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VIDEO - DUwHF #871 - Omer Reed
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AUDIO - DUwHF #871 - Omer Reed
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Howard sat down with dental legend, Dr. Omer K. Reed, to discuss life, the early days of dentistry, the industry’s trajectory, best practices, advice for new grads and so much more on Dentistry Uncensored.
Howard: I can't tell you what an honor and a privilege it is to be in Omer Reed's House. Thank you so much.
Omer: My privilege.
Howard: Oh my God.
Omer: My privilege.
Howard: Honored as alumnus of the year, University of Minnesota following the fourteen years as Adjunct Professor of Ecologic Dentistry for nine years at the University of North Carolina, Chapel Hill, building a bridge between the student and the post-graduate. Serves on the editorial board of the Independent Dentist, a United Kingdom publication that promotes personal private care. A founder in the 1970s of the American Society of Preventive Dentistry. Founder and principal of Napili, a popular international seminar series initiated in 1963 and continuing to encourage successful private practice fee for service. Undergraduate degrees and Doctorate from the University of Minnesota. Holds licenses to practice dentistry in Tanzania, East Africa and the islands of the Pacific Rim. A pioneer in group dental practice in the Unites States with a team of three dentists and four hygienists consistently serving the community for thirty years. Since 1989 pioneering the concept of the one to one future of our profession and solo delivery system, concepts such as the single chair schedule, the care pair team, the front desk-less office, advanced interactive diagnostic technologies provide the database for the future. A firm believer in his chosen spiritual commitments and family values, an Eagle Scout, a strong supporter and participant in the youth program of scouting. The year 2000 begins the forty third year of Fun in Practice and the forty seventh year of partnership with Marci, these are among the highly valued experiences of life. You've been practicing dentistry for sixty years.
Omer: Sixty years, 1947, yeah. And I've been married for sixty four.
Howard: What was harder, dentistry for sixty years or Marci for sixty four?
Omer: I'll tell you what, there's nothing ever been harder. I get up in the morning, my feet hit the floor and I say, hot dog, I get to go to the office. And Marci's been a tremendous partner and a great support and she is a good cook and she's got lots of money, so I mean, and I'm inherently lazy, so there you go.
Howard: I remember when I got there in '87, I mean, when I got out of school in '87 you were the biggest name in dentistry, no, you really were, I mean, every time I lectured for ten years they'd say, where are you from? I'd say Phoenix, they'd say, that's where Omer Reed is, and I'd say, I know. And Omer, you were so gracious with me, I remember in '87, I saw an article you'd written, I think it was dental economics, and I looked up in the Yellow Pages, found your address and thought, well, I'm just going to drive by his office, I'm going to see what... drove by, you were there, let me in, answered all my stupid question for hours and hours and hours, you were... I saw you so many times and you were just you were so available, accessible. You've seen a lot of changes in dentistry in sixty years, and I wanted... podcasters, people that listen to podcasts are usually millennials born after 1980. They're multi-casting, they have an hour commute to work, they don't like to listen to all the radio and all that stuff, and probably 25% of them are still in dental school, and the other 75% are under thirty. And I was hoping you could give them a sixty year historical perspective of dentistry since they're still in dental kindergarten.
Omer: Yeah. There's a lot of myth about the changes in dentistry. School debt of four hundred thousand, it's either that or go join the corporates, which both are a slavery that the dentist can't afford. If you owe $400000 it's going to affect your examination, your diagnosis, your treatment plan, your fee schedule and your cash presentation, there's just no question about it, subconsciously or otherwise it's going to be there. And so is corporate dentistry, I mean, that's even worse because now they tell you what to do and they pay you a little bit and that's about all there is to it. So, I would say to these guys that the myth of private personal care, single chair schedule, I refer to the Kellogg educational study on dental productivity for that single chair schedule business. The data showed that the dentist with a single chair, with a good case presentation where he diagnosed and treated the client and presented and had a financial arrangement before they sat in the chair netted more than the guy who had four, five, six chairs, because of the overhead item and all the other stuff. And the pain in the tail of this for all the gut wrenching stuff that, all these people running around all the time wearing out the carpet. So, I would say to these kids I know it's dangerous, I know everybody is advising you otherwise, but if you can find a practice where a middle aged or an elderly dentist is willing to sell his private fee for service, which is extremely important, he's willing to mentor you, I think that you should grab on to that because even if you have to borrow to do it, you already owe money anyway, so what's the difference? I am convinced that dentists do not realize that dentistry is a relationship game, it's a personal thing, it's one on one has nothing to do with all the things we've been hearing about lately. I'm just very convinced that the dentist who's caring... they don't care how much you know until they know how much you care, if you're caring and they sense that, everything goes, there's no problem. So, it's harsh advice for a kid because he's up to his armpits and hemorrhaging money and all sorts of things. I'm lecturing at the International Association for Physiologic Dentistry in October, for the subject of slavery in dentistry, whether it's the school debt or the corporate, and I've got a very succinct, punctual answer that I think is absolutely nothing short of brilliant, I'll share it with you. About thirty, forty years ago there's a fellow by the name of Rusty Sisson, he was on the board of directors of California Lutheran University with me, and he said one day to me, Reed, he said, I have a gift for you, and he said, but I'll need a half a day. I said, well, I've got a half a day today, I don't go to the airport until about ten. He said, good. So, we go off and cloistered ourselves monastically in the hotel, and he said, I want to tell you a story, we're doing a lot less than we think we are and we can do a lot more than we think we can and we are our own limitation. He said, there's a history of a very interesting program that's been tried internationally twice, the