said she needed a root canal, but she didn't want to take any x ray. She said, "Hey, Dr. Short, I need a root canal. I don't take any x-rays. I know I need it." And I explain her. I said, "Ma'am, you know, without me doing an actual exam and x-rays, I can't perform this procedure." And she was like, "Well, I need you to perform it because I have to go out the country tomorrow and I don't want to go out the country and have a toothache." So I explained to her, you know, "Medically, legally, we can't do that. And also we want to make sure that we're giving you the best procedure and making sure we're making sure we're not missing anything." And so she just got upset. She called me all kinds of names. And she started recording me and she just let me leave the office and she's made a big scene. I said, "Ma'am, you are going to have to leave. This is a private practice. And you create disturbance and this and that." And she just kind of went on and on and on and on. And then my front desk and the staff, they started getting really worried about what are we going to do? And I just reassure them to stay calm. It's going to be okay. You know, just don't say anything to the lady and then she will eventually run out of steam and leave. And so she did finally leave. I had to sit down and talk to my staff about sometimes when we're dealing with patients, you don't want to escalate to their level because that can create tension and things like that.

Wright [00:19:39] That was very interesting and this has happened to me before. Dr. Effie, this may have happened to you in practice before, but let's unpack that because I'm sure we can pull a few strategies from that story alone to equip our listeners with.

Olson [00:19:53] Yeah, I think the key is that not all difficult conversations are going to be successful.

Wright [00:19:59] That's good.

Olson [00:20:00] Success is not, "Oh, both of you leave happy and everyone is good." And that that's not success might just mean that the conversation was over. Like in that situation, it seems like the success was the conversation was over. The doctor seemed to handle it really well by debriefing with the staff. There are some people who are not capable of having difficult conversations successfully, and I think sometimes we let ourselves off the hook a little bit by, "Oh, I don't think the conversation's going to go well, so I'm not going to have it."

Wright [00:20:33] Oh, that's a good one.

Olson [00:20:34] And I don't want us to lead with that. But like for this conversation, this particular person, it didn't seem like it was going to go well. I think that the doctor handled it really well because she seemed combative and was did not seem to respect his professional opinion about what needed to happen. And so I think he handled it the best way. And sometimes that's it just is.

Ioannidou [00:20:56] It's amazing how a wise reaction can really affect the whole practice, the whole team dynamic. Right. And builds confidence. You know, if you're the leader in the practice and your team sees you reacting in such a wisdom, I think that it builds to respect. Yes, something really bad can turn into bringing people together.

Olson [00:21:17] Absolutely.

Wright [00:21:18] Yeah. I feel like that was a good example of how to interact with a team. And usually if I'm in a situation with a patient or a patient gives me feedback through a review because I look at my Google reviews as feedback that the patients are leaving me and how I handle it and how I navigate it. I always try to find the lesson in it and if there's actually any truth to it. So I look for the truth in the situation as opposed to although I do not like when I get a bad review, but I realize that I can't control everything and I can't win everyone. But what I can do is take the meat and leave the bones, if that makes sense to everyone. So your opinion, Tiffany, on de-escalation? What are some strategies that we can use and take into practice with us about the de-escalation piece?

Olson [00:22:05] So if you're in a situation where it's just not going well, calling time out, you know, hey, I seem to be getting worked up and I don't like how I'm saying this. Now, let's say before you get to that point, you could even just ask for a redo. I say something in anger. "Oh, you always do that. Sorry, Can I say that again? Because I didn't mean what I said. I just responded in anger. Can I redo that?" Ask for a redo in the moment. People respect that. That's showing humility and vulnerability. Yeah, that. "Okay. I realized I went too far. I'm sorry.".

Wright [00:22:37] I love that.

Olson [00:22:38] And then sometimes it's just a matter of like, if you are too heightened and you can't bring yourself down, then it is a matter of saying, "I think we need to take a time out and come back to this. And maybe it's, you know, maybe we can come back to it in a half hour or something and maybe we need to table it for sleep on it. Maybe we need to table it for a while." And you need to monitor yourself and know, are you getting too worked up or maybe for the other person? "Hey, I can tell that this is really affecting you. Let's let's table this for a little bit and come back to it later because, you know, I don't think we're accomplishing what we want to accomplish right now."

Ioannidou [00:23:14] Mm hmm. How do you think someone becomes more confident in communicating? Is this something that comes naturally with age? Is it something that comes naturally with experience and interaction, or is it something that you really learn out of books? Like how how does this happen?

Olson [00:23:32] Well, women, especially their confidence in communication, increases as their life and their experience increases. So and the older that they get, the more confident that they get and the more experience they have in their careers, the more confident that they get. Some of it, of course, it can be learned in textbooks, but it's more, I think, just interacting with people and practicing those skills that, you know, the good skills. And so maybe that's where the book comes into play, is learning, you know, what are the good skills, what are the right things? Therapists are also really good at that and letting you know how you should approach different situations.

Wright [00:24:11] Oh yeah.

Olson [00:24:12] I see a therapist and I love it because he gives me really practical ways to effectively communicate what I want and to do it in such a way that advances the conversation as opposed to us just continuing to butt heads about the same thing over and over again.

Wright [00:24:28] Oh, that's so good. I love advancing the conversation. One of the things that I was going to say earlier was not matching the energy. If it's a conflicting situation, I find that if I am very intentional about not matching that person's energy, then I feel like we can actually make that forward movement in, you know, we're probably all trying to get to the same thing, but it's just like, who's the person who's willing to just kind of back down a little bit? And so, yeah, it's a skill. I will say it's definitely a learned skill that you have to put in practice. But yes, talk to us.

Olson [00:25:04] Well, and I think you had a good point, Dr. Wright. You said we are all trying to get to the same thing and that's a good thing to work on for, you know, de-escalation or just having these tough conversations is figuring out, hey, what are you want out of this conversation? Like what? What would make you feel satisfied as an endpoint for this conversation? Like identifying what that is so that we know what are we working towards, what is our goal and and we can set our goals before if it's a difficult conversation, hopefully you do some thinking through it ahead of time. So you know, what do you want out of it? What is going to make you feel as though it was a successful conversation. So doing some pre-thinking before you get into the moment and have to respond in the moment.

Wright [00:25:49] Oh, I love that this is helping me out a lot. I don't know about everybody listening, but I'm gaining a lot from this.

Ioannidou [00:25:56] So this is actually a great thing. Like if someone starts a communication session or a meeting or interaction with this mindset, the mindset of, you know, what's the deliverable? Basically what would make both of us, the two parties happy, then probably the communication will be right on the point, right? Is it wouldn't this make everything easier, like easier, wouldn't this make the meeting or the interaction less stressful, I assume?

Olson [00:26:27] Yeah, I would think so. There's a it's called communicating with confidence. It's a curriculum that was put out by Lean In and Jennifer Allen. And they talk in there about when you go into an interaction thinking before you even get there, what is the impression that I want to make on the people in the meeting? What are three characteristics that I want to come across? Like, So what are those are great things for you to think ahead of time about. Oh, you know, I mean, I wish I would have done that today. Like what? You know, how do I want to come across today on this podcast? Do I want to come across knowledgeable? Do I want to come across fun? Do I want to come across and just really thinking through before we're in the situation and we're having to be reactive as opposed to proactive and really having intention behind it.

Ioannidou [00:27:18] Yeah.

Wright [00:27:19] That's good. Oh my gosh. Okay, wait. So before we get too far, can you give us like just three strategies to help us improve communication with our dental teams?

Olson [00:27:29] Yeah, I think number one is there was a quotation by I think it's Teddy Roosevelt, and he said that nobody cares how much you know.

Wright [00:27:36] And till.

Olson [00:27:37] They know how much you care. Yeah. And I love that because I think that's what it is. It's a matter of with your team, letting them know that you care, that we have a common goal, which is patient care or being the best practice, blah, blah, blah. Whatever your goal is, we're all working toward the same thing. And so letting them know that you care. And then I think also it's listening to understand.

Wright [00:28:01] That's a good one.

Olson [00:28:02] So making sure that when you're listening, you want to make sure you understand what the issue is. And with the difficult conversations, don't put off the tough conversations. Let's say that there's some tension in the office and maybe it's not even tension with you in somebody else. Maybe it's tension between other people. Don't put that off because it festers and it it affects everybody that's that's in the practice. And so addressing those issues head on, I think are really important. And one of the things that I do and I can tell that you do this too, is I seek to learn from other people, like who else is doing this really well. Yes. Who is there? Another you know, another practice that, you know, that's just killing it when it comes to morale and unity and and learn from them. What are they doing? How are they doing it so well, that's how I learn all of my stuff is asking other people. What's working for you?

Wright [00:28:57] There we go.

Ioannidou [00:28:57] This is a great point.

Wright [00:28:58] This is so good.

Ioannidou [00:29:00] I want to go back to something that you said and then we can move on. But this really struck me. Frequently in our professional life, a lot of people use it as an excuse, the fact that they don't like confrontation. So.

Wright [00:29:14] Oh, my gosh. Please, let's unpack this. Let's talk about it. Yeah.

Ioannidou [00:29:18] So with this, you are called to adjust your communication depth, if you will. So you don't that's those nodes that are very tricky and risky and they can really pop up and start a confrontation. So how how do you reconcile this on one hand to try to be real and authentic and really approach an issue in its full dimension, but also respect the fact that some personalities are different than others? So, I mean, well, what's your strategy on this?

