Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1512 Periodontist Charles Chen DDS on the Safety and Efficiency of Electronic Prescriptions : Dentistry Uncensored with Howard Farran

1512 Periodontist Charles Chen DDS on the Safety and Efficiency of Electronic Prescriptions : Dentistry Uncensored with Howard Farran

12/2/2020 4:00:00 AM   |   Comments: 0   |   Views: 272
Dr. Charles C. Chen, a periodontist, graduated from the University of Maryland receiving a B.S. degree and a D.D.S. degree. At the University of Maryland’s Baltimore College of Dental Surgery, he participated in the Accelerated Professional Training (Honors) Program to obtain his dental degree and complete his Post-Doctoral Residency in Periodontics. After graduation, he was invited to join the practice of his mentors, Drs. Robert Zupnik and Dennis Winson, and has enjoyed a wonderful fellowship. He is the founding member of numerous dental organizations and is currently participating with federal and state initiatives shaping the regulations on digitizing dental records for patient safety in prescription drugs.

VIDEO - DUwHF #1512 - Charles Chen


AUDIO - DUwHF #1512 - Charles Chen


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Please excuse any typos as this was digitally transcribed.
It is just a huge honor for me today to be podcast interviewing Dr Charles Chen DDS a periodontist graduated from the university of Maryland which you should know is the first dental school in the universe receiving a bs degree and a DDS degree at the university of Maryland’s Baltimore college of dental surgery he participated in the accelerated professional training honors program to obtain his dental degree and complete his post-doctoral residency in periodontics after graduating he was invited to join the practice of his mentors doctors Robert Zepneck and Dennis Winston and has enjoyed a wonderful fellowship in his spare time he has taught the postgraduate periodontal residency program conducted conducted connective tissue research receiving u.s patent on bone tissue regeneration he is the founding member of numerous dental organizations and is currently participating with federal and state initiatives shaping the regulations on digitizing dental records for patient safety and prescription drugs which i wanted to bring on the program because amazon just started uh delivering prescription drugs so z z c y w perio was established in 1963 by Robert zepnick and quickly grew to become one of the top paranormal practices in the dc metro region his philosophy is to put the patients first and provide the highest level of care and expertise when you choose z z c uh y w and i i got the name of those four let me see so z c y w stands for zupnik chen yen and wong edward a zupnik dr Charles c chen who you're looking at right now alex yen and cho we young and uh my gosh it's an honor to have you on the program thank you so much for joining me today oh honest mind or like i said you know being founded for yours for a long time for a young dentist is really really commendable well you're too kind and it reminds me um you go by Charles and i gotta remind uh dentists one of the uh stories uh i had um so when i was lecturing in shanghai china um godfrey who's the owner of modern dental um you know i was talking to godfrey and just loved the guy just just the most amazing man in dentistry i said to him i said um godfrey is that your first name last name and he told me a story says well when we were started grammar school they told us that people in the western world wouldn't be able to say our name so we stood in line and we came up and we each drew a name and that was my western name and i drew godfrey and i said well godfrey i love you i don't want to call you by your fake western name i want to call you your real name what's your real name he goes and i said okay godfrey and uh so i'm uh i was so glad that you're so easy uh chun kuang chen um so breaking news today um amazon is gonna start delivering prescription drugs and this is your expertise because the reason i brought you on the show is because you're the um chief um dental officer at doctor first so go to doctorfirst.com it's iprescribe gives doctors the freedom to write and renew prescriptions anywhere anytime i prescribe is your digital prescription pad featurings epcs pdmp and more since 2000 dr first has pioneered healthcare technology solutions and consulting services that securely connect people at touch points to care to improve patient outcomes they create unconventional solutions that solve care problems medication management price transparency and adherence challenges and health care and um this is um this is all new and i think the pandemic has really escalated things that were already going virtual um like working from home when this happened um dental town already had 20 of its employees work for home so we were just scaling up from 20 percent to all of them when we were closed but prescriptions has been so regulated and so difficult that it's taken amazon which went public in 1994 and this is now 2020 so hell it took 26 years for them to do this what do you um what do you think of all that well you know precision trucks being a big business lately you can see every block in every city has some kind of pharmacy so become a huge business so amazon's been slowly working its way through you know initially they're going to get into this field when they bought pill packs another company a year or two ago so they're preparing to get into this market so what it is it's going to try to increase efficiency from drug pickup with the customization of regular pickup all different items groceries any items amazon established a steady pattern of secure delivery i think that's why they feel they can cut the to the chase and have drug delivery directly to the patient instead of patient go to farmers to pick it up but i think that's a big battle between these giants based on a big big fierce fight for the market space and how how was that fight looking so dr first um was really in your backyard rock rockville Maryland uh you're not too far from that um since 2000 dr first has pioneered all kinds of solutions how do you think this solution will go well what happened we on the other end we're on the doctor's end the reason we call it doctor first because we saw inefficient medical field and we felt like doctors were the low menitotin pole everybody's getting rich everybody forcing mandate down doctor's roads and very little doctors can do so in 2000 we've set up to set up a company to make doctor's life easier by providing the doctor with the latest technology uh make it very very simple to use so it's very complicated sophisticated insight on the outside make it very simple because as we know doctors are most not the most computer savvy people in the world so we developed this product of various products over the time i think we've been pretty successful so without various products mostly dealing with medical healthcare information technology we incorporate artificial intelligence blockchain technology so we try to provide the latest technology for doctors and we've grown even though you don't see our name on the outside we almost like intel inside we are embedded so many other softwares we embedded 270 others electrochronic health records across the country we have 300 000 uh healthcare provider using our our products and a hundred thousand doctors are writing over 10 million prescriptions a month right now using the whole way more so um the the prescription writing app is i prescribe um iprescribe.com but it's owned by drfirst.com do i have that right right correct what happens i prescribe is our latest product our original product called arcopia is the desktop version of electronic prescription writing that's been around for quite a while but i prescribed jessica now because using mobile technology to provide doctor with mobile app on the phone and he satisfied all the requirements the government just put out mandate for electron prescription writing for all control substances which is going to become mandatory in 28 states by January 1st this year uh satisfy all the requirements for state for pdmp which is prescription drug monitoring program and certified all the hipaa compliance so this very very various level of the uh government mandates this simple app and by the way it's really it's ready for all doctors it's it's it's truly a revolutionary product you're ready for prime time um so what did you say what did you say i prescribed um app used to be what was what was the desktop version it's called arcopia r-c-o-p-i-a arcopia arcopia yes uh arcopia and uh my gosh that's an interesting name what um where did uh arcopia come from what what what did that mean uh r-c-o-p-i-a it used to be rx remember the driver's system drug medication or x-ray you know cornucopia so it's our copia please we shorten it too so people can pronounce it easier so you start out as rx copia right what's copia mean you know the cornucopia is a collection of various different things you know to collection combine the two words all right cornucopia that's uh that's a word i have not um done in a while but that is a uh that's because i looked up every single word you know when i came i didn't speak what in english so it stuck me in school with all the regular class so what i have to do is look up every single word in every little textbook so it's not too bad but when you have to read shakespeare like hamlet and king lear they look up every single word that took a lot of time you know what um i know and i feel horrible to have these thoughts but um the you know math is the language of science and it was german was the language between scientists and then after world war ii um it turned to english and i'm like i sat there the whole every time i'm reading something hard in english i always thought to myself