Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1255 Dr. Nada Albatish - "I Don’t ‘Sell’ Dentistry" : Dentistry Uncensored with Howard Farran

1255 Dr. Nada Albatish - "I Don’t ‘Sell’ Dentistry" : Dentistry Uncensored with Howard Farran

9/22/2019 6:00:00 AM   |   Comments: 0   |   Views: 65
Dr. Nada Albatish owns and operates a multidisciplinary practice, All Smiles Dental Centre, just north of Toronto, ranked one of the 500 FASTEST GROWING COMPANIES in CANADA.  She serves on Faculty for Clinical Mastery Series, and is currently launching an exclusive online business training program for dentists called the Brilliant Practice Mastermind.

VIDEO - DUwHF #1255 - Nada Albatish

AUDIO - DUwHF #1255 - Nada Albatish

As a passionate learner, she first completed a one year GPR, followed by hundreds of hours of CE each year before she started working in dental education.

Nada started her current practice from scratch as a solo practitioner and quickly realized she needed a strong support team as well as a team of skilled doctors in multiple specialties to help her achieve her goals as a comprehensive dentist. Today, Nada’s niche is complex and rehabilitative dentistry, supported by a team of 30, including general practitioners and specialists.  She is passionate about what she can do for patients, always excited about training and advancing her team, and she is energized by sharing with her colleagues. She loves to create opportunities for her patients, team, and colleagues to help each reach further than the success they thought possible.

She is an entrepreneur, clinician, educator, author and loves to help dentists achieve excellence, predictability, and confidence in their craft. She is committed to the success of her patients, colleagues, and the advancement of the dental profession at large.

Howard: it is just a huge honor for me today to be podcast interviewing dr. Nada Albatish: DDS who owns and operates a multidisciplinary practice all smiles dinner Center just north of Toronto ranked one of the 500 fastest growing companies in Canada she serves on faculty for clinical mastery series and is currently launching an exclusive online business training program for Dennis called the brilliant practice mastermind as a passionate learner she first completed a one-year GPR followed by hundreds of hours of CE each year before she started working in dental education not as started her current practice from scratch as a solo practitioner and quickly realized she needed a strong support team as well as a team of skilled doctors and multiple specialties to help her achieve her goals as a comprehensive dentists today not a niche is complex and rehabilitative dentistry supported by a team of thirty including general practitioners and specialists she is passionate about what she can do for patients always exciting about training and advancing her team and she has energized by sharing with her colleagues she loves to create opportunities for her patients team colleagues to help each run further than the success they thought possible she is an entrepreneur clinician educator author and loves to help dentists achieve excellence predictability and confidence in their craft she is committed to the success of her patients colleagues and advancement of dental professional large um it is just a huge honor to have you on the show today thank you so much for coming on the show how is all things Toronto doing 

Nada Albatish: excellent thank you so much for having me on the show Howard I'm a big fan oh thanks um you say you have three worked passions functional and cosmetic dentistry the business of dentistry and dental education and

Howard: I am wanted to know how long was it before you graduated before you were an owner operator of your own office how long would that take

Nada Albatish: so I graduated in 2007 I did a GPR for a year and in 2009 I open first practice so it was two years from when I got my DDS in one year from your post graduation 

Howard:I'm what I understand seems like my generation I'm 57 please don't tell me I'm younger then I'm older than your dad it seems like we came out of school and just open up our own practice but today it seems like so many people graduate and they do have five or six or seven different associate jobs in five years before they finally say I'm so miserable I'm going to open up my own why did you agree with that that they're at taking longer to open up their own practice you know what

Nada Albatish: I do I've definitely seen that trend over time myself I think it has something to do with the rising school as opposed to what it used to be before and people getting things under control in their own lives before they move on to sort of the next step and the investment in practices now is a lot more than it used to be even 20 years ago or 30 years ago so I definitely think it's something people are taking time to do but one piece of advice that I'd give doctors just based on what you just said you know they're opening practices when they're just miserable enough to want to work for themselves is that if that's the goal like you're miserable and you just want to be your own boss and that's the reason you want to open your practice you're buying yourself a very expensive job so a dental practice is a business so I think having a passion for running a business probably sets you on the path to success business mindset is that sound

Howard:  let's talk about that do you think some people are saying that one of the rises of DSOs is because a lot of dentists who graduate today don't have the business mindset like they might have thirty years ago do you think thirty years ago when I got out of school more dentists had a business mindset than in 2020 

Nada Albatish:  I think that if you look at every industry I think dentistry is just a little late if you compare to other industries when it comes to business so private practices in medicine and pharmacy actually saw the corporate world before dentistry did so I don't think that DSO is coming moving the more recent future has to do with it has to do with 20 years ago people being better businesspeople and not being as good business people now I think that we all graduate from school without business training I think you you get a dental degree and you have a license to potentially own a multi-million dollar business if you can do it right and in that you're basically a CEO and you've no business training and I think that was always that way 

Howard: before we get into next question I think it's a timely question on the smiles direct Club is probably gonna go public this week they're their IPO is all set for this week how does the business of ortho and something like smiles direct how does that set with you 

Nada Albatish:  that's a really big topic and I'll say that I think doctor directed orthodontics is more professional and ethically responsible than non doctor directed orthodontics but I mean it's it's a huge business the IPO I saw last week on the news is set at 1.4 billion dollars so there's there's clearly a market of going direct to consumer what I'm doing and what we all are doing if we're operating a dental office is a completely different business and it has a completely different value to the people that you're actually helping and that's sort of what

