E 183 Medical VA Staff by Dr Steven Kupferman

What led an DMD/MD to create a virtual assistant company hiring medically trained Filipinos?

Dr. Steven Kupferman talks to Dr. Justin Trosclair, DC on A Doctor's Perspective Podcast

Steven Kupherman, DMD, MD, FACS (UCLA Med School, Harvard for Dental Medicine) tells his story of how he parlayed being a dentist and then continuing his education at medical school to be an Oral and Maxillary Surgeon. What drove him to do an extra 10 years of schooling? While he doesn’t do root canals anymore, he can do facial traumas as well as non trauma cases of the face.

Six doctors, 30 staff and he was the one doing most of the admin and hiring and firing and finding people to cover when someone is not in the office. Everyday someone was not in the office, whether it was sick, family obligations and so forth.

What can a Medical VA do for you?

It was 2018 that he started to dabble in VA’s from the Philippines. He uses medical professionals like nurses and physical therapists etc to perform the admin tasks like verifying insurances, scrips, inventory, letters to other doctors and even answering phones in some cases.

Scribe is one of the best uses of a VA. Also, nonone should be in your office calling insurance companies.

It’s good practice to record your training so that video can be sent to teh next hire and the next without taking up your time again.
One resource for making calls is RingCentral and Zoom for the training.

When to Hire?

When is the best way to know when you should make your first medical virtual assistant hire? Replacing someone who quits is a great first step.
If they don’t touch a patient – it potentially could be outsourced

Pay

They get paid 1.5-2x the amount they would make in their country. Plus they get health insurance, paid time off, retirement options and other perks.

Risk

The Philippians virtual assistants have access to privileged patient information. The laws their are very strict and harsh if you misuse that information. Technically he says, the janitor that comes in after hours, the nurses on a regular basis, and all the people who have access to payments are all a risk as well to the clinic.

Relationship Advice

He got married young and not only a little bit of luck was involved but they grew together, had mutual respect and had the same ideals.

www.medva.com

Show notes can be found at https://adoctorsperspective.net/183

a doctors perspective e 183 dr steven kupferman medva
Full Transcript of the Interview (it will have grammatical errors and mistakes). Just Click to expand. Thanks descript!