Olson [00:29:52] So I think, first of all, it's all the way back at the beginning of what do you label it? Because we keep calling it difficult conversations, confrontational. We are calling it these things where it's conflict, conflict, conflict. I can't remember the exact definition, but conflict basically just means failure to be in agreement.

Wright [00:30:11] Mm hmm.

Olson [00:30:12] Failure to be in agreement. That's not scary. Right. And we're not in agreement about what's for dinner tonight. You know, it's like we're not in agreement about. My favorite color is orange. And your favorite color is. So conflict is just failure to be in agreement. And so when we label these things “difficult conversations,” you know, it's a sexy phrase, but it's like it's really just trying to find a way for both of us to be okay with where we are, with what the situation is. And so when we label it conflict, I think that's the main problem is just, hey, we're just having a conversation and a lot of times we build it up to be so much more than it is. And then when we're in this situation, it's like, Oh my God, I was so nervous about that and we figured it out. We did this. Okay. All right.

Wright [00:31:02] I love it so much. You made a statement that basically drew my mind to one of my favorite books that feel like has been life changing. And it's "Seven Habits of Highly Effective People." And there are several things in your statement when you were going over the three, you know, skills that we should all have to help with our dental teams. And and I begin to think about a few of those habits. I think we're doing it right now, which is sharpening the saw. That's one of the habits in the book, beginning with the end in mind. So you said like kind of thinking ahead of what do you how do you want to be perceived or what do you want to get out of this conversation? And then the other one that I just wrote down just off of memory was seek first to understand and then to be understood. Like, those are all principles that I think that we're talking about right now that goes along with this communication. So I kind of just wanted to say that in the moment that you're kind of right on there.

Olson [00:31:56] I love that.

Announcer [00:31:58] On the next Dental Sound Bites.

Wright [00:32:00] Dentistry can be a very demanding profession, but taking care of your own needs is just as important as taking care of your patients. We're talking tips for stress management, self-care, setting boundaries, and building a supportive community that will help you maintain a healthy work life balance. That's on the next Dental Sound Bites. Oh, well, this has been such a phenomenal episode. I ate it all up. I don't know about you, Dr. Effie. I think you too. Oh, I.

Ioannidou [00:32:30] Love that we learn so much. So happy that we had the chance to talk to Tiffany and dive into so many tricky situations in the practice, in the class, in the professional meetings, in so many different settings. It was great.

Wright [00:32:45] So, Tiffany, can you tell all of our listeners where can they find you?

Olson [00:32:49] You can find me at Tiffany Olson. That's Tiffany Olson.work. That's my website. And we've got all of the different workshops that I offer and I can do them virtually. We can do them in person. And I'm based in Chicago, but I travel all over for work. And so I would love to have the opportunity to work a little more closely.

Wright [00:33:12] Ay!

Wright [00:33:12] Thank you so much for everything.

Olson [00:33:14] I loved being here. Thank you.

Ioannidou [00:33:16] Thank you so much.

Olson [00:33:17] Thank you very much.

Wright [00:33:18] If you like this episode, go ahead and share it with a friend or a colleague.

Ioannidou [00:33:22] Also, don't forget to subscribe to this podcast wherever you are listening so you can get all the latest episodes.

Announcer [00:33:29] 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 Dawgs podcast. 

 

Managing Your Most Awkward Moments in the Dental office.

We had such a great time with this topic in season one that we wanted more! We’re talking awkward, strange, sticky situations with patients or peers in the dental office. We’ll dice into the stories, and the strategies on how to stay professional and compassionate in challenging situations, how to set boundaries, and ensure safety for all. This episode features guests Dr. Stephanie R. Ganter and Dr. Robert McNeill.

Dr. Stephanie R. Ganter


Dr. Robert McNeill

“There have been so many times in many patient interactions, I'll walk out and go, ‘Oh my gosh, I wish I had not done what I just did.’ And to have a ‘sit down’ with your staff and say, ‘This is what happened, quite frankly, I may have done something different if I had to do it over again’ … I think it's great to cast light on some of those issues.”

-Dr. Robert McNeill

Show Notes

• Ganter and McNeill, are dentists and hosts of the podcast and YouTube channel “Between Two Teeth.” The purpose of their podcast is to connect, discover and inspire. They love sharing their personal and professional stories with their audience.
• Each doctor takes turns sharing sticky situations and awkward moments from the operatory. Ioannidou, who has a European accent, shares a story of a patient discriminating against her at the UConn dental school clinic where she is faculty. The patient turned away from Ioannidou and asked a dental student to find a faculty member who “really speaks English."
• The situation was awkward and surprising, but the patient later apologized after Ioannidou walked out of the room to give some time and space to herself and the patient.
• The dentists agree that walking away for a minute to think and give space to a situation can help defuse awkward situations.
• McNeill shares his experience of feeling overwhelmed during his first interaction with a patient in dental school and nearly passing out. He also talks about failing his board examination due to a backup patient ripping off a rubber dam. However, he has now become a board examiner for the same examination.
• McNeil also shared his personal experience of burnout and how he struggled to balance his personal and professional life. While going through a divorce, he felt like a failure, despite his professional success and sought help from his friends and colleagues.
• Ganter got married in residency and divorced soon after starting her first job. Patients knew her as Dr. Briggs initially, but, after six months, her name changed to Dr. Garner, her maiden name.
• Patients congratulated her on her wedding which she found challenging to handle. Her name changed because of a divorce, not a wedding.
• Another story Ganter shared was when a patient made a sexually suggestive comment and grabbed her leg before a procedure. She felt angry and embarrassed in front of her staff but continued on and did the procedure. She later talked to staff to make sure they knew they could handle such situations differently in the future.
• Finally, Wright shares a sticky situation with a patient who returned to her office after getting an upper denture stating that she had “been told” a future extraction of teeth would be done free. After some heated discussion, Dr. Wright did the extractions for free to avoid further arguing. She documented everything, including the treatment plan, and got all parties involved to sign a consent form.
• Dr. Wright was frustrated because the practice was a startup and she needed to produce and that is why she took this route.
• The show ends with a rapid fire discussion of dental-related topics. Throughout the show, the guests agreed that sharing awkward moments and sticky situations is important in dentistry, to cast light on the many aspects of the profession that can cause stress and burn out and to help fellow scientists come up with solutions and feel less alone.

Resources

• Find out more about the podcast and YouTube Channel “Between Two Teeth”
• Explore  ADA Wellness resources

Transcript

Wright [00:00:00] We really want to know what's the weirdest thing that's ever happened to you as a dentist? Hello. Hello, everyone. I'm Dr. ArNell Wright.

Ioannidou [00:00:08] And I'm Dr. Effie Ioannidou. And this is Dental Sound Bites. Today we will be talking about awkward, strange and very sticky situations in the dental office.

Announcer [00:00:22] 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] Back in season one, we got a great idea from a fellow dentist and a listener to do a show on dentistry's tough, odd, and awkward situations. It was such a fun and interesting show. We couldn't get enough.

Ioannidou [00:00:50] We are diving back to our stories and we try to understand how to stay professional, how to stay compassionate in the face of the most challenging situations.

Wright [00:01:01] We are super duper excited to welcome you to Dental Sound Bites, Dr. Steph Ganter and Dr. Bobby McNeill, who are both dentists, motorbike aficionados and hosts of the podcast Between Two Teeth. Welcome. Welcome, guys.

McNeill [00:01:15] We are so excited to be here.

Ganter [00:01:17] So excited.

Wright [00:01:19] We are so excited to have you here.

Ioannidou [00:01:21] Tell us more about yourselves, your work and your YouTube channel.

McNeill [00:01:26] We have a YouTube channel Between Two Teeth and Steph, what are we about?

Ganter [00:01:31] So maybe 6 to 12 months ago, we started looking at purpose and direction and we kind of came up with a purpose statement kind of for our show, and it's to connect, discover and inspire. We want to connect with as many people as possible, discover things about the world, about experiences and stories, and then ultimately inspire ourselves. And hopefully, if we're lucky enough, inspire someone else just to do the most good in the world.

McNeill [00:01:56] Yes. And we want to live our best lives and we want to push others to live their best lives, too. So that's what we're trying to do.

Wright [00:02:03] Yeah, I love that, don't you?

Ioannidou [00:02:05] Sounds very inspiring. I'm very inspired already.

Wright [00:02:08] And we haven't even gotten started.

McNeill [00:02:10] Yes, it's working.

Ioannidou [00:02:12] It's working. I can't wait to get started soon. I start with sharing my awkward, weird story. I have so many. I have to pick one.

Wright [00:02:21] Same. Yeah, Yeah, Let's hear it. Let's jump right in.

Ioannidou [00:02:25] So, you know, I mean, obviously you can tell that I don't have any accent, right? I speak like, you know, clearly this is a Connecticut accent. I have been a faculty member at UConn Dental for more than 20 years, actually, at this day. And last year, like 19 years into the job, right? I was going to take on some type of scaling root planning after the students completed the procedure and I sat by the patient. I started giving some additional oral hygiene instructions, how you can browse your back. You know, you're in the indo proximal areas between your molars, blah, blah, blah, and the patient turns to the student and says, "Can you bring a faculty that really speaks English?"