HOward:  I focus on you know III when you're my age you've seen every rodeo for the second or third or four time there's almost nothing new so I lived through this rodeo when every dentist back in the 80s had a scream bleaching business on me Omni pharmaceutical out of Arkansas came out with a carbamide peroxide 10% everybody was bleaching for like 250 an arch it was a big business and then crest clear strips came out for 50 bucks over the counter and it's just competition we were probably charging way too much at 500 and that brought it down but you know it's just competition I think competition is good for all markets but so um when you got out you say your three work passions functional and cosmetic dentistry where does that come from

Nada Albatish: well that's that's been a long journey and education for me to learn about occlusion and so where that came from is that when I graduated from even not just school but also my GPR I was really confident in single tooth dentistry and so that's that's everything you learn in school it's carries imperio and I'm treating every tooth for what you diagnosed and that single tooth without really looking at the entire system how it all relates to each other how how it's working in the body how things are breaking down as a function of being related to each other I mean one tooth is not in a standalone sterile environment it's in a mouth which is part of a muscular system which is part of a body that can have other issues that are impacting the health of the teeth and so slowly over time I started to see those things and see some of those breakdowns and really want to help my patients more so I went and I started on a path to learn about occlusion and my husband would say like what is occlusion and I'm taking these courses and I couldn't even answer the question like I think like it I think it's the bite that's what occlusion is but what I learned over time is what it led me to is really it's about wellness it's about being able to do dentistry that works and works lasts longer and is more predictable you know when they come out of school that's kind of where they are they're they need to come out and start practicing it was like football you need your basics a pass a catch you know a tackle a block they need to come out and do a filling a crown you know just the basics how far along when they get out of school 

Howard: do you think they're ready to start the journey from 1 to tennis tree to quadrant 2 arch to full-mouth I think that it's going to be dependent on the person

Nada Albatish:  I think that once you're comfortable and everybody takes different amounts of time to get to comfort but once you're comfortable once you're competent you're unconsciously competent of what you're doing you don't have to think about it remember the first time you gave an injection I remember the first time I gave an injection it was to my best friend in school my hand was shaking I was terrified to do it that was maybe didactic con confidence but not clinical I was not yet I was very conscious of every step I was taking couple years later I give an injection I don't even have to think about it anymore and I think once you get to the point in single tooth dentistry where you're unconsciously competent and confidently doing what you're doing then it's probably time to look at the next step and one way to speed that along like you don't have to take ten years if that's what it would take you without education one way to speed that along is learning yeah I I like that unconsciously company carries fair and 

Howard: so I I loved your article in dental town because it's it just hits the nail across the head I'm so many people I mean most dentists your article is called I don't sell dentistry a doctor's mind set by dr. nada Alba Tisch February 2019 and they had a lot of debate after it and the bottom line is I mean I've been in us for 32 years if I ask a to us would you like to sell dentistry they all say no and it's like it's like it's like wow I mean the average American will buy thirteen new cars between the ages of 16 and 76 and the average car price will be thirty three thousand five hundred and then 95% of dentists will practice their whole career without ever even presenting a full mouth let's redo so so talk about your article I don't sell dentistry a doctor's a mindset

Nada Albatish: so this article first of all thank you so much thanks for allowing me to publish that and and thanks for the real positive feedback I'm honored to have been in the magazine and so this article actually stemmed for me from a conversation I had with a colleague I respect a very very much and then bumped into him I didn't at an educational event so we had both signed up for a course and we didn't know that we were each there and he said to me oh my goodness like you're you're just like selling stuff all the time and you're you know he was kind of talking to me like not like and I was taking it back a little bit and I said to him we need to have a conversation I don't sell dentistry he knows though and he's worked with me for a long time so he knows the kind of dentistry I do and he's seen the photo the before-and-after photos of my work and he sees some of my patients and so he's like then how are you doing all that dentistry and that's where my idea from the article actually stemmed from is that his thought process and I said he's an excellent clinician I admire him so much but his thought process is the same as many doctors if you're doing this you must be selling you must be you know doing something to push this stuff on people and I find that actually kind of offensive and that's where my title came from I don't sell dentistry what I do is I actually connects with patients and I can do something for people to help them on a different level and the type of Dentistry that I could provide twelve years ago the day I graduated and I want to do that for them because I know you know I'll tell you from the first time I balanced somebody's bite I learned how good I can make somebody feel by doing what I do and that's what I can offer them and if that's up their alley that's what I'm there for and if it isn't my practice offers everything anyway we're a general practice so we can help them in any way that they want and so that's the way I say I don't like even the term case acceptance and the way it's commonly thought of in dentistry about being you know low percentages of case acceptance if you offer ten people treatment and one person will say yes well if you listen to your patient and you actually know where they're at and what their goals are and offer them something II tell them everything but really tell them what's really going to work for them it's time in their life why can't your case acceptance rate be well over 90% yeah and

Howard:  you know there's this in every single zip code of every city in the u.s. you know you have all these dentists that blame everything on the economy insurance Delta you know everything and it's like okay well you're in a small town and there's this doctor in your small town who's like you Monday through Thursday 7:00 to 4:00 you know or 8:00 to 5:00 whatever but every Friday they go in there and anesthesiologist comes in there and put some sleep and they do some big five ten twenty thirty thousand dollar case sometimes you know fifty and they do this thirty forty Friday's a year and this guy is doing you know one and a half to four million a year and you're right next door in the same medical dental building and you've never done this one time and you're as old as I have and I I just don't and and even the word selling dentistry I mean you know if you what would you be insured and selling I mean maybe as a bass boat maybe as a $90,000 bass boat I'm like if that's your passion get out of dentistry go sell bass boats I mean the guys that buy these bass boats the guys that I mean I've done full mouth rehabs were when she saw the mirror she had to take a knee I mean just overwhelmed it's like why don't they believe in themselves and some things I think it's it's you know you and your article you talk about establishing a rapport with your patients well everybody except that a dental school is accepted because they got A's and math and chemistry and biology and physics and that's not necessarily your party person in a fraternity who can go into sales do you think dentistry attracts the wrong mindset to establish a rapport with people do you think they're not people persons 

