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Ep. 48: Everyday Oral Surgery x Between Two Teeth: Challenges of Being a New Doctor in a Multispecialty Practice (Part 2)
36 Plays1 year ago
Join us for Part 2 of our collaborative series with Everyday Oral Surgery and Between Two Teeth. In this episode, we tackle the frustrations faced by new doctors in a multispecialty practice. From navigating egos to managing financial arrangements, we explore the hurdles and opportunities of this dynamic environment.
This candid discussion sheds light on the realities of starting a career in dentistry. Tune in for #NewDoctorChallenges, #MultispecialtyPractice, and #DentalCareerInsights. Subscribe now for valuable insights and practical advice!
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Transcript
Introduction to the Podcast and Guest
00:00:00
Speaker
Hey there, guys. Between two teeth, we usually don't talk about teeth. But today, you're in for a special treat. We're talking about teeth. We're talking about oral maxillational surgery and periodontics with our good friend from the podcast, Everyday Oral Surgery, Dr. Grant Stuckey. Please give a listen. That's a good question. I know, Grace. I'm surprised at you. I'm surprised at you. I can't believe he keeps inviting us back on the podcast, because we just talk, talk, talk. You guys have brought up a lot of good points, I think.
00:00:29
Speaker
a lot of caffeine this morning. Yes. Oh, but I think so.
Challenges in Dental Practice Collaboration
00:00:41
Speaker
You're kind of
00:00:42
Speaker
touching and dancing around some of the awkward situations. And I think in your setting, it's much more fluid because let's say maybe Bob owns a practice and he brings Stephanie in. And so he's motivated from the beginning to get along with her and kind of make this work and understand what's going on. I think in a setting, maybe
00:01:05
Speaker
like I've been in and I think a lot of guys are going into is, you know, they're just joining a practice and then a periodontist. They're both independent contractors and they kind of start bristling at each other, really over the overlapping procedures, like basically bone grafting and implants. And so, and I think it's very unfortunate that that small area of our practice has to create such a divide for us.
00:01:31
Speaker
Because if we didn't have overlap, it would be very easy. Because I can call my orthodontist and say, hey, what do you think about this case? Blah, blah, blah. There's no threat there. There's no issues. But like you're saying, in a DSO, when a patient comes into practice, all of a sudden, it's this big, whole competing situation. I'm like, well, why are you sending him to perio? And then perio, why are you sending it to OS?
00:01:59
Speaker
And in our case, it's like, okay, the oral surgeon has more schooling. I can sedate the patient. I can do X, Y, and Z better. And then the periodontist says their argument, well, I do soft tissue better. I do suturing better. I do this. And we're like, everyone's fighting over these patients and it can get pretty just ridiculous. And we start overlooking the strengths of each person. And so I like what you guys are saying about how you work together.
00:02:27
Speaker
And Grant, you brought up, I mean, bristling. I love that word selection because that's a real nice way to put frustration at its deepest level. You just get out of residency. You're supposed to be the surgeon. And now you've got this, I mean, and with all due respect to Perry, you have this JV person around.
00:02:46
Speaker
who's kind of putting a thorn in your side to say, no, actually I'm, I'm here and I should be the expert. And especially as independent contractors, you guys both want, you kind of eat what you kill. And where, where I think it could be set up better to help both specialists out is for whoever owns the practice, to look at the practice model and say, can we afford two surgeons here?
Ethical Dynamics in Corporate Dental Entities
00:03:12
Speaker
And it's just because they're both going to place implants. They're getting both sedate patients. There are, you know, you know, perhaps wisdom teeth is something that is going to be in the oral surgeon's realm, but you have a lot of periodontists. They're making arguments that say, Hey, you know, I do take out wisdom teeth. I do place implants. I do suture. I do have the soft tissues. And so as you have these corporate organizations start to learn from kind of past personnel,
00:03:42
Speaker
miscues. I think the question they should be asking themselves is
00:03:46
Speaker
Can I have, is there enough things to do for two surgeons in the building and create that environment? Sure. Well, and I think as I hear Grant talk, you know, there's some financial disincentives to work together in what you're talking about. I think from a corporate entity perspective, you know, you want your staffing, including your surgeons to be able to have appropriate relationships. What I thought about as well, you know, at the end of the day,
00:04:16
Speaker
ethically as professionals, we have the obligation to really put the patient's best interests paramount. And it also gets into risk mitigation and risk management. I'm on the state board here in Texas and see a whole lot of untoward events in all sorts of areas.
00:04:38
Speaker
And a DSO does not want bad outcomes for patient satisfaction or hospitalizations or having to redo stuff.
00:04:48
Speaker
but there's a level of nuance there that gets tricky and ego and money. You know, money, power and relationships control so many things. And to Grant's point, you know, we've kind of backtrack a little bit on that in our own type of practice.
