Justin Trosclair 0:05
Episode 143, 3d printing dentistry and chiropractic referrals. I’m your host Dr. Justin Trosclair and today we’re calling later ops perspective. 2017 is 2018 podcast awards nominees host as we get a behind the curtain look at all types of doctors and guests specialties. Let’s hear a doctor’s perspective.

Welcome back. I am pumped that you are tuned into a doctor’s perspective. I’ve been busy. I created some more quick reference guide PDFs. One of them is the marketing. It’s a six episodes, you can go to www.adoctorsperspective.net/topmarketing, one word top marketing. So that way you can learn about like online reviews, video creation, content creation, blogging, blogging, and those types of things. In fact, one of them was in the top of 2018

And then another series that I was able to do a PDF for is the cash, PT. So www.adoctorsperspective.net/cashPT . We had a series, it was only three weeks. And then a few weeks later, I was able to get another doctor on who has an amazing podcast. That was one of the catalysts for me to create this one, a long time ago. And so he was on it. So anyway, it’s four weeks of cash practice physical therapy, we call that fee for service. I mean, in fact, most of the did is that I just interviewed for this dental series that you’re listening to right now. Their fee for service as well or cash based. And you can find a quick reference PDF for this at www.adoctorsperspective.net/dentists with an S. Well, that’s a laser is such a generic buzzword cutting edge, but like for real his technology, he’s able to digitally scan your mouth. So like if you ever like busted a tooth out, you could replace that tooth pretty much exactly how you had it versus guessing if you needed

Special implant, he’ll do some fancy impression work. And he can 3d print it right there. So you’re not in your mouth, oh, that didn’t quite fit, shaving it putting some glue and all this kind of stuff now it’s gonna be like almost a near perfect fit because he was able to get a good scan and then print it. Pretty amazing. And we’re also talking about referrals. And as a chiropractor as a physical therapy, you know, always looking for people that can refer to us and you know, refer back to them. And so he gave me like an amazing idea, one that he utilizes in his office, you know, somebody grinds, they’re going to have mouth pain, neck pain, headaches, and it can create poor motion in the spine because all this muscle stuff and so you know, he can do a temporary fitting, if it helps as well with a chiropractic getting adjusted, all of a sudden, boom, this patients like wow, these things going away. Awesome. Now we can actually put the permanent solution in your mouth and take care of both. So definitely want to tune in, he’ll give you some mock scripts of like how to approach what to say and in both fields like

You’re Dennis looking for a chiropractor. If you’re a chiropractor looking for a home these relationships, if you’re a chiropractor looking to build these relationships in your hometown, so, and then at the end, we discuss why he causes staff team members, as well as why there’s not an official only front desk person, there’s a three or four good reasons to not have somebody just be there, including like, blackmail and extortion. But also, it’s a better patient experience when everybody is cross trained. And at the end, on the relationship part, he talks about a conference that he’s going to go to, and I’ll let him talk more about that. So all the show notes can be found at www.adoctorsperspective.net/143 . Thanks again for tuning into the dental series. Let’s go #behindthecurtain.

Unknown Speaker 3:50
Live from China, in Katy, Texas. Today on the show, we’re going to continue our dentist series with Dr. Colin later. He’s a guy that specializes in sedation, cosmetic implants and those type of like higher end, I would say dental procedures. And we’re also going to discuss some things like What does no front office mean exactly. Not having a dedicated person. And when a chat with an interesting higher level practice referral relationship that he has with Ian T’s and chiropractors, and how that branches off for pretty much everybody’s benefit, which is kind of unusual. So I’m really excited to have him on the show. And welcome to the show. Hey, thanks. Happy to be here. All right. Well, you know, we always got to have the obligatory why dentistry, but we’ll take it a step further and say, you could have just been a general dentist kind of stayed in that lane. But instead, you’ve kind of branched out into the higher end, I would say, more non insurance based dentistry. So how did how did all that play out? Well, you

Unknown Speaker 4:48
get bored doing basic stuff, difficult stuff a lot better. So after doing it for a while, you should have bought into that. So maybe is associated with it. And it was a higher fee, with a high volume, kind of trying to focus on LASIK cases and that sort of stuff. And so I really enjoyed, you know, watching, you gotta look forward to those cases. I know when I started my practice on Mon Dieu, everything for everyone, but also trying to evolve and more so doing these higher level are difficult cases, and your personal satisfaction from doing the financial satisfaction as well. Just the evolution, you know, I see Dennis, you’ve been doing it for 1520 years, in garbage that they were doing one two years out of dental school, they just never change never evolved. And unfortunately, the patients actually suffer because of that, you know, by not having the best mix of the best material or, or best solutions to common dental problems, you know, presented to them, so that they don’t have to do it or don’t want to do it, and they can refer it out. But you know, kind of short change your patients just because of your ignorance, I guess, predicting what to see, of course, learning more and more depth in kind of funny things that I gravitate towards. Now,

Unknown Speaker 6:08
that’s interesting, because you got to take continuing it every year anyway, just like every other medical profession. So why not take something very interesting, or learning about new composite metals, learning about implants, learning about something that you aren’t that great at yet. And some that actually can get paid better for, I don’t really understand why they wouldn’t do that,

Unknown Speaker 6:28
well, you got these guys, and it happens, it just happens all over. You know, they finish school, they’re not a doctor, they think they know everything, they’re going to sit in their own little private world, or their Little Kingdom, and just kind of take whatever qualifies or license or requirements. And it’s in some like vacation place. And that’s it, I don’t bring any of those skills back. And it’s kind of productive, because they end up working a lot harder for a lot longer that way, if you can find courses, to increase your skill set in a safe way for your patients and for your practice, to where you do it responsibly, then you can get better and better, faster and faster to where you can do more work less time with the same or even a higher level of quality. Or you can do harder things, it takes longer, but you get paid a lot better for it. And then if you do that for however long and you’re good with your money, then you don’t have to do this for you know, tenure at you know, so you have to balance the benefit of education to the cost as far as you know, you’re away from the office, they lose money, they’re giving up your tuition of your course and your hotel kind of stuff. Right. But But by and large benefit far outweighs that needs the cost. If you pick good high quality See, and you actually use it. If you take the system, you apply any of that stuff, you just flushed a bunch of money down the drain. That’s that’s pretty dumb. But doctors are feeling good. You know, just just a personal hang up that.

