Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1246 Marc J. Novak, DMD on the Benefits of Residency : Dentistry Uncensored with Howard Farran

1246 Marc J. Novak, DMD on the Benefits of Residency : Dentistry Uncensored with Howard Farran

9/13/2019 6:00:00 AM   |   Comments: 1   |   Views: 58
Marc Novak graduated from the University of Connecticut School of Dental Medicine in 2018 and is now a practicing dentist between two practices in Northern New Jersey. He was born and raised in East Windsor, CT. With his mother and father both being successful teachers, he entered the University of Connecticut in the education program before transitioning his studies to biochemical research. After completing a research and development summer internship at a pharmaceutical company the summer before his senior year, he knew that a life stuck in a laboratory was not for him, and he chose to again transition to dentistry after observing his local dentist Dr. Pete Coombs of Suffield, CT. While applying to schools his undergraduate research advisor convinced him to continue his work and stay for a Master’s degree. His research project focused on increasing the chemical stability of proteins that could be used for functional purposes. He published several peer reviewed journal articles pertaining to the increased functional stability of Glucose Oxidase, acting as the building blocks to a biocompatible glucose sensor that has the potential to send electrical Bluetooth signals through an app to register live blood-glucose readings and limit the pain and annoyance of patient’s using drops of blood from their fingers.

VIDEO - DUwHF #1246 - Marc Novak

AUDIO - DUwHF #1246 - Marc Novak

Upon completion of Dental school, he was selected to attend the highly competitive GPR program at Morristown Medical Center in Morristown, NJ, ranked the #1 hospital in New Jersey and a top 30 hospital in the United States. He received advanced training of complex dental cases, including oral surgery, endodontics, dental implants and esthetic cases. He received a formal education on management of medically compromised patients as well as patients with special health care needs. Becoming a more well-rounded and confident practitioner afforded him to opportunity to enter private practice as an associate under the tutelage of Dr. David Paulussen of Hackettstown, NJ and Dr. Michael Gruber of Parsippany, NJ both of whom are annually recognized as two of New Jersey’s top dentists. 

When not splitting his time between the two offices, Dr. Novak is passionate about continuing education to become the best practitioner possible as well as staying physically active and traveling. He hope to use his experiences to provide the best possible care to his patients in a relaxed and welcoming atmosphere and make patients an integral part of their own treatment by educating them to the fullest extent as to the care they will be receiving.

Howard: it is just a huge honor for me today to be podcast interviewing Dr. Marc J Novak: DMD graduated from the University of Connecticut School of Dental Medicine in 2018 and now a practicing dentist between two practices in northern New Jersey he was born and raised in East Windsor Connecticut with his mother and father both being successful teachers he entered the University of Connecticut in the education program before transitioning his studies to biochemical research after completing a research development summer internship at a pharmaceutical company the summer before senior year he knew that a life stuck in a lab was not for him and he chose again to transition to dentistry after observing his local dentists dr. Pete calms of Suffield Connecticut while applying to schools his undergraduate research advisor convinced him to continue his work and stay for a master's degree his research project focused on increasing the chemical stability of proteins that could be used for functional purposes he published several peer-reviewed journal articles pertaining to the increased functional stability of glucose oxidase acting as the building blocks to a biocompatible glucose sensor that has the potential to send electrical Bluetooth signals through an app to register live glucose readings and limit the pain and annoyance of patients using drops of blood from their fingers upon completion of dental school he was selected to attend the highly competitive GPR program at Morristown Medical Center in Morristown New Jersey ranked the number one Hospital in New Jersey and top ten 30 hospitals the United States he received advanced training of complex dental cases including oral surgery endo implants aesthetic cases he received a formal education on management of medically compromised patients as well as patients with special healthcare needs becoming a more well-rounded and confident practitioner afford to him the opportunity to enter private practice as an associate under the tutelage of dr. David Paulson of Hackettstown New Jersey and dr. Michael Gruber a percipitation Jersey both of whom are annually recognized as two of New Jersey's top dentists when not splitting his time between the two offices dr. is passionate about continuing education to become the best practitioner possible as well as staying physically active and traveling he hopes to use his expertise to provide the best possible care to his patients and relax in welcoming atmosphere and make patients an integral part of their own treatment by educating them to the fullest extent as to the care they will be receiving I wanted to bring him on because you're just two years out of school and you just went through everything from A to Z about residency's and everybody in dental schools thank you all so he's graduating get a job and get a job so I do a GED so I do it residency and when I graduated so long ago I don't even know that they didn't even have half the letters of the alphabet when I graduated in 87 so I thought it'd be really cool to bring you on two years out of school to go over what are the benefits of choosing a GPR or an AED over going right into private practice and knowing what you know now what did you think of your decision 

Dr. Marc J Novak: well I just looked at it as you know in school we always were taught you know this is what a crown is or this is what a group now is and the theory behind them but when you leave there no matter how many students who have or how many patients there are you know there's always cancellations for a four-hour block to do like an molar composite and it's not as practical to learn it from just the school you know everyone may think that if you finish school you should be ready to go out and work like anything else finance business things like that but I look for something that was going to sort of increase my speed and efficiency with procedures and residency was going to be that to a tee I looked into a couple different programs and the associate dean of students at the University of Connecticut actually was on a Accreditation faculty that goes and basically looks at all the GPR HD programs around the country and when I asked him and narrowed my list down to a couple he had said you know this one may be one that you should look two down in Morristown and when I went to visit I left basically saying this is the only place I want to go after watching it just for a day pretty much 

Howard: okay well this podcast you know there's two million dentists around the world it's a huge popular show in Asia and Africa um so tell my homies what's the percentage GPR and a EGD the traditional difference 

Dr. Marc J Novak: I guess from what I understood it I was always defined as a general practice residency for Kosovo as hospital based as opposed to an AED which you know advanced education always went through more of like an academic based or you know as schools or things like that but I believe the lines have been blurred a lot more to those there's programs that are a EGD programs that are being housed at you know health centers and all different ways of looking at them so I guess the traditional way you would look at it is a GPR is more in the hospital based program where you're going through rotations and maybe doing more oral surgery to an extent where as an AED you're taking possibly more classes you're doing more research maybe like writing proposals and things like that but for the most part I don't think they're tailored one way or the other anymore it's because they there have been so many that have been sort of combined in a way that they  offer the same aspects of them now 

Howard: and what do you think so so you really so it's really not more of it's not really a distinction anymore would you almost call it a synonym at this point at this point

Dr. Marc J Novak: it's definitely closer to a synonym there are some programs that are definitely more keen to research or keen to those little aspects of Dentistry such as no public health or little things like that whereas GP ours being in a hospital you're going to see more Hospital based patients you're going to see more emergencies and you know that's not to say that a eg T's don't see the emergencies and things that's sort of the traditional definition but I think they're definitely getting close to be synonymous

