Archive for category: Podcast

You’re listening to Ascent Radio and my name is Dr. Kevin Coughlin. Today’s podcast is titled What Not to Do. You’re listening to Ascent-Dental-Solutions. My name is Dr. Kevin Coughlin and the focus of Ascent Dental Solutions is on development, training, knowledge, and a combination of teaching episodes to try to improve the health care along with the business of health care.

What Not to Do is something that I thought would be interesting to our listeners. I am a practicing dentist full time. I have 14 locations located in Massachusetts and I provide all levels of general dentistry, including IV sedation, hospital dentistry, laser care, iCat scanning, you name it and I would say we do it in our dental offices.

At this point in time, I have been providing expert help in the process and procedures of helping dentists in all phases of their career from the very beginning to the growth stage to the exit strategy. And it struck me interesting over the last couple of months, a couple of particular instances that happened that I thought I would share and open up. Although I consider myself an expert, I’m also human and the mistakes here will show an excellent example, in my opinion, of what not to do.

The first example is an individual who is periodically late for their appointments. When I say periodically late, I would say between 50 and 75 percent of the time, they are between 15 and 20 minutes late for an appointment. This is not a rare situation. I think most health care professionals deal with this.

What struck me interesting was how our company handled this particular episode. The first thing that happened is when the individual arrived at the office, they said they were sorry that they were late, they knew that they were late, but they were struck in traffic. A common excuse that we hear quite often, but it was an excuse and the individual owned up to it.

The receptionist or front desk coordinator or team member, however you’d like to refer to your employees, said to the individual, “You’re almost 20 minutes late and something like this cannot continue to happen.” And the individual turned around and walked out. I can assure you that within less than 45 minutes, I received an email saying how dissatisfied this patient was with our organization. How unhappy he was about the way he was treated. He heartfeltly tried his best to be on time for his appointment.

The results of that particular process and procedure, that in my opinion was a failure, means that we lost that individual as a patient who’s been a patient in our practice for over ten years. We also lost their wife and we lost their three children. The result of inappropriate process and procedures has a dramatic effect on your day-to-day bottom line and your reputation. At this point, I haven’t seen a social media post of this dissatisfaction, but I can assure you that will occur shortly.

The correct way that this should have been handle — and keep in mind I’m coming across as an expert in process and procedures, this is my own office and I’m someone who prides themselves on training and education. The correct way would be to first have the patient seated. Explain to the patient that their appointment was at such and such a time and that because they were running late, we would do our very best to coordinate and complete their care. In this particular case, it was a hygiene appointment. I think most up-to-date offices will have dental assistants, dental hygienists, front desk personal, doctors and associates that I think could handle a hygiene appointment, regardless of how late that patient is.

The point I would try to make in this example is the negativity should have occurred after the appointment was completed, not before or during. My personal opinion is if this was handled correctly, I think the average individual would accept the fact that they were late and they would understand that perhaps we may not be able to do as excellent a job as we would like. But in most cases, I think offices can handle this particular crisis. The result of not handling it properly was a financial hit to our company and to our reputation. And I’m sure if it’s happening to me, it’s happening to others.

So the take home point in this example is keep the negativity until after the appointment is completed and then have your treatment plan coordinator simply say to Mr. or Mrs. Smith, is there a time that is better for you so that you won’t be late? Is there a way that we can coordinate the appointment so it is easier for you and there’s less stress on you? That proper communication and relaying of that information could have created a much better outcome. In my opinion, we had the worst outcome that could possibly occur.

The second example is an individual who has 12 broken appointments over the course of two years. The patient has not been in the office for a period of two years. Out of a total of 28 teeth, 26 teeth have dental carries. Although it’s not critical, this particular patient was a Medicaid patient or MassHealth patient. And for those listeners outside the state of Massachusetts, it’s basically a government-assisted program for those individuals who are of the lower income bracket and need financial assistance.

This individual, in my opinion, was rude, they were abrupt. Their treatment plan, their radiographs, their diagnostic photos, their diagnostic impressions, everything was done. All I’s were dotted, all T’s were crossed. Her last appointment, two years ago, were to surgically remove tooth number 21 because of gross carries and inappropriate approach to endodontic or periodontal treatment, in my opinion, was valid. The tooth was deemed topless and needed to be removed.