Unknown Speaker 8:04
Well, yeah, I went to us, when I was out of school, there was a technique I was doing. If you went to the seminar, you can stay certified. But if you stop going, and you couldn’t be certified anymore, and after a couple years, I was like, Man, this, it felt like I wasn’t like progressing anywhere else. So I just was like, forget it. I’m done with this. And I took classes that I wanted to take. And one year I just had to get I was coming from China to America and I had to just get an education class, it was so brutal to just sit through a 12 or whatever hour 15 hour weekend seminar, or just stuff that you don’t care about that you just like needed to punch the punch to see the clock that that year. How like, this is brutal. I don’t know how people do this every year having just no passion for what they’re learning. blows my mind.

Unknown Speaker 8:44
Yeah, not effective. Because you’re not gonna learn attention. You’re really passionate about you really love to do, you’re gonna learn, you’re gonna be so good at back on Monday or Tuesday, whenever you get back to your office, then you’re gonna be excited about about looking for those cases, using that new knowledge pretty quickly. You know, is it just better for you better for your passions better for your practice? So what would you do?

Unknown Speaker 9:07
Yeah, what would

Unknown Speaker 9:08
you say? As far as the procedures that you do? What’s the most challenging that that you encounter?

Unknown Speaker 9:16
It’ll be a combination cases, I will do Invisalign to straighten out the teeth. Okay, lady I did I finished her Invisalign. She’s missing like 14th. And I, I created a surgical guide for implants, I printed it off in my my printer lab, place in place the implants out of the tissue closer, she’s looking fantastic, then what she’s feeling for a while now we’re maintaining her and hold your fingers, and then be ready for me to make tea for her in a few more months. So it’s just court cases that take a long time because you have to wait on biology healing, especially boning oil. So does can be challenging,

Unknown Speaker 10:06
because I can go wrong between those three months, while the I guess the screw that goes into the bone has to heal. You don’t know what the patient might do to mess it up as well. I’m assuming

Unknown Speaker 10:16
right, she stopped wearing her holding retainers, and she doesn’t have these TT that holder bite, you know, and the teeth can start shifting into a position that makes implants themselves. Not the best to make nice looking teeth on. Ah, yeah, that’s what it is you get like California some awful place, and then call us up and go oh, yeah, by the way I moved. And so he can make my teeth like a well, you have technical considerations. Good luck with that. Right? So that gets tough. Pitching expectations is a tough thing for most. And that you have to overcome that with with clear communication and communication badly. That becomes kind of a on issues. I’ve talked to patients before these big, long drawn out cases, to make sure that they understand that, that if they move, and they have to fly back for me to finish because every paid that’s on that, you know, you change you change the arrangement

Unknown Speaker 11:17
here. Ah, that’s interesting. That’s true. It was one big case. Right? Yeah. And the pre chat, you mentioned 3d printing, what exactly are you 3d printing?

Unknown Speaker 11:26
Oh. So we’ll print all the different stuff will print. Like I said, input, guess what measure but placements more accurate, more efficient, more profitable, really, because you can spend 25 minutes placing three implants versus hour and a half, two hours drilling a little bit, taking an X ray and confirm drilling a little bit more all this there’s the old manual analog text we had to do to make sure that our accuracy was was pretty good manually. So now it’s really well, I just I decide on guides, as far as the guide themselves, position of the planets being placed, all that sort of stuff. So I know all the all the issues I’ve done.

Unknown Speaker 12:08
So you got fancy technology, digital, some kind of implant I impressions and all kinds of stuff. So that you know, when you’re making the grooves or what what is it called the hardware, when you’re making the hardware, it’s actually exactly the

Unknown Speaker 12:22
same, you got a dry run on surgery from beforehand, you know, digital driver, you make sure your inventory is there, all the plans that you need and sizes and probably personal that sort of stuff as well. So that makes it pretty nice. One of the other things that we do is we’ll take a digital scan, and I’ll upload that to a designer, digital, an old designer. And then when I get you know all the new teeth back, I can print those out, and I can make some custom transfer impressions. Or I can transfer that information to the patient’s teeth. So let’s say chronic muscle, bone issues, clenching, grinding, sleep apnea, all that kind of combination patient, maybe taking some medications for dry mouth, or, you know, throwing some ADHD stuff there as well. So the ground all parties down, they’re all flat. So anatomically, the teeth are all destroyed, they’re still there, they’re taking away all the anatomy with the teeth need to function correctly without pain, facial pain, headaches, and then creating neck issues and that that translate all the way down the back. So I’m digital scan plan for the new length of all the teeth to get right back where they supposed to be. And I can print those models of the simulation and transfer on the patient so they can see, before we’ve touched anything before we create some irreversible procedure on them, they can see relatively what the final teeth will look like.