Howard:  you know what I noticed in the last 32 years is um you know a lot of states would have like a big city but the capital would be in a small town and the university would be in a small town and like in Kansas where I grew up the med school was in a small town but Wichita was the biggest town and now and a lot of these residences I would always hear people saying all the time saying make sure it's in a big town I mean if you're doing a residency in LA you'll get so many more of the rare cases than if it's in Salina Kansas and I've noticed that in Kansas the  medical schools are moving their clinics and hospitals to the biggest town like Phoenix is building you know U of A's and Tucson with 800,000 and now they're building a hospital here where there's four million so would you say that if you're gonna pick a hospital based residency and you want to get the most rare cases that you'd want to go do a residency and the biggest city you can find versus the smallest little university town you can find I think that they're definitely in just terms of sheer my grad school professor used to say everything is probability so

Dr. Marc J Novak:  I think this year probability of things of finding them in a big city with a higher population may be greater but at the same time even you know the way we were described at Morristown where we are we're a level one trauma center you know in North Jersey and we're pretty much the only one until you hit western Pennsylvania you know Western New Jersey northern New Jersey and that as you move east they have Newark and Beth Israel and all those that are over there but even a town I had never heard of Morristown before actually one of my friends from college moved here and you go and you look into some of the cases and things that we did and again it's you may find more of those cases and a higher probability in this in the big city but I think for as a population increases the number of hospitals also increase so it may just be taking away from its own pool in that sense versus if you stay you know in a hospital that may be a little more toward a rural area or a little more small urban area a lot of people look at it as well this is definitely the place I have to go because it's the only place within you know a certain traveling distance

Howard:  so you're in New Jersey now are you and are you in Parsippany yes I live in Morris right now but I practice in Parsippany two days a week and two days a week in Hackettstown well for my international viewers I can assure you that New Jersey only has two types of people there either Bruce Springsteen fans or Bon Jovi fans which one are you dr. Novak SPRINGSTEIN they always have an answer they'll never say I don't know but uh so um so y-you know she's coming out of school two hundred eighty four thousand dollars in debt so she her walnut brain  dude I want to go get a job at Aspen or Heartland or I just want to get a job and start paying down those student loans how do you how do you sell it GPR and AE GD of student loan you know money versus you know more education how did you wrestle that mentally

Dr. Marc J Novak:  I mean leaving school everyone definitely looks at if you have student loan debt that's going to be a big consideration what you do next even not residency for a GPR residency for specialties you know if you go choose to do four to six more years for oral surgery it's a real consideration you know money-wise and time wise what you're going to be getting versus what the output will be from that the way I sort of tried to look at it when I was wrestling between those was in my amount of time and I put in the investment to become where I am as a practitioner leaving school would I rather take one more year in a GPR where with this specific program and certain others I'm going to be getting a higher level of education from attendings who are going to be there with me and giving me tips versus you know the early stages of money sound really good you sign these contracts for could be two hundred thousand dollars something like that and it sounds wow that's great when I make that out of school but what's your long-term goal do you want to learn how to run a practice efficiently and if you don't have the go get it miss and you just sort of get locked into those positions I mean if your long-term goal is to be an associate at an Aspen Dental or somewhere like that for the long term then that's a great place to go and start early but if your long-term goal is to start your own practice and be your own boss and just try to get as much education as you can as early as possible to set yourself with a good foundation moving forward then I think that a residency and a AGD is a great way to go and get that education and be proactive about it because you know what those Aspen dental places there may be something you want to learn but your schedule could be packed for the whole day - the opportunity where you don't get to go out ask attendings or ask other dentists what they're doing without paying you know sometimes thousands of dollars to do see trips to San Diego or Seattle or anything like that 

Howard: I love the your post on dental town one of the one of the 50 categories is um residences a eg DS and GP ours and you're posting unanswered one of these guys questions and some of the questions that thread I thought were pretty interesting we're saying what would how would you how would you decide whether to do a EGD a GPR versus military or public health 

Dr. Marc J Novak: well for especially for military and public health if if you choose to go the military route I think that you should be for reasons above and beyond just dentistry in a way if you're focused on serving your country because everyone knows that the military is a great option in terms of you know managing your debt long-term benefits formal education for the military cheap ers are fantastic they're very competitive to get into but you have to go through the rigors of joining you know branch of the military so if you're not willing to go through what it takes in order to do that I wouldn't look at that as something I'm just gonna do this because I'll be able to pay back my loans easier in terms of the doing an AED versus GPR at that point it's what do you look for in terms of do you anticipate yourself being in an area where it's going to be a high-volume place with medically compromised patients like a big city who somebody could just wander in off the street or for AEDs are you sort of focusing more on in a way even though like we said the line is blurred or blurred a bit are you focusing more toward and maybe like a path in academics do you enjoy the research do you want to try to get a little more hands-on but also do you know with research articles and things of that nature as well 

Howard: so this guy post do you have an aeg d or GPR that you absolutely recommend or not recommend that's the weird way so the business aid is there one you love is there one you hate and basically you said the at Morristown Medical Center in New Jersey you couldn't recommend this program highly enough white way is that

Dr. Marc J Novak:  I mean you know the time when I wrote that we were getting exposed to a lot of a lot of complex cases that you know you come out of school and you just kind of have like a deer in the headlights sometimes some of these things walk in in terms of like I said if you're going to spend the one year and in a way as a financial sacrifice a time sacrifice versus going out and getting a job somewhere or getting a job in Aspen Dental you'd want it to be the most well-rounded in a way that you could deal with a couple of examples I can give that really attracted me to Morristown as a GPR our number one was when I went through there and saw how the program runs it's  run as efficiently as possible about like six or seven residents easily could make that place function well but it's run with four residents on purpose they want those residents to deal with pressure the director Elizabeth Clemente and she's a treasure of the AGD actually now her philosophy was always you know practice should be harder than the game and then she would say I want you to leave here after one year and say I'm exhausted I'm kind of beaten down this is a this was a hard program but then for the next thirty years of your life you're like well this is easy compared to what I did you know for a year in Morristown and so far my experience being out in private practice it's been like that in a while to the I talked with my goal residents who I graduated with and we're kind of like again sometimes there's some days where you sit there just starting out as a new dentist you're like man like I kind of missed the  chaos that you were dealing with in the hospital because morristown being a level one trauma center we were the only residents there pretty much for the shoulders up there were no plastic surgery residents we would go and help plastic surgeons there was no ENT residents so we can sometimes go in with the surgeons and the EMT cases and as far as oral surgery you know if they came in with gunshot wounds car accidents drunken Falls you know anything under the Sun as far as mandible fractures CMC's skull fractures we were in on those cases working them and learning how to you know put these things back together 