McNeill [00:03:10] Oh, wow.

Ganter [00:03:11] Yikes.

Ioannidou [00:03:12] It was super surprising to me. I was really shocked and I really didn't know it got me into that. Oh, my God. I'm like, What am? So I walked out of the room. I gave some space to the patient. I think she was probably, it was a bad moment. I returned a few minutes later and she apologized. Everything was back to normal. But that really few seconds when she turned and hit me with this, it was like, Oh my God.

Ganter [00:03:36] Wow.

Ioannidou [00:03:36] Such a weird and awkward situation that can very easily turn to become confrontational. Right? But by walking out and giving it a minute.

Wright [00:03:46] Absolutely.

Ioannidou [00:03:47] To kind of think what she just said and I think the student also turned to the patient and said, I don't think this was a very right comment to make. So a serious thought, what she said and everything turned out to become very nice and happy ending in the story. But it was a very, very awkward situation.

Ganter [00:04:05] I think one of the smartest things you did was to walk away and give that time.

Ioannidou [00:04:10] Yeah.

McNeill [00:04:11] In my MBA program we learned about the concept of amygdala hijacking and when something happens and emotions get high.

Ioannidou [00:04:20] Sure.

McNeill [00:04:20] Realistically, both sides are really having a hard time thinking logically about things. You step aside, you let the endogenous epinephrine and norepinephrine everything kind of settle down and then you go back in and have a reasonable conversation.

Wright [00:04:34] Yeah.

Ioannidou [00:04:34] Yeah. Because, you know, if you become defensive, this can turn very ugly. So I really didn't want to create a scene out of this. And I have to say that it has to do with the level of insecurity. You know, if you are comfortable in your skin, you know, and they say, let them in, it's fine. Let's turn the page, move on.

McNeill [00:04:52] And we often see people at a bad time in their lives. You know, they're in a spot where they, they don't want to see us. You know, you're a periodontist. I'm an oral surgeon. They don't want to be in our office. And it's stressful for them.

Ganter [00:05:04] And just kind of listening to your story. Oh, my goodness. I can't imagine the mix of emotions that were probably going through your head at that very moment. For me, I think I would be angry and just frustrated because they're yeah, they're picking on a part of you that you didn't wake up this morning and say, okay, I'm going to make this more difficult for this patient. You are authentically being you and you're there, you're showing up and you're showing up in the best version of yourself.

Ioannidou [00:05:28] Right?

Ganter [00:05:29] And you're trying to help somebody, let alone be a mentor and a role model for the dental student. All of that's frustrating.

Ioannidou [00:05:35] Yeah, that's exactly right. And. You know, it's sad because if, have this happened 25 years ago, our society was different. We have evolved so much and we are so open. Diversity has really become a central piece of our lives in higher education, even more. Right. So it was very, very weird to me. In 19 years into this job, I have never, ever experienced something like this. And I think it was a bad moment. And you're absolutely right, Bob.

Wright [00:06:01] And so you were able to just kind of, like, recover really quickly, huh?

Ioannidou [00:06:04] Yeah. No, I do recover quickly. Yeah.

Wright [00:06:07] Like, imagine if you had been super easily offended type of person. Oh, like, you would have, like, dragged that entire situation on way longer, and then nobody would have accomplished what they came into the school for that day, for sure.

Ganter [00:06:19] ArNell, Now, I love what you just brought up. As far as how long does this affect you? You know, for me, when, I when I'm in the clinic and we have certain situations that are emotionally charged, right. Sure, we can get back at it superficially and say, okay, that happened. We're going to move on. We're going to get through this procedure this day. But the tough part is people that tend to suffer in silence later on. Yeah.

Wright [00:06:44] Mm hmm. Or how many times it replayed in your head. You know what I mean? Yeah.

McNeill [00:06:47] See, I like to, I love to pivot. I compartmentalize everything. I put it in a little box, and then I turn, and then I'm on to the next.

Ganter [00:06:55] Man, and that's. I'm so happy for you.

McNeill [00:06:57] That has served me well. And that has served me poorly at other times.

Ganter [00:07:02] I'm so happy. That's a superpower.

Wright [00:07:03] Yeah. Yeah. Definitely a blessing and a curse at the same time. Yeah, all in one.

Ganter [00:07:07] Oh, my.

Wright [00:07:08] Well, Dr. McNeil, what's your tale from the offertory that you're willing to share?

McNeill [00:07:12] You know, as I looked at some of these clinical situations, my very first interaction with a patient in dental school, I almost passed out. That was a weird situation. But then I said, No, that's not enough. And then I went to, when I was taking my board examination, I had to use a backup, backup patient. That patient ripped off the rubber dam. I failed the exam. Now I'm a board examiner with the examination. And part of that was just don't let failure stop you. But then I thought about it and I said, realistically, the message that that was tough for me. I got to a point in my life in 2017, where I was appointed by the governor to the state dental board. Professionally, I was on my peak, but personally I had a hard time going into the office each day. I was burned out. I had a marriage that was not working out and it was super duper tough. And I talked to my staff. I was not the person I wanted to be just in the office. And I said to them, I said, you know, this is I'm having some challenges. I had a group of friends around me that was a group of dentists that kind of help me. And I just sat down with them and I said, Man, I am burned out. And I felt, I felt somewhat like, a like a fraud or a failure because professionally, I was like way up here. And then personally, the other stuff wasn't working out and it wasn't fun going to the office, and I didn't want to be in that spot. And that's part of probably why I do what I do now. Yeah, I think that's in part why, you know, the ADA Wellness Initiative has such a pull to me because I've been in a spot that I think so many are, and I was so fortunate and blessed to have people. I had a group, I had connections. I was able to kind of open up to appropriate people to help me out in a I that was sticky because it could have gone different directions. And certainly as a state board regulator, I'm still on the state board and I see challenges where people don't get the help they need.

Ganter [00:09:23] Wow.

Wright [00:09:24] You know, I have a question for you. Like while on this topic. Imagine had you not been able to identify that you were burnt out, like I think that a lot of people, they they postpone or they don't get the help that they need because, one, they can't identify it. Or maybe they are like all of us here. We're very well educated. We're very successful in our careers, in our lives, and we may turn a blind eye to it. Can you like what's what's your thoughts about that?

McNeill [00:09:52] Well, I love to control things. I think, Steph, she will say that.

Ganter [00:09:56] True story.

McNeill [00:09:59] I'm a hard working dentist and, you know, being in practice is very difficult. And this is just the way it's supposed to be. And you just show up day after day after day and you don't realize there's got to be something better.

Ganter [00:10:12] Right. And on that note, and thank you for sharing that, it's actually when we talk about vulnerability, authenticity a lot on our show and it's, it's easy to talk about. It's really tough to share your personal story. One of the things that I think about when I hear you tell that story is that this concept, this notion that we have to show up on our, our strong horse every day, we have to be that, that knight in shining armor for our patients, for our families, for our friends. And the truth of it is, that's not where connection lies. That's not where wellness lies. Wellness lies and the cracks. Wellness lies where we are authentically burned out and saying, Hey, it's almost like it's okay not to be okay.

Wright [00:10:58] It is okay to not be okay.

Ioannidou [00:10:59] But I think very frequently we are, you know, we kind of walk the thin line in this dilemma between the high responsibilities that we carry.

Wright [00:11:09] Yes.

Ioannidou [00:11:09] In our professional lives and then, you know, the vulnerabilities, the moments that we are like we really want to sit down and take a breath. And many times in many minds, those two cannot reconcile. It's really hard to. So I definitely give you a lot of credit for sharing with us, first of all, and also going through this experience. That's not an easy experience.

McNeil [00:11:30] Yeah, and quite frankly, it's made me a better board member. I think I've just gotten more involved with the ADA Wellness Initiative and I think help me from that component. We also talk about, you know, we're driven individuals as dentists, but you really have to be intentional in how you recharge.

Wright [00:11:48] So not only are we talking about sticky situations, we have also incorporated a little bit of wellness, resiliency and mental health into this episode. I love the direction that this has gone in.

Ioannidou [00:12:01] So, Dr. Ganter, what's your story?

Ganter [00:12:03] Oh, buddy, buckle up. So.

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Ganter [00:12:40] So I got married when I was in residency and probably too young for me. And I got a divorce right when I was getting out. The challenge is with that, your, your name. Right when I had graduated, so when I first started my first job, my name was Dr. Briggs, and so all my patients knew me as Dr. Briggs for that first, like six month period. And then it changed to Dr. Garner once the paperwork went through. So unfortunately, I got a lot of congratulations when that happened. So, I would go in and I would say, Oh, hi, Mrs. Jones, how are you doing today? And she goes, Oh, my goodness, congratulations to you. How was the wedding? Tell me all about it. And inside I was like, Oh, what do I break it to her? Is this something that I need to go into right now? My staff is kind of, you know, like, oh, I don't know how you're going to handle this one. And so, of course, you know, I'm just like I yeah, it was, it was great. But then, you know, you have the, the little lady that's going, oh, no, tell me more and more about it. And at some point you got to say, Hey, it was actually the other way. Oh, sorry about that. She was just like, Oh, no, I part of the reason I bring that up is that one, we talked about failure earlier. Failure is a part of life. Embrace it If you've haven't been touched by it yet, it's come. And I promise you that. And for me, with this story and specifically, I was a little angry about how, the, this is part of the way the world works. You know, for women, they have a choice to change their name when they get married.