Unknown Speaker 13:55
As far as possible battles,

Unknown Speaker 13:58
almost like a snap on they can see it

Unknown Speaker 14:01
find a snap off be really thick and bulky is that is it looks pretty ugly. We jacket, liquid form, in a matrix, a rubber, like a rubber impression of the digital wax up the digital printed wax up, I guess, transfer that liquid onto the teeth. And once that material sets clean off the access, and then they can stay with a few like now the benefit of that is you’re working with chiropractors is as soon as we do a transfer, we send them over to have a Justin. So all their you know heads balanced, the hips balance, you know, those are all learned back. So that if you had an issue because of the by creating postural issues, then you can test drive and see that then those can be corrected. Right? Right, because of the inclusive plan is not balanced. You can’t get those five pounds and UK, Elvis and all that stuff. It’s phenomenally difficult. If you had a problem the pelvis, it can move its way up into the back into the neck and create some medication issues or, or make doctrinal bruxism worse. So we use that as far as 3d printing those teeth. One of the other things that we use it for is a movie called custom and present face. Justin notorious for trying to, you know, take shortcuts and all sort of stuff. One of the cheaper bastards by taking on more money, right? Well, it’s a little bit more time and do a pretty inexpensive, you know, fabricated custom trade. But for your good impressions for this lovely five will be $50,000 case, which makes your impressions phenomenal, which makes the lab love you because you’re giving them good stuff. And they’re able to turn around really good stuff back to you, which makes it easier for you to deliver for your patient. It’s that saves you time. And product looks fantastic. So contrast that with not in my office, somebody used this little plastic, crappy, you know, one size fits all to try with cheap plastic mesh in there with Phil girl, and they smash it in there, they get this awful impression that doesn’t really represent a teeth well, or the gum tissue or all this other stuff that we have to look at. And then when they get a case back from the lab, who called and said, Please don’t make it work. The lab guy says, Okay, well look like crap, then, you know, the dentist is bad guys, and delivery day grinding, nothing fits. And they’re trying to use XS blue to make it work patch, it almost finished up. Because they want to say about $3 worth of customer and presence free stuff, stupid. And so they create,

Unknown Speaker 16:44
especially when you’re going to get paid 30,000 Come on throw up,

Unknown Speaker 16:47
you know, 10 bucks worth of extra materials or $3, you know, per hours plus a backup. So stupid. So we can use 3d printing for that stuff. The cool thing about 3d printing ability and digital technology that we’re using on a routine basis. Now, if I have a digital scan of you, when you come in for cleaning appointment as a new patient, and I just happen to take a scan digital record of your teeth. And then let’s say you know we see each other every six months or whatever else for cleaning for a while, then two years from now you have an accident, you fall and you knock out your front five teeth, let’s say, Yeah, I know it’s awful. And then you go, you haven’t rebuilt and all that stuff, it just doesn’t look like you. Yeah, pictures, that’s okay, it gives you kind of in the bulk of the shape of the teeth. But if I have a digital scan of you, I can just print up a model be achieved to the exact same shape size, you know, rotations crowding, whatever, or we can strain them, or that’s what you back what you started with, we can get pretty close on color, based on the natural colors of all the other natural teeth that are present. Wow. Yeah, so but that that ability from the beginning, I didn’t had the forethought to take a digital scan of my new patients digitize their mouth, if I didn’t have the ability to 3d printer, and recreate that sort of stuff. And that’s not going to happen all the time. But you have patients that you’re able to do that, for, they will absolutely tell the world about you

Unknown Speaker 18:19
just blown away

Unknown Speaker 18:22
their creativity and how you can apply the technology and their benefit

Unknown Speaker 18:25
is it 3d printing is that in house or you have like a lab that you outsource to so I

Unknown Speaker 18:29
have I have printers in house I have 3d printers right now, same company to those are the same ones. And then I had one was upgraded. So the spring and Moon right? SI to those older printers, and pro in so I’m getting credit with that. And I’ve got some really cool pieces that I’ve been waiting on this printer to show up. and stuff. And I’m going to do a bunch of the procedures for people and I’m just going to stick on YouTube and heaps of people, I do this stuff. But of course like in my office and charging money for it, everything else is just man, it takes so much time and effort everything else. So I can get video absolutely edited for me and I can prove it and all that kind of stuff with just stick it out there, you know, help patients and help dentists and stuff like that,

Unknown Speaker 19:15
as a huge computer still gonna come back and be like, Hey, your video was great. But in my particular scenario, I still need some help, you know, what can we do?

Unknown Speaker 19:25
One on One Love and officer over the shoulder with two or three people and make it really, really effective for them, they can really see every step in detail. And they’re right there with me. You know, if I had like 10 or 12 1520 docs, in my office, and I’m trying to like I’ve cast it with some head, head cam, or some crap like that, and they can’t really see the fine detail what we’re really doing, then they lose out on that. So I’d rather have a smaller group more intimate, and a higher level, you know, spirits for them, so they can pay back there patients really well. And they can do it without having pretty predators in their office, I need a digital scanner, preferably Yeah, or the ability to set it up to a scanning center to have a scan made making your own design stuff either themselves or outsource it, and either print it themselves again, and outsource it. So they don’t have to happen, you know, but it makes a big difference in in your patients perception, your abilities as well. So cutting edge high tech, and they’re coming from an office that smelled it looked like the 70s. Yeah, or, or that’s where stuff, it’s where they come in for a consultation, and they see all the stuff like whoa, the three different consultations or $50,000 rehab, because they really want to, but right but they’re, they’re well informed, and they’re smart enough to get several opinions. And they can associate Well, let’s take a digital scan will design your case. And we’ll show you everything before we start. There is no questions as far as doing why. And you can see what your facial features will look like and how you feel and also stuff after we’re done before testing thing. It’s a smarter way of doing it. And you have the end money before we begin,

Unknown Speaker 21:01
is there any associations are ways to find you. But in other states, I’m in Georgia, if I’m in New York, how do I find someone that’s doing what you’re doing,