Howard: ha I really love that what you said on what did you say you said practice harder practice should be harder than the game so yeah and Steve Kerr Stephen Curry says I want to practice the point where it's almost uncomfortable how fast you shoot so in the game things kind of slowed down Stephen Curry and this is a big controversy I think that really makes a lot of specialists mad III tell these kids um you know they  never want to do any molar endo they said well I'm no no but I'm good enough and I said well how you gonna get good if you don't do a hundred I mean until you've done a hundred you don't even do more though and they go yeah but the ended Oz was you know that we do it better and I said well who did the ended on his first 100 I mean you know what was it did Stephen Curry show up and say let me do the first 100 for you I mean you got to start somewhere it's kind of like when you're an airplane and someone's all upset because some kids crying I was in their stress out the mama I always say well how old were you when you were born you know so I'm right everybody's got to do their first root canal and I love that that you know you just  got to get in there and do it I've seen thing with programmers I there's all these programmers you go to four years of school and then there's programmers that just sit there and come home from high school they get a book called programming for dummies and decide they're gonna write their own video game app and a year later guess who's the better programmer you know so just get in there and do it um 

Dr. Marc J Novak: like you said also you know doing root canals just as an example when we entered the program we had all different interests for the residents who were there we had one who actually he's going to be an oral surgeon now so he was very into oral surgery so by the end of the program he was doing you know three implants in a row doing you know ramus like block grafts for implant sites doing all kinds of things because he was challenging himself through the program dr. Joelle Hurstville one of the other residents I was with she loved aesthetic cases and she did a beautiful pretty much full mouth rehabilitation on this person that you just couldn't believe a difference that she made for this person and I really liked and know so I would try to pick everybody's brains about you know what their methods were for endo how they went through and did their cases and we had three or four endodontist but we also had three or four general dentists who are very very good at endo that could teach us a lot so dr. Clemente actually by the end she prints off your production and she tracks your production every quarter to show you when he'd be doing more of what you may need to be doing faster and so by the end of the residency the last printout I got I had done 47 anterior root canals 31 bicuspid root canals and 27 molar root canals and that's something that I wanted to do I came to imagine how many teeth my co resident Peter took out by the end who's probably astronomically high 

Howard: well it's neat because you would think if dr. Elizabeth Clemente was in some Hospital Medical Center that she wouldn't be thinking about practice management and production everything we're how do you think you were where do you think this comes from with Elizabeth why is she thinking like a business inside of a GP r that has to you know real world has bills to pay yeah I mean 

Dr. Marc J Novak: I think that she is sort of a a combination with her where she wants us to challenge ourselves and practice you know doing these procedures to get better at and be better dentist but she also stresses that you know there is a real-world component to dentistry where you can't just do this as a hobby you know if you're going to do is she like you know you should learn to do it in a way the right way so during even these printouts to give us our production reports she also will standardize them to be what the average cost of this procedure is in you know New Jersey or Morris County just so we have an idea of how when we get out and we run a practice you know you leave there and you've only done five endows but you've done you know God knows how many molar extractions and you know like wisdom teeth extractions okay well then maybe this is something that I've learned I should refer out and spend my time doing extractions more because those are something that I feel more comfortable or feel better at so all in terms of crafting better practitioners she I believe looks at it as like a full practice point of view that we're not just gonna be teachers we're not just going to be in like residents forever we're gonna be practicing dentists and she wants us to be the best ones we can 

Howard: but that still is what I find most kids get caught up on they they're never gonna get good because they're gonna refer everything they're not good at when they're their babies I mean you're you're not gonna master a pulpotomy until you've done at least a hundred you know I mean same thing with molar endo same thing with uh with extractions and I don't know why but I just I just I didn't care I mean if I saw he's gonna pull was I didn't care what took me an hour and I remember when I got asked old eighty-seven at the the at least once a month I had to take the patient to my car and drive him over either down the street to the oral surgeon or Don gas or I would drive him to my the other direction if their oral surgeons o'mondays ready five but there was a guy about two miles on the street and I would take him to him and he'd always joke he'd always take the pace and go no big deal Howard always takes out the top half of the tooth and then he brings him here take out the bottom is Bob Sundberg who's now up in Prescott and he was such a great colleague and he always saw this honey but  that fear that they wouldn't be able to get it out just paralyze them and then though they'll never try it again so how would you talk a young kid and then the other thing that stressed me out is that they come out $284,000 student loans and half the class is already determined at graduation they hate mole or endo and they're never gonna do it I might do that's a thousand-dollar procedure you have to sell bleaching bonding veneers you don't have to sell I'm in pain I can't sleep will you help me and insurance will pay 80% and then goes back to public health I mean come on your public health a patient just walked into your office in pain and you can't treat that when eight percent of emergency room visits or odontogenic in origin because all the dentists are either closed or they decide they just don't do that I always tell you just imagine you broke your arm you go to the hospital they go oh I'm sorry doc we don't do arms you know we used to do arms but you know what we just don't like arms we only do legs like dude you're a hospital you're a dentist it's public health dentistry it's available to access they got a toothache you're doing a molar endo and if you don't like it it's because you're not good at it and if you're not good at it it's cuz you haven't done a hundred of them so go do a hundred of them until you like it so so how do you how do you walk them off the cliff to to go do something they're not gonna like

Dr. Marc J Novak: well I think that's part of it when we talked about people who want to or students who want to go to Aspen Dental or columbia dental these kind of things after those places serve a purpose and you know they  are a great business platform for people who go in there and they need help with something but the safety net of certain places like that are going right into private practice is that you have someone who's gonna say oh you don't like Moeller endo well we have an endodontist who comes in every Thursday so he'll do it all for us and you don't have to learn it you know just worried about fillings and crowns bridge whereas the residency programs that I visited if it walks through the door you're doing it you know it's you you have to learn one way or another and the in my program we had certain days that were blocked off based on the attending we had over a hundred attendings who were volunteers that would come to the hospital between general dentists oral surgeons and the Donna's prosthodontist so you had an idea of if I'm gonna do you know this molar endo on a number 18 well I kind of want to do that on a date at the end Adonis is here so you could tale your schedule to that and you know they would always show up for a same with oral surgery by the end we were able to somebody comes in says oh I broke this tooth all right you know in by the end of our program in May it's like okay I can just take this out let me section it pop the two roots out you know in and out but at the beginning you have these oral surgery days and you're a little nervous about how to get this tooth out because it's decayed to the gum line you learned some of their methods and then you sort of go back and say oh now I know what to do the next time this walks in and you know it you very well may mess it up and be putting a phone call in to dr. press who's working right across the road and say you know I broke this one and there were times where him or you know other oral surgeon would come in and have to help us with certain procedures but as far as the referring things out the benefit of the residency was if I got certain molar endows to come in now when I was just out of school I'd be like there's no way I'm doing this it looks too intimidating and now by practicing in a residency program and learning these advanced techniques and little like tidbits dying techniques just like little analytical things you learn from other dentists your fear level goes down to the point where somebody comes in and like you said oh you need to poop on me all right give me a rubber damn late we'll just access we'll take a ten file down there like you know no problem and I still have my other patient the chair ready to go I know how to balance between these 