justin: [00:00:00] Up and you're still in Los Angeles. Okay. All right. Here we go. Live from Louisiana and Los Angeles today on the program. We've got an amazing guest. I'm gonna think because he does medical virtual assistance and he's not only a dentist. He's also a medical doctor. Can you believe that a glut for punishment?
Anyway, I'm looking forward to hearing everything he has to say, because we've done some virtual assistance in the past, but not to this level in this detail. So please welcome the show Dr. Steven Erman.
dr steven: Thank you. Thanks for having me.
justin: Absolutely. Well. Okay. So when you meet someone that has a dental degree and a medical doctor, Of course, we have to ask what happened there, because we have seen some people where they're like a chiropractor and then they become a lawyer and I'm like, wait, you're double dipping.
So were you able to do like more riskier surgeries or like what happened there?
dr steven: Well, you know, I, I when I was in college, I decided that I was gonna be a dentist. I have a few uncles who are a dentist and I just thought it would be, you know, a great profession to, to go into, and it is and so I went to dental school after college and then from college, Sorry [00:01:00] from, from dental school.
You know, I was trying to think about what I was gonna do and what kind of dentist I'd be first. I thought I'd be a pediatric dentist. Cause I like kids. And then I thought, well, I'm gonna probably have my own kids. So probably not a great idea to be treating kids only. So then I I got interested in in oral and maxilla facial surgery, which is kind of like at the watershed between dentistry and.
And and it's, it's a surgical specialty, it's a dental specialty. And it, I got very interested in it. I had some great mentors in dental school and so I decided to apply to the residency programs across the country. And and I matched at UCLA, which meant that I had to go to medical school for two years, basically finished the last two years of medical school.
because I had already done the first two years of medical school in dental school. So I had to do the last two years of, of medical school finish that. And then from there I had to do residency, which was basically four years. One year was just kind of general surgery with all the surgical subspecialists and then the, then with three years of uh, oral and maxilla facial [00:02:00] surgery.
So it was a 10, it was 10 years after college. Training residency, medical school, dental school, and all that. So it was a lot of years, but very, very, very well worthwhile.
justin: That's gotta be amazing because there's not gonna be a single dental procedure that you really couldn't do. And, you know, cause I, I listen to a lot of dental podcasts and like some of 'em are cast and they're like, you can do a full facial restoration for like 30 or $40,000, you know, and they're doing implants and all these things, but man, that's another level whenever you.
Bridge it into sinus problems, sleeping problems all these different bites. Then you're like, I can actually do all of this all at the same time, because I'm super skilled. Yeah.
dr steven: Well, you don't want me doing any root canals or, or, you know, fillings or anything like that. You're past that. Yeah. I don't even know how to do that anymore.
but when it comes to any any surgical procedure you know, that evolves, you know, the, the mouth and, you know, the face and neck and all that, or those are things that you. I partake in, on, on a regular basis in my, in my practice.
justin: Are you more like trauma based or is that a different special.
dr steven: No. So, so our practice does a lot of trauma.
I [00:03:00] do I do some of it. One of my partners does the lion share of the, of the trauma. Mm-hmm we take trauma call at the level one trauma center here in Los Angeles. One of the level trauma level, one trauma centers here. So we do a lot of facial fractures, fractures of the. The eye sockets, the cheekbones, you know, the nose and any of the, you know, jaw fractures, things like that.
So so we do, we do a fair bit of that. So yeah, you know, a decent amount of trauma.
justin: Yeah. So I'm starting to put together how you develop a dental virtual assistant program. Now before I was like, this is kind of a, you know, a random thing to get into until, you know, somebody's story. But now I'm starting to kind of put the pieces together.
So how did that bridge into what you're doing and then seeing, I guess that is a hole that needed to
dr steven: be filled. Yeah. So so when I started in practice, I was the first one in and over the last 12 or 13 years, we've grown to six surgeons. And during most of that time, I had been doing a lot of the management of the practice, which means that I had to deal with all the, all the [00:04:00] staff on a regular basis.
and at one point it just became quite overwhelming. There were just so many people in the office. We didn't have the space for them. We, how many people were underneath
justin: you, would you say
dr steven: support stuff? We had about 30, some odd people working for the practice. And you know, every , you know, when you have one or two people, it's like, people are never out when you have 30 people, there's somebody out every day mm-hmm and and you know, There's just so many things that revolve around the employees their day, their day to day work, their schedules, their family schedules their time off and all that.