Nada Albatish: that's a really interesting question I've heard that I've actually heard that before you know what I don't actually think so because I think you can learn to elevate your communication skills and I think you can learn leadership of course some people might naturally be a little more apt for it but the reality is and we've learned so much just to become dentists dentistry is way harder than any of the stuff we're talking about that's the truth like doing a crown prep and all the details in between and doing 28 crown preps at the same time even is way harder than actually just listening to your patient I'm getting to know what their needs are and so I think I've learned from some great I've learned through some great people over the years but I think that you know just having that growth mindset and recognizing it before you even went to undergrad and before you went to dental school you didn't think the way you think now so I don't think it's hard to shift the way that you're speaking of people by listening to people who know how to speak to people who have learned that skill already and really finding the right mentors yeah and

Howard: you and I both know the best salesmen in dentistry Pete Janicki ran dental town sales for ten years and it was all just establishing rapport being honest being transparent I mean it's so so why um so what so so go through that so you you meet me as a new patient my what are you doing with a new patient to establish rapport that you think gets more you you're not in really a richie-rich area right

Nada Albatish:  no I'm in a very very very blue-collar town so you're the blue car insurance yeah and

Howard:  I grew in Kansas which is the most blue-collar and they have no problem spending $50,000 on f-150 if you got a little more money you buy an f250 and if you really want to rock the boat it's an it's a 98 thousand dollar f350 and they sell these all over the state and then you'll go to a dental office where every third patient pulls up in a fifty thousand dollar f-150 and and they walk out getting an mo d composite on number three in a mouth that's that that's tanks so also how do you do the new patient where you think you can co-discoverer and get them to do more comprehensive cases like you publish 

Nada Albatish: okay so I'm gonna take one step back from the new patient before that patient ever comes into your practice you need to be able to see what's wrong what's wrong with every patient is not only carries and pareo there's more going on there and not only do you need to be able to see that but your team also needs to be able to see that you know you you create a job for yourself by being the only person who knows everything and making everything reliant on you but what I can promise you is that your team members are really smart people my team members are smart and your team members aren't smart hire smarter but they are very very capable of learning and what you've learned so that they can actually have the same conversations with patients so baseline number one get educated so that you know what you're looking at number two your peach just come in in my practice the way I've set it up because I do have a busy practice at this point so the way I've set it up is that my team actually initiates those conversations and I actually schedule enough time for my team members to talk to patients it is not a factory and it's not just about a hygienist getting in there and doing as many scale polished Florence as possible it's also about having some scheduled time where they can actually talk to the patient about their previous dental experiences what their goals are where they think they are in their dental health and what's their ideal but where do they want to get to because when someone just tells you that point-blank you know exactly where you fit in to help them get there and so all this really boils down to is conversation and what conversation boils down to is not just you talking above people's heads it's also really becoming a very good listener and that takes practice

Howard:  yeah the people skills I you know my last book was people time and money I even said if you get the people's stuff right you may in people's stuff you can get it a C or a D in time and money I mean it just if you got the right be like you talk about the right people on your team aye-aye-aye so many practice management consultants say that when they walk into a dental office you can smell a million dollar practice instantly the other 99% you think you just walked into the library so here's doc Eastman is eight years in the library you know what I mean so when he hired his receptionist he he just got whoever reminded him of his favorite librarian and when you when you go to dental conferences all the dentists go by themselves it's like how do you how do you transfer this to your team so so go back to people time money your staff do you take your staff with you to continue education how do you get more people that are on board with your type of practice 

Nada Albatish: so I do occasionally take my staff with me to education depending on where we're going it's a pretty big investment I have a pretty big team and most of the education I do is in the United States so for us it's a really big venture and we've done that together what I do consistently is every time I go anywhere and learn and I expect myself to come home and implement I scheduled a meeting the week after so if I've gone away for the weekend and I'm invested in myself I am planning already when I come and if I have a long flight it's even better because I'm disconnected and I'm actually making notes and planning how I'm gonna relay this to my team and what I do is I come home and teach my team and that makes it so that we're actually implementing what we shoot what I've chosen to implement out of what we've learned the other thing is Howard I have weekly team meetings and things that I talk to my team about are things like my goals my vision for the practice and we share together and talk about what our individual core values are and what our core values are as a team so that we're in alignment and the other thing is I don't really have a problem recognizing if someone's out of alignment and whether that means that they need to change seats maybe have a different role on the team or whether they'd be happier elsewhere

Howard:  yeah the other thing I think is bizarre and dentistry is they they don't see how Walgreens and Kroger make the most money in distribution you know Southwest and fights it seems like dentists we think only think that the only money in food is a Ruth Chris in a rich area in Beverly Hills and Scottsdale and PBS gain they don't realize how much money sits in the middle class and I've always said that a percent of the dentist that are trying to be like you or chair chasing the richest 20% of the population and if you just realize that the that the middle class sometimes they eat a truce Chris and sometimes they eat at McDonald's they all have money if you can convince them if you share with them what you know what's available sometimes they're not in the mood to read fixing up their mouths and sometimes they are in the mood do you need any technology to do that I mean is there is there something technology why he's like CB CT or internal camera or something in your communication that helps you do this or is it or not really 