For a variety of reasons that are not necessary to go into at this point, the patient scheduled appointments but never showed up for those appointments and on a recent visit, she arrived at the appointment on time demanding that the treatment be done. A complete and comprehensive exam had to be redone to bring her records up to date and an evaluation concurred that 21 needed to be removed.

In my opinion, this patient was a pain in the ass. This patient was miserable, rude and just someone you’d rather not treat. As a courtesy and in my opinion, I felt that because of the clinical situation, she was definitely uncomfortable, antibiotics, in my opinion, would be a short term approach and the tooth needed to be removed. I removed the tooth surgically by laying a flap vertical releasing incision, I packed the extraction site with a Collaplug and shuttered it, homecare instructions were given. A treatment plan letter was written up and signed.

What the patient really wanted was pain medication. So after I went to the entire length to do everything possible to get her comfortable, really what she wanted was narcotics. She wanted more pain medication and I refused. She then insisted and actually threatened if I did not give her a narcotic, she would go on social media and register a formal complaint and how bad a health care provider I was and how horrible our organization was.

I share this with you because how not to handle this problem, I handled it poorly. I simply said, “I’m not interested in your comments. Please remove yourself from my office and I would like to discontinue your care. Please find another health care provider. I have no interest in providing you care or service any longer.” This, of course, did nothing but infuriate the patient. And of course, she left the office demanding her records and also her final comments were, “I will put this on social media and I will make sure everyone knows how horrible you and your organization are.”

So here I am as an expert speaking to you podcast after podcast about process and procedures. The question that I pose and I assume most listeners have had this particular experience, is what do you do? Do you cave in and give the patient the narcotic just to get rid of them, do you toe the line and simply say the answer is no, accept two Tylenol and two Motrin over the counter every four to six hours for the next couple of days and if your signs and symptoms haven’t been relieved, we’ll see you again for a follow-up emergency? The way I handled it, in my opinion, was inappropriate. I took it personal. I was irritated and aggravated at the schedule, at her and a combination of other events. And in my opinion, the worst possible outcome occurred. She then went on social media and did exactly what she said.

I guess the proper process and procedure would be to be firm, be direct, don’t cave and give the narcotics because that, in the long term, is unhealthy for your patient, but to be professional, be above the fray and continue to maintain your cool no matter how difficult it is, and simply say, “I’m sorry, I can’t give you this particular medication. I believe that it will be detrimental to your health and wellbeing.” It hurts me to share these very personal stories because it’s a reflection in how, after 35 years in this profession, I still make mistakes day-to-day. But I thought, perhaps, our listeners could learn from these mistakes and try to do better than I did.

I hope you enjoyed this particular podcast titled What Not to Do. If it’s well received, which I expect it will be, you’ll hear others. Because unfortunately, these mistakes that I’m talking about occur more frequently than I’d like to admit and perhaps sometimes we learn more from the mistakes than what we do correct.

You’ve been listening to dental health matters and this podcast is Ascent-Dental-Solutions. My special thanks to Mr. Doug Foresta and his company Stand Out and Be Heard, who’s responsible for this professional podcast. I also would like to give special thanks to Mr. Aidan Crawford and his company Short Circuit Media for helping marketing this podcast and putting together these programs.

I hope you enjoyed this evening’s podcast and I look forward to speaking to you in the near future.

Dr. Kevin Coughlin:  Welcome! My name is Dr. Kevin Coughlin. You’re listening to Ascent Radio. This is Ascent-Dental-Solutions, with a focus on knowledge, consultation, development and training. As always, I’d like to give special recognition to Mr. Doug Foresta. Without his expertise and his company, Stand Out and Be Heard, this podcast could not be put on on a regular basis. His editing and professionalism have made it a huge success.

Today, our topic is Lasers. I want to emphasize to our listeners. This is lasers outside of the box. Or what I mean, outside of the mouth. We, as health care professionals, many times look right through the mouth and many times we miss some of the most subtle things that are most important to our patients and that’s the areas outside of the mouth.

In this particular case, I’m proud to represent and introduce Mr. Scott Dupont. Scott Dupont is a Sales Representative for Cynosure. Cynosure has been around for the last 25 years. They are located in Westford, Massachusetts and they have over 20 different platforms for lasers.