And it just became very overwhelming. So I, I, I started to look at some other options for staffing. , this was in about 2018 and 2019, somewhere in that, in that time period. And I started to think, you know, what can I do here? Like, what other ways can I get all of this work done all of this administrative work for the office done.
And I had heard about outsourcing and, and things like that at and I came across the idea of having medical [00:05:00] professionals from the Philippines. working remotely, which was a novel idea before the pandemic. And I was introduced to zoom and and I had hired first one person who was gonna work remotely.
So he was going.
justin: say that again, doing what exactly answering the phones or admin, like billing or what?
dr steven: Well, I didn't know at first , I, I was thinking, just answer my emails for me and you know, just get, get me through the day you know, open up my mail, you know, just, just things. And then I started to, to realize.
they, you know, that, that he could do everything that anybody in my office could do, unless there was some patient that needed to be touched. And so he was able to write reports and do notes and letters to, to referring doctors and, and inventory and and look at the, the cameras and, you know and then call insurance companies get authorizations for procedures, find out what patients [00:06:00] benefits were put together.
You know, workers comp reports for me and, and it was endless. And so I had the first guy and, you know, and the beauty was that when I would train him on, on oral and maxilla facial surgery, he would record it in zoom. Again, this is 20 18, 20 19. And then I was like, okay, well you gotta pass that on to the next guy.
Cause I don't have time to train the next guy. So all that information got transmitted very easily to the next guy. Right. And before I knew it, I had, I had four people working for me from the Philippines. One person was calling dental insurance companies every day, finding out how
justin: it's like a voiceover IP that was based out of America,
dr steven: correct?
Yeah, just using ring central. Okay. What was it? The one we started with was RingCentral it's, you know, like it's a monthly voiceover IP system. You just turn your computer into a soft phone, you get yourself a set of headphones and, and a phone number. And, and you're, you're good to go. Wow. As long as you got a computer and, and good internet access.
So they would call insurance companies. They [00:07:00] would find out what patient's benefits were, how many, you know how many dollars they had in their dental plan and get some authorization for procedures, if it was necessary and hired another person to help us with the credentialing for our surgery center and then another person to help
justin: with.
Would you say that. The guy that you first hired was like, Hey, I'm on overwhelm. Now I have so much on my plate. Can we go ahead and hire somebody else? Like, did you have to do the process or did that person hire the next person for you that
dr steven: well, once, you know, if you, when you have 30 people, there's, you know, unless you have um, you know in a system where people have been with you for a long time, when you get to the 30 person, mark, you know, some of them leave and some of them come and some of them quit and they go out on this leave or that leave.
So when somebody left and said, yeah, you know, I'm, I'm moving to another job. I just got another one or two people from the Philippines. Yeah. And, and it, and it's just, it's gone that way ever since more or less. Because, you know, unless they're a nurse or [00:08:00] an ma or, or a dental assistant or someone who clinically has to touch the patient, it, they, they didn't need to be there.
They, I didn't need that person in my office calling the insurance company or, or doing the payroll or going through my credentialing
justin: stuff. So I use a VA from the Philippines for blogs and some it is right now, it's for blogs and turning podcasts into blogs from my clinic site that make it unrelevant for the regular person, you know, a lot of SEO type stuff and, and everything.
And of course they get paid pennies on the dollar, in a sense, compared to like, if you had a full time American social media company, doing this for you, with the medical, it's still advantageous compared to just having somebody in the office as far. Salary goes
dr steven: well, they're going to the same supermarket.
They're going to the same, you know grocery store and mall in, in the Philippines. Mm-hmm , you're just you and I are just taking advantage of the power power of the American dollar currency. Yeah. It's the same thing. If you were to go [00:09:00] to Guatemala and buy, you know buy soup at a, at a restaurant it's gonna.
You know, probably a dollar 50 where here it's $10 and 50 cents. Yeah. And that's just, that's just the nature of the American dollar, the power of the American dollar and that you're taking advantage of on a day to day basis by, by using it and giving it to somebody who is is getting, is able to buy a lot more with that dollar in the Philippines than you can do with that dollar here.
So it's arbitrage
justin: transfer it. Like they just do the currency exchange. Yeah.