Howard: so if they're listening to this on iTunes they're thinking my god what uh what GPA did you have to get have to get in there if they're watching this on youtube they're saying well how Elizabeth accepted you because you look like Russell Crowe in the gladiator oh my god if you're not Russell Crowe's son I don't know who you but how hard is it to get in these residences it's definitely 

Dr. Marc J Novak: first of all my assistant that I had in Morristown used to call me Russell Crowe as a joke because one of the patients that we had come in had said it so I think is just funny you brought did you like Russell Crowe Howard: when you're trying to get in I mean do you just want to get in any place that'll take you or or you look are there red flags like knowing what you know now or they're like GPRS and they eg DS that you wouldn't even want to go to or is there so so are they hard to get in and and what are the red flags the ones you don't want to get in I think they're they're hard to get in only in the sense the only but in the sense that it's a numbers game so there is only X amount of 

Dr. Marc J Novak: residency positions available every year you know for GPRS and AG T's or surgery and Oh everything so if there's more people who are applying then actually get in it just becomes a numbers game in terms of it being challenging and you know it's it's more difficult to go to a place that you really want to go do to sometimes the process which is the match right so the match is basically an algorithm that a lot of places will go and they'll let's say I interviewed at you know Morristown Wichita Arizona and San Diego right and I rank them one two three and four well the other residency's could rank me you know v xi like two or however and it's sort of like a crapshoot so where the place I really wanted to go my number one choice you may end up at your number three choice so you have to be cognizant of where you match programs and the same goes for oral surgery and the same goes for prosthodontist and like orthodontists so that part could be definitely stressful the benefit to doing your research about programs Morristown where I went they dropped out of the match she just said she wants to pick who she wants I'd like to go to the program and when you go to the interview like that's it they make their selection so it's a non match program I know that the year that we had applied I believe there was about 88 or 90 people from across the country who applied to Morristown because we interviewed with people from VCU you know Marquette a USC and when they were interviewing going through there it has a very good reputation but mainly one of the best things you can do is talk to former residents who went there and engage their experience and I would say not just one person but do multiple people so you can get sort of like a composite of what multiple viewpoints had on the program 

Howard: so what would you say and a GP RNA EEG I am I mean okay so first there's specialists where someone just says I want to be a pediatric dentist I only want training that so that's the specialty whereas a GPR is a tgd they want more training you see a lot of people do a GPR to a EGD and then later gone to specialize or had they already passed it like I know I don't like I knew right out of the gate I don't know how you could do one thing I mean I didn't want to do like only Moeller endo the rest of my life I mean I just but what I loved about Family Practice is that you know the variety um it scared me but like um like someone who gets a gold medalists have a really high alcoholism right because I mean if you say it's a true story I mean you if you swim the 100-meter for an hour every morning before school an hour after school from age five to 25 you know what the chance of burnout is where one day you just say I never want to swim again I mean so I didn't I  don't know how a guy just sits down and says I'm gonna do you know five six seven root canals a day five days a week for 40 years I  didn't want that but are you are you seeing that the people who know they only want to do one thing they're off and the GPRS and AEG DS want more training for family practice or do some people find out in GP are that they really only want to do endo or pediatric dentistry 

Dr. Marc J Novak: yeah I it's a great question and a great point because one of the things that the school lot of schools may not sure but sort of direct people toward as well if you know you want to do oral surgery you've got to apply now you have to make your decision if you know you want to be a pediatric dentist you have to apply now you have to make your decision and from my experience that's also been that while it's great to apply out of school you also have a lot to learn about what it is you really like in real-world dentistry and not the like sort of sheltered atmosphere that dental school can be I had a good example with my co resident dr. Peter had nine he was on the fence between oral surgery and general dentistry and he chose to go to Morristown for his GPR and after the first I would say three weeks to a month of doing the oral surgery days that we were doing interacting with the oral surgeons and seeing how they worked and just seeing you know his talent or skill for certain procedures he made the call he goes I'm gonna apply to oral surgery I want to do this for the rest of time but he also challenged himself for the rest of the year he didn't just stop doing crown and bridge and he didn't stop doing root canals he still did all those things and he said I'm never gonna get to do this again in a way so I need to make the most out of it while I'm here and I think that's a very positive attitude to have about it but the benefit is when I was considering going into endo and being an endodontist that she's resident who I was picking his brain about it in dental school I was a third year at the time he said listen if you want my advice either go into practice or do a GPR and if you go there and you say I never want to take out another tooth I never want to see you know another kid I never want to do another crown I never want to do another denture then go into endo he goes but if you leave there and say I kind of like still doing a little bit of everything and being the quarterback of the team he said go general and I think that a lot of times general dentistry is sort of going trending upward with all the CE people can take and all of the additional skills that people are learning that you know general dentistry is a great field to go into no one says you have to refer out all of your endo or you have to refer out your every extraction you do you learn how to do those things to the best of your ability and you learn you know when to call it quits or when to say this isn't for me

Howard:  I want I want to switch to this is dentistry on sensor I was switched to the the uncensored ugly part of this eye conversation that is you just got out two years ago I was 32 years ago has the amount of student loan indebtedness is you see it having kind of like moral hazard or weirdness to the profession of Dentistry I mean are people making a lot of different decisions based on their student loan indebtedness like as opposed to specialize or GPR get a job or did you think it's been perverse incentives having two hundred eighty four thousand dollars in student loans on average coming out of dental school 

Dr. Marc J Novak: I do I mean I when you look at the numbers you just compare obviously inflation all these different things what it cost you know twenty thirty years ago it's a vast difference now however I think it weighs out a lot of people that say you know okay well I just spent let's say to our eighty thousand to go to dental school they may have a hundred thousand dollars in undergraduate loans that have been compiling interest for those four years and in a way with other things weighing on their mind whether they're gonna get married buy a house it may be more difficult to justify six more years of oral surgery training when you're concerned about those finances going forward that being said if you choose to make the investment in yourself and bet on yourself to become a dentist or an oral surgeon then it just means that in a way you have to also have the priority of being smarter with the finances that you have coming out it I think it's definitely become in a way perverse it's very difficult when you just look at the rate of interest and you know there's people who could you could pay $10,000 a month you know for let's say a full year after you get and you really only put maybe like a twenty thirty thousand forty thousand dent in your actual loan principal and that compiled over many years is it's difficult to do because I don't know who's paying ten thousand off for their loans right now so I think it does weigh on people I think the smartest thing you can do though is even if it's almost what seems like a minuscule amount like a hundred dollars a month anything paying back toward your loans as quickly as possible becomes the best investment you can make in the early run versus people who just say well now I have money to put in the stock market now I have money to you know put into this rental property this house you know it's sort of I personally hate being in debt I would rather chip away at the debt that I have accrued and look at that as paying down the investment that's sort of weighing on me right now