Ioannidou [00:14:16] Or not.

Ganter [00:14:17] Or not. They have a choice.

Ioannidou [00:14:19] Or kind of this nightmare of a last name, but with conviction. I said, I never change my name. This is who I am. Whatever I said, no way. This name, the three vowels, will follow me for life.

Ganter [00:14:33] Oh, I love that. That's fantastic.

Wright [00:14:35] I didn't change my name either, actually. Right is my maiden name.

Ganter [00:14:38] I love that. And I have several colleagues that have never changed their name, but I also have several colleagues that have changed their name. Yeah. And everyone has their own reasons for or for not doing it. And the reason I bring it up is because it's kind of crazy, because if you do change your name and you're trying to, whether you're whatever for whatever reason you're doing it for, you're kind of exposed. If you go back the other way, I guess it's almost a red letter A. When you're walking around, I've had to read to say, Oh my gosh, congratulations. And I'm like, oh gosh, I don't know why it's the congratulations. And no one thinks, Hey, maybe it's the other way.

Wright [00:15:16] Yeah, yeah.

Ganter [00:15:17] But that's, my that's my first sticky situation. I want to kind of segway into one that's a little bit more close to home for me. And it happened a little bit more recently. So when we're in a lot of, our a lot of our procedures, we're doing them under IV sedation and I'll have the, the patient will kind of stretch out their arm. And a lot of times our chairs, they don't get over far enough. So I'll have the patient rest their arm on, on my legs so I can start the IV. Pretty standard set up and their palms facing up. This one gentleman decided to once, his the back of his hand, which, touch was touching my leg the other, this guy decided to turn his hand over and actually grabbed my leg. And then he had a very sexually suggestive comment right afterwards. I froze. You know, they talk about fight or flight or freeze.

Wright [00:16:03] Right. Right.

Ganter [00:16:04] I really didn't know what to say. I had two young dental assistants in there and they were just kind of watching. And one of them couldn't even control or expression. I won't say what he said, but it was very inappropriate. I ignored it. I started the sedation, we started the procedure. And the tricky part was the human in me was so angry. There was so much anger there. How could this guy just say this and violate a professional our professional relationship like that, what gave him the right to come in there? I don't go into a doctor's office and say whatever I want. What gave him the right to do that? And, and also it embarrassed me if I'm being completely honest in front of my assistant.

Wright [00:16:46] Absolutely.

Ganter [00:16:47] And I said nothing. And so there was a little bit of guilt there, little anger. And I and all the, all the while, you still need to do your absolute best to provide care to this patient as you start your procedure. So we finish up the procedure, dismiss the patient to their ride so they can go home and afterwards I have my assistants come in and they're both in their early twenties and these two assistants, one's a female and one's a male. And I said, Look, I'll never be upset if you stand up for yourself and say, Hey, that's not appropriate. That's not right. Even if it means that money walks out the door, I don't care. I want to make sure that you guys feel protected at this office.

McNeill [00:17:29] How would you do things differently if you had to do it over again? So that patient situation.

Ganter [00:17:35] You know, I've actually gone round and round. I mean, what can you do? I'm a, there's so many things here to unpack. One. Is it worth it? There's a voice in my head that saying, look, we're set up. You're going to sedate him. He's probably nervous and he's just having this nervous chatter. It's not right. But what do you do here? And, you know, the other thing is, like when you're new in practice, when you have these big cases, this case is unfortunately a high dollar case. And one of the thoughts I walk through my head is I don't want to embarrass him. That's crazy. But that's one of my thoughts. Like legitimately, I don't want to hurt his feelings.

Wright [00:18:12] But then what happens if, when you have to see that patient at a follow up, like, how was that interaction? You know, when you continue to manage them, do you chart this in your note? Do you, you know, alarm the whole team like, hey, be on the lookout for this, Right? Because I think about those things like a falling down the line of I have to see them again. Yeah.

Ganter [00:18:29] For him, there is no evidence that he would have even thought anything was wrong. He. He just goes about his normal way. It's not that it makes him. You know, we try not to have a female only in there with him. We always try to do the buddy system. Absolutely. And I pose this question, that same question. I was part of a Harvard surgical leadership program, and we had a women's surgeon group on the side here. And I posed this. I said, told the scenario. And shockingly, my scenario was the most G-rated of all of the stories that I heard from some of these women. Yeah. And it's not just in America, it's in Italy, it's in the U.K. It's all over the world.

Ioannidou [00:19:12] In Europe, this is the mainstream. That's not the point, don't even go there. But I want to say that you're absolutely right. And you knew it was your practice, It was your decision. You, you read the room, you made your decision. And, you know, if you are comfortable with it, that's perfect. It's a great resolution. The problem that I see is when those things happen in dental school and they do happen, they do happen to female dental students. And and then, you know, as a matter of fact, we started in many schools, including UConn, we started developing policies to protect students from this, because when the student is exposed to behavior like this, you know, and again, they are conflicted because on one hand, they want to complete the case for credit.

Ganter [00:20:01] Yes, of course.

Ioannidou [00:20:02] And on the other hand.

Ganter [00:20:03] They're trying to get out of there.

Ioannidou [00:20:04] Exactly. And on the other hand, they feel very uncomfortable and they don't know if this continues outside the school. So they are even more vulnerable. So it's such a complicated situation when it happens at their school level.

McNeill [00:20:20] Into Steph's point, Yes, people are always watching you. Yeah. And there have been so many times in any patient interaction, I'll walk out and go, Oh my gosh, I wish I had not done what I just did.

Wright [00:20:32] Yeah.

McNeill [00:20:33] And to have a sit down with your staff and say, this is what happened, quite frankly, I may have done something different if I had to do it over again. You know, not expecting a perfect decision when something like that happens. That's such an unusual thing. And I think it's great to cast light on some of those issues.

Ioannidou [00:20:53] Oh, absolutely. Transparency.

Ganter [00:20:55] It's the transparency and it's also the discussion point. And I also talked about this situation with a group of female dentists in my area. And I was just trying to, I don't know. And it wasn't, I didn't want to suffer in silence if I'm being completely honest. This hurt. Yeah. I don't know why comments like that have to hurt, but they do. And I think for, it hurts my ego and it's frustrating because I don't know why it always has to come back to that point. I don't know where that, that's just kind of those comments, the sexually suggestive comments. Why is, that have to be the end all? Why is it the last little zinger that, you know, you fall kind of subject to? And I guess my frustration is that more women don't kind of speak up about it. And I was actually inspired to start talking to some of these different groups because of some of the books I've been reading from some female athletes and their stories. And so I absolutely love it. And I'm encouraged by some of the women who kind of refused remain silent.

McNeill [00:21:52] And I would say, Steph, it's super important for women to hear these stories and it's super important for men to hear these stories as well.

Ioannidou [00:22:00] Absolutely. And I agree with you. We always have this conversations in the dental school when we bring gender issues and equity issues and harassment discussions. They used to be perceived as women's problems. They are not women's problems. They are society problems. And if men are not in the conversation, we will never change the situation. I really appreciate the fact that you share this story. This is huge and amazing, the way that you transparently share the story with your staff and you, you know, allow them to space, to if this happened again, how to behave and how to react and how to feel free to express themselves. That's great.

Ganter [00:22:38] Thanks.

Wright [00:22:38] Yeah. So speaking of frustrations, we've talked a little bit about that. We've talked about communication, we've talked about burnout, all of these things. My story kind of encompasses a little bit of all of those. So I have this one particular case where I did a consultation with a patient who needed an upper denture. They needed some teeth extracted on the lower they had some perio involved, teeth, excuse me. And they came in. They were by themselves the first go around. It was a female and I did the treatment plan and we were going to just start with the upper, but I made sure that I shared that sooner than later those lower teeth were going to be coming out as well. Right? So I took care of the uppers, delivered the denture. It was an immediate denture. Right. And then I did my post ops with the patient. You know, I saw them, did adjustments, blah, blah, blah. So then a month or two goes by and then the patient comes back. This time she's accompanied by a family member. And so I was just like, Oh, okay. And I am like crazy when it comes down to documentation, at least, you know, I really, really try. And so in this particular instance, I'm super duper excited that we had some documentation on file. So and what I mean by documentation is like, if I present a treatment plan to the patient and they verbally decline, I still present that treatment and we scan it in like even if we change it and give them something else on paper because the patients want to see something different on paper. And if they accept that treatment plan, I still scan in or make sure that it's a recorded what I offered the first go round. So this was all on file, right? So they were just like, No, someone told us. Someone told them that I was going to be doing the extractions for free. And I was just like, I have no idea who said that.

Ganter [00:24:24] I'm going to pause you right there.

Wright [00:24:25] Awkward, as you know. Listen, I was so, I was frustrated because, well, so, so all of this happened with I was actually seeing other patients right in the office. Right. And so then my manager comes to me and is like, okay, doc, I need to kind of pull you in the office for this. And I was just like, okay, what's going on? And so I kind of remember the situation. I go back through the computer and I'm just like, Well, the treatment plan for those teeth are right here. Long story short, I did end up doing those t I did end up extracting those teeth for free. And I know the world is probably going to slaughter me about this, but what I had to think about was what was more important in the situation. And here I am, you know, I'm like the teeth were waving in the wind. It was literally like, you know, it was one of those situations where it's like, it's not going to take me any time. The patient could literally just.