Unknown Speaker 21:10
and

Unknown Speaker 21:13
maybe some of the Facebook forums on 3d printing or digital design that sort of stuff. Okay, just was who was kind of closer to you know, FaceTime of people from from all over to shoot them a few things to get them through a couple of steps that they were getting hung up on, that’s still pictures, or they text me or or messaged me, last fall short video clips, and it was just, it just took too much time back and forth. Maybe just FaceTime. It’s easy. So didn’t see what we’re doing as part of that what I do this, they did it. They’re like, Oh, okay, well go for me pictures that are on cases that they’re working on, and that sort of stuff. So I can see that they got technique, and it was helpful. So that’s why I thought if I just take some unique stuff, and I’m doing it on YouTube, that you know, to cheer, Dennis, stuff like that, maybe we’ll see. I don’t know why they want to do but they see it as a turn and sharing all this stuff, especially some really cool cases that we do. Yeah. You know, like a full mouth additive, what’s called rehabilitation out of film material, an injectable filaments zero, which cost me about 500 bucks total all end. And I can link in all the teeth and get the bite rebalance. while they sleep better, to better smell better, psychologies better. And some of those people with either stretching exercises or pull off these remote, or Tina therapist for chiropractor, adjustments, massage, whatever, all that stuff to get back balanced and everything else to where they can lead a happier, more productive life without having to grind up with the talent because nowadays people are really health conscious, you know, the 90s when a nice smile, you didn’t have the braces, because you know, maybe look at your kid, your adult. And so that’s okay, we’ll make these crown things. Those are an overall your teeth, change the color, the shape of them going to be beautiful. Fat for 2018. That lady comes in. And she’s 16. And all her teeth are failing? Because somebody granted these tiny little toothpicks. Oh, yeah. So now it’s rehab, do what can add a bunch of implants, a bunch of bone surgery to correct a lot of stuff. So the patient was never aware that their lifetime cost was going to be hundred thousand dollars $180,000 or whatever else it was. That’s irreversible. You can’t come back from that once you rose to be an animal with a journal. Yeah, you got to know that. So I have a technique that I do with 3d printing and digital design, injecting a liquid material for all of either separated, floss some shiny one who cares, I can just put that little matrix form back with the squirt and jacket repair it in about two minutes. Really simple. Wow, you haven’t done any, any significant long term damage to the PXU. make them stronger. Adding a protective shell around what’s left.

Unknown Speaker 24:04
And you can still chew and do everything once you have this plastic

Unknown Speaker 24:09
or whatever, you know, it’s makes the existing TF stronger than what you had when you grow them off. Now they’re not as strong as natural teeth God designed, right. But he taught those up. So around two. Yeah, so some people nowadays are just more health conscious. And so some of these more modern techniques of additive destroyed without writing on the routing and policies and corners, but your nuts definitely dampening the chase and a big one. Because I see that it’s a blessing. It’s in its last basis.

Unknown Speaker 24:43
So when we were you were mentioning the Chiropractic and making sure if you’re having headaches, make sure everything’s aligned the low back and everything. Was that a relationship that you sought out? Or was it like a circumstance where one patient came in, they were seeing the chiropractor, they got the the injection in the teeth, and they’re like, Wow, my headaches are going away a lot faster. And you just kind of put the two together? Like how did that play out? And is it a requisite that they go see a chiropractor when they’re working with you or just suggested how’s that play up?

Unknown Speaker 25:12
It suggested if if there’s other postural problems, so for the monitor has been Saturday, and he’s in Oregon. And he does love this digital bike calibration, and adjustments via a piece of technology called scan, tech scan, the company itself, they also make sensors for postural position. So you can stand on a center, you can check to see how much balance you have right side less than your feet. And also how much pressure do you have on your toes versus the balls of the feet and that sort of stuff, or your heels. And you can see these patients who are out of alignment, the spine is out of alignment. So the balance of their feet, and if you if you if you cover their eyes close by, and just stand there, but have what’s called sway, kind of just kind of move back and forth a little bit. And if you shouldn’t do that if you’re roughly balanced and spines healthy, and that’s from So, so anyway, so I’m watching this lecture with my buddy Ben, and he’s talking about this stuff to where he was able to after a series of computerized analyze adjustments, when they squeezed it with a grain to the right of the left. And once you get the bypassed, the sweat improved, or what does zero significantly decrease as far as the amount of sweat. Also, when he was shown that patients would be they go home, they’re tired, that are just wiped out in this bio investment session for a few hours to the muscles have been chronic muscle spasm, that sort of stuff has been grinding and filling and awesome except for the adjustment procedure that they get a really good night’s, come back. And he would analyze again, standing, analyze this way and last thoughts there by that sort of stuff. And they were anecdotal, the patients list stopped better. Their mobility increased, your body just felt better, that sort of stuff, right? So he started making some of these connections. And, and so I was thinking about that. And I had just had a patient that came in like a week before. And she was talking about you know, she was has chiropractors been as a DENTAL PATIENT And talking about how she seems chiropractor to help with her headaches, and then all of a sudden pain and that sort of stuff. And I remember, you know what her teeth look like it was very similar to this case that Ben was showing with all this stuff. So I got back immediately calmer and had her come in, did a digital analysis ever with technical things about holy, she’s got this thing stuff that Ben was talking about during this patient case. So I did the adjustments on her. And I said, I want you to imagine a chiropractor and see what she says to her chiropractors down the street. And sure enough, she goes into the chiropractor afternoon so soon as you can practice, hey, you know, your answers really decreased. You know, what did you do? So she told the chiropractor about our adjustments, and I talked to her about balancing the button that helps to balance the neck and also stuff. And so the chiropractor called me up and said she wanted to know what did her patient. And so we got together and I was going through all this, she was totally blown away. And that’s enough, she sends me quite a few patients when they come in, they have real kind of given her some guidance. How about patients who have dental problems that are manifesting as a chiropractic issue as neck pain, shoulder pain, headaches, access the muscle tension in the masters and paralysis, and all the way down the simple portion of the skull. And it’s kind of simple when you look at these pictures were dog parents. So the masters are hypertrophy right now, like a door will never seen any of these females, especially masters in sales or past your lobes. Ah, so that’s kind of step number one, you see something real squared parents as a female, they are handling clinching all the time they’re working out those muscles, then they break to