Nada Albatish: so that's a really great question and there are a lot of great tools out there and I hear from a lot of doctors lots of things they do including getting cases waxed up so they can show it to the patient and sell it to them after they've done the records in the wax up and I'll tell you probably the best tool that I've ever learned and taught my team to kind of help us show patients so that's possible is photography which is super super simple and the best thing I used is you know a stitching app on my iPhone and stitching a before and after photo together to be able to show a patient what's possible but for me I actually just have these conversations with patients and I don't need any tools outside of communication in order to get patients to get started and it's just because they want it they want it they ask me when can I start and sometimes the challenge becomes how soon can I get them in and am i traveling to teach you know 

HOward: on dental town one of the most impressive dentist known to man is Velo Greek and we've had him on the show and he says after your article such an impressive read the maturity of a professional learned earlier rather than later please take the time to read not as bio then read it again there is a reason for success so again these kids come out of school they're $274,000 as soon they think I already are you paid for the dental education what would you say to a kid he just got out of dental kindergarten three months ago and says I I don't have the money to keep learning I already did that for eight years that part's done now it's time to go get a job as an associate and start paying back that student loans Wow how was your mindset to keep going to keep learning to keep pushing

Nada Albatish:  so I love that question and I've been asked that so much within the clinical mastery courses as well and you know what I remember when I was almost done school like after I wrote my board exams in my last year and I was so tired of sitting in classrooms and studying I thought I can't wait to graduate so I can never sit in a classroom again so I was there I was I thought very much the same way I did decide to do a GPR because I thought it would accelerate my getting confident and comfortable and the really crazy thing was when I did that I quickly realized once you graduate when you learn it elephant catapults you like your confidence from even a weekend course and something that you have worked curious about I think maybe because it's optional and you're like open to learning and not forced at that point you just can do so much with that so the advice that I would give is don't stop learning I think you're either growing or you're dying you know so if you're planning on stopping you're just gonna stagnate and you're gonna become one of those people who's frustrated with dentistry and you're gonna see some people doing really well and you're gonna wonder why that's not you and what I can tell you is if you want to do well in in any field in every business you have to keep advancing yourself and even if you just take one course every six months once a year or twice a year choose something that you're curious about that you enjoy that you see that there's more to it than what you're offering and take a course take one weekend course in it and see what that does for you because once you start seeing what you can do with that you'll realize like I did like at some point I started taking tons of courses after I realized how much I could get just one course

Howard:  so you mentioned on clinical mastery and I love the founders of that picha Nikki his wife Jen Janaki so to those homies that don't have heard of clinical mastery calm and talked about your journey and what is clinical mastery calm and why are you on the teaching faculty for them

Nada Albatish:  so clinical mastery series is an occlusion based curriculum so what we teach is we teach dentists how to become comprehensive dentists how to look beyond one tooth look at the whole mouth look at the whole system and eventually the goal is when we're done that they can confidently do cosmetic cases and rehabs and bigger cases than they could ever do before so that is really something that changed my practice there's a lot of different teaching institutions that teach similar things what I loved about clinical mastery is the practicality of it and the fact that everybody who teaches on faculty is actually a practicing dentist and we're practicing general practitioners so we can really make it practical and applicable for a GP to be able to do it at home so that's that's what that's all about so

Howard:  so is all of is everything they guess people listening might be wondering what do they teach what do they not teach is it basically all restorative occlusion cosmetic dentistry like they they might be wondering if you learned all this do you also do endo do you place implants what what do you do and what do you use an extended team for okay so I'll tell you a little bit more about cocoa mastery and then I'll answer the team question and 

Nada Albatish: so clinical mastery we have three levels of courses where we teach an occlusion restorative curriculum and then we have Jason Olinsky runs and esthetics course John nasty runs a full mouth rehab course where you can actually watch them prep and seat cases over the shoulder Lee Geary runs a amazing photography course we also now have a sleep course and created based on demand I'm actually creating with John nasty program called the brilliant practice mastermind and that'll launch in early 2020 and that is basically about the business training that we didn't get in dental school so we are really multifaceted and it's really about elevating our practices from single tooth dentistry to being being able to provide comprehensive care for our patients and now you asked about what our team's look like and we're all a little bit different one of one of the faculty says he prefers to have a supra gingival practice so I mean there we're all a little bit different we've got people in faculty who are heavily heavily surgical so they do tons of implant dentistry in conjunction with the rehabs but what I'll tell you is we're all doing some amount of regular GP work in addition to the rehabs and for me I've actually honed in on the cosmetics and the functional dentistry because that's what I love and I love the reward of being able to actually change a patient's smile by changing their teeth I didn't you just to feel that when I was just doing mm do so so now I actually feel like I'm changing somebody's life when I do this for the better so that's what I do and my extended team involves everything from endo to pareo to surgery to anesthesia because I need all that to work together to be able to deliver what I'm doing and what the rest of the team is doing even if the patients aren't getting full-arch dentistry we still try to treat them comprehensively so he said he was so funny it was just a joke a Supra gingival practice a Supra gingival practice there's a range right

Howard:  that is hilarious I've never heard that before a super general practice so um so who is your target audience who's going to these classes to where they say this is obviously you're making a lot of people happy because you guys are really busy all over the United States so who's your target market do you think