United States was the one that selected to do this, it was the Manhattan Project and the Moonshot. Hitler had a heavy water plant in Norway, and Einstein had told Roosevelt in the 1930s that they were working on it and we didn't know where they were and it was a little scary, it was sort of like North Korea. Anyway, the other one was Moonshot, and now the Russians have a nuclear weapon and they've got a satellite up there going beep, beep, and they can put one of those things down your smokestack, anywhere you want, and we knew that, that's not fun. So, Kennedy says, we're going to put a man on the surface the moon and bring him back alive by the end of the decade. Those are objectives: going to put a man, we know what that is, on the moon, we know what that is, and bring him back alive, that's a very important thing, within the decade. And it was his plan to out-finance Russia and the cold war speaks for itself. What I'm telling you is that the project has got a three-fold part to it. Number one, you have to have an objective that's unachievable by ordinary means, that was the Moonshot and Manhattan projects. We knew where the moon was, we had the gravitational [00:08:25] [inaudible], we had the distance and everything but we didn't have the fuel of the vehicle. And our answer to that when we got to brainstorming was actually nothing short of brilliant, landing, then having it coming back, it did, brilliant, absolutely brilliant. And of course, we beat Hitler with the Manhattan Project, there have been some arguments about whether that was good or bad but, nevertheless those two things show us that nationally there is a chance for this program to work. Selecting an objective that's unachievable in your means, and that's already happened for the dentist, he's got a $400000 school debt or he's going to go to the corporate, those are situations that fit that first criteria. The second criteria is equally as mind bending, you go out into the future and work back from that time to the present to generate your plan. We're all [00:09:19] [inaudible] people, we find out what we have, we're going to lug that forward and see what we can do with it, and in ten years you don't do much of anything. At age sixty five the average... The Dental Association, ADA, study shows that 95% of the dentists do not have enough net worth to retire, and of course that's true of the general population, but it shouldn't be true of a dentist, that is absolutely sinful because we have a lot of money and we are in a position to make decisions. So, working back from the future you'd go out there and decide, this is what it's going to look like when I finish, I'm not going to owe $40000, I'm not going to be in the corporate, boom, boom, boom, and you come back day by day, week by week, month by month till you get to today, and then you know what you have to do today and tomorrow and the next day to get where you want to go, and you've got that plan. And then the third thing is to monitor. Now, we don't do that very well in dentistry, in fact we don't do it at all really. The Kellogg Foundation showed that the average dentist had no idea what his production was for unit time or what kind of down-time he had or anything else. I'll tell you about that study in just a minute, but they gave us a real gift when they said, we have data to show that you are going to be ahead if you slash your overhead and do your job right with the person's relationship and then collect the money, you're home free. Well, the two instances, the Manhattan Project and Moonshot, were fueled, they were motivated, they were driven by fear. We were afraid of what would happen with the Russians if they poked one down our chimney, we didn't like the heavy water thing with Hitler, heaven's, if he'd have gotten that weapon first your life would be different today. Anyway, so, fear is the driving motivation, and I don't care how young or strong you are and how much money you married, by the way, you can marry more money in five minutes than you can earn in a lifetime fixing teeth.
Howard: Remember that Ryan.
Omer: Anyway, it's an amazing phenomenon that, because we don't monitor. Now, you'll be intrigued by the Kelloggs study when I share it with you. It was published in the '80s in the ADA journal with a bunch of data, but nobody ever released that, anyway, unfortunately, whatever. Monitoring is marketplace, productivity and finance, where do you want to go, what do you want to do and how much do you want to do it, and where you're going to get the money to do it. Now, you've got to analyze before you make your first step all the things that are going to stand in your way. And monitoring is a critically important tool that has to be mastered, you have to want to do it, it's not easy, you have to have some people come in and help you with it. I know that when I did the Kentucky, I mean, the study for timing with the stop watches and the chair, my team couldn't handle it. Mrs. Jones was sat in the chair and we'd forget to punch the watch and, oh, she's been here five minutes, that's not good enough, you want to have the absolute data. So, I hired a high school girl in the morning and one in the afternoon, and they came in and sat with a stopwatch in my operatory a whole year and... let's go into that study just for a quick second because I think it's critical. Kellogg called me, this was forty years ago, and he said, one of the guys said, we'd like you to be a motivational speaker for a workshop we're doing and this is a seminar that we're going to document so it's very important to us. We'll pay anything you want, we'll fly you from Phoenix to [00:12:52] [inaudible] and we want you to speak from eight to nine on Thursday morning and four to five on Saturday afternoon, and the theme is why you should do this, and the theme is why you should not stop doing it. And he said, when we're all finished with this... we've got thirty guys, a third of them are less than five years in practice, a third are five years or more, the last ones are seniors. A third of them are from rural Washington, then from Seattle there's a third, and there's a third from some Seattle subdivisions. And he said, so we've got a real diverse group, but he said, if one guy drops out of thirty it affects our statistics rather sharply and we can't afford that. I said, what is the secret you're going to tell them? Well, we're going to tell them a secret that'll double their net product without changing their fee structure or their time at the chair. I said, you shouldn't need me, I mean, anybody with that kind of promise ought to be sticking around. So, I said, I'll come out and take a look at it with you. So, Wednesday I flew out, Thursday, the big guy gets up in front of the group, the team was there, the doctor was there, thirty practices, and he said what he just told me. And he said, now I'm going to introduce Dr Reed, he's going to tell you why he thinks you ought to do this. And I went into a few things like, it would