Howard:  I'm gonna ask you another question um we're seeing a lot of people get out of dental school and they didn't get accepted to orthodontic school you know and and instead of accepting no they find it worth it on my program in the Caribbean in Central and South America in Eastern Europe what do you think what  do you think of the decision let's say you really wanted to be an orthodontist you came out of school two years ago it was no but you found a place in the Bahamas that but except you are you seeing much of that is it do they work their way back in the fold does anybody even care where they went to school because you can you if you have the money you can just go to any  graduate school I mean I've been to these schools all over the Caribbean um you know if you got the money that they'll take you or are you seeing that or are you not seeing that much 

Dr. Marc J Novak: I personally haven't seen it that much but at the same time you know I think far be it from you know certain programs to say you if your passion is orthodontics you know orthodontics is its own sort of monster in terms of you know if you want to just be doing orthodontics all day but you're sort of being told well too bad do crown and bridge then you're going to want to go to whatever Avenue and lengths you have to persevere and get in Orthodontics program I don't know personally about coming back into the fold for those orthodontists or you know oral surgeons or however those training programs go but if people are really gonna like I said make the investment in themselves and they feel as though they have a better shot of going to the Caribbean or something like that to get their education versus practicing for two or three years in private practice and then keep applying year after year for the prospect to get in then I think people should bet on themselves if they're that confident that is interesting also one of the things

Howard:  I love when you talk about is um creating a young dentist executive board with mentors across different disciplines I mean it's one thing to think that you're doing a residency but you can have an eternal residency if you have a mentor so so what does that mean to you creating a young dentist executive board 

Dr. Marc J Novak: so that was a philosophy that I got from one of my attendings at the hospital who came in to talk to us a little bit about what to expect in a way getting out and one of the reasons why I wanted to go to Morristown versus a program in Connecticut I've been in Connecticut my whole life was a lot of the programs from Connecticut have people who were trained at UConn so you want to learn these different viewpoints and different aspects from different people but more importantly than that is if you go out and private practice and there's one other doctor there with you can learn some great stuff but there's also the potential that you could pick up some bad hat so what I mean by the sort of young Executive Board is there are certain dentists who are out there that are you know I'm sure you've seen they are their techniques they're their way of practicing in terms of they're just hand skills in the way that their crown preps look you know those the guys you want to learn how to do crown preps by there's also some dentist who own six seven eight nine practices so if you look more on entrepreneurial route or you want to look into investment in your practice maybe that's somebody who you want to make sure that you have contact with in the future and you know you let them know this is what I want out of my career and I'm making sort of like an executive board and I want you to be a part of this the three or four dentists and specialists who I went up to then I talked to personally said I want to make you a part of my sort of quote unquote executive board they were they were happy to you know be a part of that and they have so much knowledge that they want to share and if you can take the viewpoints of five to eight different people and create your practice around that it's like playing sports you may have a coach that does things that you really liked and did things that you really hate well if you ever become a coach you want to do more of the things that you liked and less of the things you hate so if you have eight or nine coaches growing up and you have eight or nine different viewpoints that sort of becomes the  crux of what forms and you know like Jim Calhoun Mike sous-chefs key and all these other coaches out nice even that's how they get to where they are so if you want to learn to be the best you try to find a way to learn from the best we're already doing it 

Howard: nice so um back to maybe moral hazard of having so much student loan debt or perverse incentives or whatever a lot of kids are asking okay when I come out of dental school are some areas of Dentistry more marketable than others let's say she doesn't want to be a specialist but she said she's picking between should I learn Invisalign or place implants I'm sorry doing the AACD or maybe one of these sleep apnea organizations would what do you advise her to do supply and demand from being where you're at now what do you think society is willing to demand more that they need a supply of then say other areas

Dr. Marc J Novak:  just from you know a sheer numbers standpoint if you're going to choose to do a residency or even go into private practice right away I think that the most that you do the most amount of procedures and things you should really get good at is your bread and butter you know restorative crime rage and  the dyes and you need to get better at those procedures in terms of your efficiency right so if you want to do you know Invisalign and those kind of things but it takes you four and a half hours to do a root canal that's going to balance out to the fact that you may not have had the most productive day so my goal on residency I think the goal of a lot of people when you first get out is to get better at those procedures that you're going to see in and out every day and be able to manage them after that and you know you feel so you have a good grasp on them you know I guess what most people are looking for in a way would be something like Invisalign to straighten their teeth now don't just take the course ago I took this course now I know everything about Invisalign it takes a lot of practice and like almost like a whole nother realm of school in order to do Invisalign and do it well because it's just like anything else if you do a crown the crown keeps falling off for the patient because the prep wasn't done well they're gonna come back and have problems if the Invisalign was done but you have you know keep putting the patient and refinement trays and all these other things because you don't have the full education it may not be the best investment of your time so my viewpoint has been I wanted to use residency to get better at crowning big bridge working efficiently and my endo and it's really paid off for me in private practice for when I was able to moonlight starting in January of my residency with dr. policin who I work for now and I'd be able to go in there and they will you know this guy you know needs a root canal are you okay with that we yeah put him in the chair let's go so it gives you that confidence to go forward with procedures that walks through the door every day I don't know how many times you really see somebody say you can walk to the door and say oh I need veneers or you know I need Invisalign but I would be willing to bet that it happens far less than somebody saying this tooth hurts over here or I broke this filling you know on the side here so for you to be able to work those people into your schedule and learn how to do it efficiently I think is the most important thing that you can get down being two to five years out of school the full-mouth aesthetic cases that you see people going to the you know complex Invisalign to learn your own ortho to sleep apnea those things will come in time but if you're dedicating most of your time to learning sleep apnea and you haven't been able to get your crown preps under you know an hour and a half there becomes a balance that you all of a sudden don't manage your time very 

Howard: well in private practice when you told them that yeah can you do this routine on you said yeah throw them in the chair I'm ready to do it right now did you say in the voice of Maximus when you were in gladiator or more of Jim Braddock when you were in the Cinderella ban uh