Nada Albatish:  so I'll tell you we actually get ducks coming in from all over we do get a good group of people that is constantly coming in from dental town but mainly they're just doctors that recognize there's more to it so they're doing the bread-and-butter dentistry and they're recognizing that maybe there's something missing and they'd like to do more or they're seeing other doctors doing more and they want to be able to do that some of them are practice owners and some of them are associates and they all sort of have the same goal to elevate their patient care 

Howard: yeah and on the on the faculty who do you think is more handsome John nasty or Eric farmer the bald guy he's the most handsome guy on the faculty I think you should try shaving his head um you know what when everybody everybody comes out of dental school and they say okay I'm $285,000 in debt the first question they're gonna ask so I'm gonna throw you under bus for this do I have to buy a hundred and forty thousand dollars serac machine to be a cosmetic dentist like you 

Nada Albatish: so you you don't the answer is no you don't you need a good lab technician is what you need in order to do cosmetic dentistry and what I'll say is that I don't have a CEREC machine so I've been practicing twelve years I'm focused on cosmetics and what I found for me is that I kind of take a step back and tell you when I first finished my residency I wore all hats I tried to do everything myself I did surgeries implant placement specialty procedures everything and I did everything and I kind of got to the point where I what I wanted to build was a team of people that were individually skilled in what they do best what they're passionate about what they're what they're superpower is and that's what enables us to deliver the absolute best care and for my cosmetic cases I actually use gold dust in a lab and they their technicians are incredible and that's what provides me with the level of cosmetics and I'm to provide my patients hi

Howard:  Goldust era there right in my backyard there and I think Tempe Arizona oh that's right yeah yeah you don't have to so I'm gonna go through there's three things they thought of them things they can't be like you let's say by a hundred and forty thousand dollar cad game machine a hundred and forty thousand dollars CB CT and $100,000 plus laser so let's go down the list next to CB CT than laser do you have you do i have to buy because she graduated she went back to work with her mom her mom's got like this twenty five-year-old pano machine and and and so does she need to upgrade that to a CB CT 

Nada Albatish: you know that's a really good question and i think at the end of the day it is practice dependent and i think you have to do the math I mean you're a businessperson every single thing you buy needs to have a return and so do the math like what's your best case scenario how many CBC T's do you need in a month what is the monthly payment are you gonna make any money or are you just gonna break even how long is it gonna take you to pay for it is it gonna be totally obsolete by the time you're done paying for it like you got to do your numbers for me although I have a very busy practice and a routine League at CBC T's for my patients like every day I actually refer them to a radiology clinic where I get CBC T's with reports from the radiologist and I love that I'm working ready and I did the course on CB CT I get them to send me to CDs CDs so I can look at it myself but I mean I'm perfectly happy doing that so do you need all that stuff so that you could do meet to spend an extra half a million dollars on top of whatever you spent on your practice so that you can offer the best care to your patients and do really well and be profitable no that is baloney 

Howard:prove to them with their own behavior I I love pointing out to people where they already know the answer with their behavior on other issues so why don't you apply to this issue like like a like an iPhone I mean these guys get a different they upgrade their iPhone every three or four years do you really want to buy $100,000 CB CT and then use it for 30 years and you refer it to someone else and they read it for you they do in health care I mean you go to health care and they need something that your physician doesn't happen in the office so you're so smart on these things last but not least a laser some of these lasers are a hundred grand so again I mean you have to see what your passion is and what works for you I would say before you buy a laser take a course that would be my advice get educated 

Nada Albatish: so I wouldn't spend $100,000 on something that I didn't know anything about I would go learn and see in my patient pool can I actually apply that and what difference is it gonna make I mean hard tissue and soft tissue lasers you have to learn you have to learn and you have to see what what they're saying you can do and what you can actually mark it and is that actually gonna work so no needles right no need no needles with lasers does that apply to every case if you say that in your marketing are you gonna do it 100% of the time I mean those are all conversations you need to have having said that there are I've great colleagues and friends who really love lasers and practice with them day in and day out so I'm not saying that not doing these things is the right decision for you but I want to just focus on the core of your question was that if you're starting out do you need all these things so you know do be a business person you are a CEO do the math and 

Howard: what I have seen the biggest change in my 30 years as far as civilizations infrastructure is when I got a school in 87 only rich people could fly an airplane or they work for a big government or big fortune 500 company now anybody Southwest Airlines by keeping one eye on the customer one eye on costs they gave everyone the freedom to fly and I think the most important piece of equipment is a digital camera because I routinely see the people who are taking cameras and putting them on their website and they're saying this is my own work I did this people are finding that on the internet and they're jumping on airplanes and they're flying on Southwest for just a couple hundred dollars to the next town over and having it done and they're flying out of a town where I happen to know someone as their diplomat in the International Congress for oral implantology and is one of the best implantology stand Fort Scott Kansas if you go to their website you wouldn't even know that they like implants and so the the people who photo document their work and p.m. especially when it goes to cosmetics I mean I see it all the time there's a guy out here in Phoenix he's just crushing it in the cosmetic of work and he basically has he'll separate anything like a face job or a tummy tuck or whatever in like three or four major cases and then he's got like ten examples of each one of those case where it's all his own work and right now his his business dr. Shah it's almost entirely rework I mean he doesn't even do someone's first facelift tummy tuck or whatever it's all rework and they're all convinced by photography so I know Jason Lipsky he's big into photography he works with you guys but I'm get a camera start photo documenting your work also when you talk about something else I see a trend where we're gonna go back in time in 1900 health care is only 1% of the GDP there are no specialties by 2000 it's 14% of the GDP there's 50 specialties in medicine 9 in dentistry now it's 2020 there's 10 in dentistry and you have these kids come out of school and they say well I'm gonna master everything I'm gonna master endo pareo pedo profs I'm just gonna do it all and you're like really we're going back to 1900 how do you tell super motivated Batman that just on implants I mean just placed implants bone grafts sinus lists I mean you could barely learn implants and then you're gonna do all that on the side with endo peri opido profs how do you take some go-getter gangster who wants to who thinks 1900 we're going back to 1900 and say dude in 1900 there were no medical journals and now in the United States there are 40,000 b2b healthcare journals I mean take an eye there's guys and eyes that only do retinas so so how do you have a conversation with a 24 year old that's gonna learn every single thing on earth 