be absolutely insane not to do it when you're going to get a secret that'll double your net without changing your fee or your practice hours, I said, you don't need me. Then in the afternoon on Saturday I sort of, dwelt on the same theme, but I made them feel bad about leaving because of the statistical difference it would make in the study for Kellogg and all that stuff. And they're having all their bills paid at the [00:14:43] [inaudible] by Kellogg. Everyone was given a three by five card, and it was the person's name, the person's time in the chair, the person's procedure in the chair, the doctor's time in the operatory, the doctor's time out of the operatory, and the fee, those are the objective things they were measured on. So, with a stopwatch, Mrs. Jones sat in the chair and then when she got up you punched the button again and that's her time. Doctor Walks in the room, punch a watch, doctor walks out of the room, punch the watch. Well, that went on a dozen times, many times because the guy was coming and going, coming and going, running down the hall for three or four other chairs, and spreading himself thin and running his gut to the wall. I was really excited and impressed, he said, if you want to stay with the study you can do that, you can be number thirty one on the... so I said, you're on, I'm going to stay. We came back after the first year and he said we're going to send all the data that you send us, those little cards, every three months we're going to send them to Kansas, that's where the database is at the dental school. And at the end of the quarter we're going to give you your best last average, so you know what the time was for the procedures you did. We'll have to do some fiddling around a little bit to get figures to fit because you do several things at the same time but we'll work it out. So, I did it and they did it and we all came back, year one, a year later to [00:16:01] [inaudible] and there wasn't a single one of us that hadn't doubled our net. If you were doing two hundred that means you're doing four hundred net. If you were doing eight hundred net a month you're doing sixteen, it's a nice multiple. Anyway, I was impressed, I thought wow, this is something else. The second year he gets up in front of the group, we got three days with him and he's giving us all sorts of pep-talks and instructions and blah, blah, blah, then he said finally, will all of you number off one, two, three, one, two, three, the thirty of you, and they did, now he said, will all the ones please stand up, they all stood up, the team and the doctor and he said, doesn't it feel good to be a number one? Everybody smiled and he said, now, you're our control, we're not going to tell you what the secret is but we're going to let you go now and we don't want you to try to get the secret from the guys we're telling this year, and next year when you come back we'll tell you the secret. But in the meantime we'll monitor just like we have in the past and that'll help some. Well, I was impressed, they left, ten doctors and their teams, and it got real nice and quiet in there, and he said, the secret is, now you know exactly to the second what your productive period of time is and what the net on that is. He said, take your gross last year and subtract the costs, your overheads, now you've got your net, divide that by the days weeks, months, hours, days, minutes you work and you've got a piece of data that you've never had before, it'll blow your mind he said, well, it blew my mind. Anyway, make a long story short, at the end of the second year we all came back and of the twenty of us, twenty one of us, there wasn't a single one of us that didn't double our net again. Now, that's impressive, that's really impressive. And all it was doing was bringing the attention of the dentists to what was really going on in their life, they knew how to do it, they just didn't know when and how to do it. And so Kellogg was saying mend your ways. And he said I can show you the data, if you've got six chairs and six operatories and a bunch of women running around your overhead is going to destroy your net to the point where one chair with one doctor with a case presentation arranged and presented and financially arranged before they get into the chair is going to out-net them by almost twice, that's staggering. Well, he made a believer out of me in a hurry and I had my best years after that. So, I would advise the young dentists, back to the dentists again, to think about these things, maybe look up the old Kellogg's study out of the ADA journal, I think it was '85 or '86, somewhere around there, and find out what the details were because that's the only time it's been done, that's the only time that kind of thing has been done for us, and boy do we need it, I mean, we really need it. So, the Kellogg Education Foundation study, the Manhattan Project, Moonshot, that's model building, are two of the big, big tools that I think are absolutely totally essential for the dentist new or the one that's practicing. I'm going to get up in front of these guys down in Las Vegas and I'm going to say, look, we've got a bunch of guys in here with $300000 to $400000 debt from school, we've got a bunch of guys in here with $300000 to $400000 debt from buying technology that doesn't amortize itself, a lot of it does not amortize itself.
Howard: Can you explain that? A lot of these kids don't know what amortizing means.
Omer: Okay, I bought a RVG in 1982 from the guy in France that designed it and built it, I was over there lecturing and I ran across it and said holy smokes. I said, send me one, he said, send me $30000. I sent it to him, I got the machine, there was no dealer here, no repair, no nothing. And I hooked it up and it operated flawlessly.
Howard: What was it?
Omer: Radiovisiography, the thing that you take a picture of the mouth and it develops instantly on your computer in front of you. And I said, I know what time it takes me to get a film back for diagnosis, toothache, emergency or whatever or my other information in the practice, I'm not going to take the bitewings and the hygienists and all the other kind of stuff, just mine. And I'm going to add all of those minutes up and find out how long it takes for that thing to pay itself off. Well, eleven months later I had my money back. That means that the opportunity cost, that happens to be what you lose if you don't do this thing, is $300000 in ten years because that thing is earning you money. And that's amortization. Now, I can name off or rattle a bunch of hardware and technology right now, many of it's [00:20:45] [inaudible] because so many guys want it, that cannot amortize itself in your lifetime, you can spend your entire life working with it and you'll never actually break even, now that's pretty insane.
Howard: Can you name those technologies? Well, say which ones they are.
Omer: Well, I think that would get me in trouble, wouldn't it?
Howard: Well, when have you and I not been in trouble?