well at least i'm not you know native tongue german looking up all these english words i don't know how you do that um well how old were you um where were you born and raised and when did you come to the united states i was going to i was uh came here when i was 13 years old so yeah 1967. i mean i'm 1954. i came here in 1967. and was that uh looking back at your childhood was that like um fun and exciting moving to a new country or was it just traumatic and scared and leaving all your friends and food and customs and and all that i was so excited i was coming to america right so i landed here in november 67 and they remember what happened right the riots in dc started living to the right in washington dc i'm thinking what the heck am i coming in but but fortunately you know where i am when i was at school at the uh suburb of Maryland outside dc people are as kind as can be just people are so nice so i always felt like i've been very blessed the people i ran to my life and all this thing i've done it's because the people are into you know how are you as a business business and i always say people are people right and if you you say you get a in business you'll be successful with time and everything else and i agree with 100 i just been very fortunate to run into good good people well that's uh that's an amazing thing um people are good that's what i love about dentistry so much been to 50 different countries and and usually you know when you're gonna go you know lecture in salina kansas for the tenth time uh i can't get anybody to go with me but whenever it's a foreign country anywhere from one to four my boys will go with me and uh my gosh they they have dentist friends that they love in 50 countries and dentists are just they're just so good and i i look at all these uh dentists around the world and i just think why can't the countries get along like the dentists do they just sit down they're transparent they all are focused they got one eye on the patient and one eye on costs and they're trying to make everything faster better easier cheaper just for the people and then you look at the people doing the government thing and it's like i don't even know who their customer is anymore other than their own wallet uh but um that um i just love dentist and um they're just amazing so how long um you can download the iprescribe app on your phone right now yes yeah and how long has that been available to download on your phone um on an app it's been available for over a year as a matter of fact we just got a news release yesterday if you look at these release yesterday the year to year use double it within the live show increase 100 percent so it's really taken off because the app is just so easy to use and it's like a little mini computer in your pocket or many of your patient records in your pockets matter of fact because it can self-populate your patient information if you put in a few information like your patient's name uh zip code phone number maybe a birthday they're popular all the medications that are taken the last 12 months so you can be out of your office your patient call your emergency you can put all your medications history drive to drug allergy uh check pdmp you don't have to worry about which pharmacy because the pharmacy their favorite pharmacy was already listed on there it's just it is fabulous fabulous application and also you can download this register which is complicated because i can go into later with our trials with dea the very very strict rules to in unless doctrine dentists because you can't have anybody just go on an app and write prescriptions so usually take days and hours or something like that weeks to get out but we stream behind now with the approval of different government agencies down to less than 10 minutes now h state now have their own ptmp program the prescription drug monitoring program so that may vary from state to state while application downloads take less than 10 minutes which is again based on ai technology et cetera et cetera well i know you're not supposed to talk about religion sex politics or violence but i am i have to i i have to be honest i mean this is dentistry uncensored i'm not going to um uh lie or not tell you um what i really think but um i i i still think the jury's out on this uh drug thing because whenever i see them talk about all this uh opium overdose everything that makes the paper they weren't on vicodin or perkadan from walgreens they were on six different things they had a substance abuse problem and uh i think that um i always wonder if they could walk into walgreens and get vicodin and percocet without a prescription well then they wouldn't be buying it from someone making it out of a bathtub that god only knows what's in it it's cut with fentanyl they don't have the same dose they might think oh every day i take two of these but they got two that are ten times stronger i i i don't even know if um if if um the dea and all this regulation i i i actually think it kills more people um than not and i have the freedom to have my own opinion but i was really wanted to know what a really smart guy like you um thought of that i mean um right i think what happened is as dentist we're the highest prescient writer of opiates for young people not everybody but young people because wisdom teeth extraction so i think sometimes they find out this may be a gateway drug for the young people get hooked on narcotics because we wore me out writing these narcotic drugs routinely but the last two or three years i'm a practicing periodontist so right now i'm very seldom my opiates anymore i use you know maybe tylenol and combination advil that seem to take care most of the pain problems however we still need the ability to write narcotics for those people really in pain and suffering so i think this is one component of regular control so you don't have people stealing prescription pads or you know opiate meals or doctors selling prescriptions i think that's the part that control the opiate crisis but more importantly for the electronic prescription or regular medication is patient health and safety because they found the paper prescriptions caused a lot of problem because eligible handwriting loss of paper prescriptions uh pharmacies mis you know uh copying the doctor's orders so a lot of these can be corrected by electronic prescription of regular medication and opiate control you just give another layer for the government to catch you know illegal uses it won't stop the origination won't stop all the problems but i think just a way to control some of the bad apples not too many but i think just give them a way to control it but i think overall they've been very pleased the hospital doctors insurance companies with this functionality of electric electronic appreciation writing because it does save a lot of lives and save a lot of money well when you talk about uh bad um apples in every system um i i think the government has some monopoly on the bad apples but uh um there's a person on dental town who's talking about this app and he says um that it's 99 cents um it's 99 cents to download it on the um on the app store is that true or not uh i didn't think so is it chuck off for 99.99 we would made the app free so i'm not sure this so the app's free now so it used to cost money and now it doesn't i'm not sure uh we we call it free i'm not sure app store there's a cost would be associated with 99 cents i wasn't sure could you double check i should know but i don't because [Laughter] um yeah that is not the 99 cents i don't think it's coming to us but you know you know what i liked about your system the most i mean you know we're learning all these things with this pandemic because it's all new and it's very exciting and i i used to think my own mother you think i know my mother better than anyone on earth and uh and and i've been stumped a couple of times one time i came home from college and um um my sister said she was in the bathroom dyeing her hair then she came out and she had the same hair color and i said shelley said you were dying your hair red i i had no idea that she did that her whole life i thought she was a natural redhead and then i thought my redheaded sister ree took after mom turns out ree got a redhead from my dad's mom and you know so you never know but you know my mom always had all these church functions every other day she's at church for something i didn't realize until now that it was all a big social thing and that's where all of her friends work and now i look at i mean she never came home and talked about any lessons she learned or some new bible quoter theory i realized it was just her her whole social world but regarding her doctors i'm loving the fact that she doesn't at 82 have to get in a car drive across wichita go park and this and that then some of my other sisters want to drive her she's doing a tele-dentistry she's doing on her ipad and she's got to go and when i looked at what you're doing the first thing i thought is well customer service isn't going to a pharmacy dropping off the prescription spending half an hour in walgreens trying to see you know what's the best chocolate bar to eat um but to have this in advance you'd walk in there and it'd be ready to pick up that's service and and way back in the day i tried to do this with just my local walgreens in the same parking lot i said well let me just um just get a fax machine and when i get a prescription i'll fax it to you but that was back in 87 and walgreens and the guy said i don't know what's wrong but management said we can't do that you know whatever some regulation deal but man this is full service um is it better faster easier higher quality lower cost i mean you checked off all the boxes right and also some applications we're not making you know really not necessarily for our prescribed oral dentist because we don't prescribe any drugs but