Scott, can you tell us a little bit about your company and how you see the market and the marketplace moving and the advances in lasers as you see it and your company sees it?

Scott Dupont: Thanks Kevin for the introduction. I appreciate it. We’re a locally company to western Massachusetts, world headquarters. We’ve been around for about 25 years, just celebrated our 25th anniversary. We have, as Kevin mentioned, over 20 different platforms, anything from tattoo removal, skin revitalization, wrinkle reduction, laser lipolysis, CO2 laser systems for external skin revitalization and much more.

The world that we’re in now, a lot of people are seeking aesthetic treatments, facial treatments but with zero downtime. Years passed, when the CO2 lasers came out for resurfacing, that was really the only device on the market that could produce real results. But along with real results came about seven to ten days of downtime.

Kevin, the way the market is shifting, people want treatments, they want wrinkle reduction, they want skin revitalization, they want to get rid of vascular lesions, pigmented lesions on their face, but they want zero downtime. That’s the way the market place is going. They want to look beautiful, feel great with absolutely zero downtime. So that’s the direction of the market currently.

Kevin: Let me tell the listeners an interesting story. I’m a general dentist that has been practicing cosmetics since 1983. I’ve been doing Botox and dermal fill, tooth whitening, implant surgery, temporomandibular joint treatment, almost all aspects of dentistry. Since I started implementing dermal fill and Botox over the last three years, it became enormously obvious to me that I was missing the boat.

As a clinician, I looked immediately inside the mouth, and I was amazed. I believe you can talk on the statistics that it’s estimated that about 30 million people just in the United States have tattoos on their body. And almost 85 percent of those individuals over the age of 40 are trying to remove the tattoos. We as wet finger dentists, clinicians, see tattoos around the head, the neck, the face, but actually throughout the whole body and individuals are trying to remove these tattoos.

Can you talk for a little bit about what your company has and the different wavelength s that are necessary to remove the black, the blues, the greens, and the purples, and the reds from these tattoos and the uniqueness of your company and their systems?

Scott: Yeah, that’s a great topic. Even furthermore, when you go see a tattoo artist, a lot of tattoo artists won’t tattoo over somebody else’s work. So what you are seeing now are tattoo parlors partnering up with an establishment like yourself, Kevin, where they are referring patients to you to receive tattoos removal. That way they have a blank canvas to do their work over. So it’s a pretty unique time.

We were the first company to come out with a picosecond laser technology, 755 nanometer wavelength that would effectively get rid of all colors: reds, greens, blacks. One wavelength, 755 nanometers, and that was FDA cleared to get through all colors. What is really cool about the picosecond technology versus the Q-switch technology, which has been around for 20 to 30 years, is picosecond technology will allow you to get rid of the tattoo in almost half the treatments. Before, where a person was going to get rid of the tattoo and it may take 20 treatments, PicoSure technology can pretty much cut that tattoo removal process in half.

The box has a 755 nanometer wavelength to treat all colors, particularly blacks. It also has a 532 nanometer wavelength in the box as well to help with the more aggressive reds, greens, yellows and oranges. That’s a little bit about the picosecond technology.

Kevin: Scott, not to just beat a dead horse here, but when we’re talking about Pico, for some of our listeners, can you explain the technology? What actually is a Pico? Am I correct that it’s one trillionth of a second or is it one billionth of a second, one millionth of a second? Just explain a little bit about the technology because most of us, dentists, are really in to the technology aspect of providing care and treatment?

Scott: Yeah, Kevin, it’s one trillionth of a second. It’s firing almost ten times on average faster than a standard typical Q-switch laser.

Kevin: I think for consumers, which we as dentists are looking for the best and the brightest, I do believe that your company is offering something that’s quite unique to the market. And as you alluded to without tooting your own horn, if you can take a Mr. or Mrs. Smith and remove or eliminate the colors of that tattoo in four to eight visits rather than 16 to 20 visits, you’re doing a great service, you’re saving a lot of time and a lot of potentially post-operative discomfort. Although it’s not enormously painful, it’s still something that does provide a little bit of a jerk. It’s almost like a little electric shock, am I correct? How would you describe it to the dentist thinking to get involved with tattoo removal?