Omer: Well, for five years I had a beta site for the technology that Francois Duret developed, CAD/CAM, and Mrs Jones called me from Chicago one day and said, is it true? And I said, yes it's true. She said, well, every time I get an impression taken in my mouth I go absolutely absurd, she says I can't handle it I get internal claustrophobia, can I come out to Phoenix? I said, sure. I said, when are you coming? She says, when do you want me? I said, anytime next week, she said, fine, I'll be there at nine. And she says, how long will it take? I said, what's your flight home? She says well, it's up to me and I said, take the three o'clock home back to Chicago. She came in, she had an old endo that was treated, it needed to be crowned, lower right side, first molar. And I explained to her that this is going to be painless and simple, I didn't have to inject her, which is not something that is a problem for me, but we prepped the tooth, took the pictures, put the block in and pushed a button and an hour and a half later we put it in the oven, glazed it, cleaned up and seated it and that's it. And she was just ecstatic, she almost wet her pants, she says, oh, wow, I've got to pay you for this, how much is it? I said how much would you have had to pay for a crown in Chicago? She says $1400. I said, oh, okay, and she said, this is worth twice that to me, and she wrote me a check for $2800. I mean, that kind of thing is okay but if you add up the time I spent, the team and I spent and the investment I'd made, trying to get that all back, it wasn't coming, there is no way to amortize that. And CEREC's even worse, and that's not as accurate and it's just a painful thing to see my colleagues becoming computer dentists and laser dentists and all that stuff. When the data does not support a lot of it and the equipment is very expensive. So, I'm going to talk to two groups of guys, the guys that owe school debt, and the guys that owe utility debt on their... and I'm going to give them a model, the model building thing and say, can you imagine what you're going to be like when you've overcome that debt? And I said, let's talk about my old friend Viktor Frankl, friend and mentor, he was here in 1990, I got to know him fairly well. He was in Auschwitz, or in several prison camps for about three and a half years, wrote a book Man's Search for Meaning, and he left me with two things that have been absolutely terribly important in my life, good for the kids too. Number one, you have the right to choose until your dying breath what attitude you bring to any given situation, that's a choice, use the word choice don't forget that word, and he said, the second thing is, in the prison camps it wasn't the young, strong and beautiful that survived it was those who had an unconditional commitment to something in their future, unconditional commitment you put those two words together and think about what they mean to you. Very few of us have an unconditional commitment about anything, even marriage these days seems to be sort of, a rocky deal. Anyway, those are the two things that have been very valuable to me, the deaths of my children, it's up to me to choose what attitude I bring to that situation. I can be grieving still if I wish or I can be thankful for the fifty eight or sixty years we had with them. We had five kids, we had a big family, we traveled internationally a lot, it was a great life we had a lot of humor, they were very successful. And I mean, what a thing to be thankful for. And I should bellyache and bitch and moan and groan because I lost one. Well, we lost three, four of the five, Karry's still alive, my hygienist, she's 54 and working her head off, but I'm having a good time.
Howard: I drew so much strength from you watching as your children died, you were Batman, I mean, you held it all together. If one child dies...
Omer: 1980.
Howard: No, no. But, 90% of marriages fail.
Omer: Oh yeah, on the first death, just like that.
Howard: On the first one, and you and Marci survived four.
Omer: That's right. I've given her the choice, I said, maybe you ought to go find a good looking guy with a young body, you didn't sign up for this. And she smiles and says, oh, yes I did, which I think is the kind of commitment you don't see these days. Unconditional commitment is something in your future. Now, if you can change your entire view, which you have the choice to do, and actually decide that you're not going to see the debt as a millstone around your neck and you're going to be thrown in the river, but as a blessing, as a driving force, like the Manhattan Project, Moonshot, that absolutely created change that's unbelievable. And we need that kind of drive in dentistry. So, I'm convinced that Frankl was really a giant in my life with those two things. And I think that our young dentists need to have that.
Howard: But Omer, you and I have seen this corporate rodeo a couple of times, back when I first met you orthodontic centers in America was publicly traded, they were going to build their own ortho schools, they weren't going to [00:26:44] [inaudible] all doom and gloom. There was a dozen [00:26:46] [inaudible], they all went under, they disappeared for a decade, now they're back and do you think they're back to stay this time? Where do you think dentistry will be in twenty years?
Omer: Well, that's up to the individual dentist, if he decides that he's going to be an interdependent with the people coming for care and his family, not independent, interdependent, then that's an unachievable objective in his future that is unconditionally worth his commitment, and I think he can pull it off. So, it's one practice at a time to survive this corporate thing which I think is an astonishing accident for one thing, you can't live on $1000 a month or a week $100000 a year.
Howard: I mean, we live in Phoenix where they buy $1000 iPhones, what percent of Americans do you think want low fees, high volume dental clinics? And what percent do you think want low volume, high personal care, higher fee?
Omer: Well, there's a group of people called the class one triple plus, Pankey delineated what they were like, educated, motivated, successful financially, all these other things and they're not stupid, they are not stupid. I had a practice filled with class one triple pluses, they were just absolutely wonderful people and it would take two or three years to transfer the trust from me to the buying dentist in a situation of transition. And I believe that the percentage of those people... now, I don't see class four chronic adult periodontitis anymore in my practice, I can go to South Phoenix and find it when I go to St.Vincent de Paul or something, but none of the people in my practice have that, in fact running into a bleeding gingival [00:28:58] [inaudible] once in awhile is a miracle I rarely see that even. And of course Ratcliff, one of my real strong mentors, said bleeding is not good, oral systemic connection and blood loss, so, I'm very happy that these people have captured, intercepted, prevented [00:29:17] [inaudible] and that they're doing it.
Howard: Now, Perry's son is now running [00:29:22] [inaudible].
Omer: Yeah well, he's been released from his job at the university and this is sort of, his, what do they call it? Bread bowl or bread basket, and in my opinion he's doing a very poor job but somehow they're getting it into some of the stores. Southwest had a big ad in their magazine last month, things like that are beginning to happen. If the people at practices around the country and if the dentists and hygienists knew the efficacy of that product everybody would be on it all the time because it's bactericidal, it's detergent, it takes away the dead cells that sick tissues like to live on ever and it takes away complete sulfur compounds so there's no breath problem. Right down the line this is a fantastic...