dr steven: It's just a simple exchange, but you know, $1, you know, here is, goes a lot, one American dollar in their hand goes a lot further than it does in your hand. And so it's just arbitrage of, of the currency and, and you're just taking advantage of that on a day to day basis as our, all of the doctors and, and medical facilities that use our virtual assistance.
justin: Yeah. So, and not in a bad way either. It's just, like you said, it's just the power of the dollar there. You're paying them a livable. Good [00:10:00] wage is just less than we have to pay someone here and you're getting the same service. That's the thing.
dr steven: Correct. You're getting the same service. You're just you know, most of the people in the Philippines as it relates to healthcare and working for med VVA and working for.
The the doctor clients and the healthcare facility clients that we have they, you know, they're they're very, very happy with the salary. They're getting paid more, sometimes double what they would be getting paid as a nurse, for example, in a skilled nursing facility or small hospital or, or something along those lines, they don't have to commute.
They have regular shift. Their, their, their shifts are usually depending upon our clients, but for the most part, the client, our clients want them to work American hours. So they're working nighttime mm-hmm and their spouse may be working during the day. And some people like that, you know, they, you have a young family, you wanna, you know, you want, you want, you know, dad to work during the day and mom to work at night and then mom can, you know, be with the kids when they wake up in the morning.
And then she goes to sleep when they're in school. And it works out very well for a lot of the nurses that are you know, that work for medvac
justin: would people be. [00:11:00] A common objection could be. Yeah, but what about the safety of my patient's email and social security number and all this kind of stuff?
What we don't know about those Philippines, they might just steal it all and, and then uhoh who's in trouble. So have you had any of those kind of issues playing devil's advocate a little bit? Yeah.
dr steven: So, I mean, without thinking about that, this is a no brainer, I think for anybody. Right. Mm-hmm I mean, so, you know, the way I look at it is.
You know, we all have risk of bringing people to work for us, whether they're working in our office, touching our patients, talking to our patients, seeing our patients, whether they're in the billing department, in our office, going through their charts and their records and their financial information, whether it's the credit card processing company that we use, whether it's the person at the front desk who, you know, is checking in patients, whether it's the janitor that comes in at night and sees papers or charts that are available to them, or whether it's somebody in the Philippines who's going [00:12:00] through, you know, your, your EMR there's risk in, in every step of the way.
And as a business owner, as a doctor who runs a practice, you have to mitigate those risks as much as you possibly can. The risks exist, whether somebody's in the Philippines or. The janitor cleaning up the floors or the maintenance, you know, crew that comes in because there was a spill, you know, overnight or something like that, there's always gonna be risks.
So you have to, you know, deal with those risks. Now, the Philippines, fortunately their industry, the main industry in the Philippines is virtual assisting. And so they punish crimes where you have healthcare information breaches. Much more seriously than we do here in the United States. So if you, for example, have somebody who, you know, has a HIPAA violation in your office, you may not even be able to fire them.
And if you do, you may be subject to a lawsuit in the Philippines, they go to jail. And so there's, there's fear for, for the consequences of [00:13:00] of taking information there's, it's not a zero risk that it would ever happen, but there's a much more fear there than there is here. For something like that to happen.
So, so, you know, we know it exists. We, you know, we we indemnify for it. You know, we're concerned about it for everybody that comes through any of the practices that we are associated with. But that's, you know, that's the way, that's the way the world works. We have to be cautious.
justin: Well, that's really good to hear.
I think that puts a lot of people's minds at ease when they first hear this, they're like, oh, it sounds too good to be true. What about all that stuff? And then you're like, oh, Actually the government already is aware of what's going on and they've set it up to where, you know, it's kinda like going to China and do manufacturing instead of doing manufacturing, they're doing sensitive information.
They have to, to play, play that game with us. So how would a clinic know it's time to do this? Or how would they experiment with, let me just hire one and see what happens. What's the best role that you could hire for this
dr steven: four? Well, the, you know, the, the, the, the few, the few best roles are. Scribe. So if you're a busy clinician [00:14:00] and and you need a scribe you know, you get yourself an iPad or an old iPhone connected to the wifi in your office.
And you know, you just, your medical assistant turns it on and you start talking to the patient and the scribes in the background and just SCRI away everything that you're doing. And when you're done, they can send you the fully executed note and you can sign. That's really easy for your typical clinician.