Scott: I would probably describe it more like a rubber band snapping. If you were to take a rubber band and snap it against your skin, your forearm but really, really fast, that’s the kind of sensation of what a tattoo removal laser would feel like.

Kevin: Can you talk, again, a little bit again about the technology here? How do you and your company control the heat or the temperature? I believe some of your systems have a cooling system involved. Is that correct?

Scott: Yeah. Some of our systems have a cooler system built into the systems; PicoSure. What we would sell separately is a Zimmer system, it’s a Zimmer Chiller. Basically it’s a — I like to call it a mobile air conditioning system. So when you’re doing something like tattoo removal, you have a separate cooling system that sits beside the device. You turn it on and all it does is blow cool air. So as you’re doing the treatment, technically, there is a couple of different ways they do it. They’ll use the chiller to maybe flash in their face just to cool their overall body down and then after the treatment, they’ll take the chiller just to hit the spots that were treated, just to cool it down faster. So it is a separate chilling system, separate from the PicoSure technology.

Kevin: Scott, I’d like to move the topic to probably the biggest marketplace. Being a male, perhaps I’m just isolated, but with two daughters, and getting into the Botox and dermal fill, I was amazed at the number of females and also males that were interested in hair reduction to hair removal and the unwanted hair underneath the nose, around the lips, by the ears, underneath the chin area. Your systems have quite a unique, again, technology behind it. Can you talk a little bit about hair reduction and hair removal with the current systems that Cynosure offers?

Scott: Obviously, hair removal remains to be one of the top procedures requested by individuals in this marketplace. There’s two types of ways of getting hair removal. We have a couple of systems; one is called an Elite+. It has a 755 wavelength in it for skin types I, II and III. I also has a 1064 wavelength in it to treat skin types IV or V and VI. Basically, what the Elite is doing, is super fast hair removal, strictly doing hair removal, bigger spot sizes to do, bigger areas on the body. We’re talking chest, arms, legs, back and things like that.

On the face, a lot of people are tending to switch gears and using a Redscan piece on an Icon system that we have, which is an IPL system, an Intense Pulsed Light system. Smaller areas: upper lips, facial hair, ears, nose, forehead, areas that are really tiny to get a laser into, a lot of people are using the IPL system.

Then we have a Diode Laser system called the Vectus, another very high-speed hair removal system where you can do a man’s back in about ten minutes. The cool thing about the Vectus is it has proprietary technology in it called the Skintel. Skintel is a live melanin reader that will give you a live melanin index of the areas that you are treating on a body.

Say for summer months, you notice the patient you’re treating is skin type III but they’re tanned so you’re really not sure what kind of settings to use on the Vectus. You take three scans with our Skintel reader that scans the area that you’re treating and Bluetooth wirelessly sends those settings to the device based on the melanin index of that patient. Basically Skintel is an insurance policy. You think you know the skin type, you take a scan with Skintel, it will send the settings to the device based on the readings from that Skintel system, which is really cool.

Kevin: I think some of our listeners will have a different level of understanding, but basically with most lasers, you’re using the Fitzpatrick levels I, II, III, IV, V and VI, with IV, Vs and VI being mostly, let’s just say, your southern Europeans, your Hispanics, your African American’s darker pigment. The concept basically is the darker your skin is, the more the laser would get absorbed. So you’re classifying your client or patient as a I, II, III, IV, V or VI and the ability to improve and standardize those classifications will give you a better outcome. Am I correct on that?

Scott: That’s correct, yes.

Kevin: I think it’s critical again to discuss another area that I think we, as dentists, are uniquely qualified to treat, examine and discuss and that’s skin revitalization. We spend so much time trying to get the perfect shade of teeth, the perfect line for a smile, to broaden the smile, whiten the smile, close spaces, do cosmetic or orthodontic dental care. But in the end, the ability to see a better tightness, texture, and overall health of the skin is critical. And the younger that the patients start undergoing treatment, the better.

You touched a little bit about the Intense Pulsed Light or IPL. Perhaps you can discuss a little bit about skin rejuvenation and the improvements that are available, and how it certainly is a significant improvement over your conventional facials that you might get at some day spa that does not have a laser. Can you comment on that, Scott, a little bit?