Howard: When did Perry pass away?
Omer: Four, five, six years ago.
Howard: Four, five, six years. What an amazing man, I remember the first time I called him up, this is back in '87 too, first time I ever called him up to ask him a question he said, you know what? That's a long answer, why don't we just do dinner? I'm like, wow, he's going to take this dumb punk kid to dinner, and I think we closed the bar down talking about periodontal things.
Omer: Yeah, it's an amazing... he was an amazing guy.
Howard: You and him were both founders, because you were a founder of the American Society of Preventative Dentistry, I mean, back in the day, you started that in 1970, like what, eight thousand dentists back in the day?
Omer: It was absolutely amazing, it was like lemmings to the sea, I've never seen anything like it in my life. The idea got out there, we were going to have a national meeting and they showed up like, it was amazing. And their team was with them, it was just one of those amazing things. And it went... it was an ad hoc pursuit, we designed it, as board members, to get one thing done, and when it was done we were going to just dissolve the organization, we weren't going to go on forever like most of these clubs. That objective was to get the word plaque into the soaks, into the homes, into the dental offices and the hygiene hearts around America. Well, we got that done in about five years but there were two guys struggling and wrestling for the chair so we were still running seven years, we ran seven years.
Howard: His message is lost to this generation because he's not on YouTube.
Omer: It's not in the dental schools, it's not in the post doctorate courses.
Howard: I bet in your garage, attic, basement, doghouse, somewhere you might have a video. I don't even know, we tried to go buy a VCR, I mean, we don't even have a VCR, but I'm telling you it just makes me sad that if you Google him on YouTube there's nothing, there should be.
Omer: Yeah, that's right, and you go to a lecture group like I'm going to be in October, I say, how many of you have heard of Bill [00:32:03] [inaudible]? And all the hands will go up, how about Howard Farran? All the hands will go up, I said, how about C.C. Bass? One or two hands will go up, how about [00:32:03] [inaudible]? How about Nate [00:32:15] [inaudible]? An old USC periodontist, psychiatrist, medical doctor, what a combination, and no hands will go up.
Howard: I just got an idea, they're all kids listening to me but about a third of the dental school class, their mom or dad was a dentist, so, your homework assignment is, if you're a young dentist and you have a dad or a grandpa or a grandma that's a dentist, call them up and ask them if they have any old VCR tapes of some of these dental legends.
Omer: What are you looking for?
Howard: Everyone you just named.
Omer: Well, Barkley was lecturing in the early '60s in Tucson, so I took my team, three doctors and four hygienists, we were sitting in the front row, you get all the saliva. And he was introduced graciously, he's sort of, an unknown at that point, but he gets up and he adjusts his microphone a little bit and he looks at the audience and it's quiet for, I'm sure not more than twenty or thirty seconds but it seemed like an eternity, he didn't say a word, then he finally looked at everybody and says, you guys are absolute prostitutes, you're absolute whores, you take care of the effects of disease and leave the known cause working, and he says, that's amoral. It got quiet again for about thirty seconds, you could have heard a pin drop in there, nobody's talking that story anymore, but boy is it true. Now, those people that I see, that you asked about, how many want care, if they come to me the first thing they get is this preventative thing. How to floss, where to floss, we stain them and we show them that the floss has to go between the teeth and then have to take the loose end and come around the [00:33:56] [inaudible] so you can shoe shine the [00:33:56] [inaudible] of the, tooth and since the tooth is tapered, cross the taper across the floss take a short grip and a very short stroke and the floss will slide down the tooth to that half millimeter under the gum where the plaque is [00:34:07] [inaudible]. That [00:34:09] [inaudible]flossing is Ratcliff, and nobody's talking about that anymore, that's for damn sure. So, I tell them... they say, well, I floss, I say, okay then, show me how you floss, and they go, ping, ping, ping and maybe a piece of food flies out. Well, that's good but it takes seven to eight days for the food to ferment enough to be a problem, and if you have your teeth cleaned and you don't get the plaque off daily three days later you might as well have not had your teeth cleaned quite frankly, bacteriologically. And Ratcliff was overwhelmingly encouraging in that regard. And he was teaching cell biology to his hygienists, he taught the hygienists, he taught [00:34:48] [inaudible] reattachment, where you root clean and then you citric acid and [00:34:54] [inaudible] the root to prepare it and then you bought the fresh created tissue back against that, and you did that two or three times in maybe a three, four week period and over an eighteen month period you watch the bone come back up over the [00:35:06] [inaudible] even as the tissue climbed up that tooth. Now, nobody's talking about that anymore either. And Karry had that training and that's an interesting story because she's no stoop, she's really a bright, sharp able lady, and when I sold the practice I had a dealer that was doing some due diligence but they didn't do a very good job, and the guy was very nice, we got along nicely. He was there for five or six months, I gave him some dental shirts, I sent him to my barber to shape him up and he started to look like a dentist. He was a real generation hippie from back one generation, anyway, that was great. Then his wife came to town, she'd been in Philadelphia selling the house, and the second day he came to me and he said, my wife tells me that your daughter is unmanageable, she's incorrigible, what am I going to do? And I said, well Jim, it seems to me you bought and paid for the practice, I've got the cash, it's your business you can do anything you want to do, why don't you fire her? Thinking that that would be the most absurd, idiotic thing for a dentist who's assuming a transition to do it with a hygienist who's been there twenty five years, give me a break, she's the umbilical of the whole thing. And that day his wife came over and says, Karry, you're out of here, we don't need you anymore. And so Karry came to me and she said, what am I going to do? I said, find somebody else. And my sister Naomi has a daughter by the name of Beth Harman, she's practicing on 32nd and Indian School, graduated from Loma Linda, now, Loma Linda is one of the two schools that's still behaviouristic, they're not like the marine corps, they tear you apart and rebuild you in four years, they try to take the rough edges off, but they want you to be present, they want you to be humanistic, they want you to be caring and they want to teach you how to empathically listen. Empathic listening is extremely pregnant for the young dentist, write that down, empathic listening. Anyway, make a long story short, she was invited to go one day a week over to Beth's office, Karry was, she went over there and she says, I like it here, and Beth says I like you here, so she put her on full time, well, over three thousand of the people in my practice followed Karry to that practice. So, Beth inherited a practice without having to pay for it, and Karry's just happy as a tic because she's working with a person who's behaviorally very, very coaching, and she's also very able to help with the cell biology that Beth didn't get. So, it's important that these people are cared for properly and they're going to find the right place, if the guy doesn't cut the mustard he's out of there.