one application we have for regular physicians is a monitoring program to find out did the patient pick up the prescription if they didn't pick up a prescription for example high blood pressure or blood sugar why did they run out of money do they need assistance because a lot of these pharmaceutical companies have programmed to help indigent people or because they forgot so it helped monitor to make sure patients are picking up and taking the medicine because the insurance company wants these people to do well too so it's a big incentive to for patients wellness to have these monitoring programs so we really think the ultimate goal is patients health and well-being and but we want to make doctor's life easier you know we make the app so simple the doctor can use a very low cost i think that's the way because if you look at our costs compared to our competitors we like fraction of it because you know that's what it is our main goal is service to doctors and provide for patient well-being you talk about jim collins a lot you know we believe the same thing you know you prince business business but everybody wants to make a profit but you got to be some reason some higher goals some passion do to be in it so you can be excited your employee can be excited to be part of the team i think that's what makes the business grow and dentist um i mean dentists um you know there's a lot of dentists there's a lot of different opinions and all this stuff but a lot of dentists do don't want to take phone calls after hours for emergencies because they always think they're going to get duped by some some guy addicted to opioids and they'd rather just not not take the call this you're saying helps them because if they were calling you in and you have that app you would know their history is that correct exactly you know what medication they're being picked up the last 12 months doesn't matter what state doesn't matter what pharmacy you would know instantly if they've been getting prescriptions and if they've been picking up prescription on a regular basis exceeding what they're describing then you know it's opiate fraud so you don't need to to go in so that's why some of the states are mandating this this application and how do you know how many dentists have downloaded it do you know um do you have a conversation right now we just started this program a couple months ago because you know because our focus is being on medical doctors so i think over three thousand dollars three thousand dentists and we're signing up more and more right and is that um all dentists in the united states i mean we got a lot of people listening right now that are from uh canada um is that is are you available in canada or is this mostly a us thing for now we just started our flagship program this desktop program just being working in british columbia and i think work in ottawa but just the national health system we got to go through all the bureaucracy up there so we've been up there three years four years but we're finally getting adaptations so i'm not so sure about regulatory uh environment for i prescribe up in canada but i know our product is being approved we have canadian headquarters up there to help our canadian neighbors but we focus in basically on canada and united states so here's a dentist asking massachusetts will require controlled substances to be issued electronically as of 2021 the massachusetts dental society members um partner but anyway is adam is that massachusetts will require controlled substances to be issued electronically um so is that uh all 50 states i mean is that more a federal program or where is this coming from and and what is it for okay for January 1st 2021 any federal government program is medicare part d anybody prescribed controlled substances much use electronic prescription but that's federal program from the state level currently there are eight states mandatory narcotic prescription January first coming in seven weeks eighteen more cities going to join in including massachusetts so all these states if you don't write prescription electronically you cannot code it in you cannot fax it in you cannot write it in so if you don't have rich electronic shipment ability impatiently narcotic you are stuck you better call your buddy to to send it in for you because they would not accept anything other electronic prescription right well do you ever watch the movie uh uh shark tank yeah have you ever watched that yeah good because i i don't want you to think my um my questions are rude but if you were on shark tank uh they would say to you right now they would say okay you're i prescribe but there's other competition uh there's veridime uh there's i core x there's denscrip um so um what is unique about yourself as opposed to all those um other competitors well we are based our thing we think we're the foremost technology company for example the massachusetts uh listener you just talked about dea was not allowing electronic prescription writing because they worry about abuses right so we're the first one we did a pilot program at the state of massachusetts after a year pilot program study our success was what allowed da to allow electronic prescription control substances nationwide as a matter of fact their basis their requirements their standards all based on product so we're the pioneer in this system so not only that we have the most robust support system for example because we have 10 million prescription written every month our system cannot afford to be down because 1500 hospitals are using our stuff so we have 24 7 live people support we have 100 problem solving rate and we're just there all the time and we we are the top product and we stand behind our a product our uh prices fraction of what other companies are charging even not only our first year free trial basis so our products stand the test of time so and you're not gonna find anybody with protein the volume the experience that we have well congratulations on that that's uh that's very very um impressive i mean that really is something um so um tell me about your journey i mean um i know um back in dc i mean i know you're the kingpin back there i mean your resume is a mile long but tell us about your uh dental journey and how did you end up after this uh amazing career as a chief dental officer at doctor first after being a periodontist how many years were you a periodontist uh right now going on 38 38 my gosh finally i guess someone on older than me i'm i've been going on 33. so i'm i'm loving this my gosh you have a grandfather i could podcast next who's a practicing uh periodontist but but tell us about your journey because um i i think it's very interesting i you know i've been so fortunate you know i came here the innsbruck world of english i have the environment that's really loving environment in Maryland people are just accepting me no problem so i got here and i worked 13 years in a restaurant from the time i was in middle school until the week before i graduated from dental school i graduated i worked in a restaurant i loved it i love working with people it's making good money and but more important like you said i learned how to work with people right so i love restaurant business and after 13 years i had enough that's okay the day i finished dental school i'm going to become a dentist now when i went to dental school there was 70s at that time federal government had this idea that we need more dentists they weren't enough dentists go around so they have a special program set up and Maryland is the recipient of this special program they got a federal grant quite a bit of money so each year they accept 10 more students than yours usually put them in a separate facility separate faculty separate curriculum and we graduate in three years so i had to run the program so went through a three-year program and we were treated nicely we're treated like kings even though we work like dog but we're treated very well and especially you know you may know this person one of the the ladies that graduate she didn't graduate transferred to university of missouri kansas city by now connie driscoll i don't know if you know her oh i of course i know connie amazing i mean she was in my class she transferred because husband got transferred to kansas city and then so what happened they take these 10 unusual students so i worked in restaurants 13 years connie was a was a hygienist for a clip ocean bean we had a helicopter pilot from vietnam and my friend dr stephen jeffrey who is a material genius and uh he was my class he ended up to be head of the restored material for call dent supply for a long time and he's head of uh he's a dell professor at temple university right now so i met these amazing people in my three-year dental school class and when i finished i felt i didn't have enough yet so i took two more years from the periodontal program training and at that time the head of paradigm department was dr gerald bowers the guru the four father of bone and tissue grafting so we're into regeneration very early stage but he's also open-binded so he wants to learn about the old-fashioned bone resection technique so he hired people ask people to come like my old partner dr silk and dr Winston from upenn so they teach the resective techniques so i feel like real really good well-rounded dental school education education in Maryland and when i graduated again people doctors of nick Winston asked me to join them so i became their satoshi so after a few years i was doing pretty good you know i work hard they asked me to become a partner but they said no we want to save money so don't get your own lawyer use our lawyer just use one lawyer i said sure so the lord you came back and my buy-in price for the whole practice was two weeks gross two weeks gross four percent of the annual growth of the company to become a full partner so that's how you're