Office Visit: Dr. Michael J. Melkers by Kyle Patton

Dental renaissance man and top Townie talks lifelong learning

by Kyle Patton, associate editor, Dentaltown magazine

Dentists spend most of their waking hours in their practices, so they usually don’t get many opportunities to see what it’s like inside another doctor’s office. Dentaltown magazine’s recurring Office Visit profile offers a chance for Townies to meet their peers, hear their stories and get a sense of their practice protocols.

In this issue, we visit longtime Townie Dr. Michael Melkers, who has been a part of Dentaltown since 2000. On top of his numerous contributions to the magazine, Melkers has shared his advice, cases and commentary through more than 30,000 posts on the message boards.

Your father’s dental clinic seems to have greatly influenced your career path. Tell us about your family and your road to becoming a dentist.

I grew up in a dental family, but I was never pushed or drawn to dentistry. My father didn’t inspire me to be a great dentist; he inspired me to try to be a great person.

I spent a lot of time after school in my father’s lab. He’d hand me a Bic lighter and a roach carver and leave me to my own supervision. Back then, that was just fun parenting; today, he’d be on 60 Minutes. He saved all the dragons and odd sculptures I made then and gave them to me as my dental school graduation gift. I will always treasure those.

My father was a dentist, my mother was a hygienist, my uncle was an orthodontist and, for a short while, my aunt was a dental technician. Meanwhile, all I ever wanted to do was write plays, poetry and short stories. I was three credits away from an English degree when I pulled a 180 and threw myself into sciences and toward dental school. I thought that I would have all of this free time to pursue my writing and make a good living.

On top of practicing, you are also a well-known teacher, presenter, researcher and writer. How did you end up being a dental renaissance man? What drives you?

I have to point once again back to my father. It is an honor that you describe me as a “renaissance man,” because that is how he was described. He always led by example to be well read, well rounded and well traveled. He inspired a commitment to learning and a thirst for knowledge.

Right now, I have a lot on my plate. I am working on a National Institutes of Health grant with my sister, Dr. Julia Melkers, and a team at Georgia Tech. We have been studying knowledge flow in dentistry, and have some papers coming out soon. I just returned from Riga, Latvia, where I presented at the 4th Global Latvian Scientists Congress on “The Impact of Social Media on Post-Graduate Education in Dentistry.”

I think the common thread in all of the areas that I have been involved in is a strong desire to learn and to share knowledge.

I’ve had some great mentors take me under their wing when I was just out of school—Drs. John Kanca, Newton Fall, Gerard Chiche and, of course, Howard Farran. I have known and been inspired by all of them and their passions since my first year out of school, and I am privileged to call them friends. They all pursue knowledge to better themselves and share that knowledge without reservation.

What’s your favorite dental-related story to tell?

That one is pretty easy. While I was in dental school, I had this sweet old Scottish lady as one of my first denture patients. I asked her to bring in some pictures, so we could evaluate and design her new smile. She brought in shoeboxes full of photos, dating back to the 1930s and ’40s—Ellis Island, pictures with Eddie Cantor back in New York nightclubs. We rarely got anything dental done during her visits. Once, she won a game of seniors bingo and the prize was a fancy candlelight, waiter-service dinner at a McDonald’s near her home. She wore a ball gown and I rented a tuxedo. It was a dinner to remember!

What in the world prompted you to move to New Hampshire after spending 18?years practicing in Washington state?

We get that question a lot. The answer is simple: the team and Dr. Paul Wonsavage at Lyme Road Dental. Mary Osborne, a well-known dental practice consultant, called one day and asked if my wife, Jeanine, and I were “looking.” We were not, but she told us that there was a practice that I had to see.

Well, I went: I spent 15–45 minutes with every team member and a few hours with the retiring senior partner. The youngest team member had been there nine years. Dr. Wonsavage and I had the same professional friends and influences. We had both been through all of the Pankey Institute and studied in pursuit of our masterships at the highest levels. But it was the team and patients who sold us on the area. I called Jeanine at the end of the morning and told her we were selling our practice and moving to New Hampshire. While she was shocked at the time, we agree that it was and still is the best decision we’ve ever made.

Walk readers through an average day in your office.

We start each morning with a team huddle at 7:30 a.m., where we review patients, their needs and concerns, and any pending exams. The huddle invariably includes a discussion of who had what for dinner, who watched The Voice, and what crazy things one of our dogs, cats or children did.

We see patients each day from 7:40 a.m. to 3:40 p.m., one patient at a time; we do not room-hop or double-book. Two people work at the front desk, while three hygienists, three assistants and two doctors handle the rest. We are a well-tuned team and work great together. Dr. Wonsavage and I may see one or five patients a day—it depends on the day. 

What is your practice philosophy? How has your philosophy changed over the years (if it has)?

To treat patients well. That has and has not changed over the years—the commitment has stayed the same but the application has evolved. I see our practice and our entire team as patient facilitators.