Howard: But, what... you said caring, empathy, what did you...?
Omer: Listen empathically.
Howard: Listen empathically.
Omer: Yeah, it's not how long you listen it's how fast you hear.
Howard: Say that again.
Omer: Not how long you listen it's how fast you hear.
Howard: It's not how long you listen it's how fast you hear. When you talk about relationships and listen empathically, they come out of school they think well, if I want to be a great doctor like Omer Reed, I've got to go buy a laser and a chair-side milling unit, and I've got to go buy... if I don't have all the expensive bells and whistles then I'm not validated, I can't be a good dentist.
Omer: That's right. Well, I disagree with that. If you walk down the street and you meet somebody nicely dressed and they look at you and you look at them and they smile and you smile, as they pass by you, you like yourself better while you were with them that split second, you like yourself better when you're with that person. And I think it's a critically important thing to understand, when a person comes in for dental care they want somebody who listens and understands. And if you want to make sure that they know you understand you feedback what they said in your own language. My father used to say, I know you understand what you think I said. but what you heard isn't what I meant, and he's right about that because...
Howard: Say that again, that was too good.
Omer: I know you understand what you think I said, but what you heard is not what I meant. So, the meaning is the important part of it, and so if you say back to the person in your own words what you think they said they say, oh no, that's not what I meant at all, they clarify and now you... that same thing like walking down the street you can fall in love with a person in seconds, they'll walk in as a new person in the practice, they're hooked, because we care, they know it, and we have nothing else on our minds but we're present and we're welcoming them and we're glad they're here, in fact I think they're fortunate that they're here because there's some things they don't know and they need to know them.
Howard: But Omer, in all fairness though, you have a magnificent personality, charming, good looking, tall, handsome you're the whole bag of chips, these kids got accepted in dental school because they got A’s in calculus and chemistry and they sat in the library every night until midnight and they got a perfect score on their DAT exam, and they're afraid of their own shadow. So, my question is, can your personality, can... like a movie star, say a movie star's playing a character maybe a bad guy, good guy, can a dentist become Hollywood and act like you during the day and then when it's five o'clock just go home and crawl into his library?
Omer: Yeah, when a person comes in for care it's showtime, bingo, right now, and you're there present with them all the time, listening, watching and paying close attention to the things they want and need and you let them know that that's true.
Howard: And he said something very [00:41:13] [inaudible], I just want to repeat because I don't want to [00:41:15] [inaudible] your head, what dentists do wrong is they'll ask a question the patient will answer and they go right to the next question. With humans, if you don't repeat back what they said they don't think you heard it, it's like, well, he asked me ten questions he didn't even listen to me. And they do it, and spouses too, when your wife's yelling across the room and she's telling you stuff, you're like, getting it, okay I'm going to take out the trash and I'm going to do these things, but you're not repeating it back, so she's in there thinking, he doesn't even listen to me.
Omer: She's not concerned about you hearing what she said because she doesn't think you're listening, yeah, it's not how long you listen it's how fast you hear. And I think that dentistry for sixty years was a real adventure, a lot of fun, and I was at the top of my game and I hated like sin to be physically retired, but my open heart surgery, my valve replacement... and then I came back and worked...
Howard: Do you have a dental office you can play in if you ever needed somewhere?
Omer: Oh yeah, I've got several I can do that in but I've got a couple of [00:42:12] [inaudible] so I have to be careful of that too, I'm somewhat kosher. But St.Vincent de Paul's invited me in, I know the people, I know the team down there, they've got a brilliant clinic.
Howard: I want to tell you something that I... oh well, tell your friend, he's the head of the St. Vincent de Paul?
Omer: Yeah.
Howard: I really want to podcast him.
Omer: Oh, you've got to get him, he's really a brilliant man. They've just won an international award against some of the big corporates.
Howard: Yeah, what's his, Ken what?
Omer: I'll give you the numbers before you go.
Howard: Okay. But, I'm going back to nostalgia, things that like... back in the day when the owner sold the practice the owner carried, so for the seven year note the owner, it was... if you defaulted thirty, sixty, ninety days you got it back, but he had financial incentives to mentor you, to help you, to spread goodwill. Now, owners don't care, they all go through the bank. And I think it's... I've seen in Phoenix where somebody sold a $1.5 million practice doing full mouth rehabs to some punk out of school that couldn't sell half of that, so he bought a practice where they were doing like, one point three, one point four and he did like, six hundred the next year. But I think that the ideal situation for this young kid is go back and go find some dentist that'll carry the note, do you agree with that or disagree?