younger listening out there probably these guys are crazy and i told them the same i said you guys are crazy but they said no no charlie you bring a lot to the table your business you already grown very fast you know you all your income is almost equal to ours we can make you a full partner that's why this we think is fair so that's what it cost me four percent growth become equal partner and since then i've been you know we've been doing the same to our younger partners try to be fair and so it's a wonderful wonderful ride and so that's my paradigm side of the bus i'm still working i love it i love it and part time i still go teach volunteer to teach part-time at university of Maryland but i just love dentistry and then during this whole time my genius classmate from a three-year program dr g freeze he came up with this idea of a novel bone transplant material so i said okay he want me to be his clinician to test this stuff so we took out a patent on novel bone transplant material started doing experiment on it but with two poor poor young graduates we don't have any money so i think we gave a portion of company to a business people and lawyer loyalty representatives well after a year or two they got sick and tired of spending money so they found some investor in vancouver canada so they drew up our patent took over shell company and did a reverse merger or something to that sort and we become public traded in vancouver so that's my exposure to high finance in the very beginning so we did that for a while eventually you know company ran out of money so went under so but at least i got some experience a taste of what's going on then at the same time since my brother who is head of the intel satellite company who have put up he was head of the engineering division he put up like 10 satellites successfully not you know without any hits but he got as high as internet intel can go because anything above him work political appointees by different countries so he wanted to try his hand his private business so he went out and started this business for internet security because at that time internet very new so we were able to take that company public and then we got out and did something else then after a while he got tired of it so he started 2 000 star doctor first again for this medical technology uh to help the doctor so i got involved with this business not because i'm so smart or whatever i just happen to run into good people with ideas and if you follow these people's ideas and you go along for the ride it's very exciting it's a dentistry we can parlay dentistry in many many fields and i was able to do that i think all my fields so far originated because my connection to dentistry that is very uh nice and uh you did mention connie drisco uh so i do want to uh shout out um she passed away um my gosh how long ago was that um she was a teacher of mine and loved her to death and she passed away um june 22nd 2014. and uh i don't know when she was born but she was uh she was just a very very fun cool person and she was one of those uh teachers um just totally available just loved her to death um but what what a legend she was and she was the um dean emeritus of the gru college of dental medicine and a great person um so um perio not to change subjects but i think of um there's 12 professions and um we've you know we had nine the whole time i was a dentist from 87 and just like that we have 12 and i was really surprised that um you know it's change and you know humans hate change who move my cheese um but when i look at all the specialties um which one of the do these new ones like oral medicine i mean i would think they would benefit the most from these apps because a very common question um for the dentist the hygienist a patient comes in they're on all these medications there's no way um you could know what all these prescriptions are i'll give you a point um when i was in grammar school in high school during recess any car that drove by everyone knew every model and make of every car i mean you were just there were so few types of cars we thought we were smart with that we know them all well hell now i wouldn't know what half the cars driving down the interstate are there's so many of them they all look the same same thing with prescriptions i mean it seems like in 87 you could do a lot of that in your head but you don't have a chance of doing that in your head how many prescriptions are on that ipad how many do you even have every single one i'm telling you this the technology still advanced if you patient give your name they will put up and you want to write a new prescription the patient could be on 10 12 13 different drugs and the drug to drug interaction will pop up with our technology same thing with drug allergies so with ai and also you help you because ai function you shorten your stroke they kind of sell popular a lot of fields with your approval of course but this technology is just an instantaneous you can't believe our the technology these days and within fraction of a second we pull data from hospital records pharmacy records insurance records doctor's records it's incredible the technology we have you can extract data so quickly and form it in a way that's so easy for a doctor to use so when a doctor uses our app it's very simple you know it just pop up easily but the functionality behind it is incredibly difficult we have almost 400 employees now and we just we have many many patents in this field with artificial intelligence blockchain so we're in the forefront of technology and we talk about um telehealth right right now i receive a lot of referrals from my friends and most of them are sending me try to send me with secure email i can't open them because to open secure email it's like you need a degree in some kind of coding and things like that so connected with our i prescribed product there's a product called back line it's secure messaging being used widely in hospitals what happened in the back lines that allow you to secure messaging the recipient does not have to be download the app or to be certified you just have to trust the person so you can go outwards but they cannot come inwards so secure message you can use for referrals you can use for comp patient consultation but that's not the one apps it's not free with this product it's the first year is free but the the future cost is slightly higher than i prescribed but it's a great functional telehealth product it's all hipaa compliance because right now we start getting hit by you know start cranking down dents using gmail you know that's why i usually use gmail for my referrals i know it's illegal but i don't want to go to the other side either so with this secure email secure messaging called backline it's everything works and you can control your circle for example you can control whichever special what you want on your list it's fantastic in the hospital because you have four or five specialists diagnosing treating one patient and this will keep the message going on ongoing basis like a tree and keep it going but you limit who you want to be on the treatment circle so this is a very another powerful tool but i just gave a plug because i'm sure that just don't use tele dentistry a lot yet but at least another function now that's available you can use them you know on the same mobile device so um that's was actually my next question um mobile device why is it why is there not a desktop version why is it only mobile um a couple of software are mobile you only but you can have desktop version as well but we find the mobile version has a lot of energy you can't be anywhere you can be for example you say people call you middle of the night you don't know who that is but with this mobile device you don't have to go back to your office to go on a desktop you can be anywhere anytime and most people these days have a mobile device so that gives you a lot of functionality mobility and security and somebody asked me if it's what happened but lose my cell phone well nothing stored on the phone everything in the cloud so it's very secure and hyper compliant so again mobile device we find that it's going to be a freedom it's like a electronic uh prescription pad almost right you have security of it and you most people don't lose their iphone easily so it's it's again secure and it's a great functional functional device you know i knew the smartphone was going to change the world when um i um way way back when it was a motorola flip phone um you know people would leave their motorola pager and they would leave their motorola nokia flip phone that that was common people would say oh i forgot my damn phone but as soon as it connected into the internet you could be all the way out the driveway and getting ready to drive away from her house and one of the kids that panic oh my i gotta go get my phone that and that's when i realized that um the brain um is our natural intelligence and our hand was holding an augmented intelligence um that we just stared into and i i just knew that was going to be a game changer but i can't find how to do this on desktop if i go to iprescribe.com it just oh i did not know that see that's why i podcast uh people so i can uh figure this out for myself so i prescription um iprescribe.com um i prescribe is the app on your phone right and um and where is it right here uh our copia wow well that's great that was a question on dental town today um someone said right here um what did he say he said uh um i prescribe is a smartphone app no desktop application available and now i can uh tell him and he'll think i'm smart because i knew um back to those um back to all these i'm not a periodontist but i have slept in a holiday inn express um it seems like it seems like in my 30 years your specialty has been undergone the most change like i i remember when in 87 we were learning all the plaque removal and