Scott: I think the Icon system, the Icon which we have is the IPL system. If you’re looking for something to really address your patients’ needs and concerns — the truth be told, people have vessels on their face, they have them on their neck, on their chest, they have pigment on their upper chest area. Women, for example, have décolleté. On your nose you could have little telangiectasias, you could have sun damage. All these different types of things that really concern patients, you can control and handle with the one platform that we have, the IPL systems which is called the Icon.

Once you clear the vessels, clear the pigment, people also are going to discover we have wrinkles maybe around their eyes, or some laxity on their jaw area or chin. The fractionated laser technology which we have on the Icon, the 1540, will allow you to non-invasively stimulate collagen and create more uniform elastin. It also treats moderate wrinkles, acne scars it treats stretch marks if you wanted to do body procedures, it treats surgical scars, trauma scars, melasma, and it does skin resurfacing.

So it’s one system that you can start with the IPL, clear the vessels, close them out, take care of the sun damage, reds, browns, melasma, anything like that with the IPL, and then go over it right away with the 1540 fractionated laser resurfacing. So it’s a nice system where you can address all of your patient’s concerns.

Kevin: Scott, you touched on another point that I think we as dentists sometimes overlook. For someone like myself, I’m doing orthodontic care, bands, brackets removable, fixed and functional appliances. And in many cases, this orthodontic care is done on adolescence, somewhere between the ages of 13 and 15. And we’re focused on improving their teeth to improve their self esteem, but so many times these young men and women are suffering from facial acne. And rather than dope these young men and women up with drugs like Accutane, which have some significant effects long-term medically, the laser, quite honestly, can do a wonderful job, not just eliminating and reducing the scars from acne, but improving the overall skin condition and reducing the outbreaks of acne. Is that correct?

Scott: Yeah, that’s a 100 percent correct. When you have patients that have had severe acne issues and problems and you can treat it — after acne has been healed and diagnosed and you have scarring and irregularities over the tissue, you’d be surprised and amazed how powerful this 1540 is. It really changes those patients’ lives. A 13 , 14 year old, saying you can go several treatments with the 1540, it will completely restore their confidence back in that patient. So acne scarring, surgical scars with the 1540 will do an amazing job.

Kevin: The last topic I just like you to touch on is we hear so much about different competitors and different systems out there, but your company has also addressed the remodeling of adipose, the reduction and eliminating of adipose tissue or fatty tissues, on not only around the neck region, but throughout the body. Can you comment on what Cynosure is doing and how their system stacks up against some of the other systems on the market?

Scott: We really put one of our body contouring systems on the map in 2006 with our introduction to Smart Lipo. If anybody on the call knows Smart Lipo, it is a gold standard in laser lipolysis. The focus big areas of any patient, male or female, are abdomen and flanks. The system came out in 2006. We did a big direct consumer marketing campaign. And now when people search for Laser lipolysis, Smart Lipo comes up. It’s been branded and it’s very well-known in the industry.

What’s really cool about that, about two years ago, we launched a product called Sculp Sure. It’s our non-invasive body contouring system. It’s FDA approved for lipolysis, permanent fat destruction over the skin. So no topical, no anesthesia, no surgery. There are flat applicators that go over the skin and it’s using a 1060 Diode laser to go through the skin — any skin types I, II, III, IV, V and VI — and destroying the fat cells. Being non-invasive, your lymphatic system is naturally going to get rid of the fat cells over a 6 to 12-week process.

We have launched a direct to consumer marketing campaign for Sculp Sure so the people on the call now, if you haven’t seen it, you will probably start to see Sculp Sure billboards, Sculp Sure on transit systems, Sculp Sure in publications, Women’s Health, Men’s Health, People. So we’ve launched our non-invasive version of Smart Lipo, essentially called Sculp Sure, about two years ago and it’s our hottest product that we sell here at Cynosure.

Kevin:  Scott, once again, your expertise and your company, I can’t tell you how much I appreciate you doing this podcast to educate the healthcare professionals, but in particular, dentists. In full disclosure, I am an owner of Cynosure. I went to their continuing education courses. I was a true skeptic. I felt that there was no need for me to get involved with it. But Ascent Dental Solutions is a Radio Station and a podcast and an information forum to share ideas. And I could tell you, I was so impressed, not only with what these lasers could do, but with the way the company represented themselves, the way they taught me and trained me and educated my team.