Omer: Well, there's a commitment there.
Howard: Or at least half the note.
Omer: I was invited to stay for three years because I'm doing a lot of neuromuscular stuff, I had eighty people in, meth addicts, and they require, some of them, most of them, full mouth porcelain covers to make up for the wear and tear and the destruction, so I was... and he doesn't know schmule about that, so I offered to stay. And I took him to Las Vegas Institute, I gave him tuition, round trip air fare, hotel for the first of seven core meetings to learn how to be a neuromuscular or physiological dentist. I left my K7, that's the big jaw tracker hanging on the wall, and it was in good shape, and I left all my other stuff there too. When I left, I got fired the next week by the way, she came to me, she said, doctor, can I talk to you? I said, sure, she said, come on over to my desk, so I sat down, she says, we own the people, we own the scheduler, we own the chairs and units, we own the ceiling and the floors, we don't need you anymore. My answer, as a good Christian gentleman was, well, thank you, I needed to know that, and I smiled and left. She said, I want everything off the bookcases and off the walls by tomorrow at four. Well, by noon that day it was all completely... looked like somebody had flushed a toilet in there. Anyway, I was invited to stay for three years and that got cancelled because this guy's wife was...
Howard: Yeah, I'm sorry you had to go through that, that's not... so, how could an introvert, shy kid learn to be more listening empathically? I mean, Omer, when I was in your office so many times, your patients loved you, I mean, you're that guy, I mean, you really are, you're the whole package, tall, dark, handsome, all this personality. How does a young twenty five year old become a leader? How does he develop?
Omer: Go to Toastmasters.
Howard: Toastmasters?
Omer: Go to Toastmasters, it'll take a year or so before the rough edges are gone, but pretty soon you'll become articulate, confident, self focused, which you need, and maybe a little egocentric and that doesn't hurt either, I think that's the way to do it. And then you should find a mentor or two, people that you respect, that have the care skill and judgment built in that are willing to share time with you. Ratcliff, C.C. Bass, I'm trying to think of that Michigan guy, he did some interesting studies in perio on the four different types of surgical procedure that were going on at the time, full surgery with bone reduction and all this other stuff. And he found out that root planing and [00:46:32] [inaudible] like Ratcliff was doing, followed by careful follow up would reduce the necessary need for surgery and reduce the severity and critical nature of that surgery, and I was impressed with that.
Howard: Omer, I've got another question for you, let's go back to Perry Ratcliff, he was a periodontist.
Omer: Yes.
Howard: Of all the specialties, ortho, pediatric dentistry, endodontics, oral surgery, I mean, perio changed the most. So, when I got out of school thirty years ago, it was all this gum surgeries and root planing and [00:47:09] [inaudible], and then after about a decade there was this new magic titanium thing where you don't have to deal with any of that crap.
Omer: Out goes the root planing.
Howard: To fix that perio with titanium. But now, thirty years later people are saying, at sixty months, five years, 20% of the implants have periodontal implant periodon...
Omer: Periodontitis.
Howard: Periodontitis, and now I'm starting to see the pendulum come back that maybe that titanium isn't a cure for everything and maybe some of the good old fashioned periodontal stuff is coming back. So, where do you see it?
Omer: Well, the holistic dentists, there is a group of dentists that are very holistic and they believe that the ceramic implant is better than a porcelain and metal because the metal... but ceramics, whether it's a soft cure or whether it's a lab cure with, glazed and everything else, they also dissolve into the body and into the bloodstream, there's nothing sacred. Water is the...
Howard: I know, and they say, well, I have to use this porcelain implant for, because they have metal allergies, like dude, they're porcelain to metal, I mean, they're using metal implants [00:48:27] [inaudible].
Omer: Yeah, life is strange and unusual, isn't it?
Howard: Yeah, very true.
Omer: Well, I tell you, I am very happy that I met Ratcliff. I was in the air force, 1957, and the general called me over to the hospital, the colonel and I are, there are thirty of us in the building, he said, Reed, what you do now? I said, I haven't the slightest idea, he said get over and see the general, a one star general, Dr Lee, a medical doctor runs the hospital, runs the dental clinic as well of course, that's his business. And he says to me, you're from Minnesota, and I said yes, he says, you do inlays? I said yes, he said, my daughter's coming for two weeks, she's got eighteen complex MOD buccal amalgams and they're all crumbling and we want them out of there, can you do the inlays for her? And I said, sure, I'll prep them and send them all off in the hydrochlorides and put them up and get them back and seat them and finish them for you and that'll be fine. So, as luck would have it, I got those inlays all back every one of them complex, fingers, and all sorts of box forms and retainer for them, everything fit like, and the occlusion... this lab that I had out there was just nothing short of genius, in fact seven of those guys came down to be with me to start Ceramdent back in the '60s. Anyway, Christmas came and went and his daughter went back to school, and she was happy of course. And then one day he called me over again and the colonel says, oh crap, what did you do now? I go over there and he says, Reed, do you know what TDY is? I said, no. He says, well, that's temporary duty, where we cut an order for you and it tells you what you can do, and if you want to go to USC for a course for ten days you sign up for it and if we approve it, all round trip air fare, hotel and meals for you and your wife, and the tuition and the hotel, they're all paid for. So, I said, okay, I said, I've got a course I'd like to go to, and he said, well, let's sign you up, and I signed them up. He said, any course you apply for I will approve. Well, I went to twenty two postdoctoral courses on that promise in the next twenty months, and one of them was Ratcliff's. I walked into Ratcliff's and I still had my uniform on, and he looked at me and says, Captain Reed, he realized I was sort of a cocky rascal, he said, when you get back to [00:50:51] [inaudible] you're going to find in every trooper that sits in your chair has contracted this rare malady in your absence, and he smiled, but was he on the money, oh man, I tell you. Anyway, then he finished his two or three years as head of department of perio at UC Centre, San Francisco Medical Center, came to Phoenix because he had three study groups here, about eight or ten guys in each group, and he liked it here so he came here, and these guys of course became tremendous referral sources, myself included. And they moved here and he started a practice and the rest is history. The guy taught courses here, I attended them all, he was an extremely, tremendously capable tissue biologist and cell handler and he also was a friend. He would correct me without any apology at all and let me know that I was wrong and he expected me to say I'm sorry and I apologize, please forgive me, because that's the result of what happens when those things occur, and I did, because that's my nature and we got along fine. I almost re-enlisted, I had a parachute down the flight-line and I'd written the [00:52:13] [inaudible] and I had the helmet and the whole nine yards to fly over to Phoenix regarding my Buick over here.