McNeill [00:25:14] Even I could have taken them out.

Wright [00:25:16] You could have easily, could have taken them out herself. And I did decide. I said, you know what? I'm not going to argue back and forth because I'm really solution oriented. And if we would have just continued going back and forth, then a whole bunch of other things I feel could have happened because it did get really heated in the four walls of that office, right? So I ended up doing those extractions for free, but I made sure that the patient signed documentation that I had given them the treatment plan. The person like I went into my office and I typed up, you know, a different type of consent. I made sure that I explained the situation and that all parties involved, like the family member, the patient and myself, the manager, we all signed on the dotted line at that time. And so that's my sticky situation. And as a new dentist, yeah, it was really, really tough because for me it was like, yes, I could have made money off of those. But at the same time, I also have a reputation to uphold this person who they named, who was not there. I wasn't in on that conversation, whether it happened, whether it did it. But at the same time, I was like, I'm not going to argue about this. So like, let's just get it done. You have the denture already, let's just deliver it, and then it was over with from there.

Ioannidou [00:26:30] It's good that it was only the six teeth and not an implant supported over denture.

Wright [00:26:34] Yeah you know right now. Oh no. Now if it was that, then that would have been a completely different story. Yeah. And then, oh, I didn't add that we were, we were a startup, so it was literally within the first month or two of the office being open. And so then on the one hand, I'm like, All right, you know, I'm like, I really need to produce at this time. But then on the other hand, it's just like, I don't want to be the doctor who was a jerk and you know, there was somebody who made this promise. And then I don't deliver on the promise because it doesn't fall on that individual. It falls on me. You know what I mean?

Ganter [00:27:08] I love what you're talking about as far as you see in the forest. Yeah. You're not just seeing the individual trees here. Yeah. And even though you may not have had the production from those six teeth you may have won five more cases of a positive words from those patients.

McNeill [00:27:24] Steph, it makes me think about, Do you want to be right or do you want to be in a relationship? And from a state board regulatory hat standpoint, you would be amazed, the number of complaints that are filed over a $100 bill.

Ganter [00:27:39] Oh, yeah, I'm sure.

McNeill [00:27:41] A consult fee or something else. And the time out of your practice, your interaction with malpractice carriers, your own mental well-being, you're.

Ganter [00:27:51] Yeah.

McNeill [00:27:51] Leaving some money on the table.

Ganter [00:27:53] I was in, say, your, your, your old partner in practice, Ronnie used to say that he say don't be afraid to leave money on the table.

McNeill [00:28:00] And leave money on the table. There are times.

Ganter [00:28:03] Ronnie Rogers.

McNeill [00:28:04] Other dentists have thrown me under the bus clinically and unnecessarily, and I have given back money with a signed release after interacting with my malpractice carrier.

Wright [00:28:16] I do that too.

McNeill [00:28:17] And just say I did this stuff. There's nothing wrong with this. But ,but you know, you have another clinician say something and that throws everything. It doesn't happen very often. But when it does.

Wright [00:28:30] But when it does, yeah.

McNeill [00:28:32] It wears you down. And that's where talking to other people, having connections, saying, Hey, how would you handle this situation? That's why I'm glad you guys are doing this Sticky Situation webcast so people will hear this kind of stuff.

Ioannidou [00:28:45] And I think Dr. Wright's story is amazing because it's really, you know, like that. Exactly. You hit the logistics and the economics of their practice now.

Wright [00:28:54] Well, so we have a little thing that we like to do here on the show where we ask a question and then we go around with rapid fire answers. Is that okay with everybody?

Ganter [00:29:02] Love it.

Wright [00:29:03] Okay. So I want you guys to go around really quickly and complete the sentence. So the best thing about dentistry is., Steph.

Ganter [00:29:11] Freedom.

McNeill [00:29:11] Mandible.

Wright [00:29:13] Doctor Effie?

Ioannidou [00:29:14] Protecting oral health.

Wright [00:29:16] There you go. All right, so you go.

Ioannidou [00:29:18] The academician.

Wright [00:29:20] Said, So what?

McNeill [00:29:21] My answer was terrible. But that was the first thing that came into my head.

Wright [00:29:27] I love freedom. That's actually that's something. Freedom is something for another, another time. Actually, I.

Ganter [00:29:32] I say I could go off on that so much. It's, there's so much freedom within dentistry that and I love it.

Ganter [00:29:37] Okay so more quick fire. Bobby, you're going to start. What's the first word you think of when you hear dentist?

McNeill [00:29:42] Freedom.

Ganter [00:29:43] Stop.

McNeill [00:29:44] You just took your.

Wright [00:29:45] Strike it.

Ganter [00:29:47] Take it out of the reel or whatever. Stop it.

Wright [00:29:49] No. All right. So what about yours? Y'all have had 2 seconds to think of it now, so you should have an answer.

Ganter [00:29:54] Connection.

Wright [00:29:54] Connection. Dr. Effie.

Ioannidou [00:29:56] Fun people.

McNeill [00:29:57] Yes.

Wright [00:29:57] I was going to say type A. So what's the first word ,when you think of when you hear smilecon?

Ganter [00:30:04] Amazing.

McNeill [00:30:05] Fun.

Ioannidou [00:30:05] Smile. I smile, smile, smile.

Wright [00:30:09] Smile. Nice. Okay. What's the first word you think of when you hear candy?

Ganter [00:30:13] Hershey's.

McNeill [00:30:13] Caries.

Ioannidou [00:30:15] Oh, caries too. Or you know, something bad.

Wright [00:30:17] I was going to say sweets.

McNeill [00:30:20] Dental caries.

Ganter [00:30:20] You guys are not chocolate loving. Oh, my gosh.

McNeill [00:30:24] I'm an oral surgeon.

Wright [00:30:25] All right, last one. Let's see. What's the first word you think of when you hear sticky situation? Steph, you go.

Ganter [00:30:31] Opportunity.

McNeill [00:30:33] Challenging.

Wright [00:30:34] Dr. Effie.

Ioannidou [00:30:35] Resilience.

Wright [00:30:36] Resilience. I was going to say awkward moments.

Announcer [00:30:40] On the next Dental Sound Bites.

Wright [00:30:42] Difficult conversations in and out of the dental office. We're talking about the importance of mastering communication skills and how to tackle tough conversations. Get the tools and the knowledge to communicate effectively with your team, learn from crucial conversations, and set your practice up for success. Well, you guys, this has been such an amazing episode. It has been great to have you all here. And we want to just say thank you. Thank you so much for your time and for all of the wisdom and the stories that you shared with all of our listeners and with yours as well. So can you tell everyone where they can find you all? Go ahead and plug all of your channels. Your show. Let everybody know where they can get more of this.

Ganter [00:31:29] YouTube app Between Two Teeth. Our Instagram is at B, the number two teeth. I would have to say from Bobby and I, Dr. Wright, Dr. Effie. Thank you guys so much for doing what you do. It is tough. We know how tough it is to show up every day and do things just like you guys do. You got to be on. You got to have a smile. It doesn't matter what kind of day you had. You got to get that call. Thank you, guys.

Ioannidou [00:31:54] We love it. Thank you so much.

Wright [00:31:56] Thank you. So if you like this episode, go ahead and share it with a friend or a colleague.

Ioannidou [00:32:01] Subscribe to this podcast wherever you are listening so you can get the latest episodes. You can also rate and review and follow us on social media.

Announcer [00:32:11] 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.

How to Change Dentistry: A Look at Advocacy and How You Can Impact Big Change

In an ADA Dental Sound Bites first, we’re joining forces with our sister podcast, “Tooth Talk,” and diving into all thing’s advocacy: what it is, what it does and how it’s changing the profession. Plus, we explore five simple ways you can get involved right now.

Peter Aiello and Sarah Milligan

“Members of Congress and their staff want to meet you. You’re healthcare providers, you're owners, you're employers. You are really active in your community. The dentists I know are involved in a thousand other community activities. They're really pillars of their communities. And these members of Congress, you all are the people that they are dying to know within the community. And you're really leaders and they want to hear what's important to you because they know you're advocating as well on behalf of your patients.”