Dr. Marc J Novak:  probably more I'm more of the gladiator but less of like a like a gargling tone to it they to probably it was more like yeah okay

Howard:  hey another question under the GPR deal was a these kids again because of student loans are asking questions on dental town under these GPR topics um do you think they need to have disability insurance and life insurance I mean you so you're single you got all these student loans should they really be getting disability insurance or life insurance during a residency or you just bare bone in it you're single you know you get ran over by a truck you know whatever I mean what were your thoughts on disability and life insurance during residency 

Dr. Marc J Novak: I mean as far as disability insurance goes it we had the benefit of our program was we didn't just talk to dentists we brought in financial advisors we brought in dental lawyers we had all these lunch and learns with different people and one of the ones for the disability insurance was do you guys like being dentists yeah what else do you like to do and if someone said you know I like going skiing alright what happens when you're skiing down mountain and you hit it like you hit your elbow against a tree and you all of a sudden have nerve damage and you can't work oh you know for just getting us good it's little things like oh I guess I didn't think of that you know you know being you know late 20s you're like I just want to go out and have fun and go skiing but now your livelihood has to be protected so I would definitely recommend disability insurance as early as possible in your career and you know you can't be a dentist without malpractice insurance so that's gonna be an important one and you know for myself someone who is you know maybe not having a family or anything right now life insurance for me may be a little less of a priority but I know several people who are now Brad a dental school with two three kids even so life insurance should be a priority for you if you're now we gonna be a working professional

Howard:  so another question they're asking is um you know again what is more valuable know like there's a pareo there's oral maxillofacial surgery there's implants but there's a lot of ones that they're not so sure about like or facial pain sleep apnea there's even people asking like is this oral facial pain is this sleep apnea is that you know is that really going to be as important to say tario or implantology what would you say to someone who wanted to do a residency a focus on oral facial pain TMJ sleep apnea things like that 

Dr. Marc J Novak: I think oral facial pain temperament do Buehler joint discomfort especially when it comes to the procedures were seeing done now and suggestions that are being made with research coming out is going to be a bigger field in the future like dental anesthesiologist just became you know a specialty and so would you have thought maybe 20 years ago like a dental anesthesiologist being a thing not really so in a way who's to say that 20 years from now you know like a dental sleep apnea person who specializes specifically in oral facial pain sleep apnea and TMJ disorders becomes a specialty you know with more and more people you know going through the process of coming in gives you the diagnosis becomes harder and harder it also becomes more difficult to find somebody who has the educational background to assist these people with what is causing them pain and above all that's why they end up in our chair most of the times they're in pain something's wrong okay

Howard:  so are you married with children are you single without single doubt so that's another question um she plans on getting married right after dental school they're ready to make a baby is is getting married and making a baby and starting a GPR and a EGD is that are those things that don't go together or do they go together did you did you see that work out for some of your colleagues or did you see it to be a big red flag no 

Dr. Marc J Novak:  I saw it work out for  plenty of my colleagues in you know it's not to say that it will make things easier because obviously it won't but you know there's gonna be just an added variable that these people have that you know it's going to me he's gonna haven't had a challenge one of my co residents was engaged you know she had to work on planning her wedding during you know residency and she was able to still become an excellent practitioner while doing that raising a family and those kind things I've seen it done by some people who I graduated with who had kids you know right as soon pretty much as we graduated and then had kids right before residency or something but they made it work they were successful they got very good jobs after so that's not to say like you can't do these things or anything yeah I think as long as you have the knowledge that it may be an added variable and challenge for yourself but you're willing to go through that work because a family is really what you want then you should definitely again pursue that if that's what's going to make you happy and you know what you want out of life there's no need to delay it just because well I got into a residency now I can't do it I don't think that's really part of it at all

Howard:  you mentioned dental anesthesiology that's the tenth specialty that was recognized last year I mean I I when I got out of school there were nine and it took 30 I think it took 30 years later to add a tenth one do you think that's gonna be a big one like endo pareo pediatric all the others or do you think it's gonna be smaller like prosthodontics and you know public health or something like that

Dr. Marc J Novak:  I personally think that Dental anesthesiologist is going to have a bit of a exponential curve in a way I think it's going to start small obviously because there's only going to be X amount of programs that are accredited in order to have that program but even just today my office in Parsippany with dr. Gruber we have a periodontist who comes in and you know place his implants you know every other Wednesday just to like you know deal with the volume and of the patients who he was doing consultations with I would say three or four mentioned well can I be put out for this I don't want to be a wait for this procedure with the advent of you know smile in a day and all these call on for cases that people are now seeing you know advertised on just a basic cable people started saying well I might want to do that you know that it is going to be even growing put like part of the dental practice is beyond for the on six and patients are gonna want to be sedated for that so while general anesthesiologist may be able to do it somebody who also knows about the dental profession is going to find themselves and a lot of work I think in the upcoming you know ten to twenty years if you look at the way things are trending in dentistry for us yeah I couldn't 

Howard: seems like to me anything someone's done a big sample chose her sample size correctly when they took a sample they threw it back in the pool it looks like the United States about half the country is afraid of the dentist and half the country's afraid of the price so if you're addressing lower cost or less fear I would think dental anesthesiology would be would be very big I'm when someone you said Elizabeth pulled out of the matching system and just want to do her own interviews yes I find that very genius because I'm what I when I talk to dental school deans and we've had several on the program what they fear the most is that they're stuck for four years with someone that no one no one likes or wants to be around and they're like I don't care if you're a 4.0 you know you finished all your requirements when you were age five that they don't care they at the end of the day they want to hang out with someone they like so when you're applying for an AEG D or GPR or a specialty or any any job in dentistry what what questions are you asking what questions you think they should ask the directors of this program to decide if they're a fit I mean maybe that kid maybe they're a Cubs fan who likes to drink beer and there was some group of people that hate the Cubs that only drink wine I'm what what would questions would you ask if you're applying for getting in one of those programs