scaling and we'd do all kinds of fancy um procedures and you just did anything to save the tooth and it was about 10 years out of school maybe 95 all of a sudden everybody realized that you know the best way to treat periodontal disease is extract this stupid tooth and replace it with titanium and that was all the everything and then after 10 years of that all the peri-implantitis and all the problems and then Dennis started realizing that this um treating perio with titanium uh wasn't as great of an idea as everybody told you and now it seems like my periodontists are they're going back to the old world they're they're going back and for me personally you know i think it's the patient's choice but most people want to save their body part i mean most people uh don't want their eye or cut off or their ear i mean i've always been into saving natural tooth um how do you um about a quarter of our listeners are still in dental kindergarten school and a lot of times they get um tripped up by diagnosing and treating plan what advice would you give to a dentist who's looking at a case who's thinking ah conservative and do all this uh perio treatment or just extract and replace with titanium do you have any quick rules of thumb on how you wrap your mind around that no i think the biggest thing is user experience to look at the patient's condition to find out what may be the best treatment for the next 20 or 30 years and they take a lot of experience to think in this particular patient with periodontal treatment resulted better long-term success in 20 years versus implants right because you need to look at disease process the amount of progress they made the bone level the type of disease and the age of the patient so a lot of them come to it but no longer just simply extract these and put an implant because for a while everybody's doing prescription surgeries take out this tooth put an implant and you're done no because you still need to understand the occlusion right unless you fold that full arch extension you have some edentulous spaces you gotta take in consideration into that today i was at dental school today and the biggest thing we try to do is talk about inclusion you know my partners my mentors they're from up and they're big inclusion born amsterdam you know herman corn you know cohen goldman and cohen all these guys so i really believe occlusion doesn't mean natural teeth or implants you got to have the basic biologic principle behind it because otherwise implants fail too you see implant breakages but oftentimes because occlusion although it's you know very difficult to convince people of that so i think implants or natural teeth for my personal opinion i like natural teeth better however in some cases especially people live to be 80 90 100 well sometimes root care become a problem so you really have to consider which one is ideal for the patient i remember my dad i put a whole bunch in platform over the years when he's 90 years old he broke two more lower incisors i was going to put more two more in for him right my mom said no that i used to do oh it didn't either well he lived five more years i wish i'd put him in for him because he was fairly good health so 90 years old if the bone is good implies not a bad choice without worry about root tk so i think everything is based on biological principle or you got to really cater to the patient you know for individual cases there are no fast rules but implant fail one of my students you know paul rosen he's a very famous lecturer now in periodontics he said we'd be busy as paradise treating perry and blind title the rest of our careers so we got to be really careful with just you know simple rules well i don't want to get you in trouble but this is dentistry uncensored i don't want to ask you any question everyone knows um dentists get really serious when they need technology that's really expensive i mean you're talking about an app where i wouldn't care if it's free or ten dollars a month i mean i get bad at Dennis sometimes because um on dental town they're saying uh you know someone will post a link and they'll say well you have to have a prescription to read the new york times the wall street journal or our investors business daily i'm like well dude you're you're a dentist don't you think people should pay for services and you want great journalism or you just want free journalism i can't believe that dentists want free journalism and um and i really don't care if this app what it costs if it's free a dollar a month ten dollars a month because i think the extra value-added service of having it electronically sent in so if there's any problems or questions the pharmacist can you know we can fix that and then when grandpa goes over to walgreens it's all ready to go i mean that that's just full service that's just obvious um but um so they come out of school four hundred thousand dollars in student loans and then someone tells them well to treat perio you need to buy a hundred and thirty five thousand dollar millennium laser lenap or you should make these crowns chair site for same day service and that's 135 000 you always need to take a cbct that's a hundred thousand um so i wanna pin your feet down and get you in all kinds of trouble do you have four doctors in your office do you recommend a hundred and thirty five thousand dollar millennial laser lenap to treat peri-implantitis or do you do it old school with a scalpel and a scaler okay we are we run our practice like academic practice subject was first one civilian to do bone grafting outside the military we put the first one in our area to do implants and we're the first one to use millennium implants i mean lasers what happens dr ray jackman who was also a student of dr bowers gave a lecture about millennium laser lana a while back so my two partners even the much older than i was very receptive to the new ideas that they want to took the class while the machine two machines right away so i was more circumspect so i said well i'm not sure 100 sure that lynette business is going to work because i saw other type of laser that doesn't do anything for paradigm so i waited three years saw all their patients and i saw some benefits so i finally got the training so now we have four level map machines millennium laser machines in our offices however we do things differently i use it as part of adjunct to my treatment i tell them what the product is what avengers it is and now you i use the same fee as my regular surgery and i give them a little bit of warrant warranty i said listen are you going to use the lab nation for you however if the results not what i think would be i'm going to do the surgery to correct that residual defect for free so we're a little bit different because in a way it costs us more money because sometimes i take two procedures to accomplish the same result but i think as dentists or paradigms you really owe yourself to really investigate every single new technology don't just say no really listen to people you trust listen to experts listen program like yours to give them a true idea what works what doesn't work and decide if that particular machine or tool is right for the job because everything is formally based on biologic principles right everything's based on wound healing we're not going to do anything more than what's humanly possible we can use biologics these days try to stimulate try to increase what's possible but other than stem cells which is not there yet i don't see it happening anytime soon so we got to do the best we can we want to maximize the regenerative ability you know don't count on technology take that technology is nothing without basic biological biological understanding and principles so i said yes i'm going for a new technology but i'm very skeptical you got to convince me i got to see with my own eyes and if i anything doubt at all i want to make sure i'm fully comfortable with you know whatever remedial thing i can do for my patients to make sure whatever i do want to make do it right and i also want to remind uh the uh the solo practicing dentist out there that um the bizarre thing about specialists is um the fact that they have two customers they have the patient they're supposed to keep one eye on the patient one eye on cost and do everything for the patient treat other people like you want to be treated but then they got this second customer the referring dentist and you've seen pediatric dentists um figure out that the pediatrician is a better referral than a general dentist because the pediatrician gives them all the kids right out of the gate and the general dentist only gives them the ones where they've already scared the hell out of him and ruined dentistry and all that kind of stuff but but sometimes um i've heard specialists tell me that well i have to get this because my referring doctor thinks i do i mean you know how many oral surgeons and periodontists i know that have four different implant systems because of referrals um i know endodontists say that it bought a son endo big money um because you know one of their referring docs uh uh wants it um do you and then there's and then there's whenever you have a laser um there's the marketing side effects like i know a podiatrist and i'm i'm probably gonna get beat up by him one day because i've said this story too many times public but he does all of his advertising he's a laser foot doctor and when they actually get into the surgery i mean he's got the laser and he might play with it but he says it's it's ten minutes faster just get a scalpel and boom and he it really slows him down if he uses laser but it's incredible marketing did you find any of that true that some of your referrals uh wanted you to have periolase or it elevated your status that you had this fancy expensive laser uh or that patience liked it because it was a laser i don't think we don't partly