Sarah Milligan, Director, Political Affairs/ADPAC

Show Notes

• In the first episode of season two, Dr. MJ Hanlon announces the end of her time as host for the podcast, and Dr. Effie Ioaniddou is welcomed as the new co-host along with Dr. ArNelle Wright.
• This episode features the hosts of “Tooth Talk,” a sister ADA podcast, Sarah Milligan and Peter Aiello, who are experts in advocacy.
• Milligan is Director, Political Affairs/ADPAC and Aiello is Sr. Manager, ADPAC & Political Affairs.
• They both discuss their careers in advocacy and how they became involved in politics which includes coordinating the annual ADA Lobby Day event, which Dr. Wright attended and enjoyed it. More than 700 dentists and dental students attend this year’s event.
• Aiello shared that advocacy is the idea of going to the government to petition for change, and members of associations should tell their members of Congress how laws affect them. Milligan says that advocacy focuses on specific issues that affect the profession, patients and the practice. Members of Congress do not know all the little things that affect dental practice, patients, and the profession.
• All demographics of dentists are extremely supportive of each other and have the same level of urgency, fire, and love for the profession and practice, Milligan says.
• Student loan debt is a key concern among students and younger dentists. Ioaniddou says high student loan debt is preventing many dental students from pursuing their desired careers, such as academia.
• The Ready Act, which defers interest during a dentist residency, is mentioned as an example of legislation related to student loan reform. Aiello explains that there will likely be a Senate companion bill for the Ready Act and emphasizes the importance of incremental progress in advocating for legislation.
• Milligan acknowledges the significant issue of student debt, but notes that in a Republican-led Congress, it may not be a high priority issue for Republicans. However, supporting specific bills like the Ready Act can still be a meaningful step forward.
• One of the ADA's big legislative victories was the McCarran Ferguson repeal in 2020, and another was the Massachusetts medical loss ratio ballot initiative.
• Small legislative changes can also have a significant impact and don't always require a nationwide campaign, so Milligan and Aiello explain it is important to lobby at your state level as well.
• Attending Lobby Day, encouraging fellow dentists to attend are just a few ways to get involved, but Aiello says the most important thing you can do is vote. There is a record of each time you have voted in the past. While it doesn’t share who you voted for, it does help lawmakers see if you are engaged in the process and they are more likely to listen to people who vote often.

Resources:

• Read more about this year’s ADA Lobby Day
• Discover the ADA’s key advocacy issues
• Listen to episodes of “Tooth Talk”

Transcript:

Wright [00:00:00] Hello, everyone. I am Dr. Wright and this is Dental Sound Bites an ADA podcast where dentists share solutions to challenges in life and work.

Announcer [00:00:13] 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 [00:00:29] Welcome to an all new season of Dental Sound Bites. Before we dive into our topic today, I have an important message from Dr. Hanlon.

Hanlon [00:00:37] Hi, everyone. It's Dr. MJ Hanlon here. It has been an unbelievable, great pleasure and honor for me to share my knowledge and insights with you during season one of ADA's Dental Sound Bites. Unfortunately, I am concluding my time as your host. While I'm excited to explore new opportunities, I will miss you so much, Dr. Wright and our incredible community of dentists. Thank you to all the listeners for your support, engagement and feedback throughout our time together. I do appreciate the opportunity more than you know. As you continue to provide excellent dental care to your patients please remember to take care of yourselves. I wish you all the very best in the future. I'm really pleased to pass the cohost baton to your new season to co-host.

Wright [00:01:18] Well, Dr. Hanlon, we are missing you here at Dental Sound Bites. We thank you so much for all of the wisdom in the time that you shared with us. We want to welcome our new co-host, Dr. Effie Ioaniddou.

Ioaniddou [00:01:30] Thank you, Dr. Wright. This is really exciting to be part of the Dental Sound Bites. I'm Effie Ioaniddou and I'm a professor at the University of Connecticut. I'm a periodontist, I'm a clinician scientist, and I'm super excited to be part of this podcast, so with this, let's jump right in.

Wright [00:01:48] Yes, let's do it. Today we're talking all things advocacy. And who better to do this with than the hosts of our sister ADA podcast Tooth Talk. So please welcome Sarah Milligan and Peter Aiello. Hi, everybody, hey, guys.

Aiello [00:02:03] Hello.

Milligan [00:02:04] Hi. Thanks for having us.

Wright [00:02:05] Thank you all so much for being here. Can you tell us a little bit about yourselves, how you got involved in advocacy and a little bit more about your podcast?

Aiello [00:02:13] As I said, I'm Peter Aiello, one of the co-hosts of Tooth Talk I'm also the senior manager of AD PAC and political affairs here at the ADA. I kind of got into advocacy through my background, which was political campaigning. I did a lot of work in the field, so I did a lot of voter targeting, making lists of who to go talk to and rallying the troops and getting them to go knock doors and make phone calls and get people elected to Congress and try to make sure that they get out there or send people to where Sarah used to work on the Hill.

Milligan [00:02:43] Yes, I'm Sarah Milligan. I'm the director of PAC and political affairs for the ADA. And I came a slightly different tact, but very DC. When I graduated from college, I came to the Hill, wanted to work on the Hill. I was only going to do that for a year and then go to law school. Law school never happened. I have been in D.C., continuously, worked for a few members of the House of Representative and a different trade association before eventually making it to the ADA. And this has been my entire career path has been Washington focused and sort of federally based. Peter and I work on the D.C. staff of the ADA. Even though we are based in Chicago, we keep people in D.C. that are really focused on the federal government and our federal initiatives. So Congress, the bureaus and agencies and The White House.

Wright [00:03:29] Awesome, you said, Sarah, that law school never happened for you. And I have the same experience. So once upon a time I thought I was going to be a lawyer and go that whole poli-sci route and I kind of deviated and went into dentistry instead.

Milligan [00:03:43] Well, it sounds like you had a great deviation.

Aiello [00:03:48] Slightly better.

Ioaniddou [00:03:49] Not necessarily both careers, I think, are interesting, Right. Maybe that's why Dr. Wright is very active in advocacy.

Wright [00:03:55] This is a full circle moment. We're going to get into a little bit about Lobby Day in just a moment. But I found myself at Lobby Day and I enjoyed it just as much as I enjoyed doing dentistry. And I didn't have to go to law school to go.

Milligan [00:04:08] That's great. Yeah. And we are excited to talk to you about Lobby Day. Thanks for coming.

Announcer 2 [00:04:15] 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 ADA member app in your app store.

Wright [00:04:53] Well, thank you so much to everybody who sent in questions for this episode on Instagram at the American Dental Association. I would love for you all to just tell us what Lobby Day is, what happens at this amazing event, how Lobby Day impacts the profession for all of our listeners out there who they may not know. I was one of those people who didn't know that this was a thing. Call me living under a rock. I mean, I don't know, but I just didn't know. And I'm glad that I went.

Milligan [00:05:22] Yes, well, Lobby Day is a joint production between the ADA and also the American Student Dental Association. This past year, we had 700 dentists and students from all over the country, all 50 states, and we had two audiences during Lobby Day. The first one is the dentists and students that join us for Lobby Day. Our second audience is members of Congress and their staff on Capitol Hill. We need to make sure that our message is heard and that we're making an impact and that our dentists are prepared to present these issues and in a meaningful way that makes members interested and want to hear. And we don't expect every member of Congress to be with us on every issue. We usually present issues where there's something that everyone can get behind. Over the few days that we have Lobby Day, we do a series of networking events because dentists and students love to network with each other. It's a very people centric profession, as you may know. And then we also we do a lot of training. We're going to make sure that you are ready to present these issues. And then on the last day, you go to the Hill, you meet with your members of Congress, with your fellow colleagues from your state, and then you do some follow up. And we hope that you'll continue that throughout the year and then that we see you next year.

Ioaniddou [00:06:38] That's great.

Aiello [00:06:38] And it's definitely our best opportunity to show unity and as we like to say, speak with one voice united on the Hill, bringing in that many people we can almost hit every office and too it's we're one of the bigger fly-ins and people know when we're when the dentist are coming you guys you see the little tooth flags everywhere and the members of Congress. So it's like, oh, yeah, the dentists are here. So it's great to see that. And they know they're paying attention.

Wright [00:07:06] I wanted to kind of share a little bit about my experience at Lobby Day. And like I said earlier, like I thought that at one point in my career or in my life that I wanted to go to law school and do the whole, you know, lawyer role, maybe eventually politics. And then I was just like, okay, no, this is not going to work for me. So I'm on the new dentist committee, and one of my colleagues there is the one who kind of really, really encouraged all of us to kind of put our hands up and go to Lobby Day. And I was just like, man, I was a little bit intimidated because the whole politics thing, I feel like I'm not like as well-versed as some of our colleagues. And so I said, well, there's only one way for me to learn. And so I said, yes, I was going to go. And when I went, it was very eye opening, very insightful and very enlightening about all the work that's happening in the background that, you know, we say advocacy is like a reason why we get involved with the ADA and we're members and things like that. But being at Lobby Day kind of helps me see exactly what you all are doing and what it doesn't mean to truly advocate for the profession. So it was very, very informative for me and I can definitely see myself attending again. I felt really well briefed on stuff. I loved sitting in the training and all of that. But how was it for you all to get us prepared?

Aiello [00:08:26] Getting you guys prepared is the joy, that that's the easy part. Once we get our issues and once our regulatory policy and our lobbyists get the talking points together, putting the trainings together is great.

Wright [00:08:38] That's the easy part.

Aiello [00:08:39] The rest of logistics, I need a very large swear jar for so you know, and it's like it's how we fund the brunch after Lobby Day for the staff. But we have a very talented staff and I can't thank them all enough about how they work on this, this particular event. And also you all come ready to go be there.

Ioaniddou [00:08:57] Peter, I have done Lobby Day, not with the ADA, but with the AADOCR, the American Association for Dental Oral and Craniofacial Research. And it's certainly we are not 700 people going around. We are very, very few. So it's really the logistics kind of easy to handle, I guess. But when you have such a huge crowd, like in terms of practicality, to make all this appointments and setup people in the right district with the right representative and it's just a nightmare. It's it must be super hard. Kudos to you guys. This is amazing.