I can just tell you, what we ultimately want to do? We want to produce the highest level of care and service for our patients. And in my opinion, anything around that head and neck, should be available to the dental profession and to our patients.

I also would tell you without any disregard or nervousness at all, these procedures are quick, they’re effective, and for the first time, I’m seeing people really say, “Thank you, Dr. Coughlin. I am so glad you were able to offer this. I had no idea you as a dentist could be doing this or would be offering it”.

So to our listeners, I would strongly recommend that you educate yourself in these areas. Each State has certainly different by-laws and regulations and perhaps we could discuss that in a little greater detail in a future podcast.

But Scott, I want to tell you at this point, your company has been outstanding. Everything that you have said that you would, do you have delivered on. And I’ve been more than impressed and that’s why I wanted you on this podcast.

Before we close, Scott, could you just give the listeners an idea of the cost structure in the various ideas of the systems that you would probably recommend for the dental community? Just so they come away with a little bit of information, and also the best way for them to reach out to have questions answered by you and your company and how they could contact your company.

Scott:  As far as cost structure, it’s kind of hard to put a number on it. I can give some parameters based on the different technologies that you’re looking to add to the practice. If it’s one technology, two technologies, three technologies, I could say a safe ballpark would be anywhere from — depending on the system — 65 to 75k thousand dollars to anywhere upwards of — depending on how many systems that you’re going to purchase, you could go to 300k, 400k, 500k. But I think every single situation is different and that’s where the salesmen at Cynosure become your consultants. So depending on what you’re looking to do and what you’re looking to treat, we can come up with a package for you.

Kevin, I really appreciate you taking the time to have me on here. If anybody needs to reach me, my name is Scott Dupont and my cell phone number is 603-231-2603. If you are not located in my immediate region, then I can definitely get you in front of the right person that would definitely take care of you, in whichever state you appear to be in.

Kevin: We’ve been listening to Cynosure, located in Westford, Massachusetts. My guest today was Mr. Scott Dupont.

Before we close, I want to share this story. We as dentists, day in and day out, for the vast majority of us, deal with insurance codes. What’s insurance going to cover or not cover, what’s the limitation of this plan? As I ventured into dermal fill, Botox, and laser treatment, there were no real insurance codes. These are fee for services procedures, they are elective procedures, and I can’t tell you how enjoyable it is to offer our patients something that they want and need, and we can provide without all the BS and the paperwork that’s associated with so much of health care today.

Scott, Mr. Dupont, I should say, thank you so much for your expertise.

You’ve been listening to Ascent-Dental-Solutions. The focus is on education knowledge, development and training. You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin. Thank you so much for listening.

In closing, I want to thank Mr. Doug Foresta and his expertise on producing this podcast, and his company, Stand Out and Be Heard.

Thank you everybody and I look forward to our next podcast very soon. And Mr. Dupont, thank you and your company for offering this information to the health care professionals and dentists in particular.

Dr. Kevin Coughlin: Good afternoon. You’re listening to Ascent Radio. This is Ascent-Dental-Solutions, with a focus on knowledge, consultation, development and training. Today’s podcast is brought to you by Stand Up and Be Heard, and a special thanks to Mr. Doug Foresta and that company. Without his expertise and knowledge, this podcast could not be put on.

Today, we have a special guest. That special guest is Dr. David Preble, ADA Practice Institute partner.

Although this is close to our 60th podcast, I personally feel that dental associations, and in particular, the American Dental Association, has perhaps more value than ever right now with the changes that are going on in our profession. I’m hoping that Dr. Preble can provide insight and knowledge to our almost 7,000 listeners.

David, thank you so much for taking time from your busy schedule. I just wanted to say thanks so much for sharing your knowledge and expertise and also your help in working with the American Dental Association. One of the first things, Dave, I wanted to ask you is right now, can you give the listeners an idea of about the average percentage of dentists that are participating in the American Dental Association?

Dr. Preble: Sure, Kevin. We have about a 63 percent market share of dentists. And that’s basically representing more than a 161,000 licensed dentists from all 50 states, the District of Columbia and Puerto Rico.