Nada Albatish: that is an awesome question and I'm sort of laughing to myself because as you're just grabbing this I'm remembering myself when I was 24 years old and when I selected my residency program I actually chose the residency program that had the least number of specialties so that I could do all the specialties with my own two hands I'm a different different human right now my new goal in life is to not grow everything with my own two hands because that is limiting me to my own two hands and but what I'll tell you is about about that young person who's looking to do it all I you know I don't think it's such a bad thing early on to learn as much as you can if you're doing it professionally ethically and responsibly that's kind of the rule in my practice if you can take on something as a doctor and do it as well as a specialist cut you've trained yourself that much and you're really passionate about it and you want to do the right thing for that person and you can do it well then go for it do it I think what happens when people start to spread out like that because I did that is that for me I started learning that there's actually things I like more than others and what you start learning as you get older is that it's you'll have a happier life if you spend more of your time doing what you truly enjoy and there's very few people who truly love endo perio bone grafts implant placement sinus lifts cosmetics like all the things very I don't know anybody actually I say there's very few people because I really don't like to say never but I don't know anybody who loves all of it I know and how you can test that for yourself is when you get those things on your schedule just think when you see an endo on your schedule are you like yes I have an endo today or are you like oh god that dreaded hour on my schedule right and start honing in on what you actually enjoy and when you do that you can you can take more courses in that and start to excel at that and then that's where the team comes in because the incredible thing that you don't realize that I didn't realize either when I was younger is that when you have a team of people doing thing that they're passionate about the service you can provide for your patients and how much you can grow your business is way beyond what you can do yourself way beyond so and that's coming from me I would I'm super experienced in doing it all myself working seven days a week relying on only me I mean it was it was crazy town and I'm in a much better place right now because I grew from there 

Howard: so talk about your your next journey you're gonna start the brilliant the brilliant practice mastermind and now you have two of us I give your dental office once on all smiles dental centres dossier and by the way she is Canadian so she spells senator cen tre yes so I may throw off all smiles dental centres that that's about and by the way the reason you see so many Canadian British words felt different than American words is because when America started printing presses it was paid for by the letter so everybody start taking letters out just like when I got out of school in 87 if you wanted to run a classified ad it was by the word so you would just say hygienist wanted end of story you know anyway but you have another website and dr. Abbott ich Dr Al ba t is H is that gonna be is your is your brilliant practice mastermind gonna be at dr. Abbott ich komm or a whole nother website 

Nada Albatish: so the brilliant practice mastermind is actually going to be it's something I'm wanting with John nasty for clinical mastery series so it's gonna be part of clinical mastery calm it's gonna be another page on there and and what what we created that for is all the doctors that we see coming to us during an offline after courses asking all these business questions and the real common things that dentists all struggle with and so we created this based on demand and the bottom line is this is the business training that we didn't get in dental school we graduated with our DDS or our D and E and if you got practice or if you're planning to start a practice or even if you've had one for a few years you are CEO and your potential like I mentioned before is to run a multimillion-dollar business and so what we want to do with this is give people the opportunity to create something that's more than just a job for themselves it's two crits to really think about it as a business and the company and apply real business principles into dentistry and that's what we've done to achieve our success in our practices and 

Howard: what will be some of the examples of the things you'll be doing you'll be teaching 

Nada Albatish: so I mean let me give you an example of something that many practice owners don't know a whole lot about their numbers well your number you start talking numbers many practice owners have no clue where they stand they don't know if they're profitable or not and if they think they're profitable they don't know how profitable they are and they don't know what it would be like if their own two hands weren't doing the work so that in itself is issue number one in the dental industry now if you take routine business training in regular business the principal is reading financial statements different types of statements profit and loss cash flows right and if you talk to business people even who own dental offices that aren't dentists in the United States they'll talk about that your cash flow statement and knowing when you're losing right and so what we're doing that's different is that what we're going to teach you is how to know from what's happening in your practice what metrics what reports what these can you look at so that long before you've lost anything you know you've got a problem and you know how to correct it and that's kind of the difference of taking those business principles and actually applying them as myself and John have into our practices and creating success with that and with these principles is how I grew one of the 500 fastest growing companies in the country which is kind of a big deal this is not one of the 500 fastest growing dental offices it's one of the fastest growing companies it's recognized in the business industry and what I had to do with that is take business principles and apply them into dentistry and make it work and continue to grow and be profitable and responsibly 

Howard: congratulations on that I mean it's it's so bizarre I had a conversation with a graduate yesterday he's been on school two years and he says that he believes that dentists as associates should just get paid a flat rate that way they don't have to worry about anything economically and just do what's right for the patient it's like dude they don't even have that in a Disney movie I mean I mean that was never even repeated by goofy or Donald Duck er where does where does the mindset well like like just answer that question how does someone come out of dental school and think that they live in some wally world fantasy that associate should just be paid a flat salary so they can just worry about doing the right thing I mean