Aiello [00:09:32] Thank you. Thank you very much. You make it easy. You really do. The dentists make it really easy.

Milligan [00:09:36] I spend a lot of time with members of Congress that their staff and if someone is listening and they leave with nothing but what I am about to say, I would be very happy with this time investment. Members of Congress and their staff want to meet you. You are health care providers, you're owners, you're employers. You are really active in your community. The dentists, I know they were involved in a thousand other community activities. They're really pillars of their communities. And these members of Congress, you all are the people that they are dying to know within the community. And you're really leaders and they want to hear what's important to you because they know you're advocating as well on behalf of your patients.

Aiello [00:10:18] I was going to just hit on that last point you said Sarah, your a good, a constituency that represents another constituency. So you're a dentist, but you also represent your patients, and that's huge. So because everybody has teeth, so are these dentists.

Wright [00:10:33] Let's get down to the basics. What advocacy is? What does it do and how is it changing the profession?

Aiello [00:10:40] I can take the first part of the basics of what it is. There's a Margaret Mead quote out there that's I'm going to butcher it. But it's basically saying like, never doubt that a small group of dedicated citizens could change the world because it's the only thing that ever has. That is kind of what advocacy is in this 30,000 foot level. It's this idea that you can go in there and you can petition your government to do what you want it to do. And it is really important when you get a group of citizens together to do stuff like that and to kind of talk about, you know, there are multiple ways of doing advocacy, but the importance of it is like your members of Congress are not going to know all the little things, especially in dentistry, that will affect your practice and the patients and the profession. So it's really important that members of the association go to their members of Congress and explain how laws that they pass affect them. So the idea of what does it do? Sarah worked on the Hill. So when you get all these people, Sarah calling into the members of Congress, what does it do?

Milligan [00:11:41] Well, that is a great question. You know, Hill offices track every phone call that they get, every email that they get from their constituents. So there's roughly between 750 and 800,000 people in any of the 435 congressional districts. And those House members or senators who represent states, the most important people to them are their actual constituents. So whatever is important to those constituents is what those people are advocating for. So, you know, personally, you might advocate for social issues, you might advocate for lower taxes generally, when Peter and I are talking about advocacy or talking about it through the ADA lens, we are only talking about dentistry. We're not talking about issues outside of the profession, the practice, the patients. We are only talking about some very specific issues that affect the profession, which then also includes, you know, you're advocating for your patients and you're advocating for yourself as well.

Aiello [00:12:36] And changing the profession. I believe there, Doctor Oyster, that in North Carolina has said it a million times in a great way. It's like if you're not at the table, you're on the menu. So you have to be involved in order to make sure that your voice is heard. The only thing that's going to make change is people standing up and actually being involved.

Ioaniddou [00:12:52] Yeah nowadays, do you find that more younger or newly practicing dentists are involved in advocacy or do you find that it doesn't really show any difference in demographics. In other words, which group is more active and more motivated to advocate for the profession?

Milligan [00:13:09] I do not find there to be one age group that's more involved than the others. I mean, I think every age group has certainly a different perspective. An experienced practitioner is maybe looking towards the end of his or her career and some issues that might affect them. Whereas a student is looking at things like student debt, how am I going to buy a practice? How am I going to employ people? Is there enough workforce to employ to keep my doors open? What I will say and I have worked at different trade associations, the dentists at all demographics are extremely supportive of each other. The experience practitioners are really supportive of the students. The students are really supportive of the experience practitioners and think that some that are maybe ending in retirement maybe have a little bit more time on their hands. But I don't think any less urgency than a dental student who is very busy, is trying to figure out their next few years. You know, they speak at the same volume. And Peter, you tell me but I think we see the same fire and urgency and love for the profession and the practice and from all demographics.

Aiello [00:14:16] Yeah, I will definitely agree with that. I think that it's the only thing difference you see between your new dentist, your dental students, your middle of their career dentists and people that are phasing out is just the issue that's most important to them. Kind of moves a little bit. Definitely with the dental students, it's all about their student loans. It's all about how do I get into this profession and what is the government going to do to either hinder or help that?

Wright [00:14:41] Very true. And you know, when I was there in early March, I saw a variety of age groups and demographics there, too. So to your point, Sarah, I was actually surprised by the amount of dental students that were there because when I was in dental school, I had never attended. And looking back, it's something that I wish that I had done just so that I would be a little further ahead in just my knowledge of the issues. But there was like a great like prep session, so we had a good time being able to kind of go through the issues that we were going to be advocating for, both collectively and individually in districts. It was really, really good to be there.

Ioaniddou [00:15:15] What do you think are the key issues? You brought up the debt and the financial issues that students or young dentists face, but in addition to this, any comment on the other important issues that the dentists are interested in?

Aiello [00:15:29] Student loans is a big one. Insurance reform is a huge one.

Milligan [00:15:32] There's Medicaid.

Aiello [00:15:33] Medicaid, regulatory reform. These are all ways in which the regulations and the government kind of get involved in what the what you can do in your practice. Those are some of the high level issues we have, the bills that we've touched on in Lobby Day and they're really important. But the key issues are that and then workforce also medical loss ratio has come up real quick out of nowhere. Thank you, Massachusetts.

Milligan [00:15:55] We also have a lot of tax based issues. I mean, a lot of our dentist offices are small businesses. And of course, you know, we have a lot of complicated arguments revolving around tax structure. A lot of federal programs, prevention programs are funded through the federal government. So there's advocacy that takes place securing those funds every year. I would say also, you know, there are some things that like we never think of, there's sometimes been issues with credit card swipe fees. So it really, really runs the gamut to things that you would go to naturally and then other things that are sort of unintended consequences of other legislation that affects us that no one really ever thought that it would be an unintended consequence. So it's sort of keeping an eye on all of those issues all at the same time.

Ioaniddou [00:16:41] The other day it was interesting. I was sitting with one of the students in their school of UConn, and she came to my office to ask for advice pertaining to her career plans. Right. And she said and it's you know, it was like really impressive to me. It was first time I heard she said, you know, I could go and do residency. But what they want to do, I really want to change the way we practice dentistry and focus more on environmentally friendly and sustainable dental practices in terms of regulating the disposables and trying to avoid so much plastic. And I was like, so refreshing. This is so refreshing to hear from. And to your point, Sarah, before I really find that their students and their newly graduated dentists are really informed about this, right, Which is really impressive. They know more about dentistry and more about the issues than people in my generation. And, you know, I mean, I mean my 50s. So it's been around for a long time.

Milligan [00:17:40] Well, I don't know about more, but we can certainly compliment them on them on being very active and up on their issues. Yes.

Aiello [00:17:46] I mean, it is kind of something that's been floating out there that and not to throw my own generation under the bus, but the millennials, we're kind of less involved. And this generation is just on top of it, like we have our first member of Congress from was it Generation Z? So I feel like they're much more engaged.

Ioaniddou [00:18:05] Sure.

Milligan [00:18:05] Yeah.

Wright [00:18:06] One of the things that came up actually was student loan reform. That was a topic of discussion while I was there. And it was something that I was pretty interested in because, I mean, I'm not directly affected by this actual piece of legislation because I'm not in residency. So the Ready Act, but diving into student loan and student debt, can we all have a recap of where we are, what's coming next? Just a little bit more about that legislation that was discussed.

Aiello [00:18:33] Ready Act is out and there will be a Senate bill, companion bill, or I can say that with absolute certainty. So that's important when it comes to legislation in general, for us, incremental steps are a big deal in Lobby Day one of the breakout session was about how a bill really becomes a law. And what I wanted to focus on in that session was actually the understanding that nothing happens quickly in DC until it does. So this idea that like for a couple of years we just had a House bill and then we were able to find a sponsor in the Senate to get it introduced in the Senate last time around. And just continuing to focus on this and advocate on it is incredibly important. You mentioned the Ready Act. Ready Act is about deferring interest during a dentist residency.

Wright [00:19:19] Awesome.

Milligan [00:19:19] Well, student debt is such a tremendous issue. I mean, it is a huge issue that we have nationally and we always have to look at, you know, when we're looking at pieces of legislation like what is viable, what is the political environment. So I'm giving you a for instance, in a Republican led Congress, student debt is just not a huge issue for Republicans. However, there's bites that you can take at the apple that are much bigger and more meaningful that people can really get behind. So something like the Ready Act is some is something people can understand. It is not a holistic solution to student debt as a whole. But when we're looking at, you know, can we do something? Something like the Ready Act, is that something that is feasible? We've got support on both sides. Republicans and Democrats can understand this issue, and that is why it is a piece of legislation that we're supporting.

Aiello [00:20:13] And we need to do something. Just working on, as Sarah said, with the Congress is what bites can you take it the apple to lessen the burden on student debts? And every time Lobby Day comes around and we talk to the students, the number floors me. I remember meeting one student that had almost $500,000 in debt, and all I could think of was who's going to give you a loan to buy a practice if you're already $500,000 in debt?