Howard: I've only got you for a couple of more minutes. You are just as popular in the United Kingdom as you are in the United States, you've been on the editorial board of the independent dentists. It seems like thirty years ago all the dentists worked for the NHS, and they had to lower the fees until dentists started going bankrupt, they had to go bankrupt before they did the single chair thing you're talking about, which now there's like, several thousand of them, but the majority... and I see the same parallels in the United States because in Phoenix Arizona where we are right now, Delta of Arizona used to pay a thousand for a crown and a thousand for a root canal thirty years ago, now it's six fifty for a crown, so, the fees have gone down 40%, so these guys are running faster and faster and faster, do you see any parallels to the NHS in England and the PPOs in America?
Omer: Absolutely, absolutely, they are administratively enslaving and you want to be a dental slave sign up for one of those, or face your debt like it's a millstone around your neck.
Howard: Ryan, which country do we lecture have we had the most Omer Reed fans with a one chair facility? Do you remember?
Ryan: Was it Singapore?
Howard: Very good.
Omer: Where was it?
Howard: Singapore. Singapore, I had more dentists quote you there saying, well, I mean, if you want to just follow the insurance in Japan and the NHS and America and run five chairs and pass out for free, and I heard this guy named Omer Reed and he actually told my dad... but anyway, they're saying forget it all, they're just getting a room the size of this with one chair, a nice adorable assistant that can take the phone, they have no overheads, and they'll do like six fifty, or they'll do like, five hundred and take home three fifty.
Omer: Yeah, figure that out.
Howard: And then the person that's running six chairs will do like, a million two and take home under two hundred, and those guys are just, basically what they're saying is that dentistry is not a game of volume.
Omer: No, no, what you're talking about has a sharp learning curve. I would also suggest that the timid dentist you asked about, and I gave you the answer, Toastmasters, should go through LVI. LVI has a team of people that are extremely patient and very knowledgeable academically, and they care about their members. The last twenty years of my life I was extremely pleased, happy and very productive because of Bertie Jankelson and LVI preserving his work in neuromuscular dentistry. He came over in 1950 from South Africa and the same colonel said, you guys, there's a study group in town, if you want to go you can have Friday off but if you because [00:55:22] [inaudible], but he said, if you skip Saturday and I find out about it you're dead meat. So, [00:55:28] [inaudible] and I from Harvard, instructor, young little, wiry Jewish fellow, and myself were the two guys that went, well, it was October in 1958, we got a notice from the study group saying, we're going to have an interesting lecture from a guy from South Africa and we've got three guests, his name is Pankey, his name is [00:55:47] [inaudible] and his name is [00:55:47] [inaudible] from Colorado. Those names meant absolutely nothing to me, but we went. And Jankelson had a shoebox full of radio tubes and wet sponges and he was hitting the seventh cranial, and relaxing the body over a period of forty five minutes, an hour, and getting the trajectory so the mandible met the maxilla where the joint and your muscles wanted it to go, not where the teeth, which are dominant, wanted it to go. So, you watch for forward head posture, you watch for one shoulder down, you watch for breathing, airway problems and you've got yourself a person who is in trouble and they need your help, and that diagnostically, is an easy thing to diagnose. Well, I taught Jim about that and he was pretty fascinated, he went to LVI, he was fascinated, they liked him, but then when he went to try to transfer my K7, which cost $3000, there was a $7000 transfer fee and another $5000 to calibrate it, and that was too much for him. So, he went to see Clayton Chan, now, Clayton's a good friend of mine, and Clayton stayed with the [00:56:58] [inaudible] people instead of going with the new one that Bill was using, and when he went to them he went there because Clayton was using a K7, well, Clayton says he showed up for one meeting and then they hadn't seen him since. So, we're talking here about an adventure and I think that LVI probably is more meaningful in my life than Pankey Institute, I knew Pankey before there was an institute, I think that without question an institute that is driven by an egocentric person like Bill, which it takes to keep things like that going, is very valuable to the dentists that you described for me, because he needs to catch some of that, that has to be a contagious thing. He has to want to do it, where does your got to want to come from? That's a good question because a lot of guys never even thought about it because they don't know they want it. Now, there's a difference between wanting and needing, but when a person comes for care, if we can change the things they want into things they need we're home free. So, this situation with neuromuscular or physiological dentistry as they call it now, was absolutely a godsend for me.
Howard: What's the new equipment that Bill is using now instead of [00:58:21] [inaudible]?
Omer: It's a small company and they worked with Bill and his team to modify their stuff considerably to suit the program. I can't give you the name right now, but...
Howard: Well, that was the fastest hour and ten minutes on Dentistry Uncensored, that was just, that was like Beethoven playing the piano.