Unknown Speaker 29:18
another telltale sign if you have them write down, smile. Okay, if you don’t see any other lower teeth, you see the top teeth and they’re crooked. And you see no lower teeth whatsoever. what’s called a super deep bite, they’re trapped. They can’t get the teeth apart from each other to them. They says also fun again and the Masters and braless. Usually there’s sort of the face. And then they have lots of neck pain and trigger points and FCS especially. And then back down in the back the scaling muscles especially they’ll have a lot of trigger points back there. So if those patients have their bite, or LinkedIn, Twitter can see the bottom teeth, either orthodoxy, or restorative Lee by adding crowns or whatever else. And you can get, you know, that trap, that system opened up and right for the patient feels better, use a desk job better, and then coordinating with chiropractor, you’re able to keep them comfortable through those phases. Those patients again, heavy massive Paul, square john parents, and you don’t see any of their lower teeth. They also would benefit from seeing it BMT because most likely, they have sleep apnea. Sleep apnea causes them to have an increased amount nocturnal bruxism, they are suffocating, because the facial muscles of the mouth, close the teeth together, the respiratory system wants the lower jaw open and forward, the tongue of the back of the throat, open the airway so that suffocating person can breathe. And so you have this argument back and forth between the facial muscles and the respiratory system. So the where you get all the excess hair and tear on teeth, especially on all the front teeth, and not much wear on the back teeth. That’s an airway problem. So that’s where you kind of coordinate with the anti, they look at the person, they especially if they do a sleep study and get a baseline. And then we ZM with digital scan, the things we’re doing at it from our 3d model printing stuff I was talking about. And then you see it was a chiropractor and adjust them to get everything back in balance. And then you can just kind of sit back and wait and see how they respond. Because again, practice judgments can be reversible posture and against is still pretty poor than the bones and we are going to move back to that position. Right. So if the teeth are responsible for some of the arrow Bay, anti, no combination stuff is also affecting that then there’s not one of those things, except patient. So you can do only investments in the role you want to benefit airway. And the TS agree that patient is not good, better, you’re just going to have them on a rinse and repeat, you know, kind of annuity model. Yeah. So if you bring in these other groups is related people, you may even end up bringing in orthodontist as well. So that you can widen the arches, move the teeth out, that creates more airway space for the tongue for it to come forward. And then you have a dentist like me, who LinkedIn, the teeth, that opens the airway space as well, again, providing more room for time to come forward and more patient airway space, since they’re going to sleep better, their metabolism will naturally change without doing anything else. If they can breathe better, they’ll lose some weight, that’ll be better, your easy, because now that’ll be 15 2030 pounds lighter, smaller, you know, that sort of stuff. And you can get him into a comfortable position. And on a maintenance type adjustment program for their comfort. All right, you know, if you recognize it, as a chiropractor, some of these things, and you recommend the patient to see a dentist to understand disease, they can see it, fix it, or send them they can fix it. That’s better for the patient. Right? So that passes all your ethical tests. And yes, you need to be paid for your stuff. So that’s good for you. So you can pay your you know, your lake house and whatever your your you know what I mean? Yeah,

Unknown Speaker 33:30
that’s good for you. If I’m a Kairos, I’m a physical therapist, I’m looking at the things that you said. And I’m going to be calling the dentist in my town and start asking some questions or taking some people to lunches or coffees or something, to find out what kind of dentistry that they do. So you can find the one that’s kind of matching what you do with the 3d. That’s right. And now you got a relationship, and you can actually have a cup of conversation, you know, Hey, I heard it on this podcast. What are you thinking? What are you seeing, and they might have already come to your same conclusions. And then not, not at least you have a reference to give them to say, hey, you should probably take an hour Listen to this. And let’s reconvene in like a week, because your patients, my patients are going to definitely see some benefits from that. That’s fantastic.

Unknown Speaker 34:13
Absolutely. And, and again, it’s a it’s a referral and one doctors thing. But other doctors doctor for a specific reason that is articulate well. And the patient understands why. If the doctor just says, Hey, Sally Smith, I want you to go see doc later over here and happen looking at your teeth. And that’s it, she’s gonna say, but I haven’t been asked, right? See, ya know, you go see this other guy over here, he’s gonna look at your teeth. I think she’s gonna say, What does, there’s a big guy. Now, if you say, Sally, I want you to go visit with Dr. Landsberg. I’ve spent quite a bit of time discussing with him and how he treats patients with a very similar issue that you have. And I believe, in my opinion, that he is probably the best around this area, to address these things to get us some relief. Now, he’ll look at your bike fit together, and how that interacts with the muscles in your face. Okay, so you don’t work up and tell you some of the more specific things that you know he can do to help you improve. Right? It’s a whole different type of referral. Yeah. Versus I see this guy for something, yeah, or he’s the best in the area, he can definitely help you with business and this, that you have to you will be better. Okay, great. I’m not gonna call that guy I’m gonna go there. Jeremy, well, and then back and forth the same way, when a dentist sees a patient who has obvious muscle issues, both of you related to their bite, but also their posture, what they do habits, sleep habits, work, habit, you know, life stop bad personal computer, 18 hours a day all hunched over and drinking iced tea, and not moving lyst whoever postural problems may relate to sleep issues, or, or dental issues as well. So they overlap. Right? They do. You know, so the same thing if that’s if that’s in the realm, or combination of, of your referral network?

Unknown Speaker 36:24
And that’s an easy question to ask, because a lot of times, people these days, they know they sleep bad, and they know they have sleep apnea. Now, maybe not a younger person, but it just seems to be something that people are investigating these days, more so than like, five or 10 years ago.