Who's seeing lots and lots and lots of patients. You can easily have a virtual assistant. Who's probably an RN who has scribe knowledge. We have specific scribe course that we give to our virtual assistants before we endorse them to doctors. So subscribing is really easy. I think really the easiest way is is somebody who is currently in your office dealing with insurance C.
You know, I, I say there there's really no reason to have somebody working in your office, calling insurance companies. It is a, it's a colossal waste of money. You know, you're, you're spending a ton of money having somebody call insurance company. And the there's a very strong likelihood that they're calling [00:15:00] somebody out of the country in India or the Philippines, or, you know, Mexico, south America.
So that that's the easiest way to get in, you know, in the dental field you know dental offices always have to know how much money is left in the dental plan for the year. So, you know, a lot of times there's somebody who's calling now, if you have a small office and you see a few patients every day, and it's not like a, you know, a huge deal because you're the only one treating them and you have one person at the front and there's five people coming through the office.
It's not a big deal, but any sizable office has somebody doing this already? and that should be done by a med med a person.
justin: So they can do the me billing. They can do the follow up and they can do the corrections on the bills when they're wrong as well. Absolutely. You know, I said scribe. So there's lots of places now where you can use Otter, you can use rev, you can use D script and it just translates things for you automatically do these kind of describe VAs.
Do they run it through those machines? Save them a lot of sell time and then just format it. And proof freedom. Well, could I just give away some stuff? No, no,
dr steven: not at all. Not at all. You [00:16:00] know, it depends on how nuance the practice is of what you're doing. I mean, if you're, if you have a very, very regular practice where you're doing the same thing over and over and over again, you potentially can use something like that.
But in general, you know, if you're using a scribe properly, they're calling, you know, you have, you're seeing 20 patients, you know, that morning before you get there, your scribe. Spent the day before calling those 20 patients getting a full history from those patients. Oh, and then, so now they have their history present illness.
They've got the past medical history, they got the medications, they got the allergies, they got the social history all before they even come in all before they even doctor even sees them. Okay. The doctor walks in and reads that on the screen. And and then. Just just examines the patient puts together their assessment and the note, the notes are done.
You know, everything is being listened to by the, the scribe notes, as much as if not more than the doctor, they just don't know what to do. Mm. So that's how you use an efficient scribe. If you're just going, have you don't wanna record and, you know, wanna [00:17:00] record a conversation then, then that's that's, that's fine.
Yes. It's that's not, that's not what high, you know, high productive doctors are doing.
justin: Can you have someone answer your phones, just, just set of Sally in the front, answering the phone for you. Could you just have like, no one, like, like say like not maybe not dental practice, but possibly definitely like in a chiropractic clinic you could kind of sometimes get away without having a front desk person, but there's a certain point where you just be busy enough where you need somebody to flow traffic, but you could still potentially not have the fir person answer the phone.
Someone else could answer the phones and do the. And then she, this person's just quarterbacking the flow of the
dr steven: office for sure. Yes or no. Absolutely. Absolutely can do that. We have people who are trying out to do an electronic kiosk where you would walk into the office, there'd be a computer at a kiosk there, you press the button.
One of the virtual assistants gets on and says, hi, nice to meet you. You know, please enter your information, da da, da, da. And then when the patient, you know, has finished all their paperwork and they're checked in and they got everything through the em, The virtual assistant's doing this, the [00:18:00] patient sits down and then they call the nurses in the back and say, Hey, Mr.
Mr. Smith is here. He just checked in and, you know, or they send a message or, you know, or something like that. So people have already started doing those, those sorts of things. In terms of you know, in terms of certainly the stress in the medical office is always the phones ringing. People have tried to quote, outsource that and send it to a call center.
Everybody hates that. Yeah, we, we think that that's, that's just not the way to go for a medical practice. No matter how big and you know, so, so you can have two or three people from medvac who are virtual assistants working in, in their individual homes, using a voiceover IP system and answering the calls and.
You know, and as long as you have a good connection to the office, they can figure out exactly what the flow is and what's going on and who can see them and, and all that. And then the person who you had up front, who was answering calls and checking everybody in now can sort of just focus on checking everybody in and get, get to all the tasks that they have.