Kevin: Obviously, we’d love to see 100 percent of the practicing dentists being members. Are there particular areas that you think we could improve that number from 63 percent to higher? Are there things that the American Dental Association is working on, you in particular, to perhaps expand that base that’s already present?

Dr. Preble: As you said, we certainly want to and we are trying very hard to do that. What we are doing is trying to figure out that real value proposition for dentists at all stages of their careers. So both the young dentists, the millennials that are actually becoming now 50 percent of the dentists in the country, as well as the dentists in their mid-career and later career all get something that they want from the American Dental Association. We don’t just figure it out on our own, we try to ask them what it is that you want from us, and try to deliver that.

The ADA provides a broad range of services from legislative and regulatory advocacy, practice-based advocacy with third-party payers and governmental agencies, continuing education, peer review, scientific research, the development of dentistry policies and standards, as well as, practice management tools and resources. And we feel that all of these things are part of what dentists expect from the American Dental Association, but each individual decides for themselves whether or not it’s enough for them to actually join.

Kevin: I can tell you with my experience in Ascent Dental Solutions that there is basically those three broad categories that you touched on that individual who is just starting practice, who is recently graduated, their wants and needs are in a particular direction. And the ADA, in my opinion, is a tremendous asset to provide basically free information and knowledge to guide those new graduates through some of the trials and tribulations of either starting a practice, joining a practice, and determining do they compete with managed service organizations, do they consider joining managed service organizations, do they even know the difference?

And then you have that second group which have been probably practicing for 8 to 15 to 20 years and they are dealing with the practice management issues, the regulation issues, the day-to-day issues that perhaps their practice isn’t growing and doing as well as they’d hoped for a variety of reasons. And once again, the ADA has an enormous amount of asset to help that group.

Finally, the last group are those individuals more in the twilight of their career. Are they in a position to retire financially? Is their clinical practice in a position to pass on to another individual or group? Again, the ADA is there with knowledge, information and expertise.

When we look at these different areas, I know through previous conversations with you, you mentioned that there were probably three main areas or topics or issues that you thought were important to the dental profession. Would you like to touch base on those areas?

Dr. Preble: Sure. But before I do that, I’d like to come back in on what you said, because you really put it very well, those three different kind of stages of a career. Following graduation, a new dentist can really benefit from the services like our Career Center, which we are building to be even better and better, that really helps dentists make more informed and better decisions about where they want to practice, how they want to practice. Networking opportunities offered through the local and state dental societies, which are an integral part of the ADA, and practice development resources, even licensure guidance, loan refinancing options. We have this wonderful student loan refinancing programs that’s better than anything else that’s on the market and it’s saving young dentists thousands and thousands of dollars. Plus, of course, volunteer opportunities, continuing education, etc.

Then those dentists in that mid-career part, they can have ADA tools and resources to answer these third-party payer questions, accessed online scientific resources, etc. Then as they get into the later part of their career, we have practice transition information, insurance and what’s management options, answers to financial questions and then lots of opportunities for mentoring even new dentists. So there really is something for everyone.

But back to your question about these major areas that we keep seeing dentists say, “This is what we need help with. How can you help us?” There is the third-party payer reimbursement issues, whether they be public programs or private programs. This is something that is constantly in the dentists’ mind because this is the lifeblood of how they make their living. Along with that, there are lots of increasing regulatory burdens that we are seeing happen from governmental agencies, and even in the third-party payer private world, more regulation and how easy it is to do business. Those are the two big ones.

Of course, practice management itself, the business of doing practice is a big part of what dentists look for from the ADA. Because in dental school, we learn a lot about the art and science of actually treating patients and caring for patients, we don’t learn a lot about running a business. And that’s information that they really need and look to the ADA to give them in the most cost effective way. They can get all sorts of information from high-priced consultants, but when you are an ADA member, you get all that information for free. So it really is, I think, a good benefit.

Kevin: I think it’s not only good, it’s a tremendous benefit. And for listeners out there, I’m not here just tooting an organization. I firmly believe there is no real skin in the game, per se, with the American Dental Association. If you hire a Kevin Coughlin, I may have alternative motives that are specific to your wants and needs. The ADA is representing the profession and I think the profession comes first many times over the individual and hopefully, there can be a nice marriage and both benefit from it.