Unknown Speaker 36:39
Right? Like sleep apnea is a big buzzword now a lot of people looking into it, that sort of stuff. And sleep dentistry and sleep appliances and see upside down, right. So you guy with sleep apnea, moderate or severe recommendation is to seek his face, and he tries to wear that thing that he never morning. He’s 58 is brutal. You know? So okay, well, I get that’s tough, difficult, that sort of stuff. Okay, well, if you’re not alone, why don’t you wear one of these appliances that helps keep your airway open, you can drag your tongue in your mouth a little bit. But that’s better. And if you sleep better, maybe you have more energy, and you can start changing some things to where, you know, you can start losing weight and getting back being healthy. And that’s where you got the gold standard be to see if they will work at all, is that better than something might improve? You know, that sort of stuff. So package especially and again, kind of related, can make those cross reference recommendations for for a patient benefit. Very good. You know, there’s lots of chiropractors around me, refer to two of them, one who’s right down the street. And then one who’s a little bit further away, but he’s mine and his wife, hey, Dennis, and he’s fantastic. And then there’s not a chiropractor that I’d actually seen was being treated by for a while. And it was just quick assessments, cracking the back 40 bucks, you know, here and there for adjustments, and that sort of stuff. And it was really a guidance on Hey, I don’t want to come back. Right? I don’t you back Back, back in my neck and all this other stuff over and over, you know, muscle week or every two weeks. And his approach just seemed more of this recurring annuity model, which was great, I guess for him. But I didn’t feel that it was really looking out for my best. So I didn’t think that that really past fully. Pastor, nice guy. I mean, I was really happy with him, that sort of stuff. It just his, his approach was, we’ll just come back once a week or next

Unknown Speaker 38:46
year. And that’s probably what he truly felt that people needed. And there are those chiropractors, but between you and me, I’m just like, well, we should be able to do more for our patients, so they don’t have to come off and that often. And when you see a different style of chiropractic, you like, oh, there was more than just that kind of guy out there.

Unknown Speaker 39:05
Yeah, my buddy Baron me is Aaron punish Jackie’s here in Katie. He’s fantastic. I mean, he’s really good with his patients and that sort of stuff. But he really wants to get them into a better healthier lifestyle with with stretching exercise, rather, not having to commit all the time. Maybe that’s not the best business move, versus having, you know, 9000 investments a bit 30 bucks a pop, or whatever. But as patients really feel like he’s living out their centers, which in prefer a lot of other people are like, hey,

Unknown Speaker 39:36
exactly.

Unknown Speaker 39:38
That way, because

Unknown Speaker 39:40
it pays itself but it’s the long term game, I think,

Unknown Speaker 39:42
if you want more value for which you prefer better higher value patients to you are looking for that sort of approach, not, not who’s looking to come to you because your adjustment is $1 at less than the guy that’s two blocks from them, but they’ll drive two miles to save $1 a

Unknown Speaker 39:59
real smart, not not not so much. Hey, before we let you go, what about this, no front office, it sounds like a lot of people are cross trained, give us some of the pluses and minuses of having a system that way and how it kind of plays out in your office, that might be something that other dentists and other professionals because there are some clinics in my room that have lots of lots of staff as well. And maybe they can change some things up, save some money, and have better staff overall. In the whole scenario,

Unknown Speaker 40:28
one of the biggest problems that can happen in a doctor’s career, especially a private office owner, is either turnover from people moving or dying a gas or getting pregnant, and then they’re not going to come back to the workplace, or embezzlement, right. So you can protect yourself from interruption of your business by increasing the amount of cross training for your team. And as a team, as a distinguished from a staff, staff isn’t a fashion team is who you will a battle with, right. So if you have people who don’t trust you, or don’t like you, or they’re just not people, they will from you. Either they will ride they can steal from you, they will physically take money from you, and put it into some sort of credit adjustment, or whatever else, or be pissed off one day and tried to steal vacation from you, you need to give me three weeks vacation, or I am going to quit. And I’m blown, who knows where all of the insurance claims go and process and data on you. Oh, yeah, I’m a front desk, Queen and I own you, right, those are not going to let you have one. And you can protect yourself from that.

Unknown Speaker 41:45
And insulate yourself from

Unknown Speaker 41:49
your shoes and stuff like that with people being or become bitter or whatever else by just on your team. Now the other thing, when you do a desk job, after a while, the money is storing so boring and awful that you get lazy, right. So if they have an ability to do that, and the ability to interact with patients, this is why they can do it begin with and they stay happier and more functional, you get a better return from their hourly investment that you’re you’re providing true. So it’s not like shopping, for instance, she has been with me since the beginning, when I open my practice six years ago, with no insurance contracts whatsoever. And I have maintained that until this day. Very hot market. Lots of dentists moving out here that sort of ever since I’ve

Unknown Speaker 42:38
been to your fee for service or cash.

Unknown Speaker 42:41
I’ve been out of network office, there we go. So we still bill for assignment of benefit, and all that sort of stuff within the parameters of insurances that helps patients out. But we still get pretty much for full fee. Now I write off x rays and exams and little stuff like that, because then cost me an exam, be an expert, loss leader, that sort of stuff, turn up a nickel and dime people and things. So if I need a panoramic X ray to evaluate something, and they had one a year ago, in another state of the dentist insurance having to pay for this patient. Well, I require $125 X ray before I can just it just it’s easier to send it and write it off, you know, or Justin or whatever else because you know, you’re not gonna you’re gonna retire on it.

Unknown Speaker 43:31
And we don’t want to get paid anything to do an X ray, if you got paid $125 for an X ray. Congratulations, Dennis. Because that is amazing. Like, we’re lucky to get 35 or 40 bucks from the insurance company for to do an extra in the spine. It’s crazy.

Unknown Speaker 43:43
Yeah. And those x rays, bigger sensor size, all kind of stuff in your digital or Phil Ross Oh, yeah. Yes. The differences in the different professionals. Yes, exactly. Yeah, nice. Because I do have Brandon, she’s the best phones, she’s the best at personal people walk in. So that’s kind of where she stands for the most amount of time. She’s also takes care of like all billing receipts or, and sort of stuff that comes in, she’s very organized, I could not, I could not survive without her organization skills, because I don’t have that. But if I have a patient and braces, and we need to take the artwork off, and last takes all sort of stuff. So you’re filling or whatever else. Well, Rana leaves the front desk, she comes back and she takes care of the patient or to live with me. She’ll take the ortho learn a lot sticks off, I’ll finish what I need to do. And then she’ll put all that stuff back on. So that the patient doesn’t have to go to your to the Husky crap taken off, drive to my house to get filling, drive back into your basket, all that stuff put back on, you know, mad mom would be if she had our kid and it’s hot here in Texas. Yeah. So we tell them you’re a woman. But most of us don’t do this. We know how we coordinate with orthodontist. That’s again, one of those other higher level for they see one of these patients comes in, they know they’re an active treatment, they want that person to come to our office, because they know that we know how to handle this stuff, all this undue stress. And we’re telling everybody about that and appointments. So that works really well. And Miranda is happy because she gets to get away from the desk for a while and come back to the back to the patient stuff. So that’s like one of her strong students like Shelby, again, she’s been with me since beginning, she just got back from maternity leave, she’s gone for like three or four months, and how detrimental that would be if she was the only one who knew how to do patient financing, or any of this other stuff, or all my Invisalign stuff that we’re just not here today for months, and you screech to a halt to your income as the doctor or your productivity as the office. Because you are dependent on one person for your, for your desk area, right.