Dr. Marc J Novak:  I think the most important one that sometimes can be overlooked if you read all these things where they say if you're an interview then they say do you have any questions you should never say nope I'm good you know walk out that's like a red flag for the interviewee right there the most important thing I think you know because I  believe around this time of year when this is posted it'll probably be around prime interview season for residency's the first thing they should be asking is what are you looking for in a resident because what the answer from the people who you interview with what you get is gonna sort of allow you to drive the conversation a little bit more to make yourself present your yourself in a way that you seem like the best candidate for this program or yours that they may say like just somebody who shows up you know whatever you know does their work okay well I want to be challenged in a way maybe this isn't the place for me it helps you get a better idea of if you're doing the match process where you want to rank these programs some other good questions that I can remember being there is you know if you are in a CPR program and you're going to be taking call for the hospital like you said I believe it was eight percent of dental emergencies is what makes up an emergency room for per year yeah eight percent of donek Jordana genican or of origin I think by Korres since I would disagree we probably call it more like thirty percent the amount of time we spent in the IDI but you know you should ask and get an idea of what is the call schedule like am I going to be called in what can I expect as terms of the emergency department because there were times where there would be a lip laceration and they would call us at 3:00 in the morning and they'd say well we don't deal with the mouth well what's the difference between you know suturing over here by limp and suturing somebody's knee you know they just don't want to do it because they know they have dental residents the thing you have to know is our call schedule that we were on was one full week per month so we would go Thursday - Thursday and then hand the beeper off to the next resident and during that week we could you see anywhere from I had one week where I think we had I had maybe three or four calls in that week and it was it was oddly quiet but I didn't say anything I just you know didn't look at the beeper and in say they do anything but I was like this is great this nice week and the week after that I think we had something like 11 mandible fractures that we had to bring into the o.r just a day and pick them up so you never know what you're gonna get so along those lines how often would you say that residents are called per night what kind of procedures are you being called in for what can I expect in terms of what I am expected to handle in the emergency room so if for example if an emergency room resident or attending called me in and the patient had a laceration from you know the  bottom of their nose down to the front of their lip we're sort of told okay the  or the lip and the labial tissue is very fine stuff to deal with that's when you sort of say this is not for dental even though it's dealing the mouth call a plastic surgeon so you learn how to sort of define your role and but also knowing what's expected because there may be some programs who say hey if they're there we don't have plastic surgeons you got to put that back together if you're not willing to do so maybe that's not a program that you want to venture toward

Howard:  you know and here's another thing I want you to comment on because there's 56 dental schools United States there's hundreds of them around the world if not thousands and it seems a reoccurring theme as Ike I want to go to this dental school because they don't have any grad programs in endo and oral surgery in tario so we'll get to see the patients I've heard other people say yeah I did a residency I thought it was gonna be great had all this big name brand stuff but they had all these residents and all these special and if we went to the procced single-unit crowns they didn't want to do if we went to oral surgery it was the ones the oral surgeons they basically just got leftovers so when you're picking a GPR and a EGD or even a dental school um how much are you focused on are you gonna be the lowlife chopped liver getting leftovers or are you gonna get to pick these kids do you think that's a an issue or a 

Dr. Marc J Novak: factor definite factor a hundred percent you make a great point in that because some of the programs that I had visited or looked at the first thing I looked at was does it have grad programs for certain specialties and like you said you may get the leftovers because certain programs are they'll come in and through the triage process they may say this is a tough case you know we're gonna send this to grad profs I don't even get to see it I don't get to make the call of what I can do and can't do somebody else is that I don't even know is doing that so that's a definite factor the flip side of that that I would present is when I was in dental school we had the graduate programs when they were there you know when you're a fourth year and somebody comes in and you know let's just say they have a missing tooth and you want to do a bridge right you can learn about a bridge you can read about it but until you do it yourself it's  a stressful thing to try to learn and I feel as though at Connecticut I was very fortunate because we work almost side by side with the residency programs there were times where you know I can still remember I was worried about you know a pareo concern with a patient that I was seeing in an operative chair you know so the disciplines were sort of I didn't want to rebook the patient so you could go get a pareo resident dr. Billy Jay so remember and he would come over and say let me just take a look and let me tell you what I think he's there to just even give a 5 minute you know specialty console so you actually learn a lot from those guys while you're in school of how to approach that the next time you see it in terms of residency I wanted to be more so on my own and now start using what I have learned in school to try to take the next step and challenge myself to make these calls by myself but still have the attendings who I can bounce ideas off of the attendings that we had the hospital never said you have to do this or anything they were there just basically hanging around saying you know doctor you know get them in what do you think about this root canal well you know I've seen this before you definitely have to be careful because that root is gonna be you know curved distal and when you do this you have to bend your file 90 degrees to make sure you bypass that curve so if you didn't ask you wouldn't know so I think it takes a little bit of mission up on your part but like you said the I didn't like the residency program that had residents to do every little bit and piece of almost like a group practice that didn't function like a group practice

Howard:  so you're in a group practice now so you might have you've been in dental school that's group you've been in residency that's group you've been at you're in private practice now and to different ideals group um do you think that um you're it's just more fun to be in group or are you thinking of the final plans solo for

Dr. Marc J Novak:  you  know for the longest time I wanted to do solo practice and I've listened to the podcast and obviously we hear so often that you know the earlier you're able to buy when you feel confident long-term the better it will be one of the things I've sort of learned as I've transitioned into practice is the group practice model in terms of being able to have someone else there as a backup in terms of being able to manage family life you know in order to manage you know certain procedures like for example we have patients who come into my office that are sometimes get referred there and they need full mouth you know work it would be a very difficult case for me or one of the other associates I work with to do but dr. Gruber has been doing this for 30 years this is something that he does very well and so to have that as a resource when you're starting out is I think invaluable and I've almost looked more in - I think group practice is becoming a little bit bigger solo practice is excellent but if you're not there you're not making money for you know for the most part to have a group practice model where you're able to sort of have a little more of a work-life balance maybe appropriate if that's what you're in fact looking for a lot of my attendings were  in partnerships you know 5050 partnerships that were working extremely well between them and you know certain people have their patients or anything but other practices are like hey the patients are the practices patients no one person sees this guy or this guy and a lot from my experience I personally have been swayed a little more toward the group practice model at least for now then I was more so when I was coming out of school or residency and what why is that I just think for the  position I'm at now I feel very confident in the work that I do and the knowledge that I have but I still acknowledge that there's a lot more I have to learn in terms of patient management in terms of front desk management staff management you know the little things in a practice that you don't really know the ins and outs of yet to just start from scratch or buy a practice because one's available may be a little difficult and just to run that then by yourself could be equally as difficult or like I said put a new variable in that overall once I get some more knowledge or once somebody has more experience it could be beneficial to them to be on their own financially but it's all about weighing the options of what you're looking for and work-life balance I think as well 

Howard: and last but not least we went over an hour my final question over time question okay so you have finished dental school you did your GP are you did your a EGD that's all behind you what are you looking for when you were getting a job as an associate you're working with two different dentists right now you really had a lot of thoughts on how to choose a GPR what were your thoughts on looking for an associate job what were you looking for there yeah in