justin: Let me ask you this. What about your company? Are, are we hiring you to find the VA [00:19:00] for us? Are we just like, are we paying you for the access to a database? And then we find the person through your approved list. How does, how does that
dr steven: play out? Yeah, so, so the way it works is you would, you would call med V.
And we would set up a a, a, a consultation with you. We'd just find out exactly what you're looking for. And then we have. An entire team of people that are waiting to be endorsed and, and, and, and placed with with doctor's offices. So we'll give you three or four people. We'll, we'll give you a, a short video that they recorded their resume, their certifications their degrees.
And then you'll go through the three or four that we give you. And then you'll say, Hey, I'd like to interview, you know, Sally or, you know, whoever it is. And then we will, we will arrange the interview, you know, that day or the next day. And then they'll, they'll start, you know, a day later or, or whatever it is.
So once who does
justin: the training do y'all have like standard stuff that they're gonna need to know, and then it's fine tuned at the level. Correct.
dr steven: So everybody has some basic level of training and, and. We put them through at least two weeks of training and additional if they're gonna [00:20:00] be having gonna be a scribe or do something more specific.
So we put them through training, but most of them are already trained healthcare professionals. They're physical therapists, speech therapists pH nurses. So they, they obviously have medical background, medical knowledge. So we just train them. You know, it stuff and, and communication and what they're gonna be doing.
And we place the, you know, the right people with the, with the right offices that matches, you know, not always a hundred percent, but we, we do very well with it. And then once we once, once we, you know, we find once, once the doctor finds the right person, they just start right away and we just keep track of their time.
And we send a bill to the doctor every every two weeks.
justin: Okay. All right. Now I've heard there's different ways and this might be, I'm not trying to touch your toes here, but I've heard sometimes the hiring company takes a huge chunk of the money and just pays the employee very little compared to what they actually are getting charged.
And then there's some companies where they're like now it's like just a percentage of some sort. And the rest actually goes to the worker in the [00:21:00] Philippines. I don't know. Are you allowed to ask that kind of question? I mean, well, you know what I'm saying? So some people are like, I don't know if it's 70, 30 or something at that, but you know, I've heard some other VA companies are like, be careful of those, of these type of companies, because you're really not helping.
The, the person in the Philippines very much cuz the, the salary's being siphoned off by the middleman.
dr steven: so I'll, I'll tell you. We, we we pay our VAs more than, than any other company because we wanna retain them and we want our customers, our, our doctor clients to be happy. So our salaries are the highest we provide them with with healthcare insurance an HMO product for them, which is a wow, a premium insurance.
For, for the Philippines, we have we have a a retirement program for, for them that begins after a year, just like, you know some do here in the United States. So and then we, of course we have overhead, you know, that that we pay. And then there, obviously there there's a, it's a profit, you know, for profit company.
So we do, we do make some money, of course, of course which we've essentially invested all back into the company to, you know, recruit the most [00:22:00] talented. He. Individuals from the Philippines and from south America, that's great. And central America. So we, we put everything back into the company because we, we really want to grow it and we wanted to you know, to, to, to be the product that really helps out all of my medical colleagues.
justin: That's good to hear. Did they get that 13th month as well? I heard that's a thing there a 13 month salary. It's like a bonus. Something
dr steven: like. That's usually for different kinds of employee, different type of employee. Yeah. Like a contractor type of thing that you may be referring to. So we, we pay them, I got limited knowledge yeah.
You know, suffice it to say that most of our nurses are making twice what they would make working for a hospital. That's awesome. So they have a phenomenal job. It's a very regular job. We, we we make sure. We try not to hire anybody for a part-time position. We want, you know, if you, if you want a virtual assistant, we want you to have them full-time we want them to know that.
That they're, you know, that there's work for them and that that they're gonna be able to do this. Otherwise they're gonna have to find another job because they need to make money and they need to [00:23:00] eat and put yeah. Consistency and everything else. Yeah. So they want consistency. So, you know, we, we, minimum of 30 hours is, is what we ask for from, from the doctors.