promote it at all i mean we really don't do much promotion we are very low-key practice so most of referrals from watermelons from other colleagues and uh so the laser we i'm sure it's known that we have it but we don't promote it we don't use for every single patient but it's a it's as a tool for some patients for example really medical compromised patients you really can't do surgery it'd be really nice to have a nap lace in your arsenal to treat those patients right so we let people know we try to be on top of all the latest technology all this materials and i think our referral doctor trusts us you know to use our best judgment sometimes we get an argument for example sometimes really strongly recommend do a root amputation on upper molar instead of extracting put an implant in because science is so low i really don't want to do a sinus lift or whatever reasons but so our referral doctor trust us and because sometimes what i recommend some chronic bridge work and really weaken teeth they would say are you sure because dentures nice people they don't put in the whole you know reconstruction and have whole thing fall apart so i got to stick my neck outside said trust me i know it looks bad on x-ray but if you if i can clean up the perio and you do the crown and bridge stabilize those teeth they will stand the test of time and they do it and i think we end up a lot of happy patients so you develop trust over a period of time so for any specialist or general dentist the biggest thing developer circle people you trust each other you know have each other's back you know the end result is what's important you don't want to have anything that happens that's not predictable and i think that's that's a key thing again dentistry people business i have good relationship with my patients i have good relations with my referral doctors that's what makes it fun to work right because i never want to quit it's a matter of fact this morning i took my partners up nick he's 86 i brought him to teach in school with me he never wants to he just quit last year the lesson 85 years old so the reason he quit was his assistant and we our staff has been there 20 30 years we treat each other his assistant says you know doctor something hence not as good as he used to be he got mad at her for a few days then he said okay i quit so that's how he ended up his career so so we try to have a good relation we tried a good honest relationship with all staff patients and doctors and i think that's only way to go with the dentistry a wonderful wonderful profession i'm so blessed to to to get in this field i'm just happy as can be and i want to talk to you about other um bigger purchases i um you i see on your website um the cbct is expensive and you um chose the uh pax i3d green cd scanner from vatac uh korean company um how much did you pay for that and how standard of care is it outside of uh implants i mean i get it that everybody that has an implant needs that but um how what is your you know dentist always asking what is standard to care and a lot of dentists um are asking is the cbt a standard of care procedure before every implant and so um why did you pick vautec that'd be a good a good start oh i think we have two or three different vendors which tend to need to be all the vendors we look at some of the systems and for some reason we thought valtec at that time was the best quality for the value i think it's about 100 000 but i think the technology at that time to show us we felt wasn't that much different but we somehow picked that over the other system at that time i think the average cost was like hundred thousand we have three office locations so we have three cbct machines and again we use it you know believe it or not i usually take two per implant case and don't charge for either one of them because i think just need to be standard care so even with the machine cost us a lot of money we don't charge people for use as part of the procedure you know we could probably cut a little bit crazy but that's what we do because we just think diagnostic value for especially implants it's quite important you know we don't we did implants for 20-some years without the cbct machine and i thought we did pretty good but having this extra layer of security to know exactly what you're dealing with and also probably good way to show patients what it looks like i think it's the value so if possible if the value if the costs come down enough for general practitioners to have that i think the good thing to have but but diagnostic for general dental problems the force that x-ray is still the best nothing beats a full set of good dental x-rays but you're right i remember i mean um when i i would say by 87 to 19 i'd say by 1990 everyone on earth who passed the 10 000 to 30 000 placed implants um did them all on a panel i mean you know so uh so it's kind of a it's hard not to laugh when you see some young uh child uh who's placed 12 uh say it can't be done it's like okay um and and i want to ask you another thing about group um you know the interpersonal relationships are tough and you seem that you're uh very personal with uh um that you went into that practice because you're uh were drawn in with uh Robert zubnik and Dennis Winston and and you have four partners and i mean the only people that talk great about partnerships are usually people selling practices or selling them but if you talk to consultants i mean partnerships break up like marriages break up and if half the marriage is breaking every dentist i know that got divorced and broke up with his partner said the um breaking up the partnership was far worse and the reason is because when you have kids that you have family there's glue you know you just want it pretty but when you're fighting and going to war with a divorce with another dentist and you don't make love and have children and family and my god sometimes i remember one time a person bought in to half the practice for 500 000 and then they decided to get a divorce and the next two years spent 750 000 each on legal fees to get a 500 000 settlement i mean it's just it's insane and people say Dennis you know when someone you never want an opponent who got a's in calculus physics and biology uh to go after you you know you just you just don't want that so what advi why why are you so happy in your partnerships and i mean by the fact that they've lasted so long what was the key to success the communication is are you the alpha bull male and everyone else just does what you say how does it work well we're like bunch of cats so we just let everybody for themselves right so when i joined the practice zombie Winston my professors they never told me once what to do either clinically or professionally this you're the doctor you do whatever you want so when i joined the knowledge associate it's purely on a handshake no contract nothing so i can leave any time so they weren't afraid because they said you don't want to be here don't be here you know you can open next door if you want and that's how we give up and if we do the same thing all the new associates become partners we just totally trust each other to just do the right thing for the patient i think number one i gotta take the patient number two we treat each other and treat the staff really with utmost respect we don't ever fight over money you know something they always said listen one year you may be up make sure he may be up maybe five over every every dollar not gonna be happy just be close enough be fair and that's good and then we always carry on by that because you have this kind of trust and understanding about each other that's the way to go because if you fight over every dollar or whatever it's not going to work for example dr zubling loved to work he hardly ever take any vacations and when i was younger my kids were younger oh it takes six eight weeks vacation a year nobody said a thing they don't care they say you want to make less money go take more vacations so we're all free to do whatever we want for example we have three or four different implant systems because each one of us likes something different i like you know the aj coda implants my partner like non-coding plants so we order duplicate systems same thing with all the other material dental material biologics so we have total freedom it's almost individual practices little stage within the federation almost and because we trust each other little things doesn't bother us you know we just have utmost show we we stay together people like it money yes yeah some grizzles but at the end of end of the year does it really matter the happiness matters that much no i don't think so you know zubnik just retired 85 he said charlie if i worry about money i hated my profession so much retired 20 years earlier he said so i work 20 years more i love every minute of it so what difference does it make and i think we take that that view and i think for a lot of younger people especially under financial pressure they may not be so cavalier about these things but i think the long run the long run having a good group practice is such a pleasure you have people to talk to your people share your troubles and share responsibility you know by my partner he took me all this new pp even ppp loans because he's very good reading contract i was terrible at it you know so having a partner there that definitely took a lot of pressure off me and it's one of the benefits having a group practice everybody bring their talent to the table well put um during this pandemic um i mean you're involved with many dental societies study clubs um so many things um my god your volunteerism has been through the roof um but um a lot of people um um were upset that the ada went along you know that that we had to close for two months and i i i tried to let him know that they're giving the ada way way too much credit you might as well blame it