Unknown Speaker 45:51
And sometimes they quit after that maternity leave, like you know what, I just don’t want to do it. I’m gonna I’d rather stay with my kid and you’re like, Oh, my gosh,

Unknown Speaker 45:59
breaks these four months, I could have been training somebody else, right? You know, but again, you like our friends, history. If you hire for personality, and train for skill, then those people will just work out better. In the long run. The boss had to continue to train people, they want to learn new things. They don’t do the same crap over over because I get bored, like I said, so that’s where, you know, if I could have had a no fun at all model that would have been even better like a hotel. You don’t walk in being at a hotel Besides, yes, I’m calling my job. Here’s my driver’s license, my American Express, I’m checking in for the next three days. Look at your driver’s license that confirm your reservation, they swipe the card for incidentals given back to you and say your rim is that way. Thanks for coming in, you know, answer questions about where’s the pool on the phone, don’t do all this right there that have someone in the back doing that. So guys, if you can split that up to where you can’t be held hostage by a team member, or employee. At that point, if you’re trying to do that, you’re going to be happier, more productive. Team members can be happier and more productive. Your patients as they’re coming up, they’re going to sense that that person is happier. You know, instead of tension that they just hate your job been around this people Oh, they brutal. It’s so hard. It’s so hard to tell here. Because they’re they’re close to slitting their own wrist at any moment. You’re just put mixed uneasy as a consumer, that’s not going to make you want to drop down for implant rehab or whatever else, if you don’t feel the plants were is very warm and biting. So it still goes back into the front desk lyst model, that you don’t have a real dedicated front desk, person, that’s all that they do. And they can hold you hostage if they quit, die, sleep bad, go off their bands forever. Got your backup, you know, overlapping people. The ship keep her, you know, just keeps the machine keeps rocking. Exactly. Because everyone else wanting their paycheck to you know, yeah. And so if the cash flow problem because a dependency on some office personnel, everyone, not just your personal income. So it’s a smarter business way of insulating your business from those issues.

Justin Trosclair 48:20
One follow up with that when you go to pay someone who’s cross trained, do they overall make more money than if you just hired front staff and back staff or team members? I should say,

Unknown Speaker 48:31
Yeah, they’re more valuable for that. But the productivity levels so much higher than someone who’s just sitting there. And they’re like, well, the phone’s not ringing, so I don’t have anything else to do. Okay, well, let’s find some more stuff for you to do. But then the phone starts ringing. And there’s other things that I got to do can’t be done, because you’re on the phone, you know, so people will come on, and they will this office manager position with Thomas the only talking in office, if you have three offices, you need someone to help you manage, there’s three, if you have a desk person, one hygienist and one assistant, the front desk person is not the office manager, that is just best person,

Unknown Speaker 49:10
here still the manager dentist, you own the place, you’re in charge.

Unknown Speaker 49:14
Now, if you’ve got like 12, or 14 employees, swing shifts, all this other stuff, and you’re trying to coordinate, you know, personalities and issues and whatever else, you may need someone to help you with that exactly energy in your office. But most people do not want to be themselves managed. They want to be assisted or guided or part of a team. So you know, this the traditional hierarchy roles in professional offices, as chiropractors, the NT, medical doctor, whatever they met, Rob, say, just different products that were pushing, they still have the same kind of receptionist, billing person, insurance, purse, an assistant person sterilization person, a lot of persons if you don’t have a lot of patience demand two sentences, and you make no money as Doctor right? Now, if you the person who can answer the phones, coordinate insurance, collect money, you know, pay vendors for that sort of stuff, even though the person in the back, get a lot of work done on fewer patients and as more and more people into the mix, but also continue cross training them expanding their skill set, because they’re gonna be a more valuable employee, which will cost you far less than headaches and time and money. Or if they move, and you can refer one of your buddies and Georgia or someplace to work. Because he’s like, Dude, this is the best I’ve ever. Thank you so much for training like this. Yeah. That means you’re doing things right. But most people, Philip place, Philip position, you know, you hear you you answer the phone, book appointments for me and tell people how great our practices? Yeah, you don’t know how to spell my last name or school? Or that I could have kids, I’m a normal person, but I’m gonna put you in charge of being a practice. Where do you go? career choice? Exactly.

Unknown Speaker 50:59
And we’ve all in those offices.

Unknown Speaker 51:01
Yeah. When you bring someone in a lower level position, introductory, back, they can’t do very much damage. And you train them up. And they become more and more valuable employees, they move up to different roles, those become lifelong employees, you know, the greater better team members, and you’re more productive that way. So everybody’s happier that way. works better, just like they done.

Unknown Speaker 51:27
In this podcast, we have a lot of doctors, you know, they they’re making all this money. And then they end up getting divorced and losing half of it. And so I always say, hey, let’s let’s address that for a second. You got us wife, you got several children? How are you able to a find a work life balance and be keep the love alive with your significant other so that you can just continue on your merry way?