And and so you know, it's, it's been great. I mean, we, we, you know, we have, you know, tons of people that are, that are working for med. There's a lot of energy. They, they really, they really love it. They they're provided with just an incredible position with
justin: any field work, physical therapy, chiropractic psychology Anybody or do you kind of focus more on the medical and dental only at this point?
dr steven: So, yeah, we, we, we have, so, so medvac will supply a workforce to to any medical facility, whether that be a medical office, a psychologist's office, a dental office, a skilled nursing facility, a nursing. A lab any medical facility we will provide staffing for, and, and we have in each of those fields we've recently spun off a business line called Biva where we provide accounting HR, payroll staffing you know, that
justin: sounds like a natural extension of the original.
Yeah. Yeah. So
dr steven: that [00:24:00] that's, that that's gonna be the, the launch is sometime during this quarter, which is almost over, so it should, it should be coming out pretty soon. It'll be its own, you know, its own website with its own people. And obviously a different clientele, a lot of, you know, accounting firms and law firms and and and you know, you know, businesses that, that just need labor because that's the biggest crunch right now in the United States.
justin: For sure. Well, what else have I would you say that I missed, that you would think is important to talk about before the final two questions or so,
dr steven: What else? I think that's about it. I mean, I, I, I would recommend that if you've been using your virtual assistant for a long time, that you find the time to go to the Philippines and, and visit your virtual assistant I did that really early on and I found it to be you know, very rewarding for them because they really see that there's a real person on the other end.
And and you know, they, they realize how much you value your work. Sometimes when, when we do things remotely, some people, you know, they, they don't feel as, as you know, we're not as likely to tell them how much we appreciate them. . And so
justin: now how do you throw an office [00:25:00] party when you're that far away?
Like, Hey, look, here's $200. Just, just go nuts. Just go nuts. It's on me. Here's my picture.
dr steven: Just print it. Exactly. so so yeah, so if you, if you ever end up going going that way, I recommend you go there and you know, take 'em out to dinner or something like that. Absolutely. They'll tell you the
justin: best place.
Exactly. All right. So do you have any favorite books or podcasts that's kind of keeps you motivated or has changed you in a good way?
dr steven: I, I'm not a huge podcast guy just cuz I have a very short commute so I listen to podcast a little bit when I'm driving. You know, I think my, you know, my, my, my favorite book is the checklist manifesto by tool Gowane.
And that, that was something that I, you know, read early in my early, not that early, but early enough in my career where I felt it had an impact on my ability to. to grow professionally and, and, and manage, you know, day to day operations and things like that with, with minimal problems. So probably my, my most favorite book, I, I think I need to read it again.
It's been a little while
justin: I hear that. And my favorite question, [00:26:00] sometimes the audience is favorite. We typically have a spouse of some sort or a significant other, how do we keep the love alive? So we don't end up divorcing sad.
dr steven: Aww. See, it's it's a good question. Because unfortunately 50% of people at least may, maybe even higher are end up in that situation.
I got really lucky. I, my 25th wedding anniversary is coming up and so I got very lucky and got married at a very young age to an incredible person. And you know, I, I think a lot of it is luck. I was really young when I got married and as was my wife and you know, we have the same ideals.
I think it's important, you know, in, in, in a relationship that you have the same goals and not try to modify each other's goals over time, you have the same goals going in and and that that, you know, you, you agree and. And, and, and when you disagree, you agree to disagree and, and move on and, and don't let the sunset on a disagreement because it just gets buried in and, and doesn't go away.
And so you know, I think that those are, you know, some, some of the pearls that certainly have worked [00:27:00] out for me. But the, you know, it's, it's mutual respect and and and the rest will follow.
justin: What do you think. both of you seen the struggle. I mean, you were in school forever. and then she was doing whatever it was that she was doing potentially in school or whatever did that help you think when you get past that?
And you're like, I remember when you were studying 50 hours a week and look at us now we're finally reaping the benefits so many years later, does. Help at all or anything.
dr steven: Well, you know, you, for me, I was so young. We were both so young when we got married that we really kind of in many ways, grew up together.
You know, I was 22, my wife was 19. So I mean, we were kids when we got married. And so a lot of the, you know, a lot of the, the ways in which we are, people was kind of developed together. Because we've, you know, we've, we've lived together since we were, you know, essentially teenagers and. So we, you know, we, we, we, we kind of, you know grew up and and, and, and then there's a lot of respect for you know, for each other's you know, dedication to to what, you know, we, we individually [00:28:00] accomplished, you know, during those, during those years you know, my wife is an occupational therapist and she's actually a, a certified hand therapist.