on your mom because it wasn't the ada or your dental society i think there's little things that you might not have heard of before like the us government the centers for disease control the world health organization i don't think uh the ada or your mom was very high on that list of being involved in shutting it down but um how do you um you um lecture and work with a lot of dental societies and i think during the pandemic um we've seen a lot of dentists sell their practice and want to join your dso because the pandemic was something a solo dentist a lot of them didn't want to do with and the neat thing about group dentistry um i hired my first associate that first year out of school just because i just went from a 120 dental student classmates you know all that to being alone i mean that was like i was like wow that wasn't fun at all and i was so dumb i wasn't smart enough to get someone 50 60 70 years old that knew everything i of course hired someone that was the same stupid age as i was at 25 so we had fun but we didn't know anything um but um do you um you know the dsos are they can't even return all the phone calls of the dentist that want to sell them their practice do you see this strengthening study clubs where the pandemic is kind of like you know those musk when the lions come around they form a circle and put the babies in the middle and it's it's them against the jungle do you see dental societies getting stronger and more important um and having a new sense of um power um as dentists want to cluster together and learn how to uh what are the best practices to fight this pandemic not yet i think what happened is i have so many colleagues retire recently because pandemic i think when we finally able to get together again on study clubs or whatever i think then people may start talking to each other about what is that we can do as social practitioners not the eso's not bad but i think as independent practitioners which i think that's part of the reason why i became dentist because i'm an independent person i had to do my own thing but i think the dental should get together and look at the competitions out there look at the price structure and how do you know to differentiate yourself you know not just pay at some price differentiate yourself through knowledge skill personality so you can survive in this new world i think there are plenty of people out there patients they're looking for special care personalized care and i think there's a market for both but i think as an independent dentist you really got to focus more on marketing and more especially concentrate on skills you got to be able to deliver what you promise i think we do that dentistry is going to be fine i still think Dennis is going to be one of the last few independent colleges left in the u.s even i think 20 or 30 years from now i'm pretty optimistic about dentistry yeah i mean um like in the united states only five percent of americans will see a chiropractor in their lifetime but the data shows that all the people will i mean if you live out your whole life at least once you're gonna go to the dentist um you know there was a lot of this happening um this uh e prescription um even before the pandemic on January 1 2020 arizona law requires all schedule two controlled substances to be electronically prescribed um iowa um did it massachusetts north carolina oklahoma rhode island pennsylvania um is this um this is has it already affected all 50 states no 28 states by January 1st so 28 states right they will become mandatory this is no question because they need to have a uniform standard for the country so it's coming um it's really not a bad thing because if you look at efficient number the physician actually find that much more efficient they save them time trouble because with this app the very few callbacks from pharmacists and also with on this app there's a free feature that's in there it doesn't affect as much which if a discuss cost physician can look on our i prescribe and know the cost different costs from different pharmacies at the point of care they can direct patient to the cheapest place for example maybe amazon's cheaper however maybe some specials may be cbs maybe cheaper on this particular drug so on this app we can direct patients to different pharmacies although dentistry we don't prescribe anything expensive you know we talk about antibiotics on pain medicine we don't do anything fancy like physicians so that feature have less relevance to us versus general physicians but i think overall there's so much advantage to electron prescribing i think there's going to be way for the future and without i prescribed the good thing is not only you can take it anywhere the medication right automatically populate back into med history right away so within a short period of time whatever you wrote would be in your record now if you want to say mr smith call me so-and-so to do this okay you gotta enter into your patient record but if you just want to go back and see what medication would prescribe when your record would be in there automatically and that's that's a big plus but wouldn't the biggest plus be that it would be safer that um you would have some electronic thing that might be saying you can't give this patient these two medications i mean would that be exactly what's that exactly that that's right the biggest problem was the eligibility of illegible handwriting but the second one structure drug interaction you're absolutely right so these are the things that we pick up you know right away and the third thing is from a mandatory standpoint another mandate coming is you must check pdmp free right opiate epcs because they want to check the history of the uh opiate prescription so with our app one click we show number one document you checked it so you're clear with the state and second in seconds you show what kind of medication history they have because if you don't have this app on your on your phone on your record you got to go back and record it report that you checked this and what's your payment next so with this simple one click you have epcs and you have pdmp mandates you satisfy both mandates you're good to go and it takes seconds that's really really good good good thing to have so the founder um um j or the c the founder and ceo of doctor first is james chen and he lives by my brother oh are you kidding me because that's why i met the right people right you know you got to meet the right people oh my god i'm going to call my brother after the uh seminar after this podcast and say why the hell did you start again so what's what's your brother's background then well he was a graduate engineer from uh georgia tech then he went to satellite business like i said he launched like nine or ten successful satellite launches in a row for intel without failure and at that time he reached as high as he can go so he won't go into private business that's went into he's you know he's a serial entrepreneur he got into this oh another thing interesting is that the first venture you're looking for investors right so through a friend he met this gentleman back in taiwan on a handshake the gentleman gave him funding money for millions his handshake you know so just like my entryway by partners it's people that you have people that trust you you know reward their trust by working as a dog to repay their their trust but unfortunately that not too many people willing to to bet millions of dollars on the handshake you know so but again as you meet the right people at the right time yeah and the the real issue about getting financing or getting money the the problem should never be finding the money it's always paying it back that's a hard one if if you live i mean like in in i mean in america they they start sending kids when they're 12 years old applicate um credit card applications i mean i mean when patients come into your practice and they're 25 they don't have a credit card you there's a really good reason why they don't have a credit card and i was also wondering um cameron diemer who's the president dr first he lives right out here in mesa arizona so exactly we have a satellite office out there we have satellite office in in arizona we went here and one in canada so that's our office right now and that group we have a fairly large size group that mainly handles sales etc on arizona they love it so much they don't want to move back to east coast yeah and i um i don't blame them i mean today i'll tell you um so you're in you're in washington dc right now right right cold it's good what's it what's temperature there i think it's 42 degrees today i think oh my gosh 84 degrees 84 degrees and the high was uh 90 um my gosh i'm trying to think um i can't believe we went over an hour um we talked about them um was there anything um first of all um let's end on this um how was the pandemic affected at periodontist office because this is what i am seeing in arizona now remember arizona is the florida of the west i mean if you're if you live east of the mississippi river you go to florida and you know they're all crazy and if you're west mississippi you go to arizona and i can vouch they're all crazy um it seems like there's two worlds here we saw that in the last election i mean they've always been really divided though i don't see really any difference between people who are registering one part or the other it's always been a two different worlds but we live in one world here in arizona that thinks the whole virus thing is just an absurd reaction to the flu and i'm talking about four of my four boys today they they use a joke and all those patients 40 and under they're doing everything they used to do they're they're they're doing everything they don't change anything um but they don't need a root canal built up and crown an implant four quadrant certainly and so then you got this population that's uh my age