Nada Albatish:  I love the question and it makes me it does go back to mindset I think I think you're the answer is in your question and I think there's two types of mentalities that we see in dentists one is an employee mentality and one is an entrepreneurial mentality and I think that someone who wants to be paid a flat rate so they don't have to worry and don't have to think about anything is really someone who's you know signing up for the comfort of working for someone and being an employee and you know what I don't really think there's really anything wrong with that only because there's also the entrepreneurs and those two people may be able to work well enough together because someone here doesn't want to run a business but the one thing that I'll tell you that I think people forget about when they're only worried about their own comfort being let me get paid a flat rate so I can just be comfortable and not have to worry about anything you're thinking that this is all about you you're forgetting that it's not about you if you want to be successful you need to be a servant to your patients you need to be a servant to your team you need to connect your your skills and your knowledge on a human level and give people something that's going to make a difference to them and if that is your primary goal patience first you can't you can't not make it work that's where success in dentistry comes from and so that's you know so my thought process on I would never ask for a flat rate myself because I think that if you actually learn and put in the effort you can totally blow the ceiling off flat rate I don't know why you'd want that

Howard:  um so you you say you want you own and operate a multidisciplinary practice what does that mean what is a multidisciplinary practice 

Nada Albatish: so we just we have multiple specialties and and it like I said it's in a blue-collar area so when I first started the practice the goal was treat everybody we were yes to everybody and we did that and so there's a lot of bread-and-butter dentistry happening to this day in my practice and that's the goal we do take care of kids and adults and we do sleep dentistry and there is a single tooth dentistry but the goal is that everybody on the team is able to look at patients in a comprehensive way and then anything the patients need that's a specialty procedure we have a specialist in the office that can take care of that that's what multidisciplinary is so we've got an endodontist we've got well doing the ortho that's one of my passions and we have an anesthesiologist we have a dentist that's doing the surgery 

Howard:so all all those things come together to for us to be able to provide comprehensive care for the patients in the same practice and people really appreciate that because they get comfortable with us so what all what are all the specialists you have really rotate they come by once a week once a month something yeah it depends on the person but yeah I mean especially you said endodontists anesthesiologist you do the ortho what what other specialist do you have rotating your office

Nada Albatish:  so we have well our pareo is actually off with a hand injury right now but it's pareo endo um surgery and anesthesia are the main ones I take care of sort of the TMJ and cosmetics as well as the orthodontics and then we've got a team of general practitioners that does the bread-and-butter dentistry and they love what they do and and the great thing is that our communication in the office being a multidisciplinary team means that we all have access to the exact same records for the patients so our communication with each other is top-notch if we want to talk to each other weren't there you know you can just actually just talk to the person you have to pick up the phone most of the time so it's really really a great service to patients and like I said patients don't have to go anywhere so that's really great and what's really great for me is not everything has to be my superpower so what I've been able to do over the years is work less and grow which is you know it's it's my legacy and 

Howard: and if Ray Kroc didn't do that then when he died there'd be no McDonald's the Sam Walton did that when he died there'd be no you know Walmart Herb Kelleher just died a Southwest Airlines I mean when he died I mean I mean it's just amazing how if the goal is every year I work one hour less with my hands and one hour more with my systems then you can have that you know then you can slowly die and your business goes on but if you die if someone just blows a whistle and they whistle in a bulldozer to come level your building then basically you were just noise so and I would desire about you have an anesthesiologist come in it always concerns me when you go into any Hospital in the United States or Canada or the United Kingdom the ANA you cannot do the surgery and the anesthesia they're separated the only place you still find that is in dentistry you have an anesthesiologist come in which i think is is the only model we see and in all the hospitals in North America so what do you think about people wanting to go learn their own anesthesiology and then do the anesthesia while they're placing implants pulling wisdom teeth or or whatever why did you choose to go with an anesthesiologist and not do it yourself

Nada Albatish:  so I love I love that question I love the depth of all your questions I actually took a sedation course I started learning about sedation in my GPR and then I took a sedation course I'm actually certified to do the sedation myself while I do the dentistry in my practice and I have a permit for confirming facility to do that and I actually decided not to do it and I have a lot of friend really good dentist friends colleagues who are amazing surgeons who actually do their own sedation so I do think that it's a personal choice the reason I chose to have an anesthesiologist is because I really believe in people focusing on their specialty focus on what you do and if you and I right now one of my associates is doing all the sleep dentistry but when I was doing all the sleep dentistry I really appreciated being just able to focus on the dentistry and not having to worry about anything else that was going on with the patient and knowing that the patient was being taken care of you know 150 percent because eyes are on them every second and what that really boils down to Howard is that although I am running a business and money matters the business is about your profit what I did first is actually make sure that I for myself to my own standards and all my associates - we were all being ethical and responsible and professional in the care that we were giving our patients and so that's that's the way that we chose to do it it works really really well for us and honestly stress is zero stress is zero when you do that 

Howard: going back to your business hat do you you know I mean you were your ranges when the 500 fastest growing businesses in your area do you think having a dental office where it's a one-stop shop where I can just go there and these other specialists rotate through this singular office is is that your business strategy is that the goal is does that work well

Nada Albatish:  it's working really well for me and what I love about it I haven't always done that this is actually the second practice that I opened from scratch so I did have one practice before where I got to learn a lot and then I did it again and so at that time I was referring everything out so this was definitely one of my growth strategies but the other thing that I found is that our communication was so much better with the specialist having access to my software to my practice management software being able to look at the history and every x-ray every note and us being able to be in the same place so I think that the way this ended up working really well for me is for me to be able to provide comprehensive care and having everybody really working together and like we actually have doctors meetings like we've doctors dinners you know and we we actually will talk about cases so it's just something that has worked really well for me 