Revenue Sharing and Cooperation in DSOs
00:05:08
Speaker
And maybe it's a way of revenue sharing as a DSO looks at the surgical providers and say,
00:05:15
Speaker
Okay, we're going to have a little bit of a different structure where you guys, the two of you or three or four compete in some things, but there may be a revenue share model that is a little different to encourage people to work together.
00:05:30
Speaker
I like what you're saying there, Bobby. And it's almost treat them as two, it's almost like two siblings. And if mom and dad favors one. And siblings never fight. Yeah, it's just not gonna be, you know, you can choose the type of relationship you want with your sibling. And it doesn't mean you both don't have your space to shine. It's, you know. Well, and to Steph's point too, you know, there's a continual evolution. The only thing that's constant is change. And I think for OMS, you know, I think especially in the past couple of years,
00:06:00
Speaker
the leaders have sort of appreciated we can't have ourselves on an island. And we are best served when people look at us as we want to be part of a solution.
00:06:12
Speaker
And that's going to mean working with other people.
Promoting Communication in Dentistry
00:06:15
Speaker
You know, Steph and I were invited to the dental implant conference through Amos a couple of years ago. We're actually giving two talks at the Amos annual session coming up. One on communication and effectiveness. The other one's actually on kind of wellbeing. Amos through Dr. Paul Schwartz has been very involved in sort of the wellbeing initiative.
00:06:37
Speaker
working with the ADA. Can I just, Dr. Schwartz is amazing. He was one of the first people that kind of came up to me at Amos and was like, hey, we want to work better together. Yeah, he likes you better than me. He goes, where's Steph? Steph is Steph here. He's one of our subscribers. I would do it two teeth. And what Dr. Schwartz kind of taught me in that moment was that to work with somebody else, especially when you have two big egos involved,
00:07:07
Speaker
man, and it's kind of changed how I look at things too, based on his example, is just you have to give respect to get respect. And it's a tough lesson for me. I'm not great at giving the respect. And so I don't get a lot of it.
00:07:24
Speaker
But I've tried to change where I try to give more respect at the outset, even though, you know, I may not feel complete or fully fulfilled. And I really try to go out on a limb a little earlier than I used to, to try to, you know, just lay the groundwork of goodwill. And yeah, it doesn't come back every time, but a lot of times it does. Here's the deal. This is one of the things I learned. I did a public policy fellowship at Harvard Kennedy School a couple of years ago.
Managing Egos and Building Goodwill
00:07:54
Speaker
And one of the professors, fantastic guy, was a presidential advisor for four different presidents, is like, you can be the smartest person in the room, but you may not be the most effective. And figuring out how to be effective. And yes, it's managing your ego, it's managing other people's egos, it's building goodwill. I think we need to write a manual for how a period honest in an OMS can
00:08:23
Speaker
get along. Or you just wrote something on substack. Is that what that was? I'd love to hear grants take. We'll charge one dollar for it. Can we charge money on substack? You can, yeah. Oh, well we should. Maybe two dollars. That's like a riveting article or booker.
00:08:39
Speaker
Well, and I think, Grant, you help, well, riveting, that's a strong word. You know, it'll be different, we will say that. But I guess, you know, a whole lot of life, I think, you know, people try to find happiness, you know, our push between two teeth is sort of well-being and living a life best lived.
Learning from Peers and Professional Respect
00:09:02
Speaker
There's, you know, I don't like the term happiness because there's times you can't be happy, you know, you're in an environment, you know, with doing everything that we do, there's times that things are not happy at all. So I actually myself, I try to strive for peace because I think that's more important. And a lot of that peace can be determined by the differential, the delta between expectations and reality.
00:09:31
Speaker
And knowing that for an OMS and a perio to work together, you should expect there's going to be times of disagreement.
00:09:44
Speaker
period, I can probably end it there. But there's also times that you're really going to work well together. And again, I'd love to get Grant's take on some of the stuff we've been talking about. He thinks we're making it all up, I think. What do you think, Grant? Yeah, I think no. There's a couple of things you guys have said I really like. One was Steph's comment about, you know, kind of getting to know the other person, seeing what they do, even observing and shadowing them. I think
00:10:12
Speaker
if they're willing to do that is awesome and it could be a great thing. I like, similar to what you were saying, how you learned from her with the suturing type stuff. I think that is so important for us. And I think, I would guess it's usually the periodontist is more open to learning from the oral surgeon. And unfortunately it's much more harder for the oral surgeon to learn from the periodontist because we have this unfortunate chip on our shoulder
00:10:43
Speaker
where we say, hey, I went to more schooling, I did, you know, more intense cases, I, I did all this stuff. And what do I have to learn from a periodontist, right? It's this unfortunate mental block we have. And I feel the same way. Like, after I got over that block, it took me a couple of years, I started calling and talking to some periodontists that I realized were like, wow, they have good results. And how are they doing this? And what's going on? And
00:11:10
Speaker
I started getting this new respect for one in particular who's a friend of mine and all of a sudden it turned from like an enemy to like a mentor and I think it's there's a lot to be learned like you're saying and It's unfortunate that we can sometimes have a mental block and ego can get in the way That's