i mean i'm 58 to 80 that need all the dentistry and in fact they are smart about this virus because obviously it's not attacking 10 year olds like it's attacking 60 70 year olds and and uh and so man i would think a periodontal practice would have just been smacked hard as opposed to a pediatric dentist is what i'm saying is that true is that true crazy we're so swamped we were close for two and a half months then after that we've been really limited the number of patients i see you know used up i see a quick check patient for five minutes now it's half an hour because you got to sterilize your room so the time slot become very limited but yet the demand is extremely high i'm booked up way ahead i always been a little bit busy but these are really really busy so um especially people under stress you know people are locked up they watch the tv news i see so many teeth fractures it's unbelievable i used to see one fracture maybe a couple of months now i see five to ten a week people fracturing their teeth like crazy and that require extraction immediate implants and things like that so we're really really swamped so it has not affected this at all it's like you know i guess i'm very happy to say but we're very very cautious with our protocols and space and equipment so we tried the best we can but we're being small now is that just because your practice has been around for a long time and you have all these great relationships or is this a general trend that you're seeing in periodontal offices around uh the dc area oh i'm not so sure because you know i'm more familiar with my immediate general practices than other colleagues in this area but i think everybody's fairly busy i think i think because also remember a lot of people retired so these patients all of a sudden need to find a new dentist so there's quite a few patients moving around as well so i think everybody's around us is doing well besides you know washington dc everybody's federal worker i mean there's no no depression no recession here they all working right so we recession proof of this area right that is uh so uh um i'm looking at the uh dental town if you you know i really wish you do i wish you would just go to dental town and do a search for uh e-prescription and uh there's just so many questions and what's amazing is all the questions are now like um um e-prescriptions uh um do they interface with any practice management systems like if i'm using the app uh i use open dental uh does that sync and enter all the information with all the practice management systems well dependent software system we're trying to work we have we integrate 270 medical software systems but then we only have a few because we're just starting into so what happens you need to work have a working relationship integrate with the system so we got to work on the major one you know it's the major ones but without i prescribed what happened you can work independent because the medical history automatic integrate into your system so you don't really need to open your system to do that and since the history of it god might go into medication history of the solve any software system any software system so they really don't need to enter into it so that becomes a lesser issue unless you want to write down like i said you know mr so-and-so called me wanted but otherwise you can just look up medication history to know exactly what you wrote and when you wrote it yeah and um and again walmart announced January 1st that all their narcotic prescriptions would have to be e-scripts they're not taking paper anymore um so this is just clearly the trend and that's why i wanted to get you on the show and um you're just uh amazing um my gosh but yeah you would um i wish you would do that just go to dental town and type in prescribe and there's just so uh many questions and uh gosh i'm trying to answer a lot of these on the podcast but i some of them are so uh um so there's three thousand dentists and it does them all that's just amazing each week we get more we get we get a survey back because we we target in each state that have mandates we try to target local dental journals to do that now interesting you're going to say well we're not endorsed by some of the society the reasons a lot of society would get endorsement you need to pay them or some kind of fee splitting well the first is free so how much free splitting can they get right so if they partner with us they're not getting that much money but well i guess you guys would all share that because i've seen the horror stories uh bob ibsen used to talk about it all the time where you know he would have a product and he'd go down there and try to get the ada sill of approval and he just said it was like a mob shakedown for money and i don't care i i really i'm a i'm a long-term libertarian when in 1980 freshman year college when i met warren buffett and read freda trues by milton friedman i i was i i was done i mean that was just it was love at first sight and um my gosh i i don't care when i look at 5000 years of recorded history the two biggest problems are transparency and checks and balances and if you're doing something like my dad like i used to tell my four boys i don't care what you do as long as you have no problem with it being on the front page of the arizona republic tomorrow and if you're good with being this is a front page story do it but if you never ever want to see this on the front page of a newspaper you probably shouldn't do it and if you do it um you're gonna have to defend it someday possibly and and the the um all the weird ill behavior is always opaque and uh and then and then Dennis i mean Dennis don't even like checks and balances i mean they they look at hard they thought um letting hygienists have a license to do cleanings i mean you go back to uh um irene uh what was her name irene newman was the first um wasn't she the first uh hi jennis irene newman was the first dental hygienist and um they put a plaque up in her honor but it kept getting removed so so you know so what happens with apps but we say you can't do anything number one's free there's no obligation it's no contract you know so that can't shake you like us you stay in the future you don't like us walk away and you know enough we have the best product and lowest price so i figured people had nothing to lose to use our stuff to satisfy the mandates because we don't use it enough to really pay a huge amount of money i mean some product out there costs a lot and dentists we use prescriptions so sell sell them why should we pay that kind of money so we keep the costs really low we don't build in facts so we have no money for kickbacks but we want to pass the benefit directly to the dentist so we're up front we're very transparent and i think that they will show up in in our right now results and to young kids in dental kindergarten school what he just said is will always affect your whole life because like say you want to hire a consultant and they say well i want to have a one-year contract you got to pay this much i mean could you imagine going on a first date you say well if you want to go out for dinner with me you're going to sign a one-year contract and we're not just going out this friday but the first friday of every month for a year i mean why why do you need a long-term contract um when you're dealing with other humans and it can go south and to me it's a huge red flag when i'm locked in on a contract with a consultant or anything and when someone says i believe in my service so much i don't even need a contract in fact if you didn't like what i was doing i i i would even want to work with you i would um you know that that's just a deal-breaker for me but there's other people who want locked in and that's because their mentality is money is the answer what's the problem and um and that's not what it is that's how the world works it's relationships are the problem uh my oldest sister's uh a catholic nun for i've been a dentist 32 years she's been a nun for 35 years she's read every major religion in their original um language and she knows her language and she says there's not a city a person a place that's in all the major religions except for the golden rule treat other people like you want to be treated and that's the bottom line of customer service so the fact that you don't require a contract and you um you are into relationships uh just speaks volumes to you um tell your brother uh that's amazing and tell your mesa team i'm in their backyard if they're ever in the area come by and see dental town but i know you're busier than a one-armed period on us so thank you so much for taking the time to come on the show today and talk to my homies oh thank you it's an honor to talk with you i've been fan for a long time i went attended my earlier seminars you always stay with me so what you talked about is as relevant today as when i took it was young dentist so it's a great credit to you great job thank you and what's that hotel by washington d.c it's like a 30-40 morning of the mandarin oriental by the uh the ones where there's old people pretending they're george washington and and uh was was it was it mayflower or was the uh the uh marriott uh what's it what where where is uh general you lose his grand state and i'm trying to remember the neighborhood or something else right right right but washington dc willa was the wheeler yeah yeah and washington dc i mean my gosh the monuments the museums i mean it is just the coolest city in the world you must really have a lot of fun there between uh um all the historical all the museums all the everything it's just a great place to go so we come here for cherry blossom you're welcome look me up okay i will i'll hold you to it i thank you all right thank you so much for coming on the show thank you i'll talk to you soon.

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