Howard: so talk about the the profit 500 Canada's fastest growing companies and you made that list about that journey 

Nada Albatish: well it is a sort of survey that's done all over Canada for businesses that are less than five years old so five years is sort of the maximum that you can be and they look at the companies that are the fastest growing over a five year period and so the journey was I opened from scratch and we've been steadily growing every year and when I opened from scratch it was just me I had no patience I didn't buy we built the office and I hired my first receptionist who also was an assistant and I hired my first hygienist and we you know slowly grew from there and as I was treating the patients doing everything myself the first thing that happened to me was the first time I had to stay at work to like ten o'clock at night to do endo to get somebody out of pain is when I hired an endodontist so I mean some of this was there has to be time that you take out to reflect on what's happening what you're going through and how you can improve it and that was a step that turned out for me to be one of the best things I've ever done in practice and then slowly I realized you know while the endodontists was working I could be working and we could help more patients that way and so the driver and the motivation from day one has always been patient care has always been to do the best things for patients and when the leadership is that way your team follows suit that is on 

Howard: that is amazing so um back to the clinical mastery clinical master you have a lot of and it's kind of like a who's who in dentistry I mean John Aussie jason'll it's key Eric farmer years truly Chris Catalano Sam crossly Gary what is um what does he do most people do is that a certain series is it for weekend classes what is your average bread-and-butter clinical mastery doctor do 

Nada Albatish: so the average person will start with a level one occlusion course which is our first one and then we have three of those and we also have a treatment planning course that most people will take to help them actually get cases off the shelf so that it's not just that you know about occlusion and you know how to balance a bite and maybe what how to do the process of veneers but when people coming in all looking different you need to be able to give them options and to plan for that because not every patient is going to fit into like a cookie cutter mold and then photography is something that we encourage like you mentioned your best tool is your digital camera and I could not agree more and so photography is something that we encourage all of our attendees to consider if they want to get into that level of Dentistry so that they can communicate better to their patients and to their team about what they're doing and honestly with photography you can even elevate your own skills I mean what you see when you blow something up on a screen is really different than what you see by looking with your eyes or even with your you know two and a half or three times loops right so that's another thing and then once people get through that is when they start looking at things like tmd and be over the shoulder courses which are jason'll Itsuki's esthetics course and generosities rehab course and in the sleep course so there's definitely places that you can branch off to but your starting points are starting with level 1 2 3 occlusion as well as treatment planning and then your

Howard:  um your next one for occlusion one is in New York but it's sold out for September 20th the next one that's in Phoenix January 24th and 25th which would be fun to go to because January 24th and 25th the following weekend Miami Arizona Cardinals will be playing in the Super Bowl so you can do you could follow those guys out there so uh she's laughing that's is he she knows that is not gonna happen it could happen come on they tied their first game keep me in my bubble so I'm not Lisa I can't believe we went over an hour um so just my wrap up it's gonna my last and final question they know what they know they don't know what they don't know you said something above you're unconsciously competent so they went to all the school they know so much about pareo and carries she just graduated she went back to work with her mom her mom's wife she want to be your dentist her mom doesn't even own an articulator and she when you start talking about occlusion I mean I know my homies I mean I know them if you have TMJ they call the assistant takes upper/lower alginates and sends it to lab to make a tray you know a night guard and someone comes in there and does an assay to see if your insurance will pay for the night guard I mean that that's the limit of occlusion for nine out of ten American dentist period in the story and we're not talking woulda shoulda coulda but she's back with her mom her mom doesn't own articulator they have any tmd problems they they they get the assistant the receptionist to take alginates and do an FA why should they learn occlusion

Nada Albatish:  okay so that's an awesome question and the reason why you learn about occlusion is because number one all the single tooth dentistry that you're doing in the my cards you're making are not all going to work and as you start to get more into dentistry and you start to get more experience you're gonna recognize that there's gonna be things like fillings of a tooth number eight I get these questions on social media all the time like I did an mi mi lb on tooth number eight and it came off and then I did it again and it came off and I did it a third time and it came off what bonds should I use the question is what bonds should I use and so when you start asking yourself those kind of questions and likely usually my answer is that probably has something to do with the bite and not your bond and so there's gonna be types of dentistry you get into that you can't make work without knowing more about why they're actually failing and if you want to get into cosmetics and you want to get into doing things like veneers and some of the cool stuff that you see other Doc's doing maybe that have a little bit more experience and you don't want that stuff to be breaking on you you want to do long-lasting predictable dentistry you need to learn about how everything works together and occlusion really is about how everything works together it's the system joints muscles and teeth for how everything works together in the mouth to produce the results that work and lasts and so do you need an articulator before you take your first occlusion course I'm gonna go out on a limb here and I'm gonna say no I finished school I had an old Hana articulator and I think I still have it and I don't know where it is because what I did was when I started taking inclusion courses and then we start learning using articulator zap horses I actually bought the articulators that we were learning on so I could so I could start to evaluate my cases differently so if you're not using an articulator and you don't own one don't panic and you don't have to go out and buy something learn about it first get into this so that you know how to set it and have and how to treatment plan and then use it as a tool to help you have successful results so why occlusion because it's gonna elevate the care that you give to your patients if you want to take a step up 

Howard:well said dr. na de Alba Tosh it was an honor to podcast you you can find her at a clinical mastery series com she's on the road thank you so much nada for coming on the show today it was an absolute honor to podcast you I am so honored to be here thank you so much for the opportunity Howard it was fantastic to meet you alright have a rockin hot day thanks you too  

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