Albert Schweitzer said, “Patients carry their own doctor inside. They come to us not knowing that truth. We are at our best when we give the physician who resides within each patient a chance to go to work.” We are very patient-centric in our approach to care. Patients don’t always expect that, but they really appreciate it when they experience it.

When it comes to practice management, what’s something you wish you would have learned earlier in your career?

Find the best or train them to be the best, then let them do their job. Stop worrying about team salary overhead. We aspire to have the best-trained, most-skilled and highest-paid team.

You’ve been a member of Dentaltown since 2000, posted more than 30,000 times on the boards and have a ton of followers. Tell us a bit about what Dentaltown is to you, and how it has affected your career and life.

I don’t even know how to fully answer that. I cannot even imagine where I would be today without Dentaltown. There is not a thank-you large enough that I can give to Howard Farran for starting Dentaltown, and to Drs. Sameer Puri and Tarun Agarwal for founding Townie Meeting. I am a better clinician and teacher for it. Dentaltown launched my speaking career. I don’t know if I even would have started lecturing without it. I don’t know if I would have even wanted to! The camaraderie and sharing on Dentaltown has changed the world of dentistry.

How did you get your start in doing seminars?

Honestly? I was tricked! I had been sharing in study clubs that I was a member of, but I was a “lecturer.” In February 2002, I was involved with the Washington State Academy of General Dentistry as the CE chair and we were hosting a meeting in Sun Valley, Idaho. Dental technician Matt Roberts and Dr. Tom Trinkner were presenting together and Matt said, “Oh, Mike, this is actually one of your cases. Tom, have a seat. Mike, come on up and let’s present this one together.” I was cold-called onto the stage! I was so nervous the ice cubes were bouncing out of my glass.

The next year, I was the opening speaker at the first Townie Meeting, after Howard’s keynote address. It just took off from there. I will always be grateful to Howard and Dentaltown for launching my speaking career ... and to Matt for dragging me up onstage that day.

Truthfully, I’ve thought of quitting many times. It’s hard work, and it’s a challenge to balance family time and patient care. I continue to do so because I love helping make a difference. When I see frustration turn into an “aha!” lightbulb moment for an attendee, it makes it all worth it. I’ve seen many of my former attendees become lecturers themselves.

What’s an aspect of dentistry that never ceases to amaze you?

Patients. They are so filled with stories, needs and nuance. It never ceases to amaze me how much information and insight patients can bring to their own care—if we can keep our ears and minds open and our mouths shut a bit more. I will be forever indebted to Mary Osborne for the listening skills she nurtured in me.

What is the biggest problem dentists face today?

Student debt and corporate dentistry. School debt is climbing to the half-million-dollar mark. It is staggering. I don’t know how young dentists survive. Before they can even invest in a practice, they are coming out of school in crippling debt. Corporate dentistry is like a vulture preying on them, offering to pay off their debts with what I equate to indentured servitude to the lowest-quality-of-care aspect of our profession. I feel sorry for these young dentists and for the patients.

What is the greatest advancement of change you have seen during your tenure?

Easily digital imaging—digital cameras, digital X-rays, cone beam technology for diagnosis and treatment planning. My newest and favorite addition is our CariVu camera. It uses near-infrared light to visualize and record the extent of decay and fractures without using radiation. It has been an amazing game changer and such a benefit for patients. It helps us in diagnosis to not only know when to treat but also when to wait.

What’s something that remains a challenge for you?

Everything! You would think that achieving mastership in the Academy of General Dentistry (AGD) would be a pinnacle; for me it was just a plateau on the way to the next peak. Dr. Wonsavage and I both have our masterships and still take more continuing education than you would believe. Last year, aside from my teaching around the world, I also attended courses and workshops around in the U.S., Sweden and Brazil, and other online courses that I explore at my leisure almost every day.

Describe the most rewarding experience in your professional life.

Achieving my mastership in the AGD is certainly up there, but it is not my most rewarding experience—that happened since I moved to Hanover. A teenage patient was hit in the face by her horse—thankfully, she wasn’t more seriously injured, but the teeth on one side were so severely pulverized that she had enamel not only embedded in her gums but also her bone. With the help of Dr. Steve Fucini, our periodontist, and Dr. Rebekah Lucier, our endodontist, Megan did not lose a single tooth. It is so great to work with such an amazing team of specialists. The thank-you note her parents sent, I really have no words for.

Give us a snapshot of your life outside of your work.

I love my life and my wife. My obsessions are our three cats, disc golf, travel and cooking. Our cats have their own 256-square-foot outdoor enclosure that Jeanine and I built. I have a 10-hole disc golf course on our property, and have played around the world and in the World Amateur Championship. I have lectured on five continents and brought recipes home from them all.

If you could send one note back to yourself before you began practicing, what would it say?

“Twenty years from now, you will be more disappointed by the things you didn’t do than by the ones you did do. So, throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.” — Mark Twain