Dr. Marc J Novak:  you know coming out and having so many attendings it was we would get interviews and you know go to different offices I think I probably interviewed at about eight or nine offices before finally making my decision the biggest thing I believe you look for is are you going there to just basically be like a filler somebody who like somebody walks in the chair oh you'll handle this and just check cleanings and maybe you get fillings here there or you interviewing at a place that will treat you like an equal and for me one of the biggest things I was looking for was a continued mentorship somebody who I can learn a lot from the practice in Parsippany is a very large cosmetic practice it's very high-end and that's something that I would eventually love to work with but you have to learn how to manage those cases if you want to do high-end cosmetic dentistry so that's something that I wanted to balance with my office in Hackettstown it you know dr. Paulson is one of the best dentists I've seen in terms of patient interaction treatment planning and just you know getting patients to understand their dental needs and just beautiful work that's done with like high precision and just running his office well so there's a lot more bread and butter I would say with my Hackettstown office and there's a lot more advanced in my precipitate office I would recommend to somebody coming out for an associate ship trying to go between two or three offices if you're able to work in private practice because if you're able to pick up little things from one or two doctors to balance out you know you may like one thing that this guy does but hate another thing does and the other doctor does the other part really well and something else really bad so you can sort of pick and choose what you're getting from an experience and if you go to one practice where they say we're gonna work you know have you worked five days a week but you're not getting a lot of chair time you're just sort of sitting around well what you fit into five days a week there you may be able to fit in the two days you know full schedule between two different offices bouncing back and forth yeah and I think another thing that you might think and but you didn't say is um

Howard:  you you got a job in two place where one has her mastership in the Academy of General Dentistry and one has her fellowship in accounting general industry and I swear the people who get their FA GD and their MHD III figured out one year out of school they were happier they are more successful I mean dentist who take a hundred hours of CE year always get enough knowledge and answers to stay on the right trail have a happy prosperous financially successful career and that dentist he's all complaining that the stupid government's making him take these three classes to get his license renewed and is all obsess doesn't realize that so much of his unhappiness is because he doesn't know what he's doing in dentistry he's fumbling around his dinner his works not predictable but it was the fact that they had an ma Gd and FA GD - that was that did that register with you that that was something you were looking for 

Dr. Marc J Novak: definitely I just think Siemens and name and the letters after the name is if you're looking to be someone who's interested in continuing education it's definitely a factor because you're like okay I want to get to where this person is I want to learn from them how they  got there and I think one of the best outlooks you can have if you just look at a baby being born the most critical time for brain development is that first three to four years right and I would approach it no differently coming out of dental school the first three to four years of your dental development is going to be the most critical and set you on a path for how you want to pursue your practice and how you want to be as a dentist your  quality your standards so learning from something from different people about how to have that quality and have those standards I think is very  important and so if you can sort of transition out and take as much CEA as possible to learn from the people who have done it best you know I can't I came over who's Tony Robbins or not but someone had said some of the best minds in the entire world have condensed their life's work down to a hundred pages in a book for people to read and some of these you know huge you know cosmetic cases or whatever you're looking for I've condensed some of their times sometimes their life's work into 40 PowerPoint slides for you to like look into and try to master as much as you can and get the most out of it I think you need to take full advantage of that as early as possible to set yourself up for the next 30 40 years down the road 

Howard: and that last quote you said was what it's something along the lines of the that some of the greatest minds in the entire world have condensed their life's work and experiences down to a hundred pages on a bookshelf dude that is an exact line out of the beautiful mind oh my god he's just I don't even think he knows he's not Russell Crowe he's quoting the movie but hey and then and then one thing I am we gotta go word double overtime one of the things I said on you know there's so many books on leadership and leadership is too complicated nobody's gonna figure it out with geometry and calculus so go back to yourself what did you like when who were the leaders in your childhood was it was it your coach like I always thought that kids didn't follow their sports aptitude they followed the coach that motivated that made him feel good and  you know so why did some kids go into wrestling versus basketball or football or hockey or soccer and so go back who was the coach that connected to you be that person that worked with you and so that's you and what I would avoid you talking about those first three or four years or so development of you know the young dentist  says well you know they'll pay 25 percent but I don't have to pay my lab bill in this place pays 30% but I gotta pay out my lab dough hey what about one guy you admire and is motivating you and making you want to be a better dentist and the other one is a toxic piece of junk that makes you feel bad and want to quit I mean would you know if you could just and you know why Elizabeth Clemente probably dropped out of that matching program if matching programs worked then tinder should be able to marry everybody in a matter tonight I mean if it really just comes down to artificial intelligence machine learning Big Data they should say you know who your wife is let me tell you it's this one right here and it's not that way it's so complicated and what I want these young kids to do is if you're working in an environment and say you're some big DSO and the and the office manager is bullying you and making you feel bad and you're not re reaching your goals do just walk just walk right now I can't afford you to burn out hate dentistry not like it anymore I want you to have a beautiful mind I want you to find a place where you  run 20 red lights on the way to work that you yeah you know I hired an associate about an hour after I over my practice because I just went from a dental school it's a hundred and twenty classmates to solo practitioner and I was so dumb what did I did I hire another kid who just graduated an hour ago as Bob Savage I was two kids I mean if I if I had a smart business mind I would have got someone 10 20 30 years experience but what I wanted I was in my sandbox playing dentistry and I wanted another buddy to play in my sandbox with and the most fun years when it was like me and Tom Giacobbe and Sam dominic and I mean it was like three people with a shovel playing in a sandbox every day and man if you're running red lights wanting to go to work because a you mostly want to see the people at work when you get there and that's why I've got a bunch of people that have been with me 20 years because just they're  having fun and it's not toxic so that is so important I see people burned out depressed hate dentistry usually at the somewhere in their life is professionally personally somewhere there's some toxic monkey in there that needs to be edited out of your life so just  if you want a beautiful mind stay motivated find someone is their fa GE their ma g during the a GD because those people actually like dentistry there's a lot of people who hate dentistry 

Dr. Marc J Novak: yeah like you said even when interviewing it's maybe something that didn't stick out as blaring the obvious but I believe dr. Paulson and dr. Gruber both of their primary assistants that they work with had been with them for at least 25 years 

Howard: I know in my mind quit like an hour before she made her 30 years this is like can't you just stay like another month just so I couldn't say you stayed here 30 years but but yeah that that's you know just ministries fun and life is fun and I think you're gonna be a summary of the fight people you hang around the most with and so of all five of your dental friends all hate dentistry and they just want to meet at a bar and drink and talk about how horrible dentistry is well then you're gonna eventually think that but if you find five guys that would rather do a root canal than play golf my god you're gonna have a fun career thank you so much for coming on the show today and sharing your your thoughts on this stuff you're fresh you were just in at all just two years ago I was really an honor to podcast you thank you so much for coming on the show thank you had a great time pleasure meeting you and what is what is your next movie uh damn still not sure about all but I always laugh at like the old like daily shows and stuff that they have like making fun of Russell Crowe and everything so alright buddy have a great day 

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