She needed to work for 10 years before she was even able to take that exam. So, you know, oh yeah. So it's a, you know, she went through a lot. She was, when I was in dental school, she was doing her occupational therapy, you know studies and. So there's a lot of sacrifices that occur along the way.
I remember one of my one of our CLO my after residency was over, this is exactly 15 years ago almost to the day. I finished residency and my my in-laws made, made a, a party for, for me for finishing my residency. And, and it was part of, you know, finishing dental school. It was 10 years, you know we had been married 10 already, and it was 10 years since.
since starting dental school. I now finishing residency and one of, one of my friends was, came over to me and said yeah, Hey, you're, you know, you guys are having a nice a party. And I, I, I kind of downplayed it and said, yeah, it's, it's whatever, it's a party. My in-law, you know, wanna make a whole party.
And, you know, she looked, you know, looks me like in the eye. And she said, it's a big deal. Oh, she [00:29:00] like, oh, wow. You know, she was one of the, kind of an intimidating woman, you know, she just looked at me eye. She's like, it's a big deal. You guys sacrificed a lot during those 10 years, it's a big deal. yeah. Like you better enjoy that party, cuz that was a big deal.
And I hadn't, you know yeah. When you go through the grind as a, you know, as a resident as a, as a med student you know, especially back in, you know, the, the, the late nineties and early two thousands, It was hard work, you know, there was no work, work hour restrictions. Oh yeah. And and so, but when you're doing it on a day to day basis, you don't really realize, you know, you just come home, you crash and you wake up the next day and you go back to the hospital and you don't really realize how much work you put in.
And I think it's like that with a lot of things in life. Well, when
justin: nobody. Stops and celebrates the wins, or as soon as you hit that goal, it's like two seconds. And then you're like, alright, what's the next goal? You're like, dude, no celebrate you, you hit a milestone, like go have a drink, have a, have a nice meal, like enjoy, take a vacation or something.
Yeah. And most people just don't even do it. [00:30:00] dr steven: Yeah. So so I, I think that that's you know, yeah, there's a lot of you know, and I think you have to respect, you know, each other and you know, those are good questions, you know, and people don't really, I appreciate the
justin: answer. What. I appreciate the answer, you know it's always fun to hear what people have to say.
There's some themes, but the one you have is I've heard a little bit of this before, but not to that level because you were married for such a young age that it's it's another view. Yeah. So it's
dr steven: really great. Yeah.
justin: Yeah. Alright. Well, where can people find your webpage and all of
dr steven: that? So our website is www.med, dva.com, M E dva.com.
And you can just go on there and you'll be able to see some good videos and, you know, kind of the structure and how things work and some testimonials and, and all the things you need. And then of course, there's a way to contact our sales team.
justin: Well, we'll have a show notes page dedicated to you.
It'll have questions that we ans we ask. It'll also have a, a unedited transcript and the link and everything else. So this will be something that you can share and, and, and be proud of whenever it's all said and done. So I just wanna thank you for your time [00:31:00] and creating this company that I, I really do hope some people sign up or at least Inquisit inquisitive about it because This is probably the third type of VA thing that we've done here.
And this is the first one that's specific for medical grade people. That's already been vetted and that's a big difference from what I've had been in the past where it's like, Hey, here, you can do some social media stuff and you know, the, the, the marketing side of it, but this is the professional side of it.
So I really appreciate your time and enlightening all of us. So.

About the Author
Dr. Justin Trosclair, D.C., an expert in Chiropractic Care, has been focusing on back and neck pain relief for over 12 years and has delivered treatment to more than 6000 patients. With advanced training in treating disc derangement conditions, you can count on him to keep up to date with the latest research in physical medicine for spinal pain. He has 5 years of hospital experience in China, is currently working in Germany, and had a private practice in Colorado for 6 years. Dr. Trosclair hosts a doctor to doctor interview podcast called ‘A Doctor’s Perspective‘ with over 220 episodes. During his free time he wrote 3 books. Today’s Choices Tomorrow’s Health (rebooting health in 4 categories), a Do-It- Yourself acupressure book for 40 common conditions called Needle-less Acupuncture, and a step by step guide to look like a local for Chinese dinner culture called Chinese Business Dinner Culture. If you have kids, you may be interested in his 6 series tri-lingual animal coloring book series (english, spanish and chinese).