Unknown Speaker 51:49
No, let the tough one. I’ve got four kids, my wife married for 12 years now. And you know, it hasn’t been the easiest, you know, back and forth and that sort of stuff. But you have to be able to look and see what are your deficiencies and what can you fix? Because you’re not going to fix the other person. So now, you know, it’s great question, because later this week on Thursday, I’m gonna leave here, right after my Bobby stayed in cases, I’m going to drive to Fort Worth, which is relevant Dallas, born half hours away from here, and I’m going to do this program through Sunday with a guy that I know seems get Busquets a dentist up there in cranberry. And he did this weekend warrior leadership and a week long program or else. And it was it talks about these four fundamental things that you want to look into your faith, your family, your finances, and your fitness. So if you can kind of all four of those areas, then you can have a much greater work life balance. And a lot of those things parallels into to my wife and hey, our issues and, and stuff like that, as far as the role of the person, stick your teachers plotting all this treadmill for hours. You know, that sounds like I’d rather shoot myself in trouble for hours and hours non stop. Yeah, you know, I like me. But the more I realize it’s important for her, if she sees that I’m at least, like swimming every day basis, I’m looking at my fitness level, and that would make her happier. And how I like to swim. So I make me happier, too. It’s really quiet underneath the water of a pool. So you don’t listen to kid, you know, crying about video gamer. Yeah, it’s a nice break. So so you can make everybody happy doing that stuff. But you know, we don’t always have the best examples in life, how to be a good husband or a good father, provider, employer, boss, subordinate any of those things. If you if you can recognize your deficiencies, by having an answer seeking out, people who have figured it out, or are way more on the way of figuring out than you are, then just copy their stuff, go find them, talk to them, learn from them, try and read will. So I’m looking at this program is new thing, that he’s kind of starting as a soft skills. But he’s really good. And I’m looking forward to it. And I’m hoping that it will help give me a better sense of a balancing those things. Because, you know, balancing my my spiritual faith with my interaction, my family, my wife, specially my kids, looking at my financial outlook for the future current situation, you know, debt payment, investing for the future, all that sort of stuff. And especially increasing my fitness level, that’s where the importance of accountability for that is the best way to do you know, doing these programs for a while that you will evolve as a person or as a couple, or as a parent, or whatever you need to seek out another program will help you fill in some gaps. You can, you can expand on this call us if you already have in game knowledge. Or it could be just a reminder of things you already know. And that you just slacked off, you just quit doing because of laziness or, or not prioritizing it, or just becoming old 15 year leadership skills. So you have to seek out some of those programs and that sort of filter out there. In every country, every part of the world online, you can go a little over imagined in some old personal textbook kind of person, that’s helpful to actually be sitting there and going through discussion and that sort of stuff. So those programs are there, anything you’re deficient on in life, or anything stressed out, or lose sleep over? Well just seek those out for topics and coach or topics. You know, parent, coach, relationship coach, whatever else, stateless marriage counselor, you go to those people because you’re in dire straits, you’re, you know, you can serve divorce papers, you

Unknown Speaker 56:09
thought everything was great. And you get that stuff. You know, it’s not great. So you go to freakout mode, well, if you don’t work with a coach early on in your marriage, because you don’t know, you’re doing very good work, and their shame, saying, Hey, this is things you can do these things you can work on, and be more proactive on this thing, you’ll be a lot happier here, you will invest way less money. Because if if I paid off all my debt, three years, which is my plan, and then I put them in four years, now my wife divorces me, holy, that’s a lot of money that I just lost out on. And it’s a lot of your happiness a lot. Not not the model, husband or or her dad and I make a lot of mistakes, some of my middle name more than once. And so now I’m trying to be practical taking this program and committing to try and fulfill the our responsibility is to help ensure a better work life balance, for me, and for my situation. It will never be perfect. Because we’re growing individuals, we make mistakes. So seek out those God to help you and who you can have some accountability with. And you will be honest with and you start a new york as well. There’s no magic pill or bullet that’s going to fix this thing if you have this going on in your life. So seek out people just emulate them or ask them advice. Hey, how did you learn this? Usually people by lunch will help you they’ll tell you

Unknown Speaker 57:34
find something else, they’ll tell you

Unknown Speaker 57:36
that. You just throw out so much good information right there. I applaud you for taking that. That step. I’m sure your family recognizes that as well to go out there and and seek that that means there’s a change. And I think if you’re doing it now, does that change in your heart as a change in your mind that you’re already starting to implement? So that’s awesome, man. I think more guys need to hear those type of messages. So appreciate you being so open and honest with that. How can people get in touch with you contact you website, all that type of information,

Unknown Speaker 58:03
website, laser Dental Center. com, your cases, they can contact me via I mean, Facebook, I’m on Facebook, it’s easy to find me.

Unknown Speaker 58:13
But it looks like an old man on Facebook. Yeah.

Unknown Speaker 58:18
Like, who is this guy, he looks so much older on Facebook

Unknown Speaker 58:23
thing from a few weeks ago, I put it up there. And then I’ve just got distracted and haven’t had a chance to change it back to a regular picture. So I’m get to it. Now Facebook’s easiest, people contact me through messenger. And we have dentist and assistant teams tour through our office to pick up some of the tips and tricks that we do. And that sort of stuff. So we’ve had lots of visitors do that, you know, happy to help to share, as always doesn’t interrupt our workflow for the day. We’re super busy. So but my team is used to that. It makes them better at what they’re doing by by helping to teach and show people how we do things. So So yeah, website, they can see my office stuff, I guess, honesty that they need to get ahold of me or want to you for anything then yeah, just Facebook Messenger is probably the best way emails are like 60,000 unread emails sending.

Unknown Speaker 59:12
So yeah, for Facebook better be the best. Thank you again so much. Absolutely.

Unknown Speaker 59:21
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Unknown Speaker 1:01:45
We just went hashtag behind the curtain. I hope you will listen and integrate with some of these guests have said by all means please share across your social media rather review and if you go to the show notes page, you can find all the references for today’s guest. You’ve been listening Dr. Justin Trosclair

Unknown Speaker 1:02:00
giving you a doctor’s perspective.

Transcribed by https://otter.ai