Ioaniddou [00:20:38] I think another important message, this is the alternative negative of this story. People like me that and there are many that come from outside the United States, like from Europe with zero debt. Right. The freedom that this gives you to make the career choice that you want. I see many times and I talk to dental students that really want to go to academia. And the limiting factor is the huge debt that they have and their low salaries compared to their private practice income. So this is another limiting factor. I see a lot of students that reconsider academics just because of the, as you said, the $500,000 loans that they carry already at graduation. Right. So as we see now, our dental school's faculty shift to be more foreign graduates. So it's a very complicated and multidimensional issue.

Aiello [00:21:32] And that's kind of the other thing about student loans that we all like to focus on and keep an eye on is that you can tie it into so many other issues. So which is why it's important to everyone in the profession. It's not just important to the students.

Milligan [00:21:46] You know, we really encourage and want everyone to tell their individual stories. So we actually want a student or a new dentist to go right into a member of Congress and say, This is my experience. I came out of this dental school with this amount of debt, and these are some of the issues it has caused me. We go through a lot of training during Lobby Day on how to really tell your story because these members of Congress, when they are in session, their day is about every 15 minutes, a new group, a new meeting. Everybody has a trade association, everybody has a lobby. And so how are you differentiating yourself from all of these other people and all of these other issues that people have and the student debt issue and really telling your story? At the end of the day, this member of Congress is going to say, well, I remember Dr. Wright came into my office. She was really impressive, really articulate. She was a dentist. I love dentists. I love strong oral health. And she told me the story. I had no idea that dentists incurred this amount of debt during their dental school. And that's just incredible. And that's something that they would really remember and take with them.

Ioaniddou [00:22:55] What are the takeaways of their lobby day that happened?

Aiello [00:22:59] So I think my big takeaways are you're the best advocates for your profession and your patients and your practices. So come to DC, go to your members and their home offices. It's really important that you meet with them. They want to hear from you. We want you to talk to them.

Milligan [00:23:13] I think you said it perfectly, Peter. Another one of the takeaways is that you don't have to come to Lobby Day to be an advocate. I mean, we'd love for you to come to Lobby Day.

Milligan [00:23:22] I'm so glad you said that.

Milligan [00:23:24] Yes. And we have so many resources available to our dentists and dental students to kind of keep you in the fold and make sure that you know what's going on.

Wright [00:23:33] Yes. So can you guys tell us a little bit of advocacies, big wins, current legislation? Just what are some highlights, things that you could share with our listeners that they may not have as much insight into this whole advocacy piece?

Aiello [00:23:48] I think the biggest one last year is MLR and the Massachusetts medical loss ratio. Yeah, we did a podcast Tooth Talk with about what exactly that is with people who are a lot more savvy about the nitty gritty of what that means. It was with Dr. Vitaly and Paula O'Connor, who's on our State Government affairs staff. So that's kind of the to get to get the nitty gritty you to go over there and listen to that that episode. But the fact that that was a ballot initiative and dentists from all over the country helped out in Massachusetts and really worked the phones, worked the polls. There's great pictures on the social media channels of our member dentists out there waving signs, which is amazing. In Massachusetts. It's a big thing in Massachusetts.

Ioaniddou [00:24:31] Oh its amazing.

Milligan [00:24:32] Before that, we had McCarran Ferguson repeal, which was huge. That was in 2020. I will also say, though, I mean, victories don't always come in these major fights, right? We sometimes will see some kind of bill, a piece of legislation, but just one word or one sentence, sort of gives us some unintended consequences. And many times we're able to go to that member of Congress or their staff and say, you know, if you I know that you did not intend to loop us into whatever this bill is, this is how it affects our dentists and our the patients that the dentist serve. Many times we're able to have something change that's very small, that would require a big impact. And we don't always have to do that with a, you know, some kind of huge nationwide campaign. Maybe we just get the dentists in that state or in that congressional district involved to make those asks. So these winds can come at all different levels in many different forms.

Ioaniddou [00:25:30] Yeah, this is very right. You're very right. And do you do you think that Massachusetts opens the door to other states? This was a great win there. But what's the implication nationwide?

Milligan [00:25:41] It does. It provides precedents. And these things can happen in other states. If you always have this Massachusetts sort of guidebook and guiding light to go by. And what did we do there that really led to that tremendous victory? We don't want everything to be a ballot initiative.

Aiello [00:26:00] That is that's a lot of work and expensive.

Ioaniddou [00:26:03] Oh, I bet.

Milligan [00:26:04] Oh, yeah. But not everything needs to be a ballot initiative.

Aiello [00:26:06] Yes, exactly.

Milligan [00:26:07] But certainly, as I said, provides precedence in other states.

Aiello [00:26:10] Not also helps that the fact that it was a ballot initiative actually helps in other states. And this is kind of the political angle of it rather than the advocacy angle of it, But because it was a ballot initiative and they had the Massachusetts General Assembly have been kind of dragging their toes about really dealing with this. And the members up there went to the ballot like other states. Look at that and go, you know, maybe we should deal with this before we're told how to deal with it. It's that idea of like whether or not like to be able to write the law or whether you're going to get the ballot initiative law handed. So some have got to go in that middle, too.

Ioaniddou [00:26:44] That's good.

Wright [00:26:45] Yeah. If you guys can tell us if they've never been involved in advocacy, how can we get involved and do our part?

Milligan [00:26:53] We have an elevator pitch for that.

Wright [00:26:54] Okay, There we go.

Aiello [00:26:56] A couple of elevator pitches for that one.

Milligan [00:26:57] Peter take it away.

Aiello [00:26:58] All right, well, there's a laundry list, but I'm going to start with the first one. Register to vote and vote. If you don't do that, nobody cares what you think. No, no offense. I hate to be that blunt about it. I'm going to be a little blunt In this particular management.

Wright [00:27:13] Share with us.

Aiello [00:27:14] Who you vote for is completely confidential, whether or not you vote is not. And so I can go. You know when I worked in the campaign space and to a lesser extent with our members, too. When we got the voter data, I could go in and see how many times you voted, like what elections you voted and not to who you voted for. Again, I cannot stress that enough when I don't know who you would have voted for, but I could tell whether or not you vote. And if I was a member of Congress, if you came in with an issue and I noted that you couldn't even do the basic bar to entry citizen, you know, I couldn't tell you whether or not your priority would hit the top of my list, but that's why I'm not in Congress. So that's the thing. So attending Lobby Day, we've hit a couple of times. Most states do their own Lobby Day as well for their state houses go to those federal laws will definitely affect dentistry in major ways, but the state laws are really, really important. That's going to scope a practice. All that kind of stuff is going to be decided at a state level. So make sure you get involved at your state and your state level to again, sign up for those action alerts. They're incredibly important. It's it's a great way just a it's a it's the easiest thing you could do. It clocks in at about 45 seconds if you don't edit the email. But again, I do encourage you edit that email. Contacting your state government affairs people and your state society people to get an idea of what's going on in your state, how to get involved in there, and then just bring a friend to everything that's always a great one. Doctor Wright? You said you had a great experience at lobby Day. I'll grab somebody and drag them next time because then that's how we got to keep going to all the next steps. But I really can't go get a circle right back to the first one. You've got to vote.

Wright [00:28:48] That's actually my goal too, is just to invite people based off of my experience and just tell them like, this is just a foot in the door to get involved and to get excited about advocating for dentistry and the way that we practice, honestly, because one of the things that I heard while I was there is like everything that's happening now is going to affect us longer than it does more seasoned dentists and that was a wake up call for me to say, all right, even if I don't know as much as I wish I knew by coming, the more that I read, the more that I speak to people, the more that I have these discussions, I'm going to be more well versed, and then I'll feel even more confident in participating.

Aiello [00:29:26] Good. If you want resources to learn about your issues and what's important and what the ADA is working on, just go down to ADA dot org backslash advocacy that gives you all of the issues and all of the minutia I guess is a good word for it, like the really digging deep into every issue. And then once you feel comfortable with that, you come on over to our Legislative Action Center, which is at ADA dot org backslash action center you can sign up there. Plug in your email, you'll receive all of our alerts and we will be having a bunch of them on those lobby day issues coming out pretty soon. So make sure you do that as soon as you can, now while you're sitting here listening, if you're not driving.

Wright [00:30:04] There you go.

Announcer [00:30:05] On the next Dental Sound Bites.

Wright [00:30:08] We had such a great time with this topic in season one that we wanted more. We're talking awkward, strange, sticky situations with patients or peers in the dental office. We're going to dive into the stories and the strategies on how to stay calm in challenging situations, how to set boundaries and how to ensure safety for all. Dr. Effie, congrats on your first episode and Peter and Sarah, it was great to have you here. Thank you for your time. Thank you for all of the knowledge and wisdom that you've shared with us on Dental Sound Bites, and we are so grateful that you were able to join us today. Where can our guests find you?

Aiello [00:30:48] You can listen to Tooth Talk on all of your podcast platforms, so give those a check. Apple Podcasts, Google, Stitcher. Also our website is www.toothtalkshow.com. Get all our episodes, see our lovely pictures, and get to know more about us.

Ioaniddou [00:31:04] That's great. Thank you, guys.

Aiello [00:31:06] Thank you so much for having us.

Milligan [00:31:07] Thank you.

Wright [00:31:08] Thank you all so much for being here. If you like this episode, go ahead and share it with a friends or a colleague. Also, subscribe to this podcast wherever you are listening so you can get the latest episodes. You can also rate and review and follow us on social media.

Announcer [00:31:25] 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.

 

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!

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

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