We talked a little while back about managed service organizations and dental service organizations. For some of our long time listeners, I define the managed service organization as equity-backed, venture capital-backed. This doesn’t mean good or bad, it just means that there are outside parties investing large sums of money to get a return on their investment. Whereas a dental service organization is generally run and owned primarily by practicing dentists, who also have skin in the game to make a profit and a return on their investment, but ultimately, they are the clinicians providing day-to-day care, services and expertise.

Does the ADA see any particular trends? Do they see that these MSOs and DSOs, are growing? Because based on the Health Policy Institute and other research that I’ve been able to do for previous podcast, that seems to be on the rise.

Dr. Preble: It is on the rise. First and foremost, I wanted to make sure that the listeners understand that the ADA supports ADA members and dentists to have the freedom to choose whatever practice model they decide. We are not judging whether one practice model is better than the other.

But that being said, the ADA does feel very firmly both in its policy and what we tell others is we support this conviction that the health interests of patients are best protected when dental practices and the facilities for the delivery of dental care are not only owned, but controlled by a dentist. We think this is just the best interest of the public. So there aren’t those conflicts of interests between the making of money and the care and delivery of the patient.

We do understand that dentists, some choose to not want to do the management end of practice. They would prefer to just do the care part. And having DSOs or any other type of support organization that does the business part of them for that, if that is the way they choose to do that, that’s okay. But all of those dentists agree, whether they work in a DSO environment or not, that they should have control over patient care. That’s the bottom line. It’s not just ownership on paper, but its control over how patients are treated. That’s what’s important.

Kevin: And I would concur 100 percent with that, Dave. Is there programs out there that the ADA has that can educate those dentists that are interested in learning more about MSOs and DSOs? Are there programs out there that the ADA may be able to review potential contracts, working relationships to determine whether one group may be stepping out of bounds? Are there any programs like that that the ADA has to offer to its members?

Dr. Preble: I don’t think that we’re going into that specific a detail. We have resources on the Center for Professional Success that help dentists, again, whatever stage they are in their career. Although, the Health Policy Institute research has shown that the large rise in the dentists that work in DSOs is in the younger cohort. So those younger dentists, there are resources there for them to say, “These are the things that you should evaluate in your contract. Are these things that you are comfortable doing and not comfortable doing? Are these the things you are comfortable agreeing to and not agreeing to?”

We don’t get into very specifics of evaluating particular contracts for the dentists, they’d have to hire their own legal counsel to do that. We don’t have the resources to do that for every dentist here at the ADA. But we do give them the broad ideas of what you should be looking for, what you should make decisions on your own about, what you are comfortable with and what you are not comfortable with.

Kevin: David, I want to thank you so much for your time. I want to give another plug for the American Dental Association. Your representation of what the American Dental Association is, I really think that 100 percent of our members should be members. I know I personally have been a member since 1983. I’ve had my ups and downs, I’ve had some agreements and disagreements, but in the end, the mission statement to represent the dental profession and dentists, I think, goes without saying. Your expertise, your knowledge is greatly appreciated, and especially spending your valuable time on this podcast to educate our listeners I think is terrific.

For the thousands of listeners that have been paying attention to Ascent Dental Solutions, strongly think about the American Dental Association. As competition becomes greater, financial risks become greater, educational debt. The American Dental Association has programs and options all at almost no charge to its members, granted we do pay a membership fee. But I really think it’s one of the organizations that we should be promoting and can offer much needed information to us.

We’ve been listening to Dr. David Preble. David, for some of the listeners who might not be as familiar with the ADA, is there an 800 number, a website? Is there a way that questions could be answered or information could be ascertained?

Dr. Preble: Sure. The home source of cause if just www.ada.org. That’s the easiest way to get to the home base of all the information. If dentists are looking for a specifically practice management type information and information about third-party payers and things like that, we have the Center for Professional Success, which is www.success.ada.org. Those two sources should get anybody started on a host of information.

Kevin: Thank you again so much, and thank you to the listeners. You’ve been listening to Ascent-Dental-Solutions. My name is Dr. Kevin Coughlin, with a focus on development, knowledge, training and education. Our guest today was Dr. David Preble, the ADA Practice Institute Head since 2013. Thank you so much.

Dr